A test for HIV has a sensitivity of 99% and a specificity of 95%. In a population with low disease prevalence, which of the following will be true about the test?

Which of the following statistical tests is most appropriate to compare the means of blood pressure between two independent groups?

What type of error is represented when a null hypothesis is rejected despite being true?

In which of the following studies can both odds ratio and relative risk be calculated?

A study shows a statistically significant difference with a P-value of 0.03. What does this indicate?

In a double-blind randomized control trial (RCT), what bias is most effectively minimized?

Which study design is best to assess the incidence of a disease in an exposed vs unexposed group over time?

What is the purpose of matching in a case-control study?

Which measure best reflects the precision of an estimate in a clinical trial?

What statistical measure is used to summarize data from multiple clinical trials in a systematic review?

A clinical trial shows 10% of patients in the placebo group develop a disease, while only 2% in the treatment group do. What is the absolute risk reduction (ARR)?

What is the number needed to treat (NNT) if the absolute risk reduction is 0.05?

In a cohort study, disease incidence in exposed = 20%, in unexposed = 5%. What is the relative risk (RR)?

Using a 2x2 table, if TP = 80, FP = 20, FN = 10, TN = 90, what is the positive predictive value (PPV)?

From the same table (TP = 80, FP = 20, FN = 10, TN = 90), what is the negative predictive value (NPV)?

A test has 95% sensitivity and 80% specificity. Which is the correct formula for likelihood ratio positive (LR+)?

What is the purpose of calculating likelihood ratios in diagnostic testing?

In a population with low disease prevalence, what happens to the NPV of a test?

Which of the following reduces the false negative rate in diagnostic testing?

What does a relative risk (RR) of 1.0 indicate?

A diagnostic test has TP = 50, FN = 10. What is the sensitivity of this test?

What does the infant mortality rate measure?

The incidence of disease refers to:

Which of the following factors increases disease prevalence?

Which is true regarding neonatal mortality rate?

A screening test for colon cancer is implemented and detects cancer 3 years earlier. However, mortality remains unchanged. What bias is present?

What is the best screening test feature to rule out a disease?

Which screening recommendation is correct for men age ≥50 with no family history?

What is person-time used for in cohort studies?

What is the maternal mortality rate?

What is the most appropriate test characteristic when selecting a test for initial screening?

Which is a limitation of using mortality rates to evaluate screening programs?

Which study type is best for studying a rare disease?

What type of bias occurs when patients with a disease recall exposures more clearly than healthy individuals?

Which study type provides the strongest evidence for causality?

A study finds an association between fishing and lung cancer. However, smoking is more common among fishermen. What is this an example of?

What design feature helps minimize confounding in an RCT?

What distinguishes a cohort study from a case-control study?

Which bias arises when study subjects change behavior because they know they are being observed?

What test is best for analyzing the relationship between a continuous dependent variable and multiple predictors?

Which test is used to predict a binary outcome (e.g., disease vs no disease) from multiple variables?

In a study, the effect of a new drug varies significantly between age groups. This is an example of:

What is the main limitation of cross-sectional studies?

Which test is best for comparing means between more than two independent groups?

Which statistical test compares proportions between two categorical variables in a large sample?

What type of prevention is giving tetanus vaccine to a child?

Screening mammograms in asymptomatic women are what type of prevention?

What level of prevention is adjusting diabetes treatment to avoid complications?

What type of data is blood pressure measurement?

Which is an example of ordinal data?

What type of prevention is identifying a drug interaction before prescribing?

Which test compares means between two paired groups (e.g., before and after intervention)?

What does an ROC curve evaluate?

A large sample study compares two categorical variables. Which test is appropriate?

A team of researchers recruits 3,000 healthy adults and asks about their lifestyle habits (smoking, diet, exercise). They are then followed over 10 years to assess who develops coronary artery disease.

A study enrolls patients diagnosed with pancreatic cancer and a control group without the disease. Researchers compare the frequency of alcohol use in both groups.

Investigators randomly assign 500 hypertensive patients to either a new antihypertensive drug or placebo and monitor for 5 years for stroke incidence.

Researchers review hospital records from the past 15 years to identify nurses exposed to a specific disinfectant and compare their cancer rates with those who weren’t exposed.

A national survey asks adults about current smoking status and whether they have chronic bronchitis. No follow-up is conducted.

A study looks at all published trials on statins and synthesizes data to report a pooled estimate of their effect on myocardial infarction prevention.

A physician tracks outcomes in 10 patients receiving a new experimental therapy for ALS without a comparison group.

A study investigates the association between city-level air pollution levels and asthma prevalence across countries.

Researchers follow a group of diabetics and non-diabetics for 10 years to assess the incidence of Alzheimer's disease.

A clinical trial tests a new antiviral using a double-blind factorial design where participants are assigned to receive either the drug, placebo, a second drug, or combination.

Researchers begin with a large cohort of nurses. Over time, those who develop breast cancer (cases) are compared with age-matched controls within the same cohort regarding prior oral contraceptive use.

A 59-year-old man with diabetes and hypertension presents with chest pain. ECG shows ST depressions in leads V4–V6. Troponin is elevated. What is the most likely diagnosis?

A 54-year-old man presents with acute-onset chest pain radiating to the back. BP is 180/100 mm Hg in both arms. CXR shows a widened mediastinum. What is the best next diagnostic step?

A 68-year-old woman with diabetes develops sudden pulmonary edema and hypotension 4 days after an MI. Auscultation reveals a new loud holosystolic murmur at the left sternal border. What is the most likely diagnosis?

A young man collapses during a basketball game. He has a crescendo-decrescendo murmur that increases with Valsalva. What is the most likely diagnosis?

A 60-year-old woman presents with dyspnea and a diastolic murmur at the apex with an opening snap. What is the most likely diagnosis?

A patient has a high-pitched, early diastolic decrescendo murmur along the left sternal border and bounding peripheral pulses. What is the most likely diagnosis?

A 45-year-old woman with palpitations and anxiety is found to have atrial fibrillation. She is hemodynamically stable. What is the next best step?

A 70-year-old male develops pericarditis 3 days post-MI. He complains of pleuritic chest pain relieved by sitting up. ECG shows diffuse ST elevation. What is the likely diagnosis?

A young woman presents with episodic chest pain and transient ST elevation on ECG. Angiogram shows clean coronary arteries. What is the most likely diagnosis?

A 60-year-old male with a history of CAD presents with fatigue and exertional dyspnea. Echo shows EF of 30%. Which medication reduces mortality?

A 70-year-old man presents with fever and chest pain 6 weeks after an MI. ECG shows diffuse ST elevations. ESR is elevated. What is the likely diagnosis?

A 65-year-old woman with untreated hypertension presents with confusion, blurry vision, and BP of 220/130 mmHg. Fundoscopy shows retinal hemorrhages. What is the diagnosis?

A 60-year-old man with NYHA class III heart failure is started on a new drug. Later, he presents with gynecomastia and high potassium. What drug is responsible?

A patient is found to have torsades de pointes on ECG and is pulseless. What is the next best step?

