Questões de USMLE

A 35-year-old man with HIV infection and a CD4 count of 45 cells/μL presents with a 5-day history of fever, severe headache, photophobia, and neck stiffness. Cerebrospinal fluid an…

A 45-year-old man with a history of atrial fibrillation presents with a 3-week productive cough, night sweats, and 8-lb weight loss. Chest X-ray demonstrates a left upper lobe cavi…

A 58-year-old man with no known drug allergies presents to the operating room for elective right inguinal hernia repair under general anesthesia. He receives cefazolin 1 g IV 30 mi…

A 45-year-old man with HIV infection and a CD4+ count of 180 cells/μL presents to the emergency department with a 4-day history of progressive dyspnea, nonproductive cough, and fev…

A 28-year-old man with Wolff-Parkinson-White syndrome presents with episodic palpitations and is found to have antidromic atrioventricular reentrant tachycardia. Vital signs: BP 12…

A 52-year-old man with treatment-resistant major depressive disorder has been taking phenelzine 45 mg daily for 8 months with adequate symptom control. His psychiatrist adds sertra…

A 45-year-old man presents with a 2-year history of nightly zolpidem 10 mg use for chronic insomnia. He reports increasing daytime somnolence, two episodes of complex sleep behavio…

A 64-year-old man presents with acute anterior wall myocardial infarction (troponin I 4.2 ng/mL). He undergoes coronary stent placement and is started on aspirin. Vital signs: BP 1…

A 45-year-old man with a history of chronic migraines is started on topiramate 100 mg daily for prophylaxis. Two weeks into treatment, his wife reports that he seems unusually forg…

A 63-year-old man with urosepsis presents with hypotension (BP 78/52 mmHg), tachycardia (HR 118 bpm), tachypnea (RR 22), fever (39.2°C), and altered mental status despite aggressiv…

A 55-year-old man with major depressive disorder has been treated with fluoxetine 40 mg daily for 3 months with good symptom control. His psychiatrist plans to initiate phenelzine,…

A 32-year-old woman with generalized anxiety disorder presents to the emergency department after becoming unresponsive at a social event. She has taken alprazolam 2 mg daily for 8 …

A 24-year-old man with schizophrenia treated with risperidone 4 mg daily for 1 year presents with erectile dysfunction and galactorrhea. His girlfriend also reports amenorrhea for …

A 55-year-old man presents with an inferior wall myocardial infarction complicated by symptomatic bradycardia. Vital signs show BP 88/56 mmHg, HR 42 bpm, RR 16, temp 37°C, SpO2 98%…

A 68-year-old man with mild cognitive impairment is started on donepezil 5 mg daily for suspected early Alzheimer disease. His past medical history is significant for hypertension …

A 58-year-old woman with chronic osteomyelitis has been receiving intravenous vancomycin for 10 days, with a trough level of 18 mcg/mL. Her temperature is 37.8°C, blood pressure is…

A 70-year-old man with a history of hypertension and type 2 diabetes mellitus is brought to the emergency department and subsequently hospitalized for acute decompensated heart fai…

A 42-year-old man with newly diagnosed HIV infection presents to clinic for initiation of antiretroviral therapy. CD4+ count is 150 cells/μL, and viral load is 180,000 copies/mL. H…

A 7-year-old boy presents with acute otitis media (BP 105/68, HR 98, RR 22, Temp 38.5°C). Otoscopy reveals erythematous tympanum with fluid level; tympanometry confirms type B patt…

A 32-year-old man on isoniazid for latent tuberculosis presents after intentionally ingesting an unknown quantity of his medications. He is febrile (38.5°C), tachycardic (118 bpm),…

A 2-year-old boy presents to the emergency department after ingesting his mother's prenatal vitamins. Vital signs show HR 128/min, BP 92/58 mmHg, RR 22/min, and temperature 37.2°C.…

A 45-year-old man with alcohol use disorder presents with acute flushing, throbbing headache, nausea, palpitations, and diaphoresis 15 minutes after consuming one beer. Vital signs…

A 49-year-old obese man presents to his primary care physician for a routine follow-up after laboratory results revealed fasting glucose of 168 mg/dL and hemoglobin A1c of 8.0% on …

A 55-year-old woman with type 2 diabetes mellitus presents with fatigue and polyuria. Vital signs show BP 138/82 mmHg, HR 88/min, RR 16/min, temperature 37°C, SpO2 98% on room air.…