Questões de USMLE

A 3-year-old girl from rural Brazil presents with fever (38.5°C), difficulty swallowing, and painful ulcerated lesions in the oral mucosa. Physical examination reveals cervical lym…

A 3-year-old boy from West Africa presents with hepatosplenomegaly, jaundice, and severe anemia (hemoglobin 6.2 g/dL). Vital signs show temperature 38.9°C, heart rate 128/min, bloo…

A 7-year-old boy from Ghana presents with nodules on his shins, back, and elbows. He also complains of nerve pain along his forearms. Examination reveals areas of decreased sensati…

A 48-year-old woman receives cosmetic botulinum toxin injections. Five days later, she develops diplopia, ptosis, dysphagia, and descending flaccid paralysis. Vital signs: BP 128/8…

A 38-year-old woman who works in a leather factory in Venezuela presents with a painless nodule on her arm that has progressed over 6 months to multiple warty plaques with a "cauli…

A 34-year-old woman from Brazil presents with fever (38.2°C), multiple ulcerated lesions on her lip and face, and enlarged regional lymph nodes. Vital signs show BP 118/76, HR 92, …

A 34-year-old woman with untreated HIV (CD4 200 cells/μL) presents with progressive dyspnea, fever, and a nonproductive cough for 3 weeks. Chest imaging shows bilateral interstitia…

A 41-year-old man with a history of tuberculosis presents with cough and hemoptysis. Sputum smear shows acid-fast bacilli. He also has watery diarrhea and thrush. CD4 count is 85/μ…

A 6-year-old boy presents with recurrent sinopulmonary infections and chronic ulcerating skin lesions caused by respiratory viruses over the past 2 years. Vital signs show HR 102/m…

A 53-year-old man with acute myelogenous leukemia undergoing chemotherapy presents with pleuritic chest pain and hemoptysis during severe neutropenia (WBC 0.8 K/μL). Vital signs sh…

A 46-year-old man undergoes kidney transplantation. Two weeks post-operatively, he develops hypertension (BP 158/92 mmHg), tachycardia (HR 104/min), and malaise. Serum creatinine r…

A 45-year-old construction worker from Arizona presents with 2-week fever (38.5°C), productive cough, and erythema nodosum. Vitals show HR 102 bpm, RR 22, SpO2 98% on room air. Che…

A 52-year-old woman with poorly controlled diabetes (HbA1c 11.2%) presents with severe facial pain, fever (39.2°C), and black necrotic tissue involving the maxillary sinus and hard…

A 40-year-old immunocompetent woman presents with a 3-week history of progressive nodular lymphangitis along her left arm following a gardening injury. She has a small, painless ul…

A 41-year-old HIV-positive man with CD4 count of 85 cells/μL presents with fever (38.9°C), headache, and neck stiffness for 2 weeks. Vital signs show BP 110/70 mmHg, HR 98/min, RR …

A 35-year-old man from Ohio presents with fever (38.8°C), productive cough, and dyspnea after exploring a bat cave 3 weeks ago. Vital signs show HR 102/min, RR 22/min, SpO2 94% on …

A 28-year-old immunocompromised man with CD4 count of 45 cells/μL presents with severe frontal headache, fever, and neck stiffness. Lumbar puncture shows elevated protein (180 mg/d…

A 42-year-old man with a history of smoking and COPD presents with hemoptysis and a cavitary lesion in the lung. Culture of sputum grows a dimorphic fungus that appears as a mold a…

A 7-year-old boy with no significant past medical history presents with a single pruritic, scaly lesion on his arm. He recently returned from a farm visit where he played with kitt…

A 19-year-old college student presents with severe frontal headache, neck stiffness, and altered mental status for 3 days. Vital signs show temperature 38.9°C, BP 118/76, HR 102, R…

A 45-year-old man with COPD presents with hemoptysis and fever (38.2°C). Vital signs show BP 128/82, HR 98, RR 22, SpO2 88% on room air. Chest X-ray reveals a cavitary lesion in th…

A 6-year-old boy presents with a pruritic rash on exposed skin areas after playing in a grassy field. Vital signs are normal (BP 95/60, HR 98, RR 20, Temp 37.2°C, SpO2 98%). Linear…

A 20-year-old woman with no prior shellfish exposure develops acute onset wheezing, diffuse urticaria, and angioedema within 3 minutes of ingesting shrimp. Vital signs show BP 88/5…

A 19-year-old man presents with arthralgias and malar rash. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Labs reveal ANA 1:640 with anti-dsDNA antibodies; complemen…