A patient on nitroprusside develops confusion and lactic acidosis during hypertensive crisis treatment. What is the most likely cause?

A 72-year-old male suddenly collapses 5 days after an MI. He is pulseless with JVD and no breath sounds. ECG shows electrical alternans. What is the most likely diagnosis?

A patient presents with fatigue, hypotension, and JVD after an MI. Lung fields are clear. What management is contraindicated?

A 66-year-old man develops dyspnea and a new murmur 6 days post-MI. Oxygen saturation in RV is higher than in RA. What is the likely diagnosis?

A patient is post-MI and develops sudden pulmonary edema. On exam, there's a new systolic murmur. What complication is likely?

A patient with acute pericarditis presents with hypotension and muffled heart sounds. Pulsus paradoxus is noted. What is the next best step?

A 78-year-old man presents with recurrent dizziness. ECG shows complete dissociation of P waves and QRS complexes. What is the definitive treatment?

A patient with recent MI develops a rapid, irregular rhythm with no visible P waves and variable R-R intervals. What is the most likely diagnosis?

A 62-year-old male with a drug-eluting stent placed 1 month ago stops dual antiplatelet therapy. What is he at greatest risk for?

A patient with inferior MI becomes hypotensive and bradycardic. Which vessel is most likely occluded?

A 70-year-old woman is admitted for an MI. Hours later she becomes hypotensive with cold extremities, elevated JVP, and clear lungs. What is the diagnosis?

A 70-year-old man presents with fever and chest pain 6 weeks after an MI. ECG shows diffuse ST elevations. ESR is elevated. What is the likely diagnosis?

A 65-year-old woman with long-standing untreated hypertension presents with confusion, blurry vision, and BP of 220/130 mmHg. Fundoscopy shows retinal hemorrhages. What is the diagnosis?

A 60-year-old man with NYHA class III heart failure is started on a new drug. Later, he presents with gynecomastia and high potassium. What drug is responsible?

A patient is found to have torsades de pointes on ECG and is pulseless. What is the next best step?

A patient on nitroprusside develops confusion and lactic acidosis during hypertensive crisis treatment. What is the most likely cause?

A 72-year-old male suddenly collapses 5 days after an MI. He is pulseless with JVD and no breath sounds. ECG shows electrical alternans. What is the most likely diagnosis?

A patient presents with fatigue, hypotension, and JVD after an MI. Lung fields are clear. What management is contraindicated?

A 66-year-old man develops dyspnea and a new murmur 6 days post-MI. Oxygen saturation in RV is higher than in RA. What is the likely diagnosis?

A patient is post-MI and develops sudden pulmonary edema. On exam, there's a new systolic murmur. What complication is likely?

A patient with acute pericarditis presents with hypotension and muffled heart sounds. Pulsus paradoxus is noted. What is the next best step?

A 78-year-old man presents with recurrent dizziness. ECG shows complete dissociation of P waves and QRS complexes. What is the definitive treatment?

A patient with recent MI develops a rapid, irregular rhythm with no visible P waves and variable R-R intervals. What is the most likely diagnosis?

A 62-year-old male with a drug-eluting stent placed 1 month ago stops dual antiplatelet therapy. What is he at greatest risk for?

A patient with inferior MI becomes hypotensive and bradycardic. Which vessel is most likely occluded?

A 70-year-old woman is admitted for an MI. Hours later she becomes hypotensive with cold extremities, elevated JVP, and clear lungs. What is the diagnosis?

A 58-year-old man presents with crushing chest pain. ECG shows ST elevations in V2–V5. BP is 80/60 mmHg. Lungs are clear. What is the best next step?

A patient with CHF and EF of 25% is started on a new medication. Days later, labs show K+ = 6.1, Cr = 2.2. Which drug is most likely responsible?

A 72-year-old woman presents with tearing chest pain radiating to the back. CXR shows widened mediastinum. What’s the gold standard for diagnosis?

A man develops bradycardia and AV block hours after an inferior MI. BP is stable. What is the best management?

A patient with CHF is started on digoxin. What symptom should prompt immediate concern?

A 65-year-old man with PAD reports calf pain on walking, relieved by rest. What is the best initial diagnostic test?

A patient with MI develops persistent ST elevation and a new Q wave weeks later. Echo shows aneurysmal bulge. What is the diagnosis?

A patient is being treated for hypertensive emergency. Nitroprusside is started. 24 hours later, he is confused and tachypneic. What’s the cause?

A patient presents with MI symptoms. ECG shows ST elevation in leads II, III, and aVF. Which area is affected?

A 68-year-old with CHF and EF 30% is admitted with sudden decompensation. BP is 80/60 mmHg. What’s the first step?

A 55-year-old man with known CAD presents with chest pain at rest. ECG shows no ST elevation but troponin is elevated. What is the diagnosis?

A patient with newly diagnosed HFrEF is started on carvedilol. What should be monitored closely during titration?

A patient presents with tearing chest pain and blood pressure discrepancy between arms. What is the next best step?

A 67-year-old male smoker with CAD develops abdominal pain and hypotension. On exam, there’s a pulsatile mass. What is the likely diagnosis?

A 72-year-old woman with AF and hypertension is assessed for anticoagulation. What tool guides this decision?

A patient with systolic heart failure is not tolerating ACE inhibitors due to cough. What is the best alternative?

A 64-year-old man presents with calf pain on exertion relieved by rest. He has an ABI of 0.6. What is the most appropriate next step?

A patient post-MI develops persistent ST elevation and a new Q wave weeks later. Echo shows aneurysmal bulge. What is the diagnosis?

A 55-year-old man on chronic amiodarone develops dry cough and dyspnea. CXR shows bilateral infiltrates. What is the likely cause?

A 67-year-old diabetic with severe PAD cannot undergo surgery. Which drug improves walking distance?

A 32-year-old man presents with sharp chest pain worsened by lying flat and relieved by sitting up. ECG shows diffuse ST elevations and PR depressions. What is the most likely diagnosis?

A dialysis patient with sharp chest pain has a normal ECG and no ST changes. Pericardial friction rub is heard. What is the most likely cause?

A 44-year-old man presents with hypotension, JVD, and muffled heart sounds. ECG shows electrical alternans. What is the next best step?

A 59-year-old man develops leg swelling, ascites, and fatigue. Exam reveals JVD and pericardial knock. What is the diagnosis?

A 26-year-old woman presents with dyspnea and dizziness. Auscultation reveals a diastolic murmur and a tumor plop. Echo shows left atrial mass. Diagnosis?

A 40-year-old IV drug user has fever and a new systolic murmur at the left sternal border. What is the most likely diagnosis?

A 64-year-old man presents with sudden dyspnea, pleuritic chest pain, and tachycardia. ECG shows sinus tachycardia. What is the next best step?

A 70-year-old patient presents with massive PE and shock. What is the definitive treatment?

A man has positive blood cultures and new murmur. He has splinter hemorrhages and Janeway lesions. What is the best next test?

A man with Strep gallolyticus endocarditis is diagnosed. What should be done next?

