NRNP 6531 Primary Care of Adults Across the Lifespan Practice Test

NRNP 6531 Primary Care of Adults Across the Lifespan Practice Test

 

Which of the following is the first step in diagnosing an adult patient with acute asthma exacerbation?

A) Administering corticosteroids
B) Performing spirometry
C) Obtaining a complete blood count (CBC)
D) Initiating oxygen therapy

 

A 50-year-old patient presents with fatigue, weight gain, and constipation. The nurse practitioner suspects hypothyroidism. What is the most appropriate next step in diagnosis?

A) Thyroid ultrasound
B) TSH and free T4 levels
C) Thyroid biopsy
D) Radioactive iodine uptake test

 

Which of the following is a first-line treatment for hypertension in a middle-aged patient with no other comorbidities?

A) Calcium channel blockers
B) ACE inhibitors
C) Thiazide diuretics
D) Beta-blockers

 

A 45-year-old male with a history of smoking and hypertension presents with chest pain. What is the most critical diagnostic tool to use?

A) Chest X-ray
B) Electrocardiogram (ECG)
C) Pulmonary function tests
D) Arterial blood gases (ABG)

 

A 65-year-old diabetic patient is experiencing numbness and tingling in their feet. What is the most likely diagnosis?

A) Diabetic neuropathy
B) Carpal tunnel syndrome
C) Multiple sclerosis
D) Sciatica

 

For a 30-year-old female patient with depression and no history of psychiatric disorders, what initial approach is recommended?

A) Immediate psychiatric hospitalization
B) Referral for psychodynamic therapy
C) Initiating selective serotonin reuptake inhibitors (SSRIs)
D) Cognitive-behavioral therapy (CBT)

 

A 60-year-old patient with a history of osteoarthritis reports joint pain and stiffness in the knees. What is the most appropriate first-line treatment?

A) Methotrexate
B) NSAIDs
C) Corticosteroid injection
D) Antirheumatic drugs

 

Which of the following interventions is most appropriate for a 50-year-old patient with newly diagnosed type 2 diabetes?

A) Initiating insulin therapy immediately
B) Educating the patient on lifestyle changes and monitoring blood sugar
C) Prescribing sulfonylureas
D) Referral for bariatric surgery

 

A 40-year-old male presents with symptoms of severe abdominal pain, nausea, and vomiting after consuming fatty foods. What is the most likely diagnosis?

A) Appendicitis
B) Acute pancreatitis
C) Peptic ulcer disease
D) Gallbladder disease

 

In the management of chronic obstructive pulmonary disease (COPD), which of the following interventions should be prioritized for all patients?

A) Oral corticosteroids
B) Long-acting bronchodilators
C) Oxygen therapy
D) Smoking cessation

 

A 70-year-old female presents with unintentional weight loss, fatigue, and a persistent cough. What diagnostic test should be performed first?

A) Chest X-ray
B) Computed tomography (CT) scan of the chest
C) Sputum culture
D) Pulmonary function test

 

What is the most common cause of acute lower back pain in adults?

A) Spinal tumors
B) Muscle strain
C) Herniated disc
D) Ankylosing spondylitis

 

A 55-year-old woman with a history of alcohol use presents with confusion, ataxia, and nystagmus. What is the most likely diagnosis?

A) Wernicke’s encephalopathy
B) Stroke
C) Seizure
D) Delirium tremens

 

Which of the following medications is commonly used in the management of benign prostatic hyperplasia (BPH)?

A) Alpha-blockers
B) Beta-blockers
C) Proton pump inhibitors
D) Corticosteroids

 

For an adult patient with newly diagnosed hyperlipidemia, which of the following is the most appropriate first step?

A) Initiating statin therapy
B) Dietary modifications and exercise
C) Referral to a cardiologist
D) Administering niacin

 

Which vaccine should be administered to an adult patient aged 65 or older to prevent pneumococcal pneumonia?

A) MMR vaccine
B) Tdap vaccine
C) PCV13 vaccine
D) Shingles vaccine

 

A 60-year-old male presents with sudden-onset weakness in his right arm and slurred speech. What is the most critical next step?

A) Administer aspirin
B) Immediate referral to neurology
C) Perform a CT scan of the brain
D) Start intravenous fluids

 

What is the first-line treatment for a 35-year-old female with uncomplicated urinary tract infection (UTI)?

A) Ciprofloxacin
B) Nitrofurantoin
C) Amoxicillin
D) Trimethoprim-sulfamethoxazole

 

For a patient with a history of migraine headaches, which of the following is most appropriate for acute treatment?

A) Opioids
B) Triptans
C) Antidepressants
D) Antihypertensives

 

A 45-year-old female with a history of rheumatoid arthritis presents with fatigue, joint pain, and morning stiffness. Which test is most likely to aid in the diagnosis?

A) ESR and CRP levels
B) Rheumatoid factor
C) CBC with differential
D) X-ray of the affected joints

 

What is the best initial treatment for an adult patient presenting with acute otitis media?

A) Oral antibiotics
B) Warm compresses
C) Intravenous antibiotics
D) Pain management and observation

 

For an adult patient diagnosed with osteoporosis, which of the following is a recommended lifestyle change?

A) Increase calcium intake
B) Reduce physical activity
C) Avoid weight-bearing exercises
D) Start hormone replacement therapy

 

Which of the following is an appropriate screening test for colorectal cancer in an average-risk 50-year-old patient?

A) Colonoscopy every 10 years
B) Flexible sigmoidoscopy every 5 years
C) Annual fecal occult blood test (FOBT)
D) CT colonography every 5 years

 

A 55-year-old male with a history of chronic smoking presents with a productive cough and hemoptysis. What is the most appropriate next step in diagnosis?

A) Chest X-ray
B) Sputum culture
C) Bronchoscopy
D) Pulmonary function tests

 

Which of the following is the best initial approach to managing an adult patient with acute gout?

A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Colchicine
C) Corticosteroids
D) Allopurinol

 

Which of the following is a common sign of diabetes mellitus type 2 in adults?

A) Weight loss
B) Polyphagia, polydipsia, polyuria
C) Increased energy levels
D) Severe muscle weakness

 

A 40-year-old female presents with dyspnea and a dry cough. Chest X-ray shows a left-sided pleural effusion. What is the most likely diagnosis?

A) Pneumonia
B) Pulmonary embolism
C) Lung cancer
D) Congestive heart failure

 

For a 60-year-old male with mild depression and no previous psychiatric history, which is the first-line treatment?

A) Antidepressant medication
B) Psychotherapy
C) Electroconvulsive therapy (ECT)
D) Referral to a psychiatrist

 

A 30-year-old patient presents with an unexplained weight gain and increased facial hair. What is the most likely diagnosis?

A) Cushing’s syndrome
B) Polycystic ovary syndrome (PCOS)
C) Hypothyroidism
D) Adrenal insufficiency

 

A 50-year-old male presents with severe abdominal pain, vomiting, and distension. What is the most appropriate initial diagnostic tool?

A) Abdominal X-ray
B) CT scan of the abdomen
C) Serum electrolytes
D) Urinalysis

 

 

A 35-year-old male presents with fatigue, palpitations, and weight loss. His thyroid function tests show low TSH and elevated T3 and T4. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Thyroiditis
D) Thyroid cancer

 

Which of the following is the most appropriate first-line treatment for a patient with acute exacerbation of chronic asthma?

A) Oral corticosteroids
B) Antibiotics
C) Beta-blockers
D) Inhaled short-acting beta-agonist (SABA)

 

A 60-year-old patient with a history of diabetes mellitus and hypertension presents with chest pain and diaphoresis. What is the priority diagnostic test?

A) Serum lipids
B) Electrocardiogram (ECG)
C) Chest X-ray
D) Echocardiogram

 

For a patient with a history of depression who has not responded to SSRIs, which of the following medications is an alternative option for treatment?

A) Tricyclic antidepressants
B) Antipsychotic medications
C) Beta-blockers
D) Benzodiazepines

 

A 50-year-old female presents with vaginal bleeding and pelvic pain after menopause. What is the most appropriate next step in diagnosis?

A) Pelvic ultrasound
B) Endometrial biopsy
C) Pap smear
D) CT scan of the abdomen

 

What is the most common cause of acute viral pharyngitis in adults?

A) Influenza virus
B) Adenovirus
C) Epstein-Barr virus
D) Streptococcus pyogenes

 

A 45-year-old male with a history of smoking and chronic cough presents with a productive cough and shortness of breath. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Tuberculosis
C) Pneumonia
D) Asthma

 

In the management of hypertension in a patient with chronic kidney disease, which of the following medications is recommended?

A) ACE inhibitors
B) Calcium channel blockers
C) Diuretics
D) Beta-blockers

 

A 30-year-old woman presents with severe cramping and heavy menstrual bleeding. She has a history of pelvic pain. What is the most likely diagnosis?

A) Endometriosis
B) Uterine fibroids
C) Ovarian cysts
D) Polycystic ovary syndrome (PCOS)

 

Which of the following is a primary prevention strategy for cardiovascular disease in a 40-year-old patient with a family history of heart disease?

A) Statin therapy
B) Blood pressure control
C) Smoking cessation
D) Coronary angioplasty

 

A 75-year-old female presents with confusion and difficulty speaking. Her medical history includes hypertension and diabetes. What is the most likely diagnosis?

A) Stroke
B) Sepsis
C) Alzheimer’s disease
D) Hypoglycemia

 

A 40-year-old female presents with an itchy, erythematous rash on her hands and feet. She reports exposure to poison ivy during a camping trip. What is the most appropriate treatment?

A) Oral corticosteroids
B) Topical hydrocortisone cream
C) Antihistamines
D) Oral antibiotics

 

A 60-year-old male presents with difficulty swallowing and regurgitation of food. What is the most appropriate diagnostic test?

A) Upper gastrointestinal endoscopy
B) Barium swallow
C) Abdominal ultrasound
D) Esophageal manometry

 

A 25-year-old female presents with symptoms of fatigue, cold intolerance, and dry skin. What lab test should be ordered first to evaluate thyroid function?

A) Free T4
B) TSH
C) Total T3
D) Antithyroid antibodies

 

What is the most appropriate first-line treatment for a patient with mild to moderate community-acquired pneumonia?

