Medical Content Library - EndlessMedical Academy

Welcome to the most comprehensive medical education content library, featuring 3630+ carefully curated questions across 171 medical categories, designed for Physicians (MD/DO), Nurse Practitioners, and Physician Assistants preparing for major examinations.

Last updated: April 11, 2026 at 10:11 AM UTC

3630+
Medical Questions
171
Medical Categories
24
Question Types
12
Case Types
4
Difficulty Levels

Table of Contents

All 24 Question Types

Diverse question formats to test every aspect of medical knowledge:

Best next diagnostic step
Diagnostic step questions test the provider's ability to choose the most appropriate next investigation or test based on the clinical scenario. Providers must consider cost-effectiveness, diagnostic yield, patient safety, and clinical guidelines.
Clinical features
Clinical features questions test recognition and understanding of disease manifestations. Providers must identify key signs, symptoms, and clinical findings that characterize specific conditions or disease states.
Clinical trials
Clinical trials questions test understanding of research methodology, study design, and evidence-based medicine. Providers must interpret research findings, understand study limitations, and apply evidence to clinical practice.
Common clinical pitfalls
Clinical pitfalls questions highlight common mistakes in clinical practice. Providers must recognize potential errors in diagnosis, treatment, or patient management and understand strategies to avoid these pitfalls.
Common legal pitfalls
Legal pitfalls questions address medicolegal aspects of healthcare including informed consent, documentation, professional boundaries, and legal responsibilities. Providers must understand how to practice defensively while maintaining good patient care.
Complications
Complications questions test knowledge of potential adverse outcomes associated with diseases or treatments. Providers must identify, prevent, and manage complications while understanding risk factors and early warning signs.
Contraindications and precautions
Contraindication questions test knowledge of absolute and relative contraindications to medications, procedures, or interventions. Providers must identify when treatments could be harmful and understand alternative approaches for high-risk patients.
Cost effectiveness
Cost effectiveness questions examine healthcare economics and resource allocation decisions. Providers must consider cost-benefit ratios, healthcare system constraints, and value-based care principles in clinical decision-making.
Diagnostic failure scenario
Diagnostic failure questions present scenarios where standard diagnostic approaches have not yielded results. Providers must demonstrate advanced clinical reasoning to identify alternative diagnostic strategies or consider rare conditions.
Differential diagnosis by any means
These questions test comprehensive differential diagnosis skills, integrating history, physical examination, laboratory results, and imaging to distinguish between multiple possible conditions. Providers must synthesize all available information to reach the correct diagnosis.
Differential diagnosis by physical exam and history
These questions test the ability to differentiate between similar conditions based on subtle differences in physical examination findings and patient history. Providers must recognize key distinguishing features that help narrow the differential diagnosis.
Differential diagnosis by testing
These questions focus on selecting the most appropriate diagnostic tests to differentiate between conditions with similar presentations. Providers must understand which tests provide the most discriminatory information.
Emergency priorities
Emergency priorities questions test ability to rapidly assess and prioritize patient care in urgent situations. Providers must demonstrate triage skills, immediate management decisions, and understanding of emergency protocols.
Epidemiology
Epidemiology questions test understanding of disease distribution, determinants, and population health patterns. Providers must demonstrate knowledge of risk factors, prevalence, incidence, and public health implications.
Management
Management questions test comprehensive patient care skills including treatment planning, monitoring, follow-up care, and coordination between different healthcare providers and services.
Mechanism of action
Mechanism questions test understanding of underlying biological, pharmacological, or pathophysiological processes. Providers must demonstrate knowledge of how interventions work at cellular, molecular, or systems levels.
Most likely diagnosis
Diagnostic questions focus on identifying the most likely diagnosis based on patient symptoms, signs, and test results. These questions test knowledge of disease presentations, differential diagnoses, and diagnostic criteria. The correct answer should be the single most likely diagnosis given the information provided.
Natural history
Natural history questions examine the typical course of diseases over time. Providers must understand disease progression, factors affecting prognosis, and long-term outcomes with and without treatment.
Patient communication
Patient communication questions test interpersonal skills essential for medical practice. Providers must demonstrate effective communication techniques, patient counseling skills, and ability to educate patients about their conditions.
Prevention strategies
Prevention questions focus on strategies to prevent disease occurrence, progression, or recurrence. Providers must understand primary, secondary, and tertiary prevention approaches including screening programs and lifestyle modifications.
Recent changes
Recent changes questions focus on current developments in medical practice including new guidelines, treatments, or research findings. Providers must stay current with evolving medical knowledge and practice standards.
Treatment approach
Treatment questions focus on selecting the most appropriate therapeutic intervention for a given condition. Providers must consider patient factors, contraindications, drug interactions, and evidence-based guidelines to choose optimal treatment strategies.
Treatment failure scenario
Treatment failure questions test problem-solving skills when standard treatments are ineffective. Providers must consider alternative therapies, drug resistance, compliance issues, or misdiagnosis.
Underlying pathology
Pathology questions focus on understanding disease processes at the tissue and cellular level. Providers must identify pathological changes, understand disease progression, and connect pathophysiology to clinical manifestations.

All 12 Clinical Case Types

Real-world clinical scenarios across different healthcare settings:

Common clinical scenario
Common scenario cases represent frequently encountered clinical situations in everyday practice. These scenarios test competency in managing routine but important clinical presentations that form the foundation of medical practice.
Complicated condition
Complicated condition cases involve patients with multiple medical problems, complex comorbidities, or conditions that deviate from typical presentations. These scenarios test advanced clinical reasoning and management of complex patients.
Emergency
Emergency cases present acute, life-threatening, or rapidly deteriorating conditions that require immediate medical intervention. These scenarios test rapid assessment skills, priority setting, and urgent care protocols.
Emergency department case
Emergency department cases present acute medical conditions in the context of emergency care. These scenarios test triage skills, rapid assessment, emergency protocols, and acute care management typical of ED practice.
Multi-patient scenario
Multi-patient scenarios test ability to manage multiple patients simultaneously, prioritize care based on acuity, and efficiently allocate limited resources. These cases emphasize triage skills and system-level thinking.
Patient in critical condition
Critical condition cases present patients with life-threatening conditions requiring intensive care, continuous monitoring, and immediate interventions. These scenarios test critical care skills and emergency management.
Pregnant patient
Clinical scenarios involving Pregnant patient
Rare disease presentation
Rare presentation cases feature uncommon diseases or atypical presentations of known conditions. These scenarios test diagnostic skills when faced with unusual presentations and knowledge of rare but important conditions.
Resource-limited setting
Resource-limited cases present clinical scenarios where diagnostic tests, medications, or specialists may not be readily available. These scenarios test adaptability, clinical reasoning without extensive testing, and resource-conscious decision-making.
Routine visit
Routine visit cases represent typical outpatient encounters including preventive care, routine follow-ups, and standard consultations. These scenarios focus on systematic assessment, routine care protocols, and patient counseling.
Tricky question with subtle findings
Tricky findings cases feature subtle clinical signs or symptoms that can be easily overlooked. These scenarios test attention to detail, thorough clinical assessment, and recognition of subtle but important findings.
Typical presentation
Typical presentation cases feature classic signs and symptoms of common medical conditions. These scenarios test recognition of standard disease patterns and application of routine diagnostic and treatment protocols.