A 72-year-old man presents with sudden onset of severe tearing chest pain radiating to the back. BP is 180/110 in the right arm and 140/85 in the left. CXR reveals a widened mediastinum. What is the most likely diagnosis?

A 68-year-old man with known CAD presents with exertional chest pain relieved by rest. ECG is normal. What is the most appropriate initial test?

A 60-year-old man presents with a history of claudication. His ABI is 0.65. Which of the following medications is known to improve claudication symptoms and walking distance?

A 65-year-old man with AF and hypertension has a CHADS-VASc score of 3. What is the next best step in management?

A 50-year-old woman has blood pressure of 160/100 mmHg on 3 separate visits. She has no known comorbidities. What is the most appropriate next step?

A patient with HFrEF has EF 30%, sinus rhythm, and QRS duration of 160 ms. What is the most appropriate intervention?

A patient with NYHA class II HFrEF has EF of 28%. Which oral drug lowers mortality and hospitalization?

A man presents with 3 days of fever, new murmur, and Janeway lesions. He’s allergic to penicillin. What’s the best empiric treatment?

Which of the following is a major Duke criterion for infective endocarditis?

A 65-year-old man with CHF, an S3 sound, and crackles presents with new dyspnea. What is the best diagnostic test?

A patient with syncope and delta waves on ECG is suspected to have WPW. What is the next best step?

A hypertensive patient presents with asymmetric pulses and tearing chest pain. What is the best initial diagnostic test?

A man with exertional syncope has a family history of sudden cardiac death. What is the best diagnostic test?

A 65-year-old man with chronic HTN has LVH on ECG. What is the most appropriate initial treatment?

A patient with HFpEF is symptomatic despite diuretics. What drug improves outcomes in this condition?

A 68-year-old with stable angina has chest pain on climbing stairs. What is the next best step?

A 58-year-old man with PAD complains of worsening calf claudication. What is the next best test?

A 55-year-old man on amiodarone develops dry cough and interstitial infiltrates. What is the most likely diagnosis?

A patient presents with yellow vision, fatigue, and confusion. ECG shows scooped ST segments. What drug is responsible?

What ECG pattern is typically seen in Stage 1 acute pericarditis?

A 60-year-old woman with a history of rheumatic fever presents with fatigue and dyspnea on exertion. On exam, there is a loud first heart sound and an opening snap followed by a diastolic rumble at the apex. What is the most likely diagnosis?

A 72-year-old man presents with exertional syncope. On examination, he has a harsh systolic murmur best heard at the right upper sternal border, radiating to the carotids. What is the most likely diagnosis?

A 45-year-old woman presents with palpitations. ECG shows a short PR interval and a delta wave. She has no symptoms now. What is the most appropriate next step?

A patient presents with tearing chest pain and unequal blood pressures in both arms. What is the best diagnostic modality in a stable patient?

A 58-year-old man with hypertension presents with tearing chest pain radiating to his back. BP is 190/120 in the right arm and 160/100 in the left. What is the most appropriate next step?

A 72-year-old woman develops sudden shortness of breath and hypotension after MI. ECG shows electrical alternans. What is the most likely cause?

A patient with a history of MI presents with persistent ST elevation and deep Q waves on ECG weeks after the event. What is the likely diagnosis?

A patient develops hypoxia, hypotension, and JVD postoperatively. Lung exam is clear. ECG shows sinus tachycardia. What is the most likely cause?

A 60-year-old woman with longstanding hypertension has proteinuria and elevated creatinine. Which class of drugs is most appropriate for renal protection?

A 72-year-old man collapses 5 days after an anterior MI. He is hypotensive, with muffled heart sounds and jugular venous distension. ECG shows electrical alternans. What is the diagnosis?

A patient with chronic stable angina is found to have an LDL of 155 mg/dL. What is the best next step in management?

A 68-year-old woman has a crescendo-decrescendo systolic murmur at the right upper sternal border that radiates to the carotids. She has delayed carotid upstroke and exertional dizziness. What is the diagnosis?

A patient with atrial fibrillation has a CHADS-VASc score of 3. What is the most appropriate treatment?

A patient with COPD presents with lower extremity edema, ascites, and JVD. Echocardiogram shows right ventricular hypertrophy. What is the diagnosis?

A 65-year-old man with hypertension and CAD develops new-onset AF. What is the most important initial step?

A patient presents with a mid-diastolic murmur and opening snap at the apex. She is a recent immigrant from Southeast Asia. What is the most likely diagnosis?

A 66-year-old man with HFpEF is started on a new drug that reduces hospitalization and cardiovascular death. What is the drug?

A 59-year-old man presents with sudden syncope while shaving. His HR is 40 bpm and ECG shows sinus bradycardia. What is the best initial treatment?

A young woman develops torsades de pointes after starting sotalol. What is the mechanism behind this arrhythmia?

A patient with hypertension and BPH is prescribed a drug that improves urinary symptoms and lowers BP. Which drug is this?

A 70-year-old man with a history of CAD and reduced EF presents with episodes of syncope. ECG reveals sinus rhythm with a prolonged QT interval. What is the most likely arrhythmia?

A patient with recent PCI and DES placement develops chest pain 3 weeks later. ECG shows new ST elevations. Troponins are elevated. What is the likely cause?

A 62-year-old woman with paroxysmal AF is started on warfarin. What is the goal INR for stroke prevention?

A 55-year-old man has left ventricular hypertrophy on ECG. What is the most likely cause?

A 63-year-old woman has chronic atrial fibrillation and a CHA₂DS₂-VASc score of 3. What is the most appropriate treatment to prevent stroke?

A 59-year-old man with known systolic heart failure is admitted with decompensated HF. Echo shows EF 25%. Which of the following is NOT shown to reduce mortality in HFrEF?

A 72-year-old woman with hypertension presents with episodes of syncope. Her ECG reveals sinus bradycardia with frequent pauses. What is the best long-term management?

A 66-year-old man complains of severe tearing chest pain radiating to his back. BP is 180/100 in the right arm and 140/90 in the left. What’s the most appropriate immediate management?

A 75-year-old man with known HFpEF is admitted for dyspnea and volume overload. Which of the following improves mortality in HFpEF?

A 64-year-old man is diagnosed with hypertrophic obstructive cardiomyopathy. What is the best initial medical therapy to prevent syncope and sudden death?

A 70-year-old woman presents with lower extremity edema and ascites. She has JVD, hepatomegaly, and pericardial knock on auscultation. What is the most likely diagnosis?

A patient with a bicuspid aortic valve is asymptomatic. What screening is recommended?

A 68-year-old woman is started on amiodarone for AF. Which of the following tests should be monitored regularly?

A man collapses while running. ECG shows ST elevations in V1–V3 with a pseudo-RBBB pattern. He has a family history of sudden death. What is the likely diagnosis?

A 60-year-old man with heart failure has a QRS duration of 165 ms and EF of 30%. Which therapy will improve his survival?

A patient on long-term doxorubicin develops fatigue and dyspnea. Echo shows EF of 25%. What is the most likely cause?

