Questões de USMLE

A 67-year-old man with a 50 pack-year smoking history presents with persistent cough, hemoptysis, and 8-pound weight loss over two months. Vital signs show BP 138/86, HR 92, RR 18,…

A 49-year-old man is admitted with severe acute pancreatitis. Two days later he develops worsening hypoxemia and requires mechanical ventilation. Chest radiograph shows diffuse bil…

A 68 year old woman is admitted for vomiting and profuse diarrhea for 3 days. She is dizzy on standing and has dry mucous membranes. BUN is 46 mg/dL and creatinine is 1.6 mg/dL. Ur…

A 63-year-old man with a history of asthma presents with fever (38.5°C), pleuritic chest pain, and dyspnea. Vital signs show BP 128/82 mmHg, HR 102/min, RR 22/min, and SpO2 92% on …

A 1-day-old female presents with severe respiratory distress, cyanosis, and a scaphoid abdomen. Vital signs show HR 165/min, RR 68/min, BP 58/38 mmHg, and SpO2 78% on room air. Phy…

A 26-year-old woman presents in winter with headache, dizziness, and nausea after using a faulty gas heater. Vital signs: BP 118/76, HR 102, RR 20, Temp 37.2°C, SpO2 98%. Physical …

A 56-year-old man with 25 years of sandblasting exposure presents with progressive dyspnea, cough, and chest tightness. Vital signs: BP 138/82, HR 92, RR 22, SpO2 88% on room air. …

A 70-year-old man with acute intracranial hemorrhage receives intravenous mannitol. Within hours, he develops worsening dyspnea and bibasilar crackles. Vital signs show BP 168/92 m…

A 68-year-old man with hypertension presents with acute dyspnea and orthopnea. Vital signs: BP 168/95 mmHg, HR 110/min, RR 22/min, SpO2 88% on room air. He takes lisinopril but rep…

A 46-year-old woman presents with acute onset hematuria and rapidly rising creatinine (baseline 0.8 mg/dL, now 3.2 mg/dL). Vital signs: BP 156/94 mmHg, HR 92, RR 18, temp 37.2°C, S…

A 42-year-old woman presents with fever (38.9°C), diffuse maculopapular rash, and bilateral flank pain 5 days after starting trimethoprim-sulfamethoxazole for a skin infection. Vit…

A 72-year-old man with a history of hypertension, type 2 diabetes mellitus, and chronic kidney disease (baseline creatinine 1.4 mg/dL) undergoes cardiac catheterization via femoral…

A 68-year-old man with a 10-year history of type 2 diabetes mellitus and hypertension presents for routine follow-up. His baseline serum creatinine is 1.8 mg/dL (eGFR 38 mL/min/1.7…

A 28-year-old woman with a 3-month history of systemic lupus erythematosus presents to the emergency department with a 5-day history of malaise, dyspnea, and dark urine. Her temper…

A 41-year-old man presents with hypertension (BP 158/96 mmHg, HR 88/min) and bilateral flank fullness. His father required dialysis at age 52. Physical examination reveals palpable…

A 52-year-old man with a history of hypertension presents with a 3-day history of productive cough, fever, and dyspnea. Chest imaging confirms pneumonia. On admission, his blood pr…

A 56-year-old man with a 10-year history of type 2 diabetes and hypertension presents to the emergency department with progressive nausea, malaise, and dyspnea over 2 days. He deni…

A 34-year-old woman with a 6-year history of systemic lupus erythematosus presents to the emergency department with dyspnea and bilateral ankle edema. Her medications include predn…

A 72-year-old man with hypertension develops oliguria after prolonged hypotension (BP 78/52 mmHg) during septic shock. Over 48 hours, serum creatinine rises from 1.2 to 4.8 mg/dL, …

A 42-year-old male construction worker is extricated from a collapsed building after being trapped under heavy rubble for 6 hours. He sustained severe crush injuries to both lower …

A 71-year-old man with a 15-year history of hypertension presents to the emergency department with a 2-day history of severe occipital headache, blurred vision, and nausea. His wif…

A 78-year-old woman with poor oral intake for 3 days presents with hypotension (BP 88/52), tachycardia (HR 110), and oliguria. Serum creatinine is 2.8 mg/dL (baseline 0.9), BUN 48 …

A 54-year-old man presents for follow-up 3 weeks after emergency percutaneous coronary intervention for ST-elevation myocardial infarction. During hospitalization, he developed acu…

A 68-year-old man with newly diagnosed multiple myeloma presents to the emergency department with fatigue, nausea, and a 3-day history of decreased urine output. He started bortezo…