A) Oral azithromycin
B) IV ceftriaxone
C) Oral doxycycline
D) Oral amoxicillin

 

A 55-year-old male presents with pain and tenderness in his elbow after playing tennis. He reports difficulty extending his arm. What is the most likely diagnosis?

A) Tennis elbow (lateral epicondylitis)
B) Bursitis
C) Carpal tunnel syndrome
D) Rotator cuff injury

 

A 70-year-old patient with a history of hypertension and smoking presents with new-onset abdominal pain and a pulsatile mass in the abdomen. What is the most likely diagnosis?

A) Abdominal aortic aneurysm
B) Acute pancreatitis
C) Diverticulitis
D) Peptic ulcer disease

 

A 40-year-old male presents with a history of heartburn, regurgitation, and a sour taste in his mouth, especially after meals. What is the first-line treatment?

A) Proton pump inhibitors (PPIs)
B) H2 blockers
C) Antacids
D) Surgery

 

What is the most common cause of secondary hypertension in a young adult?

A) Hyperthyroidism
B) Pheochromocytoma
C) Renal artery stenosis
D) Obstructive sleep apnea

 

A 65-year-old patient with a history of osteoporosis presents with sudden-onset back pain after lifting a heavy object. What is the most likely diagnosis?

A) Osteoporotic fracture
B) Herniated disc
C) Spinal tumor
D) Sciatica

 

A 50-year-old male presents with yellowing of the skin, fatigue, and dark urine. What lab test should be ordered first to evaluate liver function?

A) Liver enzymes (ALT, AST)
B) Total bilirubin
C) Hepatitis panel
D) Serum albumin

 

Which of the following is an appropriate pharmacologic treatment for a patient with newly diagnosed generalized anxiety disorder (GAD)?

A) Antidepressants (SSRIs or SNRIs)
B) Benzodiazepines
C) Antipsychotics
D) Antihistamines

 

A 70-year-old female presents with urinary incontinence and frequent nocturia. What is the most appropriate first-line treatment for overactive bladder?

A) Bladder training
B) Anticholinergic medications
C) Beta-blockers
D) Diuretics

 

A 45-year-old male presents with chronic lower back pain that radiates down his leg. What is the most likely diagnosis?

A) Sciatica
B) Lumbar strain
C) Spinal stenosis
D) Herniated disc

 

A 50-year-old patient presents with swelling, redness, and warmth in his big toe joint. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Rheumatoid arthritis
D) Septic arthritis

 

Which of the following is an essential aspect of managing a patient with chronic heart failure?

A) Limiting fluid intake
B) Strict bed rest
C) Smoking cessation
D) Immediate use of diuretics

 

A 40-year-old female presents with a dry cough, night sweats, and unintentional weight loss. What is the most appropriate next step in diagnosis?

A) Chest X-ray
B) Sputum culture for tuberculosis
C) Computed tomography (CT) scan of the chest
D) Pulmonary function test

 

Which of the following is the first-line treatment for a patient with acute viral gastroenteritis?

A) Intravenous fluids
B) Oral rehydration therapy
C) Antibiotics
D) Anti-diarrheal medications

 

A 30-year-old male presents with a rash and systemic symptoms such as fever and joint pain. He also reports recent travel to an endemic area. What is the most likely diagnosis?

A) Dengue fever
B) Systemic lupus erythematosus (SLE)
C) Chickenpox
D) Measles

 

Which of the following is a common complication of untreated hypertension?

A) Hyperthyroidism
B) Stroke
C) Glaucoma
D) Osteoporosis

 

 

A 60-year-old male with a history of hypertension presents with sudden-onset weakness on one side of his body, difficulty speaking, and dizziness. What is the most likely diagnosis?

A) Transient ischemic attack (TIA)
B) Stroke
C) Seizure
D) Multiple sclerosis

 

A 40-year-old female presents with a painless lump in her breast. She is asymptomatic and has no family history of breast cancer. What is the most appropriate next step in management?

A) Mammogram
B) Breast ultrasound
C) Fine needle aspiration
D) Biopsy

 

A 50-year-old male with a history of smoking presents with a chronic cough, wheezing, and difficulty breathing. Pulmonary function tests show a reduced FEV1/FVC ratio. What is the most likely diagnosis?

A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Bronchitis
D) Pneumonia

 

A 45-year-old female presents with fatigue, weight gain, and constipation. Her TSH levels are elevated, and free T4 levels are low. What is the most likely diagnosis?

A) Hyperthyroidism
B) Hypothyroidism
C) Thyroid cancer
D) Graves’ disease

 

A 30-year-old male presents with a red, painful, swollen joint at his big toe. What is the most likely diagnosis?

A) Osteoarthritis
B) Gout
C) Rheumatoid arthritis
D) Psoriatic arthritis

 

A 50-year-old male presents with a history of progressive dyspnea, dry cough, and clubbing of the fingers. Chest X-ray shows bilateral interstitial markings. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Pulmonary fibrosis
C) Pneumonia
D) Lung cancer

 

A 65-year-old female presents with an episode of severe chest pain, shortness of breath, and diaphoresis. What is the first diagnostic test to perform?

A) Chest X-ray
B) Electrocardiogram (ECG)
C) Cardiac enzyme tests
D) Stress test

 

A 75-year-old male presents with weight loss, fatigue, and difficulty swallowing. He reports a history of smoking. What is the most likely diagnosis?

A) Esophageal cancer
B) Gastroesophageal reflux disease (GERD)
C) Achalasia
D) Peptic ulcer disease

 

A 40-year-old female presents with joint pain and swelling in her hands and wrists. She also reports morning stiffness lasting for more than an hour. What is the most likely diagnosis?

A) Osteoarthritis
B) Rheumatoid arthritis
C) Lupus
D) Gout

 

A 60-year-old male presents with a history of severe right-sided chest pain, which worsens with deep breathing and coughing. What is the most likely diagnosis?

A) Pneumonia
B) Pulmonary embolism
C) Costochondritis
D) Acute myocardial infarction

 

A 50-year-old female presents with recurrent headaches, nausea, and vomiting. Her blood pressure is 170/100 mm Hg. What is the most appropriate next step in management?

A) Administer a beta-blocker
B) Prescribe a calcium channel blocker
C) Perform a funduscopic exam
D) Start an ACE inhibitor

 

A 45-year-old male presents with intermittent abdominal pain, bloating, and diarrhea. His symptoms are triggered by stress. What is the most likely diagnosis?

A) Irritable bowel syndrome (IBS)
B) Celiac disease
C) Peptic ulcer disease
D) Crohn’s disease

 

A 50-year-old male presents with a 6-month history of diarrhea, weight loss, and fatigue. Stool tests show blood and fat. What is the most likely diagnosis?

A) Crohn’s disease
B) Ulcerative colitis
C) Celiac disease
D) Colorectal cancer

 

A 65-year-old female with a history of osteoporosis presents with a history of recent falls and fractures. Which of the following is the most appropriate treatment?

A) Bisphosphonates
B) Calcium supplements only
C) Vitamin D supplements only
D) Exercise therapy

 

A 70-year-old female presents with confusion, urinary incontinence, and difficulty walking. What is the most likely diagnosis?

A) Dementia
B) Parkinson’s disease
C) Normal pressure hydrocephalus
D) Stroke

 

A 50-year-old male presents with episodic palpitations, dizziness, and a racing heart. His ECG shows a narrow complex tachycardia with a regular rhythm. What is the most likely diagnosis?

A) Atrial fibrillation
B) Paroxysmal supraventricular tachycardia (PSVT)
C) Ventricular tachycardia
D) Premature ventricular contractions

 

A 40-year-old female presents with abdominal bloating, fatigue, and joint pain. Her blood tests show elevated transglutaminase antibodies. What is the most likely diagnosis?

A) Crohn’s disease
B) Celiac disease
C) Irritable bowel syndrome
D) Gallstones

 

A 60-year-old male presents with new-onset confusion and an inability to concentrate. He has a history of diabetes mellitus and hypertension. What is the most likely cause of his symptoms?

A) Hyperglycemia
B) Hypertension
C) Alzheimer’s disease
D) Hypoxia

 

A 35-year-old female presents with a complaint of frequent, painful urination, along with lower abdominal discomfort. Urinalysis shows positive leukocyte esterase and nitrites. What is the most likely diagnosis?

A) Urinary tract infection (UTI)
B) Interstitial cystitis
C) Pyelonephritis
D) Bladder cancer

 

A 60-year-old male presents with recent-onset depression, insomnia, and weight loss. His thyroid function tests are normal, but he has a family history of depression. What is the most appropriate next step in treatment?

A) Cognitive-behavioral therapy
B) Antidepressant medications
C) Electroconvulsive therapy (ECT)
D) Thyroid replacement therapy

 

A 45-year-old female presents with persistent heartburn despite using over-the-counter antacids. What is the most appropriate next step in management?

A) Referral for endoscopy
B) Prescribe proton pump inhibitors (PPIs)
C) Advise weight loss
D) Start H2 blockers

 

A 70-year-old female with a history of osteoarthritis presents with new pain and swelling in her left knee. What is the most likely diagnosis?

A) Osteoarthritis flare
B) Rheumatoid arthritis
C) Gout
D) Bursitis

 

A 55-year-old male with a history of hypertension presents with dizziness, headache, and visual changes. His blood pressure is 210/120 mm Hg. What is the most likely diagnosis?

A) Hypertensive crisis
B) Stroke
C) Acute glaucoma
D) Anemia

 

A 65-year-old male presents with a 6-month history of worsening shortness of breath and fatigue. Physical examination reveals a loud S3 heart sound and bilateral crackles. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Congestive heart failure
C) Pulmonary fibrosis
D) Pneumonia

 

A 45-year-old female presents with an itchy, red rash on her hands and feet after camping in a wooded area. What is the most likely cause of her symptoms?

A) Poison ivy exposure
B) Fungal infection
C) Contact dermatitis
D) Eczema

 

A 30-year-old male presents with a painless ulcer on his genital area. He reports a recent unprotected sexual encounter. What is the most likely diagnosis?

A) Genital herpes
B) Syphilis
C) Chlamydia
D) Gonorrhea

 

A 40-year-old female presents with chronic constipation and bloating. Her colonoscopy shows diverticulosis. What is the most appropriate treatment?

