Questões de USMLE

A 17-year-old boy undergoing screening colonoscopy for familial polyposis presents with hundreds of adenomatous polyps throughout the colon. Vital signs are normal (BP 118/76, HR 7…

A 67-year-old man with atrial fibrillation has been taking warfarin for 18 months. He presents to the emergency department with severe epistaxis, hemoptysis, and a 2-day history of…

A 30-year-old woman experiences sudden severe dyspnea, hypotension (BP 80/50), and cyanosis during active labor. Minutes later, she develops profuse bleeding from intravenous sites…

A 19-year-old woman with known peanut allergy accidentally ingests a dessert containing peanuts. Within minutes, she develops diffuse urticaria, wheezing, and lightheadedness. Vita…

A 38-year-old woman with newly diagnosed atrial fibrillation presents to the anticoagulation clinic to initiate warfarin therapy. Vital signs are stable: BP 118/76, HR 102, RR 16, …

A 45-year-old woman presents to the emergency department with fever (38.9°C), hypotension (88/52 mmHg), tachycardia (118 bpm), and altered mental status. Blood cultures are drawn a…

A 69-year-old woman with rheumatic heart disease presents with progressive dyspnea and orthopnea. Vital signs: BP 148/92 mmHg, HR 108/min, RR 22/min, SpO2 92% on room air. Physical…

A 34-year-old woman at 32 weeks gestation presents to the obstetric unit with a chief complaint of headache and blurred vision for 6 hours. Vital signs are: BP 158/102 mmHg, HR 92/…

A 62-year-old man with no documented penicillin allergy undergoes elective colorectal surgery. Prophylactic cefazolin is not administered perioperatively. On postoperative day 3, h…

A 67-year-old man with atrial fibrillation is anticoagulated with warfarin. He visits three different clinics for medication refills and has labs drawn at each site, but results ar…

A quality improvement team uses a Plan-Do-Study-Act (PDSA) cycle to reduce patient wait times in an outpatient clinic. In the Plan phase, they hypothesize that staggering appointme…

A 42-year-old man with type 2 diabetes mellitus presents for routine follow-up. His current HbA1c is 8.2% despite metformin monotherapy. The endocrinology team initiates a quality …

A 55-year-old man with type 2 diabetes mellitus is started on metformin 1000 mg twice daily by his primary care physician for glycemic control. His baseline serum creatinine is 0.9…

A 40-year-old man with acute myocardial infarction is admitted to a community hospital's cardiac care unit. He receives timely reperfusion therapy and is discharged after an uncomp…

A 450-bed teaching hospital implements a rapid sepsis recognition protocol in the emergency department, which includes automated EHR alerts for lactate >2 mmol/L and systemic infla…

A 3-year-old girl is brought to the office by her parents who express concern about their daughter's behavior. They report that she frequently refuses to comply with requests, thro…

A 45-year-old man presents to his primary care physician accompanied by his wife. Three days ago, he was passed over for promotion at work, which he had anticipated receiving. Sinc…

A 73-year-old woman with mild cognitive impairment and limited English proficiency is discharged from the hospital after treatment for community-acquired pneumonia. She is prescrib…

A 16-month-old boy is brought to the pediatric clinic by his mother for a well-child visit. She expresses concern that he did not walk independently until 14 months of age, noting …

A 28-year-old medical student observes an attending physician enter a patient's room without performing hand hygiene before examining a hospitalized 62-year-old male with pneumonia…

A 67-year-old male with newly diagnosed atrial fibrillation is prescribed dabigatran 150 mg twice daily in the outpatient clinic. The electronic health record contains recent labor…

A 52-year-old surgeon consistently performs procedures without preoperative surgical site marking, despite two informal conversations about the practice gap. The hospital's surgica…

A 68-year-old man with systolic heart failure (EF 35%) presents with dyspnea, orthopnea, and 8-pound weight gain over two weeks. Vitals: BP 158/94, HR 108, RR 22, SpO2 92% on room …

A hospital measures the time from emergency department arrival to percutaneous coronary intervention for ST-elevation myocardial infarction patients. The target is a door-to-balloo…