Medicine (Professional) quiz

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Sample questions

• A placebo-controlled clinical trial is conducted to assess whether a new antihypertensive drug is more effective than standard therapy. A total of 5000 patients with essential hypertension are enrolled and randomly assigned to one of two groups: 2500 patients receive the new drug and 2500 patients receive placebo. If the alpha is set at 0.01 instead of 0.05, which of the following is the most likely result?
• A 5-year-old boy is brought to the physician because of a 2-day history of fever and painful swelling of the left ankle. He has had recurrent cervical lymphadenitis and pneumonia since infancy. Two years ago, a culture from an abscess in the cervical region grew Staphylococcus aureus. His temperature is 38°C (100.4°F). Examination shows a tender, erythematous, edematous left ankle; there is point tenderness over the medial malleolus. A bone scan shows increased uptake in the left lower tibial metaphysis. Culture of bone aspirate grows Serratia marcescens. Nitroblue tetrazolium test shows no color change. Which of the following is the most likely mechanism for these findings?
• A 52-year-old man is admitted to the hospital because of severe dyspnea and cough productive of tenacious, brownishyellow sputum for the past 3 weeks. He has a 15-year career history of sandblasting old buildings. He has smoked two packs of cigarettes daily for the past 30 years. The patient is 168 cm (5 ft 6 in) tall and weighs 59 kg (130 lb); BMI is 21 kg/m2 . Vital signs are temperature 36.8°C (98.2°F), pulse 94/min, and blood pressure 150/92 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 70%. On physical examination he is in moderately severe distress with pursed lips and cyanotic nail beds. Chest has an increased anteroposterior diameter. Auscultation of the chest discloses scattered wheezes and rhonchi over all lung fields. Cardiac examination discloses muffled heart sounds and an S4. Fingers are clubbed. Chest x-ray shows hyperinflated lungs, flattened diaphragm, large, irregular opacities in the upper lobes, and eggshell calcifications of the hilar lymph nodes. In addition to antibiotic therapy, which of the following is the most appropriate intervention?

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