A man develops hypotension and tachycardia after starting nitroprusside. Labs show metabolic acidosis and altered mental status. What is the cause?

A 70-year-old man has MI with ST elevation in II, III, aVF. 2 hours later, he becomes hypotensive with clear lungs and JVD. What is the cause?

A patient on carvedilol, lisinopril, and furosemide presents with gynecomastia and hyperkalemia. Which new drug was likely added?

A 69-year-old diabetic patient has an LDL of 195 mg/dL. What is the best next step?

A 65-year-old man presents with fatigue and mild jaundice. ECG shows AV dissociation and a heart rate of 38 bpm. He has no chest pain. What is the most appropriate management?

A 72-year-old woman presents with 3 months of worsening dyspnea and leg swelling. Echo shows EF 58% and impaired LV relaxation. What is the diagnosis?

A 76-year-old man with aortic stenosis is not a candidate for surgery due to multiple comorbidities. What is the best treatment?

A patient presents with hypotension, JVD, and clear lungs post-MI. Which medication is contraindicated?

A 70-year-old man with MI develops bradycardia and hypotension. What is the most likely cause?

A patient with dilated cardiomyopathy is NYHA class III with EF of 30%. What device improves survival?

A 60-year-old man has persistent ST elevation and Q waves 3 weeks post-MI. What is the diagnosis?

Which is the best initial test for suspected constrictive pericarditis?

A 70-year-old man with AF is started on warfarin. Which test must be monitored?

A patient with atrial fibrillation has a CHADS-VASc score of 1 (male). What is the best next step?

A 70-year-old woman on verapamil develops constipation. What is the most likely cause?

A patient with EF 30% is found to be on diltiazem for rate control. What’s the concern?

A 60-year-old man has a loud holosystolic murmur at the apex that radiates to the axilla. What is the most likely diagnosis?

A patient with STEMI is in a rural clinic with no PCI available. What is the best next step?

A patient with type 2 diabetes and LDL of 195 mg/dL is asymptomatic. What is the best step?

A young man with HOCM is prescribed digoxin. What is the risk?

Which of the following is a contraindication to beta-blocker use in acute MI?

A patient cannot exercise and has LBBB. Which test is preferred for ischemia detection?

When is pharmacologic stress testing preferred over exercise ECG?

A patient with asthma is undergoing pharmacologic stress testing. Which drug is contraindicated?

A patient presents with ST elevation in leads I, aVL, V5, and V6. What is the most likely site of infarction?

A diabetic patient with an LDL of 162 mg/dL and no known ASCVD is started on atorvastatin. What drug class is atorvastatin?

A 65-year-old post-MI patient with EF 30% and NYHA class II symptoms is stable. What therapy is essential?

A 61-year-old man with 3 hours of substernal chest pain and ECG showing STEMI in II, III, aVF is in a rural clinic. PCI is 3 hours away. What is the best next step?

A 47-year-old diabetic woman has LDL of 102 mg/dL. She exercises regularly. What is the best lipid management step?

A patient with EF 28% and atrial fibrillation is on metoprolol, furosemide, and digoxin. HR is 42 bpm with dizziness. ECG shows sinus bradycardia and 1st degree AV block. What is the best step?

A 54-year-old man with no comorbidities walks 3 flights of stairs without chest pain. He has atypical chest discomfort. ECG is normal. What is the best next step?

A 70-year-old woman with HTN has calf pain after walking 2 blocks. ABI = 0.65. What is the best management?

A man with a history of DVT develops leg heaviness and skin pigmentation around the ankles. Duplex shows no DVT. Likely diagnosis?

A 68-year-old man with chest pain during exertion has transient ST depression on treadmill test and normal troponins. What’s the diagnosis?

A 58-year-old man presents with a harsh systolic murmur at the 2nd right intercostal space that radiates to the carotids. He experiences syncope with exertion. What is the most likely diagnosis?

A 65-year-old woman is diagnosed with systolic heart failure. She is started on enalapril. Which of the following is the mechanism of action of this drug?

A 72-year-old male presents with syncope. ECG reveals prolonged QT interval. Which medication is known to prolong the QT interval?

A 60-year-old patient is found to have persistent ST elevations and deep Q waves weeks after an MI. Echo shows an outward bulge. What is the diagnosis?

A 66-year-old man has JVD, hepatomegaly, and a pericardial knock on auscultation. What is the most likely diagnosis?

A young man with recurrent syncope is found to have ST elevations in V1–V3 and RBBB pattern. What is the diagnosis?

A dialysis patient develops sharp chest pain and friction rub. ECG is normal. What is the most likely diagnosis?

A 45-year-old man with asthma is started on propranolol and develops wheezing. What is the explanation?

A patient develops nausea, confusion, and yellow vision. ECG shows atrial tachycardia with AV block. What drug is responsible?

A man with known HOCM collapses while running. What medication should be avoided?

A 65-year-old man with a history of hypertension presents with acute chest pain radiating to the back. On exam, there is a difference in systolic BP between arms. ECG is normal. What is the most appropriate next diagnostic step?

A 70-year-old man with known CAD presents with syncope. ECG shows prolonged PR interval with intermittent dropped QRS complexes. What is the best treatment?

A 60-year-old diabetic presents with crushing chest pain. ECG shows ST elevations in V1–V4. He is hypotensive and tachycardic. What is the culprit vessel?

A patient with a recent anterior STEMI becomes hypotensive and develops a new holosystolic murmur at the apex. What is the most likely cause?

A 58-year-old male presents with substernal chest pain. Troponins are elevated but ECG is nonspecific. He has chronic kidney disease. What is the best initial management?

A 40-year-old man presents with palpitations. ECG shows short PR interval and delta waves. What is the best initial management in a stable patient?

A 60-year-old patient with heart failure has EF of 30%. Despite beta-blockers and ACEi, he remains symptomatic. What next medication reduces mortality?

A 70-year-old woman with heart failure is started on an SGLT2 inhibitor. What additional benefit does this class offer?

A young man dies suddenly during sleep. His ECG showed pseudo-RBBB and ST elevation in V1–V3. What is the diagnosis?

A patient presents with a wide-complex tachycardia at 180 bpm and is hemodynamically unstable. What is the next step?

A 58-year-old man with known heart failure presents with dizziness. ECG reveals a wide QRS and LBBB with QRS duration of 160 ms. EF is 30%. What is the next best step in management?

A 65-year-old woman with atrial fibrillation and CHADS-VASc score of 3 is on warfarin. She is scheduled for elective surgery. What should be done with anticoagulation?

A patient develops acute dyspnea and hypotension 1 week post-MI. He has distant heart sounds and pulsus paradoxus. ECG shows electrical alternans. Diagnosis?

A 72-year-old man develops acute onset chest pain. ECG shows ST elevation in leads V1–V4. What is the most likely culprit artery?

A patient with CHF is given digoxin. He now has anorexia, yellow vision, and new arrhythmias. What is the best next step?

A 55-year-old man presents with recurrent syncope. ECG shows sinus bradycardia and pauses >3 seconds. What is the next step?

