Questões de USMLE

3.602 questões com gabarito e explicação.

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A 2 month old boy has recurrent viral and fungal infections, difficulty feeding, and episodes of perioral twitching. He was born with a conotruncal cardiac defect. Physical examina
An 8 year old boy is brought to the physician because of frequent ear infections and progressive difficulty walking. His parents report that he often stumbles and has had several e
A 6-year-old boy with sickle cell disease presents with fever (39.2°C), lethargy, and nuchal rigidity. Vital signs show HR 128/min, RR 28/min, BP 102/68 mmHg, and SpO2 98% on room
A 17 year old boy is evaluated for recurrent sinusitis and chronic watery diarrhea. He has had two prior episodes of Giardia lamblia infection. He is otherwise healthy. Serum immun
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 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 27-year-old man presents with fever (39.2°C), cough, and dyspnea. Vital signs show BP 118/76, HR 102, RR 22, SpO2 88% on room air. Chest X-ray reveals bilateral infiltrates. Bloo
A 7 month old infant has chronic diarrhea, oral candidiasis, and recurrent viral and bacterial respiratory infections. Flow cytometry shows normal B cell count, low CD4 positive T
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 longitudinal diabetes study has intermittent missing hemoglobin A1c values because some patients miss clinic appointments but later return. Investigators use patients' prior A1c
Investigators are designing an observational study comparing fracture risk in chronic glucocorticoid users and nonusers. They are particularly concerned that age and sex differ sub
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
Investigators study a possible association between a pesticide and Parkinson disease. They enroll 120 patients with Parkinson disease and 200 controls without Parkinson disease. Am
A new antiviral medication is introduced for a chronic infection in a city of 1 million people. The drug does not prevent new infections, but it markedly shortens the duration of s
A 30 year old primigravid woman experiences an intrauterine fetal demise at 32 weeks' gestation. In the same hospital that year, there are 8 late fetal deaths and 12 neonatal death
A nested case control study of venous thromboembolism is conducted within a large cohort of women using oral contraceptives. Each time a new thrombosis case occurs, controls are se
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 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 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 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 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 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 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 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
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