A) High-fiber diet
B) Antibiotics
C) Steroids
D) Surgery

 

A 55-year-old female presents with intermittent, sharp chest pain and palpitations. An ECG shows normal sinus rhythm and no significant findings. What is the most likely cause of her symptoms?

A) Gastroesophageal reflux disease (GERD)
B) Costochondritis
C) Coronary artery disease
D) Panic attacks

 

A 50-year-old male presents with a red, swollen, and painful knee joint. He reports no trauma, but he has a history of gout. What is the most appropriate next step in treatment?

A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Joint aspiration
C) Corticosteroid injection
D) Antibiotics

 

A 35-year-old female presents with complaints of fatigue, weight loss, and hyperpigmentation of her skin. She has a history of autoimmune disease. What is the most likely diagnosis?

A) Addison’s disease
B) Graves’ disease
C) Cushing’s syndrome
D) Hypothyroidism

 

 

A 50-year-old male with a history of smoking presents with a chronic cough, weight loss, and hemoptysis. A chest X-ray shows a mass in the upper lobe. What is the most likely diagnosis?

A) Tuberculosis
B) Lung cancer
C) Pulmonary embolism
D) Pneumonia

 

A 40-year-old female presents with a painful, swollen joint in her left knee. She has a history of recent illness with fever and a sore throat. What is the most likely cause of her symptoms?

A) Rheumatoid arthritis
B) Gout
C) Septic arthritis
D) Reactive arthritis

 

A 65-year-old male with a history of diabetes presents with new-onset confusion, agitation, and slurred speech. His blood glucose level is 350 mg/dL. What is the most likely diagnosis?

A) Diabetic ketoacidosis
B) Hyperosmolar hyperglycemic state
C) Hypoglycemia
D) Stroke

 

A 60-year-old female presents with a history of constipation, abdominal pain, and bloating. She reports the symptoms have been worsening over the past few months. What is the most appropriate next step in evaluation?

A) Colonoscopy
B) Barium swallow
C) Abdominal ultrasound
D) CT scan of the abdomen

 

A 50-year-old male presents with a 3-month history of heartburn, regurgitation, and difficulty swallowing. He reports his symptoms are worse at night. What is the most likely diagnosis?

A) Peptic ulcer disease
B) Gastroesophageal reflux disease (GERD)
C) Hiatal hernia
D) Esophageal cancer

 

A 75-year-old female with a history of dementia presents with sudden-onset confusion, fever, and dysuria. What is the most likely cause of her symptoms?

A) Stroke
B) Urinary tract infection (UTI)
C) Acute coronary syndrome
D) Delirium due to medications

 

A 40-year-old female presents with a history of chronic headaches, dizziness, and neck pain. She also has a history of anxiety. What is the most likely cause of her symptoms?

A) Cervical spondylosis
B) Tension headaches
C) Migraines
D) Hypertension

 

A 55-year-old male presents with a 6-month history of progressive difficulty swallowing solids and liquids, along with unexplained weight loss. What is the most appropriate next step in evaluation?

A) Barium swallow
B) Endoscopy with biopsy
C) CT scan of the chest
D) Esophageal manometry

 

A 45-year-old female presents with intermittent abdominal pain, diarrhea, and a change in bowel habits. Her symptoms are often triggered by stress. What is the most likely diagnosis?

A) Irritable bowel syndrome (IBS)
B) Inflammatory bowel disease (IBD)
C) Celiac disease
D) Lactose intolerance

 

A 60-year-old male presents with new-onset chest pain, dyspnea, and a history of deep vein thrombosis. What is the most likely diagnosis?

A) Pulmonary embolism
B) Myocardial infarction
C) Pneumothorax
D) Aortic dissection

 

A 50-year-old female with a history of hypertension presents with shortness of breath, orthopnea, and swelling of the lower extremities. What is the most likely diagnosis?

A) Congestive heart failure
B) Chronic obstructive pulmonary disease (COPD)
C) Pulmonary embolism
D) Asthma

 

A 60-year-old female presents with dry mouth, difficulty swallowing, and a sensation of a lump in her throat. What is the most likely diagnosis?

A) GERD
B) Sjorgren’s syndrome
C) Hypothyroidism
D) Achalasia

 

A 45-year-old male presents with low back pain that radiates down his left leg. The pain is worse with prolonged sitting and standing. What is the most likely diagnosis?

A) Herniated disc
B) Osteoarthritis
C) Rheumatoid arthritis
D) Spondylolisthesis

 

A 70-year-old male presents with a sudden onset of severe chest pain radiating to his back. He has a history of hypertension. What is the most likely diagnosis?

A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis

 

A 45-year-old female presents with a history of excessive thirst, frequent urination, and blurred vision. What is the most likely diagnosis?

A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Hyperthyroidism
D) Diabetes insipidus

 

A 60-year-old male presents with pain and swelling in his knee after an injury. He reports difficulty with weight-bearing. What is the most appropriate diagnostic test?

A) X-ray of the knee
B) MRI of the knee
C) Ultrasound of the knee
D) Joint aspiration

 

A 45-year-old female presents with a 2-week history of cough, fever, and fatigue. Chest X-ray shows consolidation in the right lower lobe. What is the most likely diagnosis?

A) Acute bronchitis
B) Pneumonia
C) Tuberculosis
D) Chronic obstructive pulmonary disease (COPD)

 

A 55-year-old male presents with pain and stiffness in his shoulders and hips. His symptoms are worse in the morning and improve with activity. What is the most likely diagnosis?

A) Rheumatoid arthritis
B) Polymyalgia rheumatica
C) Osteoarthritis
D) Gout

 

A 40-year-old female presents with frequent episodes of dizziness and lightheadedness upon standing. She also reports fatigue. What is the most likely diagnosis?

A) Orthostatic hypotension
B) Anemia
C) Hyperthyroidism
D) Hypoglycemia

 

A 50-year-old male presents with sudden-onset severe abdominal pain, vomiting, and fever. He has a history of alcohol use and epigastric pain. What is the most likely diagnosis?

A) Acute pancreatitis
B) Gallstones
C) Peptic ulcer disease
D) Appendicitis

 

 

A 55-year-old male with a history of chronic alcohol use presents with confusion, ataxia, and nystagmus. What is the most likely diagnosis?

A) Delirium tremens
B) Wernicke’s encephalopathy
C) Hypoglycemia
D) Stroke

 

A 45-year-old female presents with a history of intermittent abdominal pain, diarrhea, and weight loss. She also reports fatigue and joint pain. What is the most likely diagnosis?

A) Crohn’s disease
B) Irritable bowel syndrome
C) Celiac disease
D) Ulcerative colitis

 

A 70-year-old male presents with difficulty urinating, weak urinary stream, and nocturia. His prostate-specific antigen (PSA) level is mildly elevated. What is the most likely diagnosis?

A) Prostate cancer
B) Benign prostatic hyperplasia (BPH)
C) Urinary tract infection
D) Acute prostatitis

 

A 60-year-old female with a history of hypertension presents with sudden-onset visual disturbances, a headache, and dizziness. What is the most likely diagnosis?

A) Stroke
B) Hypertensive emergency
C) Migraine headache
D) Retinal detachment

 

A 50-year-old female presents with fatigue, weight gain, and cold intolerance. Her physical exam reveals dry skin, bradycardia, and coarse hair. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Addison’s disease
D) Chronic fatigue syndrome

 

A 45-year-old male with a history of asthma presents with worsening shortness of breath, wheezing, and chest tightness. He also reports using his inhaler more frequently. What is the most likely diagnosis?

A) Acute asthma exacerbation
B) Chronic obstructive pulmonary disease (COPD)
C) Pneumonia
D) Pulmonary embolism

 

A 35-year-old female presents with fatigue, weight gain, and hirsutism. She has a history of irregular menstrual cycles. What is the most likely diagnosis?

A) Polycystic ovary syndrome (PCOS)
B) Cushing’s syndrome
C) Hypothyroidism
D) Hyperprolactinemia

 

A 55-year-old male presents with a persistent cough, night sweats, and weight loss. He has a history of tuberculosis exposure. What is the most appropriate next step in evaluation?

A) Chest X-ray
B) Sputum culture for acid-fast bacilli
C) CT scan of the chest
D) Bronchoscopy

 

A 40-year-old female presents with a history of severe, bilateral knee pain, stiffness, and swelling, particularly in the mornings. She has a positive rheumatoid factor test. What is the most likely diagnosis?

A) Rheumatoid arthritis
B) Osteoarthritis
C) Gout
D) Systemic lupus erythematosus (SLE)

 

A 25-year-old female presents with new-onset severe, unilateral headache, associated with nausea, photophobia, and phonophobia. What is the most likely diagnosis?

A) Tension headache
B) Cluster headache
C) Migraine headache
D) Sinus headache

 

A 70-year-old male presents with a history of falling, forgetfulness, and confusion. On examination, he has difficulty remembering recent events. What is the most likely diagnosis?

A) Vascular dementia
B) Alzheimer’s disease
C) Delirium
D) Normal aging

 

A 60-year-old female presents with a history of fatigue, muscle weakness, and difficulty climbing stairs. She has a history of a rash across her cheeks. What is the most likely diagnosis?

A) Systemic lupus erythematosus (SLE)
B) Polymyositis
C) Dermatomyositis
D) Rheumatoid arthritis

 

A 55-year-old male presents with progressive difficulty walking, balance problems, and a resting tremor. What is the most likely diagnosis?

A) Alzheimer’s disease
B) Parkinson’s disease
C) Huntington’s disease
D) Multiple sclerosis

 

A 65-year-old female presents with a history of weight loss, palpitations, and excessive sweating. On examination, her thyroid is enlarged. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Graves’ disease
D) Hashimoto’s thyroiditis

 

A 45-year-old male presents with fever, sore throat, and enlarged lymph nodes. His rapid strep test is negative. What is the most likely cause of his symptoms?

A) Epstein-Barr virus (EBV) infection
B) Streptococcus pyogenes
C) Cytomegalovirus (CMV) infection
D) Human immunodeficiency virus (HIV) infection

 

A 55-year-old female presents with a new onset of shortness of breath, fatigue, and a history of swollen ankles. On examination, she has elevated jugular venous pressure and bilateral lower extremity edema. What is the most likely diagnosis?

