Questões de USMLE

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A 3-month-old boy presents with severe watery diarrhea, diffuse dermatitis, and poor feeding for 2 weeks. Vital signs show HR 128/min, RR 32/min, temperature 37.2°C, and BP 85/50 m
A 72-year-old man with newly diagnosed pancreatic cancer presents with jaundice, weight loss of 8 kg over 2 months, and epigastric pain. Vital signs: BP 118/76, HR 92, RR 18, Temp
A county health department follows 20,000 residents for 1 year after a contaminated water exposure. At baseline, 200 residents already have documented immunity to hepatitis A from
A rapid screening test for celiac disease has the same sensitivity and specificity in all populations. A family medicine clinic uses the test in asymptomatic adults, whereas a gast
A randomized controlled trial enrolls 500 healthy adults (mean age 35) during winter. Symptomatic, PCR-confirmed influenza develops in 10% of placebo recipients and 5% of vaccine r
A multicenter trial enrolls patients with acute decompensated heart failure in waves of 4 at each site. Within each group of 4, exactly 2 patients are assigned to the new diuretic
A team develops a questionnaire to measure asthma control in adolescents. Pediatric pulmonologists review the draft noting it includes wheeze frequency and rescue inhaler use but o
A longitudinal diabetes study has intermittent missing hemoglobin A1c values because some patients miss clinic appointments but later return. Investigators use patients' prior A1c
A 54-year-old male with chronic renal failure receives a kidney transplant and begins cyclosporine immunosuppression. Six months later, he presents with progressive fatigue and dys
A 29-year-old woman presents with severe vaginal bleeding and hypotension (BP 80/50, HR 120, RR 22) two days after vaginal delivery of her second child. Despite aggressive fluid re
A randomized controlled trial evaluating a new antihypertensive medication requires all participants to complete a 2-week placebo run-in phase before randomization. Patients presen
A 52-year-old woman with rheumatoid arthritis (ESR 48 mm/h, CRP 12 mg/L) presenting with joint pain and morning stiffness is screened for a biologic therapy trial. She has no histo
A 63-year-old man with acute ST-elevation myocardial infarction (BP 128/82, HR 102, RR 18, SpO2 98%) presents with elevated troponin I (2.8 ng/mL) and anterior wall changes on ECG.
A 41 year old man with long standing intravenous drug use dies of infective endocarditis. In the same city, an 84 year old woman dies of heart failure. Public health officials emph
A randomized trial of a new asthma medication in 400 patients shows no difference in FEV1 decline (primary endpoint: -120 mL/year in both groups; p=0.18). Investigators perform 40
A 58-year-old man with type 2 diabetes (HbA1c 9.2%, fasting glucose 187 mg/dL) presents for cost analysis study enrollment. Linear regression models his HbA1c versus annual healthc
A 58-year-old man with type 2 diabetes mellitus presents for device validation testing. Blood pressure is 138/82 mmHg, heart rate 76/min, temperature 37.2°C. A fasting glucose obta
A term male infant is born after an uncomplicated pregnancy but dies from neonatal sepsis on day 12 of life. County records show 12 infant deaths before age 1 year and 3,000 live b
A 35-year-old woman on oral contraceptives presents with left leg swelling, pain, and warmth. Vital signs show BP 118/76, HR 92, RR 16, temp 37°C, SpO2 98%. Doppler ultrasound conf
A 34 year old man who survived childhood Hodgkin lymphoma is followed in a survivorship clinic. Investigators study 2,000 adults who received mantle radiation as children and obser
A 46 year old woman presents with progressive exertional dyspnea, lower extremity edema, and abdominal distention. Her pretest probability of pulmonary hypertension is estimated at
A trial of 12,000 adults with chronic low back pain compares a new exercise app with standard counseling. Mean pain score improves by 0.2 points on a 10 point scale in the app grou
A psychiatry research group develops a novel 12-item anhedonia scale in 200 patients with major depressive disorder (mean age 42, BP 128/82, HR 88) and 100 healthy controls (BP 120
A hospital initiates annual low-dose CT screening for high-risk smokers (age 55-75, ≥30 pack-years). Five years later, screened patients (BP 138/82, HR 78, RR 16, SpO2 98%) demonst
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