Questões de USMLE

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A cancer screening program detects numerous tumors with excellent 10-year survival rates. However, interval cancers discovered between screening visits in asymptomatic patients dem
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
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
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 multicenter hypertension trial finds that a small number of blood pressure readings are missing because some laboratory printouts were accidentally destroyed in a flood affecting
A rehabilitation study evaluates mobility outcomes in 47 elderly patients (mean age 72) using a 0–20 mobility scale. At baseline, 60% of highly functional participants score 20 des
A 50-year-old man with heart failure (ejection fraction 35% on echocardiography) on metoprolol and lisinopril completes a new 12-item questionnaire designed to measure medication a
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 27-year-old nulliparous woman presents for contraception counseling. Vital signs are stable (BP 118/76, HR 72, RR 14, Temp 37°C). She takes no medications and denies contraindica
A 78-year-old woman with advanced dementia (MRI shows cerebral atrophy) presents with baseline Mini-Cog score of 0/30. Her daughter reports progressive memory loss over 3 years des
A data safety monitoring board reviews efficacy outcomes every 3 months during a large stroke prevention trial enrolling 2,400 patients. The biostatistician notes that repeated loo
A 59 year old man with refractory lymphoma enrolls in a phase 2 trial with 3 treatment arms. After a planned interim analysis, the arm with the lowest response rate is dropped and
A 61 year old woman with chronic obstructive pulmonary disease enrolls in a cohort study of coffee intake and lung cancer. Investigators adjust for smoking status as current, forme
A 48 year old man with alcohol use disorder is admitted for pancreatitis. Researchers study only hospitalized patients and find that among admitted patients, obesity appears negati
A cohort study follows 82 year old adults with severe aortic stenosis to estimate time to hospitalization for heart failure. Many participants die from noncardiac causes before the
A dermatopathologist reviews 60 skin biopsy slides, classifying each as benign or malignant based on histologic features including cellular atypia and mitotic rate. Four weeks late
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 26-year-old man presents with fever (38.8°C), productive cough, and malaise 2 weeks after cleaning a chicken coop in the Ohio River valley. Vital signs show BP 118/76, HR 92, RR
A 32 year old woman with stable generalized anxiety disorder completes the same validated anxiety inventory on Monday and again 1 week later before any treatment change. Investigat
A 52-year-old man with hypertension (BP 168/98 mmHg, HR 88, RR 16, Temp 37.2°C) undergoes evaluation for cardiovascular risk. A regression model predicts systolic blood pressure us
A 55-year-old man with poorly controlled diabetes mellitus presents with fever (39.2°C), tachycardia (110 bpm), and black necrotic tissue on the hard palate extending into the righ
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