A) Congestive heart failure
B) Chronic obstructive pulmonary disease
C) Pulmonary embolism
D) Acute myocardial infarction

 

A 50-year-old male presents with a painful, swollen right great toe. He reports that the pain started suddenly in the middle of the night. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Rheumatoid arthritis
D) Psoriatic arthritis

 

A 65-year-old male presents with a history of progressive shortness of breath, especially with exertion. He has a history of smoking. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Pulmonary embolism
D) Pneumonia

 

A 40-year-old female presents with a history of nausea, vomiting, and abdominal pain after eating fatty meals. What is the most likely diagnosis?

A) Peptic ulcer disease
B) Gallstones
C) Acute pancreatitis
D) Gastritis

 

A 70-year-old male presents with sudden-onset weakness, slurred speech, and facial droop. He has a history of hypertension. What is the most likely diagnosis?

A) Stroke
B) Bell’s palsy
C) Hypoglycemia
D) Transient ischemic attack (TIA)

 

 

A 60-year-old male presents with progressive muscle weakness and difficulty getting up from a chair. He has a history of recent upper respiratory tract infection. What is the most likely diagnosis?

A) Guillain-Barré syndrome
B) Myasthenia gravis
C) Muscular dystrophy
D) Amyotrophic lateral sclerosis

 

A 55-year-old female with a history of hypertension presents with severe, sharp chest pain radiating to her back. She reports nausea and difficulty swallowing. What is the most likely diagnosis?

A) Aortic dissection
B) Acute myocardial infarction
C) Gastroesophageal reflux disease (GERD)
D) Pulmonary embolism

 

A 45-year-old male presents with chronic joint pain, morning stiffness, and joint deformities in his fingers. He has a positive anti-cyclic citrullinated peptide (anti-CCP) antibody test. What is the most likely diagnosis?

A) Rheumatoid arthritis
B) Osteoarthritis
C) Systemic lupus erythematosus
D) Psoriatic arthritis

 

A 70-year-old female presents with a gradual onset of difficulty swallowing, hoarseness, and a persistent cough. She has a history of smoking. What is the most likely diagnosis?

A) Esophageal cancer
B) Gastroesophageal reflux disease (GERD)
C) Laryngeal cancer
D) Chronic bronchitis

 

A 40-year-old female presents with recurrent episodes of joint swelling, fever, and a butterfly-shaped rash on her face. What is the most likely diagnosis?

A) Systemic lupus erythematosus (SLE)
B) Rheumatoid arthritis
C) Psoriatic arthritis
D) Sjögren’s syndrome

 

A 60-year-old male presents with gradual onset of difficulty with fine motor skills, including handwriting and buttoning his shirt. He has a history of tremors and rigidity. What is the most likely diagnosis?

A) Parkinson’s disease
B) Multiple sclerosis
C) Alzheimer’s disease
D) Amyotrophic lateral sclerosis (ALS)

 

A 50-year-old male with a history of diabetes presents with a painful, red, swollen left toe. He reports the pain started suddenly at night. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Psoriatic arthritis
D) Rheumatoid arthritis

 

A 65-year-old male with a history of smoking presents with a chronic cough, hemoptysis, and dyspnea on exertion. Chest X-ray shows a mass in the upper lobe of the lung. What is the most likely diagnosis?

A) Lung cancer
B) Pneumonia
C) Tuberculosis
D) Chronic obstructive pulmonary disease (COPD)

 

A 50-year-old female presents with excessive thirst, frequent urination, and blurry vision. Her fasting blood glucose level is 210 mg/dL. What is the most likely diagnosis?

A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Hyperthyroidism
D) Diabetes insipidus

 

A 55-year-old female presents with a persistent cough, dyspnea, and unintentional weight loss. She has a history of smoking. What is the most appropriate next step in diagnosis?

A) Chest X-ray
B) Spirometry
C) Sputum culture
D) Pulmonary function tests

 

A 60-year-old male presents with a history of progressive shortness of breath, especially on exertion. He has a history of smoking. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Pulmonary embolism
C) Pneumothorax
D) Pneumonia

 

A 45-year-old female presents with abdominal pain, bloating, and diarrhea. She also reports a family history of colon cancer. What is the most appropriate next step in evaluation?

A) Colonoscopy
B) Abdominal ultrasound
C) CT scan of the abdomen
D) Stool test for occult blood

 

A 65-year-old female presents with a history of fatigue, weight loss, and increased appetite. Her thyroid is enlarged, and laboratory results show suppressed TSH and elevated free T4. What is the most likely diagnosis?

A) Hyperthyroidism
B) Hypothyroidism
C) Graves’ disease
D) Hashimoto’s thyroiditis

 

A 70-year-old female presents with confusion, difficulty concentrating, and poor short-term memory. She has a history of hypertension and diabetes. What is the most likely diagnosis?

A) Alzheimer’s disease
B) Vascular dementia
C) Delirium
D) Normal aging

 

A 40-year-old male presents with pain, redness, and swelling in his right knee following an injury. He is unable to fully extend the knee. What is the most likely diagnosis?

A) Ligament injury
B) Meniscal tear
C) Patellar dislocation
D) Osteoarthritis

 

A 55-year-old female with a history of hypertension presents with sudden-onset chest pain radiating to her back. She is diaphoretic and nauseous. What is the most likely diagnosis?

A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Acute pericarditis

 

A 45-year-old female presents with shortness of breath, chest tightness, and wheezing, particularly in the early morning. She has a history of seasonal allergies. What is the most likely diagnosis?

A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Bronchitis
D) Pneumonia

 

A 50-year-old male presents with a dull ache in his right upper quadrant. He reports a history of greasy food consumption and occasional indigestion. What is the most likely diagnosis?

A) Gallstones
B) Hepatitis
C) Pancreatitis
D) Peptic ulcer disease

 

A 60-year-old female with a history of hypertension presents with sudden onset of blurred vision, headache, and nausea. What is the most likely diagnosis?

A) Hypertensive emergency
B) Stroke
C) Migraine headache
D) Retinal detachment

 

A 40-year-old male presents with chronic, non-productive cough, shortness of breath, and a history of chronic smoking. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Pneumonia
D) Tuberculosis

 

 

A 65-year-old male presents with a sudden onset of chest pain, shortness of breath, and diaphoresis. He has a history of hypertension and diabetes. What is the most likely diagnosis?

A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Acute pericarditis

 

A 50-year-old female with a history of migraine headaches presents with a new headache that is different in quality and intensity. She also has nausea, vomiting, and visual disturbances. What is the most appropriate next step in evaluation?

A) CT scan of the head
B) MRI of the brain
C) Lumbar puncture
D) Ophthalmologic examination

 

A 40-year-old male presents with sudden-onset severe right lower quadrant pain, fever, and nausea. His white blood cell count is elevated. What is the most likely diagnosis?

A) Acute appendicitis
B) Ectopic pregnancy
C) Ovarian torsion
D) Urinary tract infection

 

A 60-year-old male presents with complaints of chest tightness, especially after exertion. He denies any recent trauma or pain radiating to the left arm. What is the most likely diagnosis?

A) Angina
B) Acute myocardial infarction
C) Aortic dissection
D) Gastroesophageal reflux disease (GERD)

 

A 55-year-old female presents with new-onset fatigue, weight gain, and cold intolerance. Her physical exam reveals dry skin, bradycardia, and coarse hair. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Addison’s disease
D) Cushing’s syndrome

 

A 45-year-old male presents with intermittent abdominal pain, bloating, and diarrhea. His symptoms are relieved by bowel movements. What is the most likely diagnosis?

A) Irritable bowel syndrome
B) Crohn’s disease
C) Ulcerative colitis
D) Celiac disease

 

A 60-year-old male presents with intermittent claudication, especially when walking long distances. He has a history of smoking and diabetes. What is the most likely diagnosis?

A) Peripheral artery disease
B) Deep vein thrombosis
C) Varicose veins
D) Osteoarthritis

 

A 55-year-old female presents with joint pain, particularly in the mornings, along with stiffness and swelling in the fingers. She has a history of rheumatoid arthritis. What is the most appropriate treatment?

A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Methotrexate
C) Acetaminophen
D) Biologic agents

 

A 50-year-old male presents with abdominal pain, diarrhea, and weight loss. He has a history of Crohn’s disease and is non-compliant with his medications. What is the most likely cause of his current symptoms?

A) Flare-up of Crohn’s disease
B) Irritable bowel syndrome
C) Celiac disease
D) Colorectal cancer

 

A 65-year-old female presents with a history of dizziness, fainting spells, and fatigue. Her physical exam reveals a slow heart rate, and her ECG shows sinus bradycardia. What is the most likely diagnosis?

A) Sick sinus syndrome
B) Atrial fibrillation
C) Hypothyroidism
D) Myocardial infarction

 

A 60-year-old male presents with a gradual loss of memory and difficulty with problem-solving and decision-making. His wife reports that he has become increasingly disoriented. What is the most likely diagnosis?

A) Alzheimer’s disease
B) Vascular dementia
C) Delirium
D) Parkinson’s disease

 

A 45-year-old female presents with generalized muscle weakness and difficulty lifting her arms. She has a history of progressive weakness and a rash on her upper chest. What is the most likely diagnosis?

A) Dermatomyositis
B) Systemic lupus erythematosus
C) Myasthenia gravis
D) Polymyositis

 

A 40-year-old female presents with frequent heartburn, regurgitation, and chest pain, particularly after meals. What is the most likely diagnosis?

A) Gastroesophageal reflux disease (GERD)
B) Peptic ulcer disease
C) Gallbladder disease
D) Esophageal cancer

 

A 55-year-old female with a history of diabetes presents with sudden-onset blurry vision and difficulty seeing at night. What is the most likely diagnosis?

A) Diabetic retinopathy
B) Cataracts
C) Glaucoma
D) Macular degeneration

 

A 50-year-old male presents with pain in his left leg after walking short distances. He has a history of smoking and hypertension. What is the most likely diagnosis?