Difficulty Levels

Questions calibrated for different stages of medical education:

Easy
Easy questions test fundamental medical knowledge. These questions focus on common conditions with typical presentations, basic diagnostic criteria, first-line treatments, and straightforward management plans. Easy questions require recall of basic medical facts and application of simple concepts. They typically include a more limited patient context with fewer variables.
Moderate
Moderate questions test intermediate clinical knowledge. These questions involve less common conditions, atypical presentations of common conditions, more nuanced diagnostic criteria, second-line treatments, and management plans with multiple considerations. Moderate questions require integration of multiple concepts and application of clinical reasoning. They typically include more detailed patient context with additional variables to consider.
Hard
Hard questions test sophisticated knowledge expected of specialists, attendings, and subspecialists already in their careers. These questions cover rare conditions, complex atypical presentations, challenging diagnostic dilemmas, advanced treatments, and management plans requiring careful weighing of multiple factors. Hard questions require nuanced clinical judgment, complex decision-making, and deep integration of different medical domains. They typically include extensive patient context with many variables, subtle findings, and complex past medical history.
Expert
Expert questions test the highest level of medical knowledge and clinical expertise. These questions involve cutting-edge medical knowledge, complex diagnostic challenges, or specialized clinical scenarios that require renowned expert-level understanding. People knowing answers to these questions are usually involved themselves in latest research studies, are world wide known experts and have in-depth detailed knowledge in the domain area.

All 171 Medical Categories

Comprehensive coverage across all medical fields with question counts:

