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Clinical Case Scenarios in Internal Medicine Quiz

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Which of the following is a recognized risk factor for the development of osteoporosis?

Excessive alcohol consumption

Explanation

Excessive alcohol consumption is a risk factor for osteoporosis.

A 45-year-old female presents with a swollen, painful joint that is warm to touch and has limited range of motion. Laboratory analysis of joint fluid reveals a leukocyte count of 20,000/mm³ with predominantly neutrophils. What is the most likely diagnosis?

Gout

Explanation

Symptoms and joint fluid analysis findings suggest gout.

A 35-year-old male presents with recurrent episodes of painful urination, frequency, urgency, and suprapubic discomfort. Urinalysis shows pyuria and bacteriuria. What is the most likely diagnosis?

Acute bacterial cystitis

Explanation

Symptoms and urinalysis findings suggest acute bacterial cystitis.

A 55-year-old female presents with progressive fatigue, palpitations, and unintentional weight loss. On examination, there is an enlarged thyroid gland with palpable nodules. Laboratory tests reveal elevated thyroid hormone levels. What is the most likely diagnosis?

Toxic multinodular goiter

Explanation

Symptoms, examination findings, and laboratory results suggest toxic multinodular goiter.

A 50-year-old male presents with a sudden onset of severe right lower quadrant abdominal pain, nausea, and vomiting. On examination, there is tenderness and guarding at McBurney's point. What is the most likely diagnosis?

Appendicitis

Explanation

Presentation and examination findings are consistent with appendicitis.

Which of the following is a characteristic feature of Graves' disease?

Exophthalmos

Explanation

Graves' disease commonly presents with exophthalmos.

A 50-year-old obese male with a history of poorly controlled type 2 diabetes mellitus presents with a sudden onset of severe chest pain, diaphoresis, and dyspnea. His ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?

Acute myocardial infarction

Explanation

Presentation and ECG findings are consistent with acute myocardial infarction.

A 30-year-old female presents with fatigue, cold intolerance, and weight gain over the past few months. On examination, there is diffuse thyroid enlargement and a bruit over the thyroid gland. Laboratory tests reveal elevated thyroid hormone levels. What is the most likely diagnosis?

Graves' disease

Explanation

Symptoms, signs, and laboratory findings suggest Graves' disease.

Which of the following medications is commonly used for the treatment of essential hypertension?

Lisinopril

Explanation

Lisinopril is a commonly used medication for essential hypertension.

#10

A 70-year-old male presents with progressive dysphagia to solids and liquids, weight loss, and regurgitation of undigested food. What is the most likely diagnosis?

Esophageal cancer

Explanation

Symptoms are consistent with esophageal cancer.

#11

A 45-year-old male presents with sudden-onset severe chest pain radiating to the back. On examination, blood pressure in the right arm is 180/100 mmHg, and in the left arm is 110/70 mmHg. What is the most likely diagnosis?

Aortic dissection

Explanation

Discrepancy in blood pressure between arms suggests aortic dissection.

#12

A 65-year-old female presents with progressive dyspnea on exertion, fatigue, and pedal edema. She has a history of rheumatic fever. On examination, there is a loud holosystolic murmur best heard at the apex, and an S3 gallop rhythm is present. What is the most likely diagnosis?

Mitral regurgitation

Explanation

History of rheumatic fever and auscultatory findings suggest mitral regurgitation.

#13

A 60-year-old male presents with a sudden-onset severe headache described as the 'worst headache of my life'. On examination, neck stiffness is noted. What is the most likely diagnosis?

Subarachnoid hemorrhage

Explanation

Sudden severe headache with neck stiffness suggests subarachnoid hemorrhage.

#14

Which of the following is a typical symptom of acute pancreatitis?

Referred pain to the right shoulder

Explanation

Referred pain to the right shoulder is characteristic of acute pancreatitis.

#15

A 55-year-old male presents with intermittent claudication, characterized by cramping leg pain that occurs with exercise and resolves with rest. What is the most likely diagnosis?

Peripheral artery disease

Explanation

Intermittent claudication suggests peripheral artery disease.

Clinical Case Scenarios in Internal Medicine Quiz

Which of the following is a recognized risk factor for the development of osteoporosis?

A 45-year-old female presents with a swollen, painful joint that is warm to touch and has limited range of motion. Laboratory analysis of joint fluid reveals a leukocyte count of 20,000/mm³ with predominantly neutrophils. What is the most likely diagnosis?

A 35-year-old male presents with recurrent episodes of painful urination, frequency, urgency, and suprapubic discomfort. Urinalysis shows pyuria and bacteriuria. What is the most likely diagnosis?

A 55-year-old female presents with progressive fatigue, palpitations, and unintentional weight loss. On examination, there is an enlarged thyroid gland with palpable nodules. Laboratory tests reveal elevated thyroid hormone levels. What is the most likely diagnosis?

A 50-year-old male presents with a sudden onset of severe right lower quadrant abdominal pain, nausea, and vomiting. On examination, there is tenderness and guarding at McBurney's point. What is the most likely diagnosis?

Which of the following is a characteristic feature of Graves' disease?

A 50-year-old obese male with a history of poorly controlled type 2 diabetes mellitus presents with a sudden onset of severe chest pain, diaphoresis, and dyspnea. His ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?

A 30-year-old female presents with fatigue, cold intolerance, and weight gain over the past few months. On examination, there is diffuse thyroid enlargement and a bruit over the thyroid gland. Laboratory tests reveal elevated thyroid hormone levels. What is the most likely diagnosis?

Which of the following medications is commonly used for the treatment of essential hypertension?

A 70-year-old male presents with progressive dysphagia to solids and liquids, weight loss, and regurgitation of undigested food. What is the most likely diagnosis?

A 45-year-old male presents with sudden-onset severe chest pain radiating to the back. On examination, blood pressure in the right arm is 180/100 mmHg, and in the left arm is 110/70 mmHg. What is the most likely diagnosis?

A 65-year-old female presents with progressive dyspnea on exertion, fatigue, and pedal edema. She has a history of rheumatic fever. On examination, there is a loud holosystolic murmur best heard at the apex, and an S3 gallop rhythm is present. What is the most likely diagnosis?

A 60-year-old male presents with a sudden-onset severe headache described as the 'worst headache of my life'. On examination, neck stiffness is noted. What is the most likely diagnosis?

Which of the following is a typical symptom of acute pancreatitis?

A 55-year-old male presents with intermittent claudication, characterized by cramping leg pain that occurs with exercise and resolves with rest. What is the most likely diagnosis?

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