A) Peripheral artery disease
B) Deep vein thrombosis
C) Sciatica
D) Osteoarthritis

 

A 65-year-old male with a history of hypertension presents with new-onset visual disturbances, a headache, and nausea. What is the most likely diagnosis?

A) Hypertensive emergency
B) Stroke
C) Glaucoma
D) Meniere’s disease

 

A 55-year-old female presents with a headache, scalp tenderness, and jaw claudication. She also has a history of weight loss and fever. What is the most likely diagnosis?

A) Temporal arteritis
B) Cluster headache
C) Migraine headache
D) Tension headache

 

A 60-year-old female with a history of hypertension presents with sudden-onset right-sided weakness, facial droop, and speech difficulty. What is the most likely diagnosis?

A) Stroke
B) Transient ischemic attack (TIA)
C) Seizure
D) Bell’s palsy

 

A 45-year-old male presents with fatigue, muscle pain, and a rash on his face. His laboratory results reveal elevated creatine kinase levels and positive antinuclear antibodies (ANA). What is the most likely diagnosis?

A) Systemic lupus erythematosus (SLE)
B) Dermatomyositis
C) Polymyositis
D) Rheumatoid arthritis

 

A 70-year-old female presents with weakness, dizziness, and a history of falling. She also has bilateral lower extremity edema. What is the most likely diagnosis?

A) Congestive heart failure
B) Stroke
C) Peripheral neuropathy
D) Parkinson’s disease

 

 

A 45-year-old female presents with a history of abdominal bloating, diarrhea, and weight loss. Her lab results show positive antibodies to gliadin. What is the most likely diagnosis?

A) Celiac disease
B) Crohn’s disease
C) Irritable bowel syndrome
D) Ulcerative colitis

 

A 50-year-old male presents with fatigue, pale skin, and dizziness. His laboratory results reveal a hemoglobin level of 9.0 g/dL. What is the most likely diagnosis?

A) Iron deficiency anemia
B) Vitamin B12 deficiency anemia
C) Aplastic anemia
D) Hemolytic anemia

 

A 65-year-old male with a history of smoking presents with chronic cough, wheezing, and shortness of breath. Spirometry reveals an FEV1/FVC ratio of less than 70%. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Pulmonary embolism
D) Interstitial lung disease

 

A 55-year-old female presents with episodic dizziness, vertigo, and tinnitus. She has a history of gradual hearing loss. What is the most likely diagnosis?

A) Meniere’s disease
B) Benign paroxysmal positional vertigo (BPPV)
C) Labyrinthitis
D) Vestibular neuritis

 

A 60-year-old male presents with pain and swelling in his left ankle after an injury. The physical exam reveals limited range of motion and tenderness along the anterior talofibular ligament. What is the most likely diagnosis?

A) Ankle sprain
B) Achilles tendon rupture
C) Fracture
D) Tendonitis

 

A 50-year-old female with a history of hypertension and diabetes presents with sudden-onset weakness in the right arm and slurred speech. What is the most likely diagnosis?

A) Stroke
B) Transient ischemic attack (TIA)
C) Seizure
D) Multiple sclerosis

 

A 40-year-old male presents with worsening joint pain and swelling, particularly in his knees and elbows. He has a history of psoriasis. What is the most likely diagnosis?

A) Psoriatic arthritis
B) Rheumatoid arthritis
C) Gout
D) Osteoarthritis

 

A 55-year-old female presents with weight gain, fatigue, and a puffy face. Her lab results show elevated cortisol levels, and she has a rounded “moon face.” What is the most likely diagnosis?

A) Cushing’s syndrome
B) Hypothyroidism
C) Addison’s disease
D) Pheochromocytoma

 

A 65-year-old male presents with blurred vision, eye pain, and redness. He has a history of uncontrolled diabetes. What is the most likely diagnosis?

A) Diabetic retinopathy
B) Cataracts
C) Glaucoma
D) Retinal detachment

 

A 50-year-old female presents with a 3-month history of cough, weight loss, and night sweats. Her chest X-ray shows a cavitary lesion in the upper lobe of the lung. What is the most likely diagnosis?

A) Tuberculosis
B) Pneumonia
C) Lung cancer
D) Aspergillosis

 

A 45-year-old male with a history of alcohol use disorder presents with confusion, tremors, and agitation. He is disoriented and has a temperature of 101°F. What is the most likely diagnosis?

A) Delirium tremens
B) Acute alcohol intoxication
C) Wernicke-Korsakoff syndrome
D) Acute psychosis

 

A 60-year-old female presents with a history of burning sensation in her chest after meals, especially at night. What is the most likely diagnosis?

A) Gastroesophageal reflux disease (GERD)
B) Peptic ulcer disease
C) Cholelithiasis
D) Esophageal cancer

 

A 50-year-old male with a history of smoking presents with a new-onset cough, chest tightness, and difficulty breathing. His spirometry shows an FEV1/FVC ratio of less than 70%. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Pulmonary embolism
D) Pneumothorax

 

A 40-year-old male presents with a severe headache, nausea, and photophobia. His neck is stiff, and he has a positive Brudzinski sign. What is the most likely diagnosis?

A) Meningitis
B) Migraine
C) Tension headache
D) Cluster headache

 

A 60-year-old female presents with memory loss, difficulty concentrating, and poor judgment. She has a history of hypertension and diabetes. What is the most likely diagnosis?

A) Vascular dementia
B) Alzheimer’s disease
C) Normal aging
D) Depression

 

A 65-year-old male presents with difficulty swallowing, regurgitation of food, and a sensation of a lump in his throat. What is the most likely diagnosis?

A) Achalasia
B) Gastroesophageal reflux disease (GERD)
C) Esophageal cancer
D) Hiatal hernia

 

A 45-year-old female presents with a history of dry mouth, dry eyes, and difficulty swallowing. Her lab results show positive anti-Ro and anti-La antibodies. What is the most likely diagnosis?

A) Sjögren’s syndrome
B) Systemic lupus erythematosus
C) Rheumatoid arthritis
D) Scleroderma

 

A 50-year-old male presents with severe pain in his left big toe, swelling, and redness. His serum uric acid levels are elevated. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Psoriatic arthritis
D) Rheumatoid arthritis

 

A 60-year-old female presents with chronic fatigue, muscle weakness, and weight gain. She has a history of hypertension and a recent stress fracture. Her thyroid function tests show an elevated TSH and low free T4. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Cushing’s syndrome
D) Addison’s disease

 

A 55-year-old female presents with polyuria, polydipsia, and weight loss. Her fasting blood glucose is 180 mg/dL. What is the most likely diagnosis?

A) Type 2 diabetes mellitus
B) Type 1 diabetes mellitus
C) Diabetes insipidus
D) Hyperthyroidism

 

 

A 60-year-old male with a history of hypertension and diabetes presents with a persistent dry cough and shortness of breath. His chest X-ray reveals bilateral infiltrates. What is the most likely diagnosis?

A) Heart failure
B) Pulmonary edema
C) Pneumonia
D) Chronic obstructive pulmonary disease (COPD)

 

A 50-year-old female presents with a red, painful, swollen joint in the first metatarsophalangeal joint. Her serum uric acid levels are elevated. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Rheumatoid arthritis
D) Pseudogout

 

A 40-year-old male presents with sudden-onset left-sided weakness and facial droop. He has a history of hypertension and hyperlipidemia. What is the most likely diagnosis?

A) Stroke
B) Transient ischemic attack (TIA)
C) Bell’s palsy
D) Multiple sclerosis

 

A 65-year-old male presents with dysphagia, weight loss, and chronic cough. He has a history of smoking and alcohol use. What is the most likely diagnosis?

A) Esophageal cancer
B) Gastroesophageal reflux disease (GERD)
C) Achalasia
D) Hiatal hernia

 

A 55-year-old female presents with fever, fatigue, and a butterfly-shaped rash over her cheeks. Her laboratory results show positive antinuclear antibodies (ANA) and anti-dsDNA antibodies. What is the most likely diagnosis?

A) Systemic lupus erythematosus
B) Rheumatoid arthritis
C) Dermatomyositis
D) Sjögren’s syndrome

 

A 60-year-old female presents with sudden-onset severe headache, nausea, vomiting, and vision changes. Her blood pressure is 190/100 mmHg. What is the most likely diagnosis?

A) Hypertensive emergency
B) Migraine headache
C) Subarachnoid hemorrhage
D) Cluster headache

 

A 45-year-old female presents with weight loss, sweating, and heat intolerance. Her thyroid function tests show a low TSH and high free T4. What is the most likely diagnosis?

A) Hyperthyroidism
B) Hypothyroidism
C) Cushing’s syndrome
D) Addison’s disease

 

A 55-year-old male presents with sudden onset of chest pain that radiates to the back. His blood pressure is markedly different in each arm. What is the most likely diagnosis?

A) Aortic dissection
B) Acute myocardial infarction
C) Pulmonary embolism
D) Pericarditis

 

A 50-year-old female presents with intermittent upper abdominal pain, bloating, and early satiety. She has a history of gallstones. What is the most likely diagnosis?

A) Cholecystitis
B) Peptic ulcer disease
C) Gastroesophageal reflux disease (GERD)
D) Irritable bowel syndrome

 

A 70-year-old female presents with difficulty walking, tremors, and rigidity. She has a history of depression and cognitive changes. What is the most likely diagnosis?

A) Parkinson’s disease
B) Alzheimer’s disease
C) Multiple sclerosis
D) Huntington’s disease

 

A 65-year-old male with a history of smoking presents with a chronic cough and weight loss. His chest X-ray reveals a mass in the upper lobe of the right lung. What is the most likely diagnosis?

A) Lung cancer
B) Tuberculosis
C) Chronic obstructive pulmonary disease (COPD)
D) Pneumonia

 

A 50-year-old female presents with night sweats, weight loss, and a persistent cough. Her chest X-ray reveals a cavitary lesion. What is the most likely diagnosis?

A) Tuberculosis
B) Pneumonia
C) Lung cancer
D) Sarcoidosis

 

A 45-year-old male with a history of diabetes presents with blurred vision, difficulty reading, and floaters in his left eye. What is the most likely diagnosis?

A) Diabetic retinopathy
B) Cataracts
C) Glaucoma
D) Macular degeneration

 

A 50-year-old male presents with severe lower back pain after lifting a heavy object. He is unable to straighten his back and has pain radiating down his left leg. What is the most likely diagnosis?