A 28-year-old athlete collapses during a game. ECG shows short PR interval and delta wave. What arrhythmia is most likely?

A patient with long QT syndrome is experiencing palpitations. What is the best long-term therapy?

A patient presents with exertional dyspnea, bibasilar crackles, and displaced apical impulse. EF is 25%. What medications improve mortality?

A 59-year-old man with HFrEF has EF 30% and resting HR 78 bpm despite maxed beta-blocker. What medication reduces hospitalizations?

A 28-year-old man presents with sudden onset chest pain and syncope. ECG shows diffuse ST elevations. Bedside echo shows large pericardial effusion. What is the most immediate management?

A 55-year-old smoker presents with leg pain while walking. ABI is 0.7. What is the best initial treatment to improve symptoms and function?

A 60-year-old with longstanding HTN and recent stroke has a carotid bruit. Duplex ultrasound shows 85% carotid stenosis. Best next step?

A 30-year-old woman has a crescendo-decrescendo murmur at the right upper sternal border. It radiates to the neck and increases with squatting. Diagnosis?

A patient with systolic heart failure (EF 28%) is already on ACE inhibitor, beta-blocker, and spironolactone. His BP is 120/70 and HR 75. What drug should be added?

A 62-year-old man collapses suddenly. ECG shows polymorphic VT. QT interval is prolonged. What is the most appropriate treatment?

A patient presents with a new murmur and positive blood cultures. TEE shows vegetations on a prosthetic valve. What is the most appropriate therapy?

A 55-year-old man presents with bilateral leg swelling and elevated JVP. There is a pericardial knock. What is the most likely diagnosis?

A patient with endocarditis develops sudden left-sided weakness. CT head shows ischemic infarct. What is the next best step?

A 68-year-old man with ESRD presents with chest pain and pericardial friction rub. ECG is normal. What is the most likely diagnosis?

A 28-year-old woman presents with sharply demarcated, erythematous plaques with a silvery scale on her elbows and knees. What is the most likely diagnosis?

A 35-year-old man presents with intensely pruritic, linear burrows in his interdigital spaces and genital region. What is the most likely diagnosis?

A 22-year-old woman presents with a herald patch followed by multiple oval lesions in a “Christmas tree” distribution on the trunk. What is the most likely diagnosis?

A 66-year-old man presents with painless, pearly papules with telangiectasias on the nose. Biopsy reveals palisading nuclei. What is the most likely diagnosis?

A 40-year-old man presents with purple, polygonal, pruritic papules on his wrists. What is the most likely diagnosis?

A diabetic patient presents with red-brown plaques with central atrophy over the shins. What is the most likely diagnosis?

A 32-year-old woman has symmetrical depigmented macules on her hands and perioral region. What’s the likely diagnosis?

A 24-year-old male presents with a pustular rash on his face and back. What’s the best initial treatment for moderate acne?

A 45-year-old woman has recurrent facial flushing and telangiectasias exacerbated by spicy food and hot drinks. Diagnosis?

A 4-year-old boy develops honey-crusted lesions around his mouth. What is the best initial treatment?

A 58-year-old man presents with a chronic, non-healing ulcer on a sun-exposed area of his scalp. It is ulcerated and bleeds easily. What is the most likely diagnosis?

A 6-year-old boy develops a circular, scaly plaque with central clearing and raised erythematous borders on the forearm. What is the most likely diagnosis?

A 23-year-old woman presents with painful, tender red nodules over her shins. She also has a history of recent sore throat. What is the diagnosis?

A 16-year-old boy has numerous open and closed comedones, papules, and pustules over his face and back. What is the pathogenesis of this condition?

A 34-year-old woman with a history of lupus develops painless oral ulcers and a malar rash after sun exposure. What type of rash is this?

A 48-year-old man presents with thickened skin and yellowish discoloration of the toenails. KOH prep reveals septate hyphae. What is the treatment of choice?

A child presents with small vesicles and honey-colored crusting on the face. Which organism is most likely responsible?

A 27-year-old woman presents with grouped vesicles on an erythematous base on her lips. Tzanck smear shows multinucleated giant cells. What is the likely diagnosis?

A 30-year-old woman has greasy, yellowish scales in her scalp and nasolabial folds. What is the most likely diagnosis?

A patient presents with multiple cafe-au-lait spots and axillary freckling. What condition is most likely?

A newborn has a firm, blue-red vascular nodule on the face that rapidly grows in the first year. What is the most likely diagnosis?

A 29-year-old man with celiac disease presents with grouped vesicles on extensor surfaces, especially elbows and knees. What is the most likely diagnosis?

A 42-year-old woman presents with violaceous nodules with scale and scarring on the scalp, leading to patchy hair loss. What is the most likely diagnosis?

A 60-year-old man presents with an irregular, pigmented lesion with asymmetry, color variation, and diameter of 8 mm. What is the most likely diagnosis?

A 50-year-old woman with long-standing rheumatoid arthritis develops persistent ulcers with undermined borders on her legs. Diagnosis?

A child presents with bright red cheeks (“slapped cheek” appearance) and a lacy rash on the trunk. What is the most likely cause?

A 31-year-old woman presents with annular, erythematous plaques with trailing scale behind the edge. Diagnosis?

A 35-year-old woman develops widespread epidermal detachment with mucosal involvement after starting a new anticonvulsant. Diagnosis?

A 75-year-old man presents with itchy, tense bullae on the lower abdomen and thighs. What is the most likely diagnosis?

A 19-year-old woman has hypopigmented, slightly scaly macules on her trunk. KOH prep shows “spaghetti and meatballs” appearance. What is the diagnosis?

A 40-year-old man presents with multiple soft, flesh-colored, pedunculated lesions in his axillae. What are these called?

A 28-year-old woman presents with chronic eczematous patches on her hands. Patch testing shows nickel sensitivity. Diagnosis?

A 65-year-old woman with long-standing sun exposure presents with rough, scaly patches on her face and forearms. Diagnosis?

A 30-year-old man has hyperpigmented, velvety plaques on the back of his neck and axillae. What is the next step in management?

A 24-year-old athlete presents with painful vesicles on the lateral edge of one finger. What is the diagnosis?

A 7-year-old girl has hair loss with black dots in the scalp and scaling. What is the most likely diagnosis?

A 29-year-old male with history of IBD develops painful pustules that ulcerate with violaceous borders. Diagnosis?

A patient presents with multiple dome-shaped, umbilicated papules on the trunk. Diagnosis?

A 45-year-old man presents with rough, wart-like growths on his hands after working with wood. Biopsy shows koilocytosis. What is the diagnosis?

A newborn has a large port-wine stain over the face. What condition should be ruled out?

A 33-year-old female presents with hypopigmented macules on the back that become more visible in the sun. KOH prep shows short hyphae and spores. Best treatment?

A 21-year-old presents with target-like lesions after HSV infection. Diagnosis?

A child presents with well-demarcated perioral dermatitis after prolonged use of topical steroids. What is the treatment?

A 55-year-old male presents with rapid-onset multiple seborrheic keratoses. What should be ruled out?

A child presents with linear streaks of vesicles after playing in the garden. Most likely cause?