Advanced Imaging in Kidney Lesions 4 questions
Exploration of advanced imaging techniques, such as multiphase CT and diffusion-weighted MRI, to differentiate between malignant and benign kidney lesions.
Anatomy > Endocrine Anatomy 6 questions
Anatomy > Endocrine Anatomy
Anatomy > Hepatobiliary Anatomy 9 questions
Anatomy > Hepatobiliary Anatomy
Anatomy > Lower Limb Anatomy 5 questions
Anatomy > Lower Limb Anatomy
Anatomy > Oral Anatomy 8 questions
Anatomy > Oral Anatomy
Anatomy > Peripheral Neuroanatomy 3 questions
Anatomy > Peripheral Neuroanatomy
Biochemistry > Clinical Biochemistry 17 questions
Biochemistry > Clinical Biochemistry
Biochemistry > Enzymology 1 questions
Biochemistry > Enzymology
Biochemistry > Hormonal Biochemistry 3 questions
Biochemistry > Hormonal Biochemistry
Biochemistry > Molecular Genetics 4 questions
Biochemistry > Molecular Genetics
Biochemistry > Neurochemical Analysis 12 questions
Biochemistry > Neurochemical Analysis
Biochemistry > Oncological Biochemistry 6 questions
Biochemistry > Oncological Biochemistry
Clinical Pathology > Therapeutic plasma exchange 5 questions
Clinical Pathology > Therapeutic plasma exchange
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia 2 questions
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia > Neuroinflammation and TPE 5 questions
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia > Neuroinflammation and TPE
Clinical Pathology > Therapeutic plasma exchange > Neurological Applications of TPE 2 questions
Clinical Pathology > Therapeutic plasma exchange > Neurological Applications of TPE
Clinical Pathology > Therapeutic plasma exchange > Oncologic Interventions with TPE 4 questions
Clinical Pathology > Therapeutic plasma exchange > Oncologic Interventions with TPE
Clinical Pathology > Therapeutic plasma exchange > Renal Applications of TPE 3 questions
Clinical Pathology > Therapeutic plasma exchange > Renal Applications of TPE
Clinical Pathology > Therapeutic plasma exchange > TPE Innovations and Research 8 questions
Clinical Pathology > Therapeutic plasma exchange > TPE Innovations and Research
Critical Care Medicine > Cardiovascular Support Strategies 1 questions
Critical Care Medicine > Cardiovascular Support Strategies
Cystic Kidney Lesions in Glomerulonephritis 2 questions
Cystic Kidney Lesions in Glomerulonephritis
Endocrinology > Pituitary Gland Disorders 5 questions
Endocrinology > Pituitary Gland Disorders
Imaging in Cystic vs Malignant Lesions 1 questions
Imaging in Cystic vs Malignant Lesions
Immunology 4 questions
Immunology
Internal Medicine 18 questions
Internal Medicine
Nephrology > Dialysis Management 5 questions
Nephrology > Dialysis Management
Nephrology > Glomerulonephritis 1 questions
Nephrology > Glomerulonephritis
Nephrology > Glomerulonephritis > Amyloid-Related GN 4 questions
Nephrology > Glomerulonephritis > Amyloid-Related GN
Nephrology > Glomerulonephritis > Autoimmune Connective Tissue GN 7 questions
Nephrology > Glomerulonephritis > Autoimmune Connective Tissue GN
Nephrology > Glomerulonephritis > Autoimmune-Triggered Crescentic GN 2 questions
Nephrology > Glomerulonephritis > Autoimmune-Triggered Crescentic GN
Nephrology > Glomerulonephritis > Bacterial Infection GN 7 questions
Nephrology > Glomerulonephritis > Bacterial Infection GN
Nephrology > Glomerulonephritis > Chronic Membranoproliferative GN 1 questions
Nephrology > Glomerulonephritis > Chronic Membranoproliferative GN
Nephrology > Glomerulonephritis > Chronic Sclerosing Glomerulonephritis 5 questions
Nephrology > Glomerulonephritis > Chronic Sclerosing Glomerulonephritis
Nephrology > Glomerulonephritis > Complement-Mediated GN 1 questions
Nephrology > Glomerulonephritis > Complement-Mediated GN
Nephrology > Glomerulonephritis > Cryoglobulinemic Glomerulonephritis 14 questions
Nephrology > Glomerulonephritis > Cryoglobulinemic Glomerulonephritis
Nephrology > Glomerulonephritis > Drug Toxicity GN 1 questions
Nephrology > Glomerulonephritis > Drug Toxicity GN
Nephrology > Glomerulonephritis > Eosinophilic GN 2 questions
Nephrology > Glomerulonephritis > Eosinophilic GN
Nephrology > Glomerulonephritis > Fabry Disease Nephropathy 1 questions
Nephrology > Glomerulonephritis > Fabry Disease Nephropathy
Nephrology > Glomerulonephritis > Fibrocellular Glomerular Disease 2 questions
Nephrology > Glomerulonephritis > Fibrocellular Glomerular Disease
Nephrology > Glomerulonephritis > Glomerular Hypercellularity Disorders 2 questions
Nephrology > Glomerulonephritis > Glomerular Hypercellularity Disorders
Nephrology > Glomerulonephritis > HIV-Associated Nephropathy 5 questions
Nephrology > Glomerulonephritis > HIV-Associated Nephropathy
Nephrology > Glomerulonephritis > Hematological Disorder GN 16 questions
Nephrology > Glomerulonephritis > Hematological Disorder GN
Nephrology > Glomerulonephritis > Henoch-Schönlein Purpura Nephritis 11 questions
Nephrology > Glomerulonephritis > Henoch-Schönlein Purpura Nephritis
Nephrology > Glomerulonephritis > Hepatitis C-Related GN 2 questions
Nephrology > Glomerulonephritis > Hepatitis C-Related GN
Nephrology > Glomerulonephritis > Hypertensive GN 5 questions
Nephrology > Glomerulonephritis > Hypertensive GN
Nephrology > Glomerulonephritis > IgA Nephropathy 11 questions
Nephrology > Glomerulonephritis > IgA Nephropathy
Nephrology > Glomerulonephritis > IgM Nephropathy 3 questions
Nephrology > Glomerulonephritis > IgM Nephropathy
Nephrology > Glomerulonephritis > Infection-Triggered Glomerulonephritis 2 questions
Nephrology > Glomerulonephritis > Infection-Triggered Glomerulonephritis
Nephrology > Glomerulonephritis > Infective Endocarditis-Associated GN 4 questions
Nephrology > Glomerulonephritis > Infective Endocarditis-Associated GN
Nephrology > Glomerulonephritis > Ion Channel Disorder GN 2 questions
Nephrology > Glomerulonephritis > Ion Channel Disorder GN
Nephrology > Glomerulonephritis > Ischemia-Induced GN 4 questions
Nephrology > Glomerulonephritis > Ischemia-Induced GN
Nephrology > Glomerulonephritis > Light Chain Deposition Disease 2 questions
Nephrology > Glomerulonephritis > Light Chain Deposition Disease
Nephrology > Glomerulonephritis > Lupus Nephritis 29 questions
Nephrology > Glomerulonephritis > Lupus Nephritis
Nephrology > Glomerulonephritis > Metabolic Syndrome GN 2 questions
Nephrology > Glomerulonephritis > Metabolic Syndrome GN
Nephrology > Glomerulonephritis > Minimal Change Disease 1 questions
Nephrology > Glomerulonephritis > Minimal Change Disease
Nephrology > Glomerulonephritis > Myeloma-Associated GN 28 questions
Nephrology > Glomerulonephritis > Myeloma-Associated GN
Nephrology > Glomerulonephritis > Obesity-Associated GN 4 questions
Nephrology > Glomerulonephritis > Obesity-Associated GN
Nephrology > Glomerulonephritis > Occupational Exposure GN 2 questions
Nephrology > Glomerulonephritis > Occupational Exposure GN
Nephrology > Glomerulonephritis > Paraneoplastic GN 5 questions
Nephrology > Glomerulonephritis > Paraneoplastic GN
Nephrology > Glomerulonephritis > Parasitic Infection GN 63 questions
Nephrology > Glomerulonephritis > Parasitic Infection GN
Nephrology > Glomerulonephritis > Pauci-Immune Glomerulonephritis 1 questions
Nephrology > Glomerulonephritis > Pauci-Immune Glomerulonephritis
Nephrology > Glomerulonephritis > Post-Infectious Glomerulonephritis 16 questions
Nephrology > Glomerulonephritis > Post-Infectious Glomerulonephritis
Nephrology > Glomerulonephritis > Pregnancy-Related GN 2 questions
Nephrology > Glomerulonephritis > Pregnancy-Related GN
Nephrology > Glomerulonephritis > Radiation-Induced GN 2 questions
Nephrology > Glomerulonephritis > Radiation-Induced GN
Nephrology > Glomerulonephritis > Rapidly Progressive Glomerulonephritis 9 questions
Nephrology > Glomerulonephritis > Rapidly Progressive Glomerulonephritis
Nephrology > Glomerulonephritis > Renal Parenchymal Infiltration GN 3 questions
Nephrology > Glomerulonephritis > Renal Parenchymal Infiltration GN
Nephrology > Glomerulonephritis > Secondary Glomerulonephritis 5 questions
Nephrology > Glomerulonephritis > Secondary Glomerulonephritis
Nephrology > Glomerulonephritis > Sports Supplement-Induced GN 3 questions
Nephrology > Glomerulonephritis > Sports Supplement-Induced GN
Nephrology > Glomerulonephritis > Systemic Vasculitis GN 11 questions
Nephrology > Glomerulonephritis > Systemic Vasculitis GN
Nephrology > Glomerulonephritis > Transplant-Related GN 1 questions
Nephrology > Glomerulonephritis > Transplant-Related GN
Nephrology > Glomerulonephritis > Vascular Injury GN 1 questions
Nephrology > Glomerulonephritis > Vascular Injury GN
Nephrology > Hydronephrosis and Obstruction 1 questions
Nephrology > Hydronephrosis and Obstruction
Nephrology > Hydronephrosis and Obstruction > Hydronephrosis in Tumor-Induced Obstruction 3 questions
Nephrology > Hydronephrosis and Obstruction > Hydronephrosis in Tumor-Induced Obstruction
Nephrology > Hypertension 7 questions
Nephrology > Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes 4 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Acromegaly-Associated Hypertension 6 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Acromegaly-Associated Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Adrenal Hyperplasia Hypertension 5 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Adrenal Hyperplasia Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Cushing's Syndrome Hypertension 66 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Cushing's Syndrome Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Hyperparathyroidism Hypertension 8 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Hyperparathyroidism Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > PCOS and Hypertension 6 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > PCOS and Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Primary Hyperaldosteronism 11 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Primary Hyperaldosteronism
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Reninoma Hypertension 2 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Reninoma Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Thyroid-Related Hypertension 4 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Thyroid-Related Hypertension
Nephrology > Hypertension > Hypertension Clinical Trials 4 questions
Nephrology > Hypertension > Hypertension Clinical Trials
Nephrology > Hypertension > Hypertension Complications 10 questions
Nephrology > Hypertension > Hypertension Complications
Nephrology > Hypertension > Hypertension Epidemiology Trends 3 questions
Nephrology > Hypertension > Hypertension Epidemiology Trends
Nephrology > Hypertension > Hypertension Genetic Research 16 questions
Nephrology > Hypertension > Hypertension Genetic Research
Nephrology > Hypertension > Hypertension Pathophysiology Insights 4 questions
Nephrology > Hypertension > Hypertension Pathophysiology Insights
Nephrology > Hypertension > Hypertension Screening Technologies 2 questions
Nephrology > Hypertension > Hypertension Screening Technologies
Nephrology > Hypertension > Hypertension in CKD 3 questions
Nephrology > Hypertension > Hypertension in CKD