A) Lumbar herniated disc
B) Sciatica
C) Osteoarthritis
D) Spondylolisthesis

 

A 40-year-old female presents with a history of unexplained weight gain, menstrual irregularities, and hirsutism. Her blood tests show elevated levels of testosterone and LH. What is the most likely diagnosis?

A) Polycystic ovary syndrome (PCOS)
B) Cushing’s syndrome
C) Hypothyroidism
D) Hyperprolactinemia

 

A 60-year-old male presents with progressive difficulty swallowing, weight loss, and a history of heavy alcohol use. What is the most likely diagnosis?

A) Esophageal cancer
B) Achalasia
C) Gastroesophageal reflux disease (GERD)
D) Gastric cancer

 

A 55-year-old female presents with a history of progressive joint pain, particularly in the hands and wrists, along with morning stiffness. What is the most likely diagnosis?

A) Rheumatoid arthritis
B) Osteoarthritis
C) Gout
D) Psoriatic arthritis

 

A 50-year-old male presents with muscle weakness, cramps, and fatigue. His lab tests reveal a serum potassium level of 2.9 mEq/L. What is the most likely cause of his symptoms?

A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypercalcemia

 

A 60-year-old female with a history of diabetes presents with a new-onset pressure ulcer on her right heel. What is the most appropriate initial management for this wound?

A) Debridement and dressing change
B) Antibiotic therapy
C) Immediate surgical intervention
D) Skin grafting

 

A 55-year-old male presents with sudden-onset chest pain radiating to his left arm. He is diaphoretic, and his blood pressure is low. His ECG shows ST elevation in leads II, III, and aVF. What is the most likely diagnosis?

A) Acute myocardial infarction
B) Unstable angina
C) Pericarditis
D) Pulmonary embolism

 

 

A 45-year-old male presents with frequent urination, especially at night, and difficulty starting his urine stream. His digital rectal exam reveals a firm, enlarged prostate. What is the most likely diagnosis?

A) Benign prostatic hyperplasia (BPH)
B) Prostate cancer
C) Acute prostatitis
D) Urinary tract infection

 

A 65-year-old female presents with shortness of breath, fatigue, and edema in her lower extremities. Her chest X-ray reveals cardiomegaly, and her BNP levels are elevated. What is the most likely diagnosis?

A) Heart failure
B) Chronic obstructive pulmonary disease (COPD)
C) Pulmonary embolism
D) Aortic stenosis

 

A 50-year-old male presents with dysphagia, regurgitation of undigested food, and chest pain. His barium swallow shows a “bird-beak” appearance. What is the most likely diagnosis?

A) Achalasia
B) Gastroesophageal reflux disease (GERD)
C) Esophageal cancer
D) Hiatal hernia

 

A 60-year-old male presents with tremors, bradykinesia, and rigidity. He has a history of depression and sleep disturbances. What is the most likely diagnosis?

A) Parkinson’s disease
B) Alzheimer’s disease
C) Multiple sclerosis
D) Amyotrophic lateral sclerosis (ALS)

 

A 55-year-old female with a history of hypertension and hyperlipidemia presents with sudden-onset severe chest pain, diaphoresis, and nausea. Her ECG shows ST elevation. What is the most likely diagnosis?

A) Acute myocardial infarction
B) Unstable angina
C) Aortic dissection
D) Pericarditis

 

A 50-year-old male presents with severe upper abdominal pain, nausea, and vomiting. His serum amylase and lipase levels are elevated. What is the most likely diagnosis?

A) Acute pancreatitis
B) Peptic ulcer disease
C) Gallbladder disease
D) Gastroesophageal reflux disease (GERD)

 

A 40-year-old female presents with pain and swelling in her left knee after a sports injury. There is bruising and limited range of motion. What is the most likely diagnosis?

A) Knee sprain
B) Torn meniscus
C) Anterior cruciate ligament (ACL) tear
D) Fracture

 

A 45-year-old male presents with a red, painful, swollen joint in his big toe, and his serum uric acid levels are elevated. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Rheumatoid arthritis
D) Pseudogout

 

A 60-year-old male with a history of alcohol use disorder presents with confusion, tremors, and hallucinations. His blood pressure is elevated, and he has a temperature of 100.5°F. What is the most likely diagnosis?

A) Delirium tremens
B) Alcohol intoxication
C) Acute psychosis
D) Wernicke-Korsakoff syndrome

 

A 55-year-old female presents with weight gain, fatigue, constipation, and cold intolerance. Her TSH level is elevated, and free T4 is low. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Cushing’s syndrome
D) Addison’s disease

 

A 50-year-old male with a history of diabetes presents with painful, red, and swollen joints. His serum uric acid levels are normal, and his joint aspiration reveals calcium pyrophosphate crystals. What is the most likely diagnosis?

A) Pseudogout
B) Gout
C) Osteoarthritis
D) Rheumatoid arthritis

 

A 65-year-old female presents with progressive memory loss, confusion, and difficulty performing activities of daily living. Her MRI shows hippocampal atrophy. What is the most likely diagnosis?

A) Alzheimer’s disease
B) Vascular dementia
C) Normal aging
D) Parkinson’s disease

 

A 60-year-old female with a history of hypertension presents with sudden-onset chest pain that radiates to her back. Her blood pressure is significantly different in both arms. What is the most likely diagnosis?

A) Aortic dissection
B) Acute myocardial infarction
C) Pulmonary embolism
D) Pericarditis

 

A 40-year-old male presents with a history of fever, sore throat, and fatigue. He has enlarged, tender lymph nodes, and his monospot test is positive. What is the most likely diagnosis?

A) Infectious mononucleosis
B) Acute bacterial pharyngitis
C) Tonsillitis
D) Influenza

 

A 50-year-old female presents with a history of progressive joint pain, particularly in her knees and hips, and difficulty standing up after sitting for a long period. What is the most likely diagnosis?

A) Osteoarthritis
B) Rheumatoid arthritis
C) Gout
D) Psoriatic arthritis

 

A 60-year-old male presents with difficulty swallowing, a sensation of food sticking in his throat, and chest pain. His barium swallow reveals a “bird-beak” appearance. What is the most likely diagnosis?

A) Achalasia
B) Gastroesophageal reflux disease (GERD)
C) Esophageal cancer
D) Hiatal hernia

 

A 45-year-old female presents with fever, fatigue, and a butterfly-shaped rash across her face. Her laboratory tests show a positive ANA and elevated anti-dsDNA antibodies. What is the most likely diagnosis?

A) Systemic lupus erythematosus
B) Rheumatoid arthritis
C) Dermatomyositis
D) Sjögren’s syndrome

 

A 55-year-old male presents with progressive difficulty with balance, walking, and tremors. He has a history of depression and cognitive decline. What is the most likely diagnosis?

A) Parkinson’s disease
B) Multiple sclerosis
C) Huntington’s disease
D) Amyotrophic lateral sclerosis (ALS)

 

A 60-year-old female presents with dizziness, vertigo, and a sensation of fullness in her left ear. What is the most likely diagnosis?

A) Meniere’s disease
B) Benign paroxysmal positional vertigo (BPPV)
C) Vestibular neuritis
D) Labyrinthitis

 

A 50-year-old male presents with severe chest pain, sweating, and nausea. His ECG shows ST elevation in leads V2 to V4. What is the most likely diagnosis?

A) Acute anterior myocardial infarction
B) Unstable angina
C) Aortic dissection
D) Pericarditis

 

 

A 60-year-old male presents with fatigue, dyspnea, and a dry cough that has persisted for several months. His chest X-ray shows bilateral infiltrates, and his pulmonary function tests show restrictive lung disease. What is the most likely diagnosis?

A) Idiopathic pulmonary fibrosis
B) Chronic obstructive pulmonary disease (COPD)
C) Pneumonia
D) Pulmonary embolism

 

A 45-year-old female presents with persistent dry cough, night sweats, and weight loss. She has a history of recent travel to a high-risk area for tuberculosis. What is the most likely diagnosis?

A) Tuberculosis
B) Bronchitis
C) Pneumonia
D) Lung cancer

 

A 55-year-old female with a history of hypertension presents with sudden-onset severe headache, nausea, vomiting, and blurred vision. Her blood pressure is 200/120 mmHg. What is the most likely diagnosis?

A) Hypertensive crisis
B) Cluster headache
C) Subarachnoid hemorrhage
D) Tension headache

 

A 50-year-old male with a history of smoking presents with a persistent cough, hemoptysis, and weight loss. His chest X-ray shows a mass in the upper lobe of the right lung. What is the most likely diagnosis?

A) Lung cancer
B) Tuberculosis
C) Pneumonia
D) Chronic obstructive pulmonary disease (COPD)

 

A 45-year-old female presents with a history of excessive thirst, frequent urination, and blurred vision. Her blood glucose level is 280 mg/dL. What is the most likely diagnosis?

A) Diabetes mellitus type 2
B) Diabetes insipidus
C) Cushing’s syndrome
D) Hyperthyroidism

 

A 60-year-old male with a history of atrial fibrillation presents with sudden-onset weakness, slurred speech, and right-sided facial droop. His blood pressure is 160/100 mmHg. What is the most likely diagnosis?

A) Stroke
B) Transient ischemic attack (TIA)
C) Bell’s palsy
D) Seizure

 

A 50-year-old female with a history of rheumatoid arthritis presents with fever, sore throat, and a red rash that appears suddenly. Her throat culture is negative, and her white blood cell count is elevated. What is the most likely diagnosis?

A) Rheumatic fever
B) Infectious mononucleosis
C) Acute bacterial pharyngitis
D) Systemic lupus erythematosus

 

A 45-year-old male presents with pain and swelling in his right knee after playing soccer. The knee is tender to palpation, and the range of motion is limited. What is the most likely diagnosis?

A) Meniscus tear
B) Osteoarthritis
C) Rheumatoid arthritis
D) Ligament sprain

 

A 55-year-old female presents with acute onset of shortness of breath, tachypnea, and pleuritic chest pain. Her ECG is normal, and her D-dimer is elevated. What is the most likely diagnosis?

