USMLE STEP 1 PRACTICE QUESTIONS PRO

Following a week of empiric therapy, the patient continues to deteriorate. The blood cultures show no growth after 5 days. Three sets of blood cultures are taken over 24 hours followed by empiric antibiotic therapy with gentamicin and vancomycin. An echocardiogram reveals 5-mm vegetation on the aortic valve with moderate regurgitation. Laboratory investigations reveal a WBC count of 14,500/μL with 5% bands and 93% polymorphonuclear cells. Prominent axillary lymphadenopathy is noted. Abdominal examination reveals a tender and mildly enlarged spleen. A cardiac examination reveals an early diastolic murmur loudest at the left 3rd intercostal space. Physical examination reveals generalized pallor.

His vital signs include: blood pressure 120/60 mm Hg, pulse 90/min, and temperature 38.0☌ (100.4☏). The patient admits that he has always lived in poor hygienic conditions in overcrowded quarters and in close contact with cats. His past medical history is unremarkable. He denies any history of cardiac disease. He says his symptoms began 3 weeks ago and that his appetite has decreased and he has lost 3 kg (6.6 lb) in the last 3 weeks. The findings are most consistent with which diagnosis?Ī 27-year-old man who recently emigrated as a refugee from Somalia presents with fever, weight loss, fatigue, and exertional chest pain. Further evaluation revealed parasitemia and a few schistocytes, poikilocytes, and merozoites in tetrad formation. The peripheral blood smear showed basophilic ring- and pear-shaped structures inside many red cells and extracellular basophilic rings on Wright-Giemsa staining. Laboratory testing revealed the following: Hemoglobin

His symptoms started a few days after he returned home. He traveled to the Netherlands for 4 days a month ago. He has drenching night sweats and has had 2 episodes of non-bilious vomiting over the past few days. He adds that he is fatigued all the time and has a generalized weakness.

Which of the following is the most likely causative organism for this patient’s condition?Ī 50-year-old man presents to the office with complaints of fever and chills for 4 weeks. Gram staining of a sputum sample is negative for any organism. A chest radiograph reveals multiple homogenous opacities in the lower lobe of the right lung and right-sided pleural effusions. A large tender node is palpable in the right axilla. On physical examination, there are decreased breath sounds on the right side. His temperature is 39.4☌ (103.0☏), the pulse is 110/min, and the respirations are 26/min. The patient denies any history of tick bites.

He says he is a farmer with daily contact with rabbits, horses, sheep, pigeons, and chickens and reports cleaning the barn 3 days before his symptoms started. He describes the cough as productive and says he is fatigued all the time.

USMLE STEP 1 PRACTICE QUESTIONS PRO

Students: Educators’ Pro Tips for Tough TopicsĪ 55-year-old man presents with fever, chills, fatigue, cough, sore throat, and breathlessness for the past 7 days.Maternity Nursing and Care of the Childbearing Family.Diversity, Equity, Inclusion, and Belonging.

Usmle step 1 practice questions