Questões de USMLE

A 79-year-old man takes high-dose beta blockers for coronary disease. He presents with dizziness. ECG shows a heart rate of 42 per minute with narrow QRS complexes and no preceding…

A 78-year-old man is brought to the emergency department because of recurrent syncope. Pulse is 32 per minute. ECG shows P waves occurring regularly at 80 per minute and QRS comple…

A 66-year-old man with prior anterior wall myocardial infarction presents with acute palpitations and near syncope. Vital signs: BP 78/48 mmHg, HR 180 bpm, RR 22, SpO2 92% on room …

A 67-year-old man comes to the emergency department because of palpitations and mild shortness of breath that began this morning. He has hypertension and coronary artery disease. P…

A 74 year old man comes to the clinic because of intermittent palpitations and reduced exercise tolerance for 3 months. He has hypertension and diabetes mellitus. Pulse is irregula…

A 29-year-old man presents to the emergency department with palpitations and dyspnea. He has a 15-year history of recurrent syncope triggered by emotional stress or sudden auditory…

A 42-year-old man with prior myocardial infarction presents with asymptomatic ventricular bigeminy on Holter monitoring. Vital signs: BP 118/76 mmHg, HR 72 bpm, RR 16, temp 37°C, S…

A 45-year-old woman with paroxysmal atrial fibrillation is started on flecainide for rhythm control. She has a history of hypertension but normal ventricular function. Three weeks …

A 72-year-old man with chronic atrial fibrillation and CKD stage 3 is found to have a heart rate of 110 bpm at rest. He is currently on diltiazem. His digoxin level is 2.8 ng/mL (t…

A 58-year-old man presents with palpitations and dyspnea on exertion. Vital signs: BP 138/82 mmHg, HR 92 bpm, RR 18/min, temp 37.2°C, SpO2 98% on room air. ECG demonstrates an rSR-…

A 79-year-old man with atrial fibrillation presents with blood pressure 148/92 mmHg, heart rate 62 bpm, respirations 16/min, and oxygen saturation 98% on room air. He has hypertens…

A 72-year-old man with a 10-year history of hypertension presents with progressive dyspnea on exertion, orthopnea, and lower extremity edema. Physical examination reveals a lateral…

A 34 year old woman develops fatigue, dyspnea on exertion, and bounding peripheral pulses several months after creation of a large arteriovenous fistula for hemodialysis access. Sk…

A 74-year-old man with a 50 pack-year smoking history and hypertension presents for routine follow-up. Vital signs show BP 158/92 mmHg, HR 88 bpm, RR 16, temp 37°C. On abdominal ex…

A 67-year-old man with hypertension controlled on lisinopril presents with bilateral calf claudication after walking two blocks, relieved by rest. Vital signs show BP 158/92 mmHg, …

A 31 year old man who injects heroin presents with fever, pleuritic chest pain, and shortness of breath. Examination shows a new holosystolic murmur at the left lower sternal borde…

A 12 year old boy is brought to the clinic because of fever and migratory pain in both knees and ankles. Three weeks ago he had a sore throat that was not treated. Examination reve…

A 34 year old woman develops sudden right arm weakness and aphasia that resolve within 30 minutes. She has no vascular risk factors, but she recently completed a long international…

A full term newborn develops profound cyanosis within hours of birth. The infant of a mother with poorly controlled diabetes remains severely hypoxemic despite supplemental oxygen.…

A 66 year old man presents 2 months after a large anterior myocardial infarction because of persistent fatigue and exertional dyspnea. ECG shows persistent ST segment elevation in …

A 64 year old woman presents with progressive exertional dyspnea and orthopnea for 2 months. She had an inferior myocardial infarction 1 year ago. Cardiac examination reveals a hig…

A 72 year old man comes to the clinic because of exertional chest pain and several episodes of lightheadedness while climbing stairs. He has a history of hyperlipidemia and hyperte…

A term newborn develops tachypnea and cyanosis shortly after birth. The infant aspirated meconium during delivery. Echocardiography shows no structural heart defect, but pulmonary …

A 19 year old male collegiate basketball player collapses briefly during conditioning drills. He reports several months of exertional chest tightness. His uncle died suddenly at ag…