A) Pulmonary embolism
B) Pneumonia
C) Acute myocardial infarction
D) Pneumothorax

 

A 50-year-old male presents with unexplained weight loss, excessive thirst, and frequent urination. His laboratory results show elevated blood glucose levels, but his HbA1c is normal. What is the most likely diagnosis?

A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Diabetes insipidus
D) Hyperthyroidism

 

A 60-year-old male presents with a persistent productive cough, wheezing, and shortness of breath. He has a history of smoking. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Bronchitis
D) Pneumonia

 

A 55-year-old female presents with a complaint of fatigue, dizziness, and pale skin. Her hemoglobin level is 9 g/dL, and her ferritin level is low. What is the most likely diagnosis?

A) Iron-deficiency anemia
B) Vitamin B12 deficiency anemia
C) Folate deficiency anemia
D) Aplastic anemia

 

A 45-year-old female presents with bilateral upper abdominal pain, nausea, and vomiting. Her serum lipase is elevated, and her ultrasound reveals multiple gallstones. What is the most likely diagnosis?

A) Cholecystitis
B) Pancreatitis
C) Peptic ulcer disease
D) Gastritis

 

A 60-year-old female presents with increasing forgetfulness, difficulty concentrating, and repetitive questioning. Her Mini-Mental State Examination (MMSE) score is 22/30. What is the most likely diagnosis?

A) Alzheimer’s disease
B) Normal aging
C) Depression
D) Vascular dementia

 

A 50-year-old male with a history of diabetes presents with a non-healing ulcer on his left foot. He also complains of numbness and tingling in his feet. What is the most likely diagnosis?

A) Diabetic neuropathy
B) Peripheral arterial disease
C) Cellulitis
D) Gout

 

A 55-year-old female with a history of hypertension and hyperlipidemia presents with sudden-onset severe chest pain radiating to her back. Her blood pressure is 180/100 mmHg. What is the most likely diagnosis?

A) Aortic dissection
B) Acute myocardial infarction
C) Pulmonary embolism
D) Pericarditis

 

A 60-year-old male presents with a persistent cough, fever, and pleuritic chest pain. He has a history of chronic smoking. What is the most likely diagnosis?

A) Pneumonia
B) Chronic obstructive pulmonary disease (COPD)
C) Lung cancer
D) Tuberculosis

 

A 55-year-old female presents with sudden-onset severe headache, nausea, vomiting, and blurred vision. Her blood pressure is elevated at 180/110 mmHg. What is the most likely diagnosis?

A) Hypertensive encephalopathy
B) Cluster headache
C) Subarachnoid hemorrhage
D) Migraine headache

 

A 60-year-old male presents with acute onset of shortness of breath and pleuritic chest pain. His D-dimer level is elevated. What is the most likely diagnosis?

A) Pulmonary embolism
B) Pneumonia
C) Pneumothorax
D) Pericarditis

 

A 50-year-old female presents with severe, burning epigastric pain that improves after eating, but worsens at night. Her endoscopy reveals a gastric ulcer. What is the most likely cause?

A) Helicobacter pylori infection
B) Nonsteroidal anti-inflammatory drug (NSAID) use
C) Stress-related mucosal injury
D) Alcohol consumption

 

 

A 60-year-old male with a history of smoking presents with hemoptysis, weight loss, and persistent cough. A chest X-ray reveals a large mass in the right upper lobe. What is the most likely diagnosis?

A) Lung cancer
B) Tuberculosis
C) Pneumonia
D) Chronic obstructive pulmonary disease (COPD)

 

A 50-year-old female presents with joint pain, fatigue, and a butterfly-shaped rash across her face. Her laboratory results reveal a positive antinuclear antibody (ANA) and anti-dsDNA. What is the most likely diagnosis?

A) Systemic lupus erythematosus
B) Rheumatoid arthritis
C) Psoriatic arthritis
D) Osteoarthritis

 

A 55-year-old male presents with sudden-onset chest pain radiating to his back and left arm, along with diaphoresis and nausea. His ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?

A) Acute inferior myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis

 

A 50-year-old female presents with heat intolerance, increased sweating, weight loss, and palpitations. Her thyroid-stimulating hormone (TSH) is low, and free T4 is elevated. What is the most likely diagnosis?

A) Hyperthyroidism
B) Hypothyroidism
C) Addison’s disease
D) Cushing’s syndrome

 

A 45-year-old male presents with severe pain and swelling in his right great toe, with a red and inflamed joint. His serum uric acid levels are elevated. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Rheumatoid arthritis
D) Pseudogout

 

A 60-year-old female presents with a complaint of dizziness and spinning sensation when turning her head. Her symptoms are triggered by positional changes. What is the most likely diagnosis?

A) Benign paroxysmal positional vertigo (BPPV)
B) Meniere’s disease
C) Vestibular neuritis
D) Labyrinthitis

 

A 50-year-old male presents with a cough, fever, and shortness of breath for the past 3 days. His chest X-ray shows bilateral infiltrates. What is the most likely diagnosis?

A) Pneumonia
B) Acute bronchitis
C) Chronic obstructive pulmonary disease (COPD) exacerbation
D) Pulmonary embolism

 

A 65-year-old female presents with progressive difficulty swallowing, regurgitation of food, and chest pain. Her barium swallow reveals a “bird-beak” appearance. What is the most likely diagnosis?

A) Achalasia
B) Gastroesophageal reflux disease (GERD)
C) Esophageal cancer
D) Hiatal hernia

 

A 60-year-old male with a history of hypertension presents with sudden-onset severe headache, nausea, vomiting, and blurred vision. His blood pressure is 220/130 mmHg. What is the most likely diagnosis?

A) Hypertensive emergency
B) Subarachnoid hemorrhage
C) Tension headache
D) Acute glaucoma

 

A 45-year-old female presents with fatigue, weight gain, and cold intolerance. Her TSH level is elevated, and free T4 is low. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Addison’s disease
D) Cushing’s syndrome

 

A 50-year-old male presents with shortness of breath, wheezing, and a productive cough with greenish sputum. He has a 20-year history of smoking. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Pneumonia
D) Tuberculosis

 

A 40-year-old female presents with pain and swelling in her left knee after a fall during a soccer game. She reports feeling a pop at the time of injury. What is the most likely diagnosis?

A) Anterior cruciate ligament (ACL) tear
B) Meniscus tear
C) Osteoarthritis
D) Patellar fracture

 

A 55-year-old male with a history of alcohol use disorder presents with confusion, tremors, and hallucinations. His blood pressure is elevated, and he has a temperature of 101°F. What is the most likely diagnosis?

A) Delirium tremens
B) Acute psychosis
C) Wernicke-Korsakoff syndrome
D) Alcohol intoxication

 

A 45-year-old female presents with increased thirst, frequent urination, and a history of weight loss. Her fasting blood glucose is 290 mg/dL. What is the most likely diagnosis?

A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Diabetes insipidus
D) Hyperthyroidism

 

A 60-year-old male presents with swelling in his lower extremities, fatigue, and shortness of breath. His chest X-ray reveals cardiomegaly, and his BNP level is elevated. What is the most likely diagnosis?

A) Heart failure
B) Pulmonary embolism
C) Chronic obstructive pulmonary disease (COPD)
D) Acute coronary syndrome

 

A 50-year-old female presents with severe epigastric pain that is relieved by eating but worsens at night. An upper endoscopy reveals a duodenal ulcer. What is the most likely cause of the ulcer?

A) Helicobacter pylori infection
B) Nonsteroidal anti-inflammatory drug (NSAID) use
C) Stress-induced ulcer
D) Alcohol consumption

 

A 45-year-old male presents with pain and swelling in his left knee. He has a history of rheumatoid arthritis and has been experiencing increased joint pain. What is the most likely diagnosis?

A) Rheumatoid arthritis flare
B) Osteoarthritis
C) Gout
D) Bursitis

 

A 55-year-old male presents with sudden-onset, severe abdominal pain radiating to his back. His blood pressure is elevated, and he has a history of smoking and hypertension. What is the most likely diagnosis?

A) Abdominal aortic aneurysm rupture
B) Acute pancreatitis
C) Gastritis
D) Peptic ulcer disease

 

A 60-year-old female presents with progressive memory loss and difficulty completing activities of daily living. Her MRI shows hippocampal atrophy. What is the most likely diagnosis?

A) Alzheimer’s disease
B) Vascular dementia
C) Depression
D) Normal aging

 

A 45-year-old male presents with blurred vision, floaters, and sudden-onset eye pain. He has a history of high blood pressure. What is the most likely diagnosis?

A) Retinal detachment
B) Glaucoma
C) Diabetic retinopathy
D) Cataracts

 

 

A 50-year-old female presents with irregular menstrual cycles, hot flashes, and vaginal dryness. Her FSH and estradiol levels are elevated. What is the most likely diagnosis?

A) Menopause
B) Premature ovarian failure
C) Polycystic ovary syndrome (PCOS)
D) Hypothyroidism

 

A 60-year-old male with a history of coronary artery disease presents with sudden-onset chest pain radiating to his left arm, diaphoresis, and nausea. His ECG shows ST-segment elevation in leads V1-V4. What is the most likely diagnosis?

A) Acute anterior myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis

 

A 55-year-old male with a history of hypertension presents with sudden-onset severe headache, nausea, and vomiting. His blood pressure is 210/120 mmHg. What is the most likely diagnosis?

A) Hypertensive emergency
B) Subarachnoid hemorrhage
C) Migraine headache
D) Cluster headache

 

A 45-year-old female presents with severe upper abdominal pain that radiates to her back. Her lipase and amylase levels are elevated, and her ultrasound shows a dilated common bile duct. What is the most likely diagnosis?

A) Acute pancreatitis
B) Gallbladder disease
C) Gastritis
D) Peptic ulcer disease

 

A 60-year-old male presents with progressive shortness of breath, wheezing, and cough. He has a 40-year history of smoking. Pulmonary function tests show a decreased FEV1/FVC ratio. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Lung cancer
D) Pneumonia

 

A 45-year-old male presents with pain and swelling in his right ankle after an inversion injury during a basketball game. He reports feeling a “pop” at the time of injury. What is the most likely diagnosis?