Nephrology > Hypertension > Hypertension in Elderly Populations 12 questions
Nephrology > Hypertension > Hypertension in Elderly Populations
Nephrology > Hypertension > Lifestyle Modification Strategies 4 questions
Nephrology > Hypertension > Lifestyle Modification Strategies
Nephrology > Hypertension > Malignant Hypertension Crisis 2 questions
Nephrology > Hypertension > Malignant Hypertension Crisis
Nephrology > Hypertension > Neurogenic Hypertension Mechanisms 9 questions
Nephrology > Hypertension > Neurogenic Hypertension Mechanisms
Nephrology > Hypertension > Pediatric Hypertension Management 4 questions
Nephrology > Hypertension > Pediatric Hypertension Management
Nephrology > Hypertension > Pharmacological Treatment Advances 5 questions
Nephrology > Hypertension > Pharmacological Treatment Advances
Nephrology > Hypertension > Renovascular Hypertension > Advanced Pharmacotherapy Analysis 9 questions
Nephrology > Hypertension > Renovascular Hypertension > Advanced Pharmacotherapy Analysis
Nephrology > Hypertension > Renovascular Hypertension > Antihypertensive Drug Adherence 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Antihypertensive Drug Adherence
Nephrology > Hypertension > Renovascular Hypertension > Biochemical Markers Evaluation 7 questions
Nephrology > Hypertension > Renovascular Hypertension > Biochemical Markers Evaluation
Nephrology > Hypertension > Renovascular Hypertension > Diagnostic Imaging Techniques 1 questions
Nephrology > Hypertension > Renovascular Hypertension > Diagnostic Imaging Techniques
Nephrology > Hypertension > Renovascular Hypertension > Dietary and Nutritional Factors 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Dietary and Nutritional Factors
Nephrology > Hypertension > Renovascular Hypertension > Elderly Patient Considerations 3 questions
Nephrology > Hypertension > Renovascular Hypertension > Elderly Patient Considerations
Nephrology > Hypertension > Renovascular Hypertension > Endovascular Treatment Options 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Endovascular Treatment Options
Nephrology > Hypertension > Renovascular Hypertension > Exercise and Physical Activity 3 questions
Nephrology > Hypertension > Renovascular Hypertension > Exercise and Physical Activity
Nephrology > Hypertension > Renovascular Hypertension > Fibromuscular Dysplasia Insights 12 questions
Nephrology > Hypertension > Renovascular Hypertension > Fibromuscular Dysplasia Insights
Nephrology > Hypertension > Renovascular Hypertension > Genetic Predisposition Studies 12 questions
Nephrology > Hypertension > Renovascular Hypertension > Genetic Predisposition Studies
Nephrology > Hypertension > Renovascular Hypertension > Hormonal Modulation Influence 1 questions
Nephrology > Hypertension > Renovascular Hypertension > Hormonal Modulation Influence
Nephrology > Hypertension > Renovascular Hypertension > Interventional Radiology Advances 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Interventional Radiology Advances
Nephrology > Hypertension > Renovascular Hypertension > Lifestyle Intervention Outcomes 10 questions
Nephrology > Hypertension > Renovascular Hypertension > Lifestyle Intervention Outcomes
Nephrology > Hypertension > Renovascular Hypertension > Longitudinal Patient Studies 8 questions
Nephrology > Hypertension > Renovascular Hypertension > Longitudinal Patient Studies
Nephrology > Hypertension > Renovascular Hypertension > Medical Management Strategies 6 questions
Nephrology > Hypertension > Renovascular Hypertension > Medical Management Strategies
Nephrology > Hypertension > Renovascular Hypertension > Microvascular Complications 5 questions
Nephrology > Hypertension > Renovascular Hypertension > Microvascular Complications
Nephrology > Hypertension > Renovascular Hypertension > Pediatric Renovascular Hypertension 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Pediatric Renovascular Hypertension
Nephrology > Hypertension > Renovascular Hypertension > Peripheral Vascular Implications 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Peripheral Vascular Implications
Nephrology > Hypertension > Renovascular Hypertension > Pharmacokinetic Considerations 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Pharmacokinetic Considerations
Nephrology > Hypertension > Renovascular Hypertension > Pregnancy-Related Considerations 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Pregnancy-Related Considerations
Nephrology > Hypertension > Renovascular Hypertension > Research and Innovations 11 questions
Nephrology > Hypertension > Renovascular Hypertension > Research and Innovations
Nephrology > Hypertension > Renovascular Hypertension > Resistant Hypertension Challenges 8 questions
Nephrology > Hypertension > Renovascular Hypertension > Resistant Hypertension Challenges
Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 175 questions
Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment
Nephrology > Hypertension > Renovascular Hypertension > Stress and Psychosocial Factors 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Stress and Psychosocial Factors
Nephrology > Hypertension > Renovascular Hypertension > Surgical Interventions 7 questions
Nephrology > Hypertension > Renovascular Hypertension > Surgical Interventions
Nephrology > Hypertension > Renovascular Hypertension > Technological Diagnostic Advances 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Technological Diagnostic Advances
Nephrology > Hypertension > Resistant Hypertension Treatment 6 questions
Nephrology > Hypertension > Resistant Hypertension Treatment
Nephrology > Hypertension > Salt Sensitivity Studies 5 questions
Nephrology > Hypertension > Salt Sensitivity Studies
Nephrology > Lifestyle and Renal Health 11 questions
Nephrology > Lifestyle and Renal Health
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 15 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 80 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Genetics and MGRS 2 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Genetics and MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > MGRS-Associated Renal Diseases 8 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > MGRS-Associated Renal Diseases
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Pathophysiology MGRS 10 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Pathophysiology MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Risk Stratification MGRS 2 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Risk Stratification MGRS
Nephrology > Nephrology Imaging > Advanced Imaging Techniques for Renal Lesions > 3D Imaging in Kidney Lesion Assessment 5 questions
Nephrology > Nephrology Imaging > Advanced Imaging Techniques for Renal Lesions > 3D Imaging in Kidney Lesion Assessment
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions 5 questions
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions > CT in Differentiating Malignant from Benign Kidney Lesions 6 questions
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions > CT in Differentiating Malignant from Benign Kidney Lesions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging 10 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation 8 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques 26 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Ultrasound Criteria for Kidney Lesion Differentiation 1 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Ultrasound Criteria for Kidney Lesion Differentiation
Nephrology > Nephrology Imaging > Iodinated contrast 2 questions
Nephrology > Nephrology Imaging > Iodinated contrast
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Acute Kidney Injury Monitoring 6 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Acute Kidney Injury Monitoring
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Congenital Anomaly Detection 8 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Congenital Anomaly Detection
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Infective Lesion Identification 8 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Infective Lesion Identification
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Lymphoma Lesions Evaluation 4 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Lymphoma Lesions Evaluation
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification 22 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection 5 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Traumatic Injury Assessment 3 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Traumatic Injury Assessment
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Tumor Infiltration Analysis 5 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Tumor Infiltration Analysis
Nephrology > Nephrology Imaging > MRI Advances in Renal Lesion Evaluation > Functional MRI Techniques for Renal Lesion Evaluation 3 questions
Nephrology > Nephrology Imaging > MRI Advances in Renal Lesion Evaluation > Functional MRI Techniques for Renal Lesion Evaluation
Nephrology > Nephrology Surgery 3 questions
Nephrology > Nephrology Surgery
Nephrology > Proteinuria Studies 9 questions
Nephrology > Proteinuria Studies
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Endocrine Hypertension Syndromes > Pheochromocytoma Hypertension 9 questions
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Endocrine Hypertension Syndromes > Pheochromocytoma Hypertension
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration 15 questions
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration
Pharmacology 14 questions
Pharmacology
Pharmacology > Dermatological Pharmacology 2 questions
Pharmacology > Dermatological Pharmacology
Pharmacology > Neuropharmacology 1 questions
Pharmacology > Neuropharmacology
Pharmacology > Psychopharmacology 10 questions
Pharmacology > Psychopharmacology
Physiology > Cutaneous Physiology 4 questions
Physiology > Cutaneous Physiology
Physiology > Endocrine Physiology 5 questions
Physiology > Endocrine Physiology
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Physiology > Endometrial Physiology
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Physiology > Fetal Physiology
Physiology > Lymphatic Physiology 3 questions
Physiology > Lymphatic Physiology
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Physiology > Muscle Physiology
Physiology > Reproductive Physiology 2 questions
Physiology > Reproductive Physiology
Physiology > Vascular Physiology 1 questions
Physiology > Vascular Physiology
Psychiatry > Adult Psychiatry > Mood Disorders 2 questions
Psychiatry > Adult Psychiatry > Mood Disorders
Psychiatry > Adult Psychiatry > Mood Disorders > Persistent Depressive Disorder 4 questions
Psychiatry > Adult Psychiatry > Mood Disorders > Persistent Depressive Disorder
Psychiatry > Adult Psychiatry > Mood Disorders > Postpartum Depression 9 questions
Psychiatry > Adult Psychiatry > Mood Disorders > Postpartum Depression
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Psychiatry > Geriatric Psychiatry
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Toxicology > Forensic Toxicology

