Questões de USMLE

A 19-year-old male with no past psychiatric history presents to the emergency department with acute agitation, paranoia, and visual hallucinations. He is started on haloperidol 5 m…

A 27-year-old woman with a history of intravenous heroin use is brought to the emergency department by paramedics after being found unresponsive in her apartment. Her roommate stat…

A 55-year-old man presents with progressive fatigue and recurrent bacterial infections. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Physical examination reveals mo…

A 28-year-old woman with panic disorder is started on paroxetine 20 mg daily. After 2 weeks of treatment, she reports decreased libido and delayed orgasm. When the prescriber expla…

A 52-year-old man with chest pain presents to the emergency department. His electrocardiogram shows nonspecific ST changes. A high-sensitivity troponin I is drawn and results at 0.…

A surgical team is performing a laparoscopic cholecystectomy. Before the first incision, the circulating nurse initiates a time-out procedure. During the time-out, the anesthesiolo…

A 28-year-old man with no prior psychiatric history is admitted to the psychiatric unit with acute-onset psychosis manifesting as command hallucinations and paranoid delusions. He …

A 52-year-old man with newly diagnosed type 2 diabetes attends a nutrition counseling session. The counselor explains dietary modifications and prescribes a detailed meal plan. Two…

A 9-year-old girl is brought to the pediatrician by her adoptive parents for evaluation of academic difficulties that began 7 weeks ago. Her third-grade teachers report that she is…

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 35-year-old woman presents 3 months after sexual assault with recurrent intrusive memories, avoidance of trauma reminders, persistent negative mood, and hypervigilance. Vital sig…

During a well-child visit, a 4-year-old boy's mother mentions that she has been using corporal punishment to discipline him. She states that she spanks him with an open hand on the…

A 62-year-old man with symptomatic heart failure is enrolled in a randomized controlled trial comparing a novel ACE inhibitor (Drug A) to standard therapy (Drug B). He is randomize…

A 62-year-old man is admitted to the ICU with sepsis secondary to pneumonia. His hospital course is complicated by acute kidney injury requiring vasopressor support. On hospital da…

A hospital infection control team implements a bundle to prevent catheter-associated urinary tract infections (CAUTI). The bundle includes using aseptic technique during insertion,…

A 52-year-old man with newly diagnosed stage 4 pancreatic cancer presents to his oncology appointment. His oncologist recommends a combination chemotherapy regimen that has a media…

A 28-year-old unmarried woman with no children presents to her primary care physician requesting surgical sterilization. Vital signs are normal (BP 118/76, HR 72, RR 14, Temp 98.6°…

A hospital transitions from a paper-based medication ordering system to computerized physician order entry (CPOE). Three months after implementation, a review shows that while tran…

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 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 61-year-old man with metastatic pancreatic adenocarcinoma presents with profound weight loss despite consuming 2500 kcal daily. He has lost 35 pounds over 3 months, reduced muscl…

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 28-year-old primigravida at 32 weeks gestation presents for routine prenatal care. Vital signs: BP 158/95 mmHg, HR 92/min, RR 16/min, Temp 37.2°C. Laboratory results reveal prote…

A 27-year-old woman undergoes partial hepatectomy for living-donor liver transplantation to her brother. Three weeks postoperatively, she reports right upper quadrant fullness but …