A teenage girl has acne and starts isotretinoin. What is the most important test before starting treatment?

A boy presents with hypopigmented patches on the face. There is mild scaling, no itching. Diagnosis?

A patient develops itchy, blistering lesions on sun-exposed skin. Biopsy shows subepidermal clefts. What is the diagnosis?

A woman presents with lacy white patches in the oral mucosa and violaceous skin papules. What’s the most likely diagnosis?

A 70-year-old presents with small red papules that bleed on scratching. What are these?

A 9-month-old infant presents with an erythematous diaper rash that spares the skin folds. What is the most likely diagnosis?

A diaper rash presents as beefy red plaques with satellite lesions involving the skin folds. What is the most likely diagnosis?

A teenager has comedones, pustules, and nodules. What is the best treatment for severe nodulocystic acne?

What is the most effective topical agent for comedonal acne?

A 25-year-old with psoriasis is prescribed methotrexate. What must be done before starting?

A patient has silvery scaly plaques on the elbows. What is the first-line treatment for mild psoriasis?

A man presents with multiple pearly nodules on the face with telangiectasias. What is the diagnosis?

A patient has a non-healing, scaly ulcerated lesion on the lower lip. What is the diagnosis?

What is the treatment of choice for superficial BCC on the face?

A child has erythematous, well-demarcated rash with yellow scales on the scalp and diaper area. Diagnosis?

A child has pruritic plaques in flexural areas and a history of asthma. Most likely diagnosis?

What is the most common location of SCC with a high risk of metastasis?

Which pediatric skin condition resolves spontaneously and presents with vesicles and eosinophils on smear?

Which psoriasis treatment increases the risk of lymphoma with long-term use?

A 42-year-old woman presents with facial flushing, telangiectasias, and pustules. Which topical agent is preferred for papulopustular rosacea?

A 60-year-old fair-skinned man has an irregular dark lesion on his back. ABCDE criteria are met. What is the next step?

What staging method is used for melanoma and predicts prognosis based on tumor depth?

A 58-year-old man with a 5-year-old chronic wound over an old burn site has an ulcerated lesion. What’s the best next step?

A 70-year-old with melanoma and no nodal involvement undergoes wide excision. What is needed next?

A 40-year-old woman with rosacea and eye irritation develops blepharitis. Best treatment?

A 42-year-old woman with fair skin complains of redness and flushing of her cheeks, especially after drinking wine or exposure to sun. There are no comedones. What is the most likely diagnosis?

A 25-year-old woman is being started on oral isotretinoin for severe cystic acne. Which of the following must be tested before treatment initiation?

A 7-year-old boy presents with an intensely itchy rash that worsens at night. He has linear burrows between his fingers. What is the best treatment?

A patient with multiple painful nodules and disfiguring scars at earlobe piercing sites is diagnosed with keloids. What is the most effective treatment?

A 55-year-old male presents with an asymmetrical pigmented lesion on his back. Which of the following features is most concerning for melanoma?

A 30-year-old man has itchy, red lesions on his fingers and wrists. KOH prep is negative. Lesions worsen at night. What is the next best step?

A teenage girl with severe acne has been prescribed isotretinoin. Which lab abnormality would warrant discontinuing the medication?

A patient has a brown-black sharply demarcated waxy lesion on the back. There is no change over time. What is the best next step?

A patient presents with pustules and nodules on the back and jawline refractory to doxycycline. Isotretinoin is considered. What must be stopped before initiating therapy?

A 68-year-old male has a non-healing ulcer on a sun-exposed area. It is ulcerated with rolled borders. What is the likely diagnosis?

Which skin cancer has the lowest metastatic potential?

Which of the following is associated with fair skin, intermittent sun exposure, and large nevi?

Which skin condition should always prompt a glucose screening test in an adult?

A patient with a non-healing burn wound develops a painful mass. What cancer must be ruled out?

What is the best way to manage recurrent skin infections in a patient with a history of MRSA?

Which acne treatment requires dual contraception and monthly pregnancy testing?

What skin condition is most associated with celiac disease?

A child presents with multiple hypopigmented macules that are ash leaf shaped. Next best step?

A farmer presents with an ulcerating nodule after rose thorn injury. What is the likely pathogen?

Which UV light is most implicated in causing skin cancer?

A 21-year-old man presents with intense nocturnal itching and linear burrows between his fingers. What is the most appropriate next step in management?

A 68-year-old man in a nursing home presents with widespread crusted skin and minimal itching. What is the best treatment?

A 5-year-old boy with scabies develops pustules and honey-crusted lesions. What complication has likely occurred?

A 19-year-old woman is starting oral isotretinoin for nodulocystic acne. What test is mandatory before initiation?

What lab values must be monitored monthly in a patient on isotretinoin?

A 20-year-old woman on isotretinoin reports mood swings and sadness. What is the best course of action?

A 25-year-old develops a raised, thick, shiny scar that extends beyond the original ear piercing site. What is the diagnosis?

What is the first-line treatment for symptomatic keloids?

Which of the following features best differentiates a hypertrophic scar from a keloid?

A 33-year-old woman with a large ear keloid is concerned about recurrence after surgery. What adjunctive therapy will reduce this risk?

A 15-year-old boy presents with polyuria, polydipsia, and weight loss over the past two weeks. Blood glucose is 385 mg/dL. Ketones are positive in urine. Which is the most likely diagnosis?

A 55-year-old obese woman is diagnosed with type 2 DM. What is the most appropriate initial pharmacologic therapy?

A patient with type 1 diabetes presents with nausea, vomiting, and Kussmaul respirations. Glucose is 450 mg/dL, and bicarbonate is 14 mEq/L. What is the next best step?

A 45-year-old man with diabetes is found to have microalbuminuria. What is the best initial treatment?

A diabetic patient presents with numbness and burning pain in the feet. What is the most appropriate next step?

A 17-year-old girl with known type 1 DM is found unconscious. Her glucose is 32 mg/dL. What is the next best step in management?

A 10-year-old boy with new-onset T1DM is started on insulin. Which insulin provides basal coverage?

A patient with known type 1 DM presents with vomiting, abdominal pain, and deep breathing. Labs show high glucose, low bicarb, and high anion gap. Which electrolyte must be carefully monitored?

Which insulin type has the fastest onset of action?

A patient with type 1 DM is experiencing frequent hypoglycemic episodes at night. What is the best change in insulin regimen?

A 35-year-old man with poorly controlled type 1 DM presents with abdominal pain and fruity breath. ABG shows pH 7.12, HCO3 10. What is the most appropriate next step?

A 22-year-old man with T1DM asks about lifestyle modifications. What advice is most important to prevent complications?

What is the recommended HbA1c target in non-pregnant adults with diabetes?

A patient is diagnosed with DKA. After initial fluid resuscitation, insulin is started. Serum potassium is 3.1 mEq/L. What is the next best step?

What is the main mechanism of hyperglycemia in type 1 diabetes mellitus?

A 70-year-old man with type 2 DM presents with confusion, dehydration, and a glucose of 950 mg/dL. Serum osmolality is elevated. There are no ketones. What is the likely diagnosis?