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Sample Medical Questions

Explore 400 example questions from our comprehensive database of 3630+ medical questions:

A 56-year-old man with anxiety presents with 3 days of watery diarrhea after completing a 7-day antibiotic course for a dental infection started 10 days ago. Vi...
A. C. difficile diarrhe...
B. Symptoms can present...
C. Onset requires concu...
D. Nitrofurantoin is th...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 16-year-old girl presents to the emergency department after a morning of repeated, forceful nonbloody emesis following a 2‑day viral‑like illness with myalgia...
A. Water‑soluble contra...
B. Multiphase CT esopha...
C. Flexible esophagosco...
D. Thin‑barium swallow ...
Type: differential_testing Difficulty: hard Category: Unknown 📷 Includes Image
A 29-year-old pregnant woman (G2P0, prior early miscarriage) at 13 weeks by ultrasound presents to a rural emergency department during an ice storm with progres...
A. Add tacrolimus 0.05–...
B. Switch to mycophenol...
C. Begin intravenous cy...
D. Start belimumab 10 m...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 22-year-old woman presents with intermittent cola‑colored urine and mild edema after upper respiratory infections for the past year. Past history includes epi...
A. IgA nephropathy sugg...
B. Poststreptococcal gl...
C. Alport syndrome with...
D. Thin basement membra...
Type: differential_physical_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 12-year-old boy is brought to the emergency department for 3 days of escalating agitation, insomnia, profuse sweating, and pounding palpitations following a b...
A. Graves disease with ...
B. Subacute (de Quervai...
C. Toxic multinodular g...
D. Factitious thyrotoxi...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A 45-year-old woman presents to clinic for tremor, anxiety, and fever developing within several hours after an urgent‑care physician started linezolid for presu...
A. Inducible or ocular ...
B. Generalized lead‑pip...
C. Dry mucous membranes...
D. Hypothermia, pinpoin...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 14-year-old boy with cerebral palsy, chronic spontaneous urticaria, folate deficiency anemia on supplementation, and a history of intermittent urinary retenti...
A. Avoid systemic fluor...
B. Begin ciprofloxacin ...
C. Use levofloxacin 750...
D. Administer moxifloxa...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 53-year-old woman presents to the ED after a low‑energy fall with acute right groin pain. Vitals: pulse 131/min on arrival, respirations 8/min improving to 16...
A. Deep branch of the m...
B. Acetabular branch of...
C. Ascending branch of ...
D. Inferior gluteal art...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 47-year-old woman is referred for blood and protein in the urine found on screening. She has no fever, throat pain, or recent travel. She had a small skin abs...
A. Ultrasound‑guided pe...
B. Serum galactose‑defi...
C. Throat culture with ...
D. Repeat endoscopic ul...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
A 10-year-old boy develops abrupt palpitations, dizziness, and mild shortness of breath while playing a video game at home. He has had two brief self‑limited ep...
A. Ventricular fibrilla...
B. Prolonged sinus paus...
C. Acute bronchospasm w...
D. Symptomatic hypotens...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 60-year-old woman is brought to a critical-access emergency department during a severe winter dust-and-wind event that has grounded rotor and fixed-wing trans...
A. Calculate the alkali...
B. Obtain serum cerulop...
C. Measure total serum ...
D. Perform bedside penl...
Type: differential_testing Difficulty: expert Category: Unknown 📷 Includes Image
A 41-year-old woman with no known structural heart disease presents to urgent care with 35 minutes of abrupt-onset pounding palpitations, throat fullness, and l...
A. A prior sinus‑rhythm...
B. During the tachycard...
C. Pseudo r′ in V1 and ...
D. Emergence of rate‑re...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 30-year-old man comes to a small rural clinic with sudden left flank pain radiating to the groin, nausea, and restlessness. He smokes 0.5 pack/day for 5 years...
A. We will start with a...
B. We will schedule a C...
C. You do not need any ...
D. We must do an MRI wi...
Type: patient_communication Difficulty: easy Category: Unknown 📷 Includes Image
A 28-year-old man with weight loss, heat intolerance, tremor, and palpitations is diagnosed with Graves disease after outpatient testing showed suppressed TSH, ...
A. Start methimazole an...
B. Give potassium iodid...
C. Use high‑dose predni...
D. Proceed directly to ...
Type: prevention Difficulty: easy Category: Unknown 📷 Includes Image
A 4-year-old boy is brought to the ED for progressive weakness and drooling after a family gathering where several adults ate home‑canned vegetables; the child ...
A. Blockade of presynap...
B. Competitive antagoni...
C. Inhibition of acetyl...
D. Direct opening of ry...
Type: mechanism Difficulty: easy Category: Unknown 📷 Includes Image
A 42-year-old woman with cervical spondylotic myelopathy scheduled for decompression next month undergoes preoperative labs that reveal discordant thyroid indic...
A. TSH‑secreting pituit...
B. Resistance to thyroi...
C. Persistent antibody‑...
D. Familial dysalbumine...
Type: differential_comprehensive Difficulty: expert Category: Unknown 📷 Includes Image
A 20-year-old woman of North African origin presents to the emergency department with two weeks of episodic blood-streaked sputum that progressed this morning t...
A. Switch remission ind...
B. Continue rituximab-b...
C. Add avacopan 30 mg o...
D. Escalate to daily or...
Type: treatment_failure Difficulty: hard Category: Unknown 📷 Includes Image
A 29-year-old woman presents for a routine primary‑care visit. She exercises regularly three times weekly, works in construction, and uses marijuana occasionall...
A. Defer lumbar punctur...
B. Order the multiplex ...
C. Screen the patient t...
D. Perform urgent lumba...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 35-year-old woman presents to a rural urgent care with severe dyspnea and pleuritic chest tightness that worsened over 12 hours while working a double shift i...
A. Begin oral prednison...
B. Start oral prednison...
C. Initiate oral predni...
D. Start oral prednison...
Type: treatment Difficulty: expert Category: Unknown 📷 Includes Image
A 27-year-old woman with 10 pack‑years of cigarette use (currently 1 pack/day since age 17) presents with 5 days of hemoptysis producing blood‑tinged, frothy sp...
A. Do not add plasma ex...
B. Start plasma exchang...
C. Initiate a bridging ...
D. Delay rituximab to p...
Type: recent_changes Difficulty: expert Category: Unknown 📷 Includes Image
A 48-year-old man with biopsy-proven Takayasu arteritis (aortic involvement treated with prior glucocorticoids and tocilizumab, now off therapy for 8 months) an...
A. Anterior tarsal tunn...
B. Common fibular (pero...
C. L5 radiculopathy fro...
D. Posterior tarsal tun...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image
A 32-year-old woman with congestive heart failure from prior myocarditis, bronchiolitis obliterans with chronic cough, and nasal polyps presents to urgent care ...
A. Calculate post-test ...
B. Order imaging immedi...
C. Rely on sensitivity ...
D. Repeat the same test...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 37-year-old man is referred to nephrology for edema and heavy proteinuria. Over 6 weeks he noted periorbital swelling in the mornings and progressive ankle sw...
A. Tip variant focal se...
B. Cellular variant foc...
C. Perihilar variant fo...
D. Membranous nephropat...
Type: pathology Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 28-year-old primigravid woman at 22 weeks’ gestation presents after falling onto her outstretched left hand while stepping off a bus. She reports immediate ra...
A. Adopt immediate non‑...
B. Delay imaging for 2 ...
C. Obtain immediate low...
D. Schedule bone scinti...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
A 39-year-old woman comes to a routine primary care visit to set up care after moving. She asks for help with low mood and less interest in hobbies over the pas...
A. Ask the PHQ‑2 now; i...
B. Use the PHQ‑2 only a...
C. Order repeat thyroid...
D. Send her for a brain...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
A 29-year-old man with microscopic polyangiitis leading to kidney failure performs home automated peritoneal dialysis (APD) nightly using a cycler. He also has ...
A. Switch to manual CAP...
B. Wait for power resto...
C. Attempt to continue ...
D. Start high-dose oral...