A) Ankle sprain
B) Achilles tendon rupture
C) Ankle fracture
D) Ligament tear

 

A 60-year-old female presents with progressively worsening fatigue, weakness, and difficulty swallowing. Her laboratory results show anemia and a positive antinuclear antibody (ANA). What is the most likely diagnosis?

A) Systemic lupus erythematosus
B) Multiple sclerosis
C) Myasthenia gravis
D) Rheumatoid arthritis

 

A 55-year-old male presents with severe burning chest pain, dysphagia, and regurgitation of food. An esophagram shows a “bird-beak” appearance. What is the most likely diagnosis?

A) Achalasia
B) Gastroesophageal reflux disease (GERD)
C) Esophageal cancer
D) Hiatal hernia

 

A 50-year-old female presents with chronic joint pain and stiffness, particularly in her hands and feet. Her rheumatoid factor is elevated, and her ESR is high. What is the most likely diagnosis?

A) Rheumatoid arthritis
B) Osteoarthritis
C) Gout
D) Psoriatic arthritis

 

A 45-year-old male presents with a history of excessive alcohol consumption and recent confusion, tremors, and hallucinations. His vital signs are stable, and his urine is positive for ketones. What is the most likely diagnosis?

A) Alcoholic ketoacidosis
B) Delirium tremens
C) Acute alcohol intoxication
D) Wernicke-Korsakoff syndrome

 

A 55-year-old male with a history of diabetes presents with a non-healing ulcer on his left foot, along with numbness and tingling in his feet. His ankle-brachial index is decreased. What is the most likely diagnosis?

A) Diabetic neuropathy
B) Peripheral arterial disease
C) Cellulitis
D) Gout

 

A 50-year-old female presents with joint stiffness, particularly in the mornings, along with fatigue and muscle aches. Her ESR and CRP levels are elevated. What is the most likely diagnosis?

A) Polymyalgia rheumatica
B) Fibromyalgia
C) Rheumatoid arthritis
D) Osteoarthritis

 

A 60-year-old male presents with sudden-onset severe abdominal pain radiating to his back, nausea, and vomiting. His blood pressure is elevated, and he has a history of hypertension and smoking. What is the most likely diagnosis?

A) Abdominal aortic aneurysm rupture
B) Acute pancreatitis
C) Gastritis
D) Peptic ulcer disease

 

A 55-year-old female presents with a complaint of unexplained weight loss, persistent cough, and a family history of lung cancer. A chest X-ray shows a mass in the left upper lobe. What is the most likely diagnosis?

A) Lung cancer
B) Tuberculosis
C) Pneumonia
D) Chronic obstructive pulmonary disease (COPD)

 

A 45-year-old male presents with frequent urination, excessive thirst, and a history of recent weight loss. His fasting blood glucose level is 350 mg/dL. What is the most likely diagnosis?

A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Diabetes insipidus
D) Hyperthyroidism

 

A 60-year-old female presents with progressive difficulty swallowing, regurgitation of food, and chest pain. A barium swallow reveals a “bird-beak” appearance of the esophagus. What is the most likely diagnosis?

A) Achalasia
B) Gastroesophageal reflux disease (GERD)
C) Esophageal cancer
D) Hiatal hernia

 

A 50-year-old male with a history of diabetes presents with pain, swelling, and redness in his right knee. His uric acid level is elevated. What is the most likely diagnosis?

A) Gout
B) Osteoarthritis
C) Rheumatoid arthritis
D) Psoriatic arthritis

 

A 60-year-old male presents with shortness of breath, wheezing, and a productive cough with greenish sputum. His FEV1/FVC ratio is decreased on pulmonary function testing. What is the most likely diagnosis?

A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Pneumonia
D) Tuberculosis

 

A 50-year-old female presents with severe pain in the left lower abdomen, nausea, and fever. Her pelvic exam reveals cervical motion tenderness, and her white blood cell count is elevated. What is the most likely diagnosis?

A) Pelvic inflammatory disease (PID)
B) Ovarian cyst rupture
C) Ectopic pregnancy
D) Endometriosis

 

A 55-year-old male presents with acute-onset left-sided facial weakness, difficulty speaking, and slurred speech. His blood pressure is 160/100 mmHg, and his CT scan shows no acute findings. What is the most likely diagnosis?

A) Stroke
B) Transient ischemic attack (TIA)
C) Bell’s palsy
D) Seizure

 

 

A 60-year-old male presents with a complaint of increasing shortness of breath and fatigue. His physical exam reveals jugular venous distention, bilateral lower extremity edema, and crackles on auscultation. What is the most likely diagnosis?

A) Heart failure
B) Pulmonary embolism
C) Chronic obstructive pulmonary disease (COPD)
D) Pneumonia

 

A 50-year-old female with a history of frequent heartburn presents with worsening chest pain, especially after meals. She also experiences regurgitation and difficulty swallowing. What is the most likely diagnosis?

A) Gastroesophageal reflux disease (GERD)
B) Myocardial infarction
C) Esophageal cancer
D) Peptic ulcer disease

 

A 45-year-old female presents with a positive family history of breast cancer, along with a palpable mass in her left breast. A mammogram reveals an irregular mass with spiculated margins. What is the most likely diagnosis?

A) Breast cancer
B) Fibroadenoma
C) Cystic breast changes
D) Mastitis

 

A 60-year-old male presents with a 2-day history of fever, chills, productive cough, and pleuritic chest pain. His chest X-ray shows consolidation in the right lower lobe. What is the most likely diagnosis?

A) Community-acquired pneumonia
B) Pulmonary embolism
C) Tuberculosis
D) Lung cancer

 

A 50-year-old female presents with fatigue, cold intolerance, weight gain, and constipation. Her TSH is elevated, and free T4 is low. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Diabetes mellitus
D) Adrenal insufficiency

 

A 45-year-old male presents with a painful, swollen right great toe that is red and warm to the touch. His uric acid levels are elevated. What is the most likely diagnosis?

A) Gout
B) Rheumatoid arthritis
C) Osteoarthritis
D) Psoriatic arthritis

 

A 55-year-old female presents with complaints of worsening memory loss and difficulty concentrating. She has a family history of Alzheimer’s disease. What is the most likely diagnosis?

A) Alzheimer’s disease
B) Depression
C) Vascular dementia
D) Normal aging

 

A 65-year-old male with a history of heavy alcohol use presents with confusion, tremors, and hallucinations. His blood pressure is elevated, and his heart rate is 110 beats per minute. What is the most likely diagnosis?

A) Delirium tremens
B) Alcohol withdrawal syndrome
C) Wernicke-Korsakoff syndrome
D) Acute alcohol intoxication

 

A 50-year-old male presents with nausea, vomiting, and right upper quadrant pain after a fatty meal. His liver function tests reveal elevated bilirubin and alkaline phosphatase. What is the most likely diagnosis?

A) Gallstones
B) Acute pancreatitis
C) Peptic ulcer disease
D) Hepatitis

 

A 45-year-old female presents with a sudden onset of dizziness, tinnitus, and a feeling of fullness in her ear. Her symptoms are worse with changes in head position. What is the most likely diagnosis?

A) Meniere’s disease
B) Benign paroxysmal positional vertigo (BPPV)
C) Labyrinthitis
D) Vestibular neuritis

 

A 55-year-old male presents with lower back pain, which radiates to his left leg. He has a positive straight leg raise test. What is the most likely diagnosis?

A) Herniated disk
B) Osteoarthritis
C) Spinal stenosis
D) Spondylolisthesis

 

A 45-year-old male presents with a persistent cough, hemoptysis, weight loss, and night sweats. His chest X-ray reveals a cavitary lesion in the upper lobe of the lung. What is the most likely diagnosis?

A) Tuberculosis
B) Lung cancer
C) Pneumonia
D) Chronic obstructive pulmonary disease (COPD)

 

A 50-year-old female with a history of hypertension and diabetes presents with sudden-onset left-sided weakness and slurred speech. Her blood pressure is elevated, and her CT scan shows an ischemic infarct in the right middle cerebral artery territory. What is the most likely diagnosis?

A) Stroke
B) Transient ischemic attack (TIA)
C) Bell’s palsy
D) Seizure

 

A 40-year-old female presents with severe epigastric pain that is relieved by eating but worsens at night. An upper endoscopy reveals a duodenal ulcer. What is the most likely cause of the ulcer?

A) Helicobacter pylori infection
B) Nonsteroidal anti-inflammatory drug (NSAID) use
C) Stress-induced ulcer
D) Alcohol consumption

 

A 60-year-old male presents with progressive shortness of breath, particularly with exertion, and a dry cough. He has a history of rheumatoid arthritis. A chest X-ray reveals interstitial lung disease. What is the most likely diagnosis?

A) Rheumatoid arthritis-associated lung disease
B) Chronic obstructive pulmonary disease (COPD)
C) Pulmonary embolism
D) Lung cancer

 

A 55-year-old female with a history of type 2 diabetes mellitus presents with a non-healing ulcer on her left foot. She reports numbness and tingling in her feet. What is the most likely diagnosis?

A) Diabetic neuropathy
B) Peripheral arterial disease
C) Cellulitis
D) Gout

 

A 50-year-old male presents with fatigue, weight loss, and pruritus. His liver function tests show elevated AST, ALT, and alkaline phosphatase. An ultrasound reveals hepatomegaly. What is the most likely diagnosis?

A) Hepatitis
B) Cirrhosis
C) Gallstones
D) Non-alcoholic fatty liver disease (NAFLD)

 

A 45-year-old male presents with back pain after a lifting injury. His physical exam reveals tenderness over the lumbar spine, but no neurological deficits are noted. What is the most likely diagnosis?

A) Muscle strain
B) Herniated disk
C) Spinal stenosis
D) Osteoporosis

 

A 50-year-old female presents with fatigue, weight gain, and cold intolerance. Her TSH is elevated, and free T4 is low. What is the most likely diagnosis?

A) Hypothyroidism
B) Hyperthyroidism
C) Addison’s disease
D) Cushing’s syndrome

 

A 60-year-old male with a history of chronic smoking presents with a chronic cough, hemoptysis, and dyspnea. His chest X-ray reveals a mass in the right lung. What is the most likely diagnosis?

A) Lung cancer
B) Pneumonia
C) Tuberculosis
D) Chronic obstructive pulmonary disease (COPD)

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