What is the primary difference between DKA and HHS?

A type 1 diabetic patient plans to run a marathon. What is the most appropriate recommendation?

A newly diagnosed type 1 diabetic asks about dietary advice. What is most important?

A type 1 DM patient develops hypoglycemia while driving. What is the appropriate first step?

A 12-year-old child with T1DM is hospitalized with DKA. When can subcutaneous insulin be started?

Which of the following is the most common cause of death in diabetic ketoacidosis?

A 40-year-old woman has HbA1c of 6.3%. What is the diagnosis?

A type 1 diabetic asks about sick day rules. What should be recommended?

What is the insulin of choice in DKA management?

What is the most common cause of death in patients with diabetes mellitus?

A diabetic patient complains of blurred vision. Fundoscopy shows microaneurysms and hard exudates. What is the diagnosis?

Which test is most sensitive for early diabetic nephropathy?

A 60-year-old diabetic man has numbness, tingling, and burning in both feet. What is the most likely diagnosis?

A diabetic patient complains of early satiety and vomiting. What is the likely diagnosis?

A diabetic patient has lost foot sensation and has a painless ulcer on the plantar surface. What is the best next step?

What is the most effective strategy to prevent progression of diabetic retinopathy?

Which of the following is a manifestation of diabetic autonomic neuropathy?

Which long-term diabetic complication is best prevented by ACE inhibitors?

What is the earliest renal change seen in diabetic nephropathy?

How often should a diabetic patient undergo a comprehensive eye exam?

Which of the following is the most important screening tool for diabetic foot neuropathy?

A diabetic patient presents with fever, swelling, and foul-smelling discharge from a foot ulcer. What is the next best step?

What is the most likely cause of Charcot foot in diabetes?

A 65-year-old diabetic with poor vision develops a retinal detachment. What form of retinopathy is most associated?

Which lipid goal is most appropriate in a 55-year-old diabetic with no cardiovascular history?

A diabetic patient with ESRD is on dialysis. What is the most common cause of his kidney failure?

What structural change characterizes advanced diabetic nephropathy?

A diabetic patient complains of orthostatic dizziness. BP drops from 130/80 to 90/60 on standing. HR is unchanged. What is the cause?

A diabetic presents with sudden foot pain and deformity. Foot is warm, swollen, but pulses are intact. X-ray shows bone destruction. What is the diagnosis?

A 40-year-old woman presents with fatigue, cold intolerance, weight gain, and constipation. TSH is elevated, free T4 is low. What is the diagnosis?

What is the most common cause of hypothyroidism in iodine-sufficient regions?

A patient presents with heat intolerance, weight loss, palpitations, and tremors. TSH is low, free T4 is high. What is the most likely diagnosis?

A 30-year-old woman has hyperthyroidism, exophthalmos, and a diffusely enlarged thyroid. Which test confirms the diagnosis?

Which of the following is most specific for Graves disease?

What is the first-line treatment for Graves disease in most non-pregnant adults?

A 28-year-old pregnant woman with newly diagnosed Graves disease. What is the drug of choice in the first trimester?

A 45-year-old woman has a painless, firm thyroid nodule. TSH is normal. What is the next best step?

A patient has a cold thyroid nodule on RAIU scan. What is the most appropriate next step?

A 32-year-old woman has a thyroid nodule. TSH is low. What is the next best step?

A 35-year-old woman presents with a tender, enlarged thyroid and recent viral illness. Labs show elevated ESR and low TSH. What is the most likely diagnosis?

Which of the following thyroid disorders presents with high fever, delirium, tachycardia, and nausea?

A thyroid biopsy reveals Orphan Annie eye nuclei and psammoma bodies. What is the most likely diagnosis?

A thyroid tumor invades blood vessels and spreads hematogenously to bone. What is the most likely diagnosis?

A 45-year-old woman with thyroid nodule has high calcitonin levels. What is the likely diagnosis?

What thyroid cancer is associated with RET proto-oncogene mutations?

A patient with a rock-hard, fixed thyroid and compressive symptoms has low TSH. What is the likely diagnosis?

A patient has low TSH, low T3, and low T4. What is the most likely diagnosis?

A patient has an asymptomatic goiter and normal TSH. What is the most appropriate initial test?

A thyroid cancer patient is treated with total thyroidectomy and levothyroxine. What is the goal of TSH suppression?

A 68-year-old woman has TSH of 6.5 mIU/L and normal free T4. She is asymptomatic. What is the diagnosis?

A 30-year-old pregnant woman is diagnosed with hypothyroidism. What is the treatment of choice?

What thyroid hormone change is expected during normal pregnancy?

A patient on chronic amiodarone therapy develops fatigue and weight gain. TSH is elevated. What is the likely diagnosis?

A 60-year-old man with multinodular goiter has compressive symptoms. What is the treatment of choice?

Which thyroid condition has the highest risk for airway compromise?

What is the most sensitive marker for thyroid function screening?

A thyroid nodule in a patient with previous head/neck radiation has normal TSH. What is the next best step?

A post-thyroidectomy patient has hoarseness and difficulty speaking. What is the most likely nerve injured?

What is the most common presentation of thyroid cancer?

A 55-year-old woman is found to have elevated calcium and PTH on routine labs. She has no symptoms. What is the most likely diagnosis?

What is the most common cause of secondary hyperparathyroidism?

A patient with CKD on dialysis has high PTH and high calcium. What is the most likely cause?

Which of the following is a classic EKG finding in hypercalcemia?

A 45-year-old woman presents with muscle cramps and perioral numbness. Labs show low calcium and high phosphate. What is the most likely cause?

What is the most common cause of hypocalcemia in hospitalized adults?

Which vitamin is required for calcium absorption in the gut?

A child with vitamin D deficiency presents with bowing of legs. What is the diagnosis?

What lab findings are typical of vitamin D deficiency?

A patient has elevated PTH, high calcium, and low phosphate. What is the cause?

What bone disorder is caused by vitamin D deficiency in adults?

What is the best initial treatment for severe hypercalcemia?

What electrolyte abnormality increases the risk of tetany and Chvostek sign?

What lab abnormality is often seen with hypomagnesemia-induced hypocalcemia?

What is the most common cause of hypercalcemia in hospitalized patients?

A 42-year-old woman presents with central obesity, moon face, and easy bruising. Her 24-hour urinary cortisol is elevated. What is the most likely diagnosis?

Which of the following tests helps differentiate the cause of Cushing syndrome?

A patient with suspected Cushing disease has low ACTH and high cortisol. What is the most likely source?

A 25-year-old man has hyperpigmentation, fatigue, and hypotension. Labs show low sodium, high potassium, and low cortisol. What is the likely diagnosis?

What is the best initial test for adrenal insufficiency?

A patient has recurrent episodes of palpitations, headache, and sweating. What is the best initial test?

What is the preoperative management for pheochromocytoma?

A patient with pheochromocytoma undergoes adrenalectomy. What is the most common postoperative complication?