Type: management Difficulty: easy Category: Nephrology > Hypertension > Renovascular Hypertension > Pediatric Renovascular Hypertension 📷 Includes Image
A 57-year-old woman presents to her primary care clinic for progressive exertional dyspnea, reduced walking distance, and ankle swelling over several months. Sh...
A. Heart failure with p...
B. Primary deconditioni...
C. Chronic thromboembol...
D. Moderate persistent ...
Type: diagnosis Difficulty: hard Category: Unknown 📷 Includes Image
A 39-year-old right-handed woman who works rotating twelve-hour shifts as an emergency department nurse presents with progressive hand paresthesias and object d...
A. Schedule definitive ...
B. Schedule carpal tunn...
C. Proceed with endosco...
D. Defer surgery and re...
Type: management Difficulty: expert Category: Unknown 📷 Includes Image
A 27‑year‑old woman presents with easy bruising around the eyes after minor rubbing, waxy translucent papules on the eyelids, and scattered purpura on the neck....
A. Congo red–stained de...
B. Congo red fluorescen...
C. Polarized light reve...
D. Strong negative bire...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
A 73-year-old woman presents with abrupt, severe, tearing chest pain radiating between the scapulae that began 40 minutes ago while she was standing in her kitc...
A. Begin intravenous es...
B. Initiate intravenous...
C. Administer an unfrac...
D. Give sublingual nitr...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A public health nurse precepts a prenatal group visit in a community clinic during respiratory virus season. The goal is to align counseling with current guidan...
A. Counsel that Abrysvo...
B. Recommend giving mat...
C. Use Arexvy or mResvi...
D. Avoid maternal RSV v...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
You are asked to staff a cutaneous lymphoma clinic and triage follow‑up cadence by anticipating the natural course over the next 3–5 years. Four new patients wi...
A. Progression risk is ...
B. Progression risk is ...
C. Progression risk is ...
D. Progression risk is ...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 76-year-old woman living alone on a cattle ranch 90 miles from the nearest tertiary center presents to a six-bed critical-access hospital with 6 weeks of prog...
A. Transmission electro...
B. Paraffin-section imm...
C. CLIA-certified APOL1...
D. Vascular-laboratory ...
Type: differential_testing Difficulty: expert Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 50-year-old woman with hypertrophic cardiomyopathy, ulcerative colitis, diabetic retinopathy, secondary hyperparathyroidism, a circadian rhythm sleep disorder...
A. We should perform an...
B. A partial shave toda...
C. A strong topical ste...
D. Because winter sunli...
Type: patient_communication Difficulty: easy Category: Unknown 📷 Includes Image
A 27-year-old man presents to the emergency department with sudden large‑volume bright red hemoptysis and lightheadedness. He has a history of bronchiectasis af...
A. Place in lateral dec...
B. Insert a nasogastric...
C. Use noninvasive vent...
D. Nebulize tranexamic ...
Type: treatment Difficulty: easy Category: Unknown 📷 Includes Image
A 32-year-old woman with a history of treated cervical cancer presents to an urgent care for cough and wheeze during a seasonal viral surge. She is a current sm...
A. Prescribe oxygen as ...
B. Start oxygen without...
C. Delegate all oxygen ...
D. Chart that oxygen is...
Type: legal_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
Four women with recurrent symptomatic narrow-complex tachycardia compatible with typical AV nodal reentrant tachycardia (short RP) are scheduled for electrophys...
A. Patient C: Left-domi...
B. Patient A: Right-dom...
C. Patient B: Codominan...
D. Patient D: No corona...
Type: legal_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 47-year-old man with spastic diplegic cerebral palsy presents for evaluation of chronic, painful oral erosions and episodic flaccid bullae on the chest and ax...
A. With first‑line ritu...
B. With first‑line ritu...
C. With first‑line ritu...
D. With first‑line ritu...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 54‑year‑old woman with a 6‑year history of definite Ménière’s disease (recurrent spontaneous vertigo lasting 1–3 hours, fluctuating low‑frequency sensorineura...
A. Vertigo attack frequ...
B. Vertigo attacks ofte...
C. Bilateral involvemen...
D. Hearing thresholds t...
Type: natural_history Difficulty: hard Category: Unknown 📷 Includes Image
A 31-year-old gravida 2 para 1 at 24 weeks’ gestation is co‑managed by nephrology and maternal–fetal medicine for biopsy‑proven IgA nephropathy diagnosed 3 year...
A. Invasive meningococc...
B. Encapsulated‑bacteri...
C. Risk restricted to H...
D. Antibiotic prophylax...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 69-year-old man of West African ancestry is admitted for months of exertional dyspnea that now limits a single flight of stairs, orthostatic lightheadedness w...
A. Wild-type transthyre...
B. Immunoglobulin light...
C. Cardiac sarcoidosis ...
D. Sarcomeric hypertrop...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A 36-year-old woman with childhood-onset growth hormone deficiency (not currently treated), epilepsy (levetiracetam 1,000 mg twice daily), multiple endocrine ne...
A. Targeted–release bud...
B. By activating minera...
C. By dual antagonism o...
D. By selectively inhib...
Type: mechanism Difficulty: hard Category: Unknown 📷 Includes Image
A 37-year-old woman with antiphospholipid antibody syndrome presents with 90 minutes of crushing substernal chest pain radiating to the left arm and jaw. She wo...
A. Papillary muscle rup...
B. Post-infarction vent...
C. Left ventricular fre...
D. Early left ventricul...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 15-year-old boy is brought to a small rural clinic after colliding with another player during a school soccer match. He reports sudden severe pain in the righ...
A. Deep fibular nerve c...
B. Superficial fibular ...
C. Tibial nerve ischemi...
D. Saphenous nerve dist...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 78-year-old woman is seen in clinic to arrange an outpatient native‑kidney biopsy for persistent hematuria and subnephrotic proteinuria. She has schizophrenia...
A. Document informed co...
B. Record a witnessed v...
C. Complete a generic p...
D. Enter an electronic ...
Type: legal_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
In clinic you see four patients with biochemically confirmed primary hyperparathyroidism (persistently elevated serum calcium and inappropriately high intact PT...
A. For Patient 1, expla...
B. For Patient 2, advis...
C. For Patient 3, recom...
D. For Patient 4, sugge...
Type: patient_communication Difficulty: easy Category: Unknown 📷 Includes Image
An 11-year-old boy with repaired myelomeningocele (clean intermittent catheterization four times daily), congenital hydrocephalus with a functioning ventriculop...
A. Requirement for acut...
B. Moderate-to-severe c...
C. A noninvasive compos...
D. Initiation of high-d...
Type: complications Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN
A 50-year-old man presents to a rural clinic during a winter storm that has closed highways for 24–48 hours. He reports a painless midline neck lump that has sl...
A. Thyroglossal duct cy...
B. Second branchial cle...
C. Dermoid cyst of the ...
D. Lingual thyroid at t...
Type: differential_physical_history Difficulty: easy Category: Unknown 📷 Includes Image
A 31-year-old primigravida at 28 weeks has 2 weeks of intensely pruritic periumbilical urticarial plaques that have progressed to tense blisters on the abdomen ...
A. Placenta‑driven loss...
B. Autoantibodies to de...
C. A delayed type IV hy...
D. IgE‑mediated food al...
Type: mechanism Difficulty: easy Category: Unknown 📷 Includes Image
A 62-year-old woman with vasculitis and bilateral progressive hearing loss presents to the cardiology clinic with exertional chest pressure. She is afebrile at ...
A. Document specific ri...
B. Record comprehensive...
C. Proceed with oral co...
D. Have the patient wai...
Type: legal_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 53-year-old woman at 24 weeks’ gestation after donor-egg in vitro fertilization is brought to the obstetric triage area from a prenatal visit because she felt...
A. Use centralized, web...
B. Use site-level strat...
C. Assign treatment by ...
D. Randomize by hospita...
Type: clinical_trials Difficulty: moderate Category: Unknown 📷 Includes Image
A 22‑year‑old woman is 16 weeks pregnant. She underwent a living‑donor kidney transplant 3 years ago and has had no rejection in the past 2 years. She works par...
A. Continue tacrolimus ...
B. Continue tacrolimus ...
C. Increase tacrolimus ...