A 60-year-old man has flushing, diarrhea, and bronchospasm. 5-HIAA in urine is elevated. What is the diagnosis?

Which nutrient is required for serotonin synthesis in carcinoid tumors and becomes deficient?

What hormone is overproduced in carcinoid tumors?

A 34-year-old man with hypertension is found to have adrenal mass. Plasma aldosterone/renin ratio is elevated. What is the next step?

A 16-year-old girl with delayed puberty and hypertension is found to have low cortisol and androgens. Which enzyme deficiency is responsible?

A 6-year-old boy with precocious puberty has hypertension and low renin. Labs show low cortisol and high androgens. What is the most likely enzyme deficiency?

A patient with Addison’s disease is brought to the ED with hypotension, abdominal pain, and vomiting. What is the best immediate management?

A 45-year-old patient with HTN and unexplained hypokalemia is suspected to have primary hyperaldosteronism. What lab ratio supports the diagnosis?

A 35-year-old woman with Cushing syndrome has low ACTH and imaging shows adrenal mass. What is the most appropriate treatment?

A 22-year-old male with ambiguous genitalia and HTN is diagnosed with congenital adrenal hyperplasia. Which form is likely?

Which of the following is characteristic of an adrenal incidentaloma that should be removed surgically?

A patient with chronic corticosteroid use abruptly stops medication. What is the most likely complication?

A 45-year-old man has enlarged hands, coarse facial features, and joint pain. IGF-1 is elevated. What is the most likely diagnosis?

What test confirms acromegaly after elevated IGF-1 is detected?

What is the first-line treatment for acromegaly due to pituitary adenoma?

A 50-year-old woman presents with excessive thirst and urination. Labs show high sodium and low urine osmolality. What is the most likely diagnosis?

A water deprivation test fails to concentrate urine, but desmopressin increases urine osmolality. What is the diagnosis?

What is the most common cause of central diabetes insipidus?

A patient with bipolar disorder develops polyuria and dilute urine unresponsive to desmopressin. What is the diagnosis?

A hospitalized patient is found to have hyponatremia, low serum osmolality, and inappropriately concentrated urine. What is the diagnosis?

What is the most appropriate initial treatment for asymptomatic SIADH-induced hyponatremia?

What is a potential complication of rapid correction of chronic hyponatremia?

A 28-year-old woman presents with galactorrhea and amenorrhea. Her serum prolactin is elevated. What is the most appropriate next step?

What is the first-line treatment for a prolactin-secreting pituitary adenoma?

A patient with a pituitary macroadenoma develops fatigue, hypotension, and decreased libido. What condition is likely?

A boy with short stature has delayed bone age compared to chronological age. What is the most likely cause?

A 13-year-old boy is tall with early secondary sexual characteristics and advanced bone age. What is the most likely cause?

A 10-year-old girl with short stature and delayed bone age is found to have high TSH and low T4. What is the most likely diagnosis?

What lab is most useful in screening for growth hormone deficiency in children?

What is the next step in a child with short stature, delayed bone age, and low IGF-1?

A child with suspected Turner syndrome has short stature and normal bone age. What is the first diagnostic test?

A 15-year-old girl has delayed puberty and decreased height velocity. Bone age is 11 years. What does this suggest?

A 52-year-old woman reports irregular periods, hot flashes, and night sweats. FSH is elevated. What is the most likely diagnosis?

What is the most effective treatment for vasomotor symptoms (hot flashes) in menopause?

Which of the following is a contraindication to HRT in menopause?

A 50-year-old woman is started on HRT. What is the primary risk in women with a uterus receiving unopposed estrogen?

A postmenopausal woman on HRT complains of breast tenderness. What is the most likely cause?

What bone-related benefit does HRT provide in postmenopausal women?

A 47-year-old woman has menopausal symptoms but irregular menses. What is the most likely hormonal pattern?

A 53-year-old woman without a uterus wants HRT. What regimen is most appropriate?

What is the best non-hormonal therapy for vasomotor symptoms in a woman with breast cancer history?

A 51-year-old woman has vaginal dryness and dyspareunia post-menopause. What is the most appropriate treatment?

A 19-year-old male presents with small testes, gynecomastia, and tall stature. Karyotype is 47,XXY. What is the diagnosis?

A male athlete using anabolic steroids presents with testicular atrophy and low LH. What is the most likely mechanism?

A 35-year-old male has infertility and low testosterone. LH and FSH are high. What is the most likely diagnosis?

Which of the following is a long-term risk of anabolic steroid abuse?

A female athlete develops hirsutism, deep voice, and amenorrhea. She admits to using "supplements." What is the most likely diagnosis?

What is the best test to assess bioavailable testosterone in a hypogonadal man?

A 17-year-old male presents with delayed puberty, low LH/FSH, and anosmia. What is the diagnosis?

What is a distinguishing lab pattern in secondary hypogonadism?

A bodybuilder using testosterone develops gynecomastia. What is the most likely mechanism?

A 30-year-old woman has irregular periods, acne, and hirsutism. Labs show elevated LH:FSH ratio. What is the most likely diagnosis?

A 45-year-old woman presents with a 2.5 cm thyroid nodule. Her TSH is normal. What is the best next step?

A 35-year-old woman has a thyroid nodule and low TSH. What is the next best step?

A 1.2 cm solid hypoechoic thyroid nodule with irregular margins is found on ultrasound. TSH is normal. What is the best next step?

A 0.8 cm thyroid nodule is found incidentally. It is spongiform with no suspicious features. What is the next best step?

A patient with a 1.8 cm thyroid nodule has an FNA showing Bethesda III (atypia of undetermined significance). What is the best next step?

A patient with a history of radiation exposure in childhood presents with a firm thyroid nodule. What is the best next step?

A thyroid nodule FNA shows papillary carcinoma. What is the next best step?

A 60-year-old woman has a 4 cm thyroid nodule. Ultrasound shows coarse calcifications and irregular margins. What is the best next step?

A 35-year-old woman has a “hot” thyroid nodule with suppressed TSH. What is the best next step?

A 2.5 cm isoechoic thyroid nodule has smooth margins and no calcifications. TSH is normal. What is the best next step?

A 4-year-old child presents with chronic mouth breathing, nasal congestion, and a hyponasal voice. Physical exam reveals adenoid facies. What is the most appropriate diagnostic test?

A diabetic patient presents with severe otalgia and purulent discharge. On exam, granulation tissue is visible in the external auditory canal. What is the most appropriate next step?

A 7-year-old presents with recurrent tonsillitis. He has had 8 episodes in the past year. What is the next best step?

A patient with sleep apnea and tonsillar hypertrophy undergoes polysomnography. What is the most definitive management?

A swimmer develops pain on moving the ear, with an edematous canal and pruritus. What is the likely organism?

A man with allergic rhinitis reports sneezing, nasal congestion, and itchy eyes. What is the pathophysiology?

A 30-year-old singer presents with hoarseness for 2 weeks. No fever or pain. What is the most likely cause?

A 65-year-old presents with recurrent sinus infections and nasal crusting. CT reveals sinus opacification. What is the best next step?