D. Switch tacrolimus to...
Type: cost_effectiveness Difficulty: hard Category: Unknown 📷 Includes Image
A 71-year-old man comes to clinic because his feet have burned, tingled, and felt numb for 6 months, worse at night, and he has begun to feel unsteady in the da...
A. Order low‑cost scree...
B. Go straight to nerve...
C. Order a whole‑body P...
D. Check only an HbA1c ...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
A 4-year-old girl is brought to clinic for new eyelid puffiness and ankle swelling over 5 days. Parents also noticed frothy urine. She has no fever, cough, rash...
A. Obtain a first‑morni...
B. Schedule an ultrasou...
C. Order CT thoracoscop...
D. Start high‑dose loop...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 29-year-old woman is evaluated in a small critical access hospital clinic during a winter storm that has grounded air transport and closed mountain passes for...
A. Progressive hepatic ...
B. Sinusoidal obstructi...
C. Primary sclerosing c...
D. Portal vein thrombos...
Type: natural_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 58-year-old White man is brought to a tertiary-care emergency department in early winter because of 36 hours of rapidly worsening shortness of breath and pass...
A. Arrange urgent admis...
B. Begin intravenous cy...
C. Start daily therapeu...
D. Treat with rituximab...
Type: treatment Difficulty: expert Category: Psychiatry > Geriatric Psychiatry 📷 Includes Image
A 2-year-old girl is brought to the pulmonary clinic for evaluation of chronic wet cough since infancy, persistent nasal congestion, and recurrent otitis media ...
A. Primary ciliary dysk...
B. Primary ciliary dysk...
C. Primary ciliary dysk...
D. Primary ciliary dysk...
Type: epidemiology Difficulty: hard Category: Unknown 📷 Includes Image
A 81-year-old man is admitted for progressive dyspnea, new purpura, malaise, and acute kidney injury on background limited scleroderma, osteoarthritis, and urin...
A. Discontinue therapeu...
B. Escalate to daily 1....
C. Continue alternate‑d...
D. Add caplacizumab to ...
Type: treatment_failure Difficulty: hard Category: Unknown 📷 Includes Image
A 56‑year‑old man in the ED starts urgent therapeutic plasma exchange for an antibody‑mediated neurologic flare. He presented with palpitations from narrow‑comp...
A. Pause the exchange; ...
B. Pause briefly; give ...
C. Administer 10 mL of ...
D. Treat as an anaphyla...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 4-year-old girl is brought to the emergency department 14 hours after passing cola-colored urine that started the evening after a runny nose and sore throat b...
A. Time‑averaged protei...
B. Trajectory of eGFR a...
C. Serial concentration...
D. Achievement of compl...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 72-year-old man with chronic right‑sided cholesteatoma and conductive hearing loss presents to clinic after 6 weeks of intermittent otorrhea, crusting, nasal ...
A. Equating a low‑titer...
B. Deferring urgent ind...
C. Ruling out pulmonary...
D. Attributing chronic ...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 78-year-old man presents to a rural urgent-care outpost during a regional ice storm that has closed highways and grounded medical evacuation for the next 18–2...
A. Hold doxazosin and r...
B. Start midodrine 10 m...
C. Begin an intravenous...
D. Stop all antihyperte...
Type: complications Difficulty: moderate Category: Nephrology > Glomerulonephritis > Hematological Disorder GN 📷 Includes Image
A 49-year-old man comes for a routine annual visit and asks about his risk of IgA nephropathy because his sister in Japan was recently diagnosed. He is completi...
A. IgA nephropathy is m...
B. The highest prevalen...
C. Rates are similar wo...
D. Prevalence is highes...
Type: epidemiology Difficulty: moderate Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 25-year-old man presents to a small mountain clinic after suddenly feeling a pop in the back of his left ankle while sprinting uphill. He immediately had seve...
A. Place a posterior sp...
B. Immobilize with a kn...
C. Inject corticosteroi...
D. Begin early active s...
Type: treatment Difficulty: easy Category: Unknown 📷 Includes Image
A 44-year-old G3P1 woman at 24 weeks’ gestation presents to the obstetric triage unit after 4 hours of pounding palpitations, shortness of breath, and new right...
A. It crosses the blood...
B. It acts peripherally...
C. It lowers sympatheti...
D. It activates ATP‑sen...
Type: mechanism Difficulty: hard Category: Unknown 📷 Includes Image
A 34-year-old woman is seen for a routine visit to discuss management options for a progressively enlarging bilateral multinodular goiter discovered on a workpl...
A. Proceed with total t...
B. Administer a standar...
C. Continue long‑term m...
D. Offer unilateral hem...
Type: treatment Difficulty: hard Category: Unknown 📷 Includes Image
A 32-year-old woman is brought to the emergency department after a high-speed motor vehicle collision with dashboard impact to the right knee and a brief loss o...
A. Common fibular (pero...
B. Tibial nerve, typica...
C. Femoral nerve, more ...
D. Sural nerve, a cutan...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 40-year-old woman with Takayasu arteritis seen by rheumatology returns for a routine visit to review new lab results and discuss what they mean. She lives wit...
A. Explain that tiny ki...
B. Explain that salt in...
C. Explain that a bladd...
D. Explain that low hea...
Type: patient_communication Difficulty: easy Category: Unknown 📷 Includes Image
You are preparing an interim epidemiologic report from a single‑centre quality‑improvement registry that now includes 148 consecutive adults with angiographical...
A. Baseline urine prote...
B. Angiographic stenosi...
C. Baseline office syst...
D. Bilateral renal‑arte...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 58-year-old woman presents for routine eye care after noticing mild glare while driving at night. She denies halos, acute visual loss, or eye pain. Past histo...
A. Black patients in th...
B. Mexican‑American pat...
C. Women of all races h...
D. Risk of primary open...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
You are the neurohospitalist on call evaluating three simultaneous admissions for neuromuscular symptoms. All are women without pregnancy. Which single diagnosi...
A. Myasthenia gravis in...
B. Lambert–Eaton myasth...
C. Botulism in Patient ...
D. Brainstem ischemic s...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 40-year-old man presents with sudden severe pain, swelling, and erythema of the left first metatarsophalangeal joint for 18 hours. He drinks beer on weekends,...
A. Arthrocentesis of th...
B. Empiric colchicine w...
C. Order serum urate an...
D. Obtain MRI of the fo...
Type: diagnostic_step Difficulty: moderate Category: Unknown 📷 Includes Image
A 29-year-old Black man presents to an academic nephrology clinic with 6 months of progressive bilateral leg swelling, periorbital puffiness, and foamy urine. H...
A. Sparsentan, oral, ti...
B. Atrasentan, oral, 0....
C. Cyclosporine (modifi...
D. Rituximab, intraveno...
Type: clinical_trials Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
Four recruits present to the base clinic after a week of load‑bearing marches. Vitals at triage are stable in all four. Medications used by the group are occasi...
A. Patient C: Sudden ho...
B. Patient A: Inversion...
C. Patient B: Painful r...
D. Patient D: Lateral e...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
You are the on‑call gastroenterology consultant asked to triage four adults with laboratory‑confirmed Clostridioides difficile infection at a community hospital...
A. Administer bezlotoxu...
B. Administer bezlotoxu...
C. Administer bezlotoxu...
D. Administer bezlotoxu...
Type: treatment_failure Difficulty: hard Category: Unknown 📷 Includes Image
A 28-year-old woman is evaluated for persistent hypertension. Ten months ago, hydrochlorothiazide was titrated to 50 mg once daily. Eight weeks later, amlodipi...
A. Perform percutaneous...
B. Add spironolactone 2...
C. Perform percutaneous...
D. Schedule surgical ao...
Type: treatment Difficulty: easy Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection 📷 Includes Image
A 36-year-old man is brought to the ED for abrupt confusion, transient aphasia, and diffuse bruising noted by family earlier today. Weight 82 kg and height 178 ...
A. Initiate emergent th...
B. Await ADAMTS13 activ...
C. Perform red blood ce...
D. Administer intraveno...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
A 50‑year‑old woman in a mountain town clinic presents with a slowly enlarging 1.1‑cm erythematous, scaly plaque on the dorsal forearm, present for 8 months. It...
A. Perform a deep shave...
B. Apply imiquimod 5% c...
C. Arrange Mohs microgr...
D. Use clobetasol 0.05%...
Type: treatment_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 43-year-old woman presents to a U.S. nephrology clinic after persistent urinary abnormalities reported over 3 months. She notes two episodes of tea-colored ur...
A. Per KDIGO 2021 Glome...
B. Because of baseline ...
C. We can perform a sam...
D. To minimize bleeding...
Type: patient_communication Difficulty: expert Category: Unknown 📷 Includes Image
A 58-year-old woman residing in an assisted-living facility is brought to the emergency department 45 minutes after abrupt dyspnea and confusion during ambulati...
A. Ninety-day all-cause...
B. A hierarchical compo...
C. Ventilator-free days...
D. Time to kidney-repla...
Type: clinical_trials Difficulty: expert Category: Unknown 📷 Includes Image
A 28-year-old G2P1 at 28 weeks’ gestation presents with six weeks of nocturnal numbness and tingling in the thumb, index, and middle fingers of both hands, wors...
A. Nerve conduction stu...
B. MRI of the wrist wit...
C. CT of the cervical s...
D. Serum antinuclear an...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 59-year-old woman presents for a routine visit for progressive exertional fatigue, ankle edema, and numbness in her feet over 9 months. She denies illicit dru...
A. Order serum and urin...
B. Start high‑dose NSAI...
C. Schedule coronary an...
D. Request endomyocardi...
Type: diagnostic_failure Difficulty: moderate Category: Unknown 📷 Includes Image
A 50-year-old man with narcolepsy presents to the emergency department after abrupt onset of dyspnea, pleuritic chest discomfort, lightheadedness, and a brief n...
A. Acute cardiac tampon...
B. Massive pulmonary em...
C. Right ventricular in...
D. Tension pneumothorax...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A 59-year-old man presents for a routine primary care visit in November. He has a history of influenza in prior seasons, normal pressure hydrocephalus with shun...
A. Administer an age‑ap...
B. Provide the intranas...
C. Defer all influenza ...
D. Administer the intra...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 43-year-old man presents to the emergency department with brown urine that started a few hours after the onset of a sore throat, cough, and low‑grade fever. H...
A. IgA immune‑complex d...
B. Subepithelial immune...
C. Linear IgG along the...
D. Kimmelstiel–Wilson n...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
A 61-year-old man presents to the emergency department with sharp, left-sided chest pain that began 12 hours ago. The pain worsens with deep inspiration and whe...
A. Acute pericarditis c...
B. Acute ST-elevation m...
C. Pulmonary embolism p...
D. Aortic dissection wi...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 13-year-old boy is brought to the pediatric emergency department with three days of high fever, malaise, diffuse itchy rash, facial puffiness, tender neck nod...
A. Obtain and document ...
B. Proceed with the bio...
C. Accept verbal permis...
D. Ask only the adolesc...
Type: legal_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 71-year-old man with chronic osteomyelitis of the right tibia (intermittent drainage), paroxysmal nocturnal hemoglobinuria, common variable immunodeficiency w...
A. Obtain two sets of b...
B. Proceed first to ult...
C. Initiate low‑dose co...
D. Defer systemic antib...
Type: emergency_priorities Difficulty: expert Category: Unknown 📷 Includes Image
An 87-year-old man with focal segmental glomerulosclerosis that did not improve with high‑dose steroids started tacrolimus 6 weeks ago. Ten days ago, his primar...
A. Tacrolimus toxicity ...
B. Prerenal azotemia fr...
C. Acute interstitial n...
D. Renal vein thrombosi...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
An 88-year-old woman presents to the emergency department with 2 days of melena, dizziness on standing, and epigastric discomfort. History includes mitral steno...
A. Bleeding duodenal ul...
B. Acute variceal hemor...
C. Mallory–Weiss tear a...
D. Dieulafoy lesion in ...
Type: diagnosis Difficulty: hard Category: Unknown 📷 Includes Image
You are the medical director for a volunteer EMS service in a remote county with a single ambulance and a very limited drug budget. Helicopter transport is ofte...
A. The randomized ALPS ...
B. Amiodarone significa...
C. Lidocaine reduced mo...
D. Either drug doubled ...
Type: clinical_trials Difficulty: easy Category: Unknown 📷 Includes Image
A 72-year-old man living in assisted living presents with 3 days of large-volume watery diarrhea. He reports 10–12 stools daily that wake him from sleep and con...
A. Low stool osmotic ga...
B. High stool osmotic g...
C. Loose stools only af...
D. Greasy, foul‑smellin...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 41-year-old woman presents 12 hours after a sore throat began. This morning she noticed dark, tea-colored urine and mild puffiness around the eyes. She denies...
A. Manage as an outpati...
B. Start oral prednison...
C. Treat presumptively ...
D. Admit to the hospita...
Type: clinical_pitfalls Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
An 18-year-old man presents with months of paroxysmal pounding headaches, profuse diaphoresis, palpitations with tremulousness, and episodic pallor followed by ...
A. Immediate propranolo...
B. Add a beta-adrenergi...
C. Initiate doxazosin 1...
D. Use a titratable int...
Type: contraindications Difficulty: moderate Category: Unknown 📷 Includes Image
A 49-year-old woman presents to an outpatient gastroenterology clinic for discussion of durable enteral access after 3 months of documented oropharyngeal dyspha...
A. Blind “pull” percuta...
B. Direct introducer (“...
C. Radiologically inser...
D. Laparoscopy‑assisted...
Type: contraindications Difficulty: expert Category: Unknown 📷 Includes Image
A 23-year-old man with type 1 diabetes mellitus and congenital aortic stenosis collapses at home with palpitations and lightheadedness during a viral illness wi...
A. Facial flushing is t...
B. Chest discomfort mos...
C. Dyspnea is the most ...
D. Headache is the most...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
A 34-year-old man with hypertrophic cardiomyopathy (max septal thickness 20 mm, no resting LVOT gradient, AICD not yet placed), prior blastomycosis (treated), b...
A. Begin an early discl...
B. Provide a prompt fac...
C. Direct a detailed up...
D. Give a brief clinica...
Type: management Difficulty: expert Category: Unknown 📷 Includes Image
A 27-year-old man presents to a university fertility clinic with his partner after 9 months of unsuccessful attempts at conception. He is otherwise healthy and ...
A. Counsel complete can...
B. Advise cannabis cess...
C. Recommend cutting ca...
D. Proceed directly to ...
Type: patient_communication Difficulty: hard Category: Unknown 📷 Includes Image
A 58-year-old woman with biopsy-proven giant cell arteritis 14 months ago arrives to the ED after awakening 2 hours earlier with painless vision loss in the rig...
A. Permanent, severe vi...
B. Sudden complete mono...
C. Acute posterior isch...
D. Rapid-onset steroid-...
Type: natural_history Difficulty: hard Category: Unknown 📷 Includes Image
A 48-year-old woman with a past diagnosis of microscopic polyangiitis (MPO-ANCA positive) in remission for 4 years presents with 10 days of low energy, tea-colo...
A. Relapse of MPO-ANCA–...
B. Antibody disease aga...
C. IgA build-up in the ...
D. Primary complement-d...
Type: differential_comprehensive Difficulty: easy Category: Unknown 📷 Includes Image
A 26-year-old woman with rheumatoid arthritis and systemic lupus erythematosus presents with edema, new macroscopic hematuria, and a rising creatinine. She work...
A. Serum cryoglobulins ...
B. Repeat ANCA testing ...
C. Anti‑GBM IgG ELISA w...
D. Serum and urine prot...
Type: differential_testing Difficulty: expert Category: Unknown 📷 Includes Image
A 47-year-old construction worker presents with abrupt pleuritic right‑sided chest pain, dyspnea at rest, and dry cough that began 4 hours after a 6‑hour car ri...
A. CT pulmonary angiogr...
B. Ventilation–perfusio...
C. Serial bilateral low...
D. Apply a very‑low‑ris...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
A 30-year-old woman reports months of palpitations with abrupt onset and termination, sometimes followed by several seconds of lightheadedness and brief pauses....
A. High-resolution ECG-...
B. Standard cine cardia...
C. Immediate diagnostic...
D. Noncontrast chest CT...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
An 81-year-old man is brought to the emergency department 20 minutes after abrupt pleuritic chest pain, presyncope, and new shortness of breath that began while...
A. Administer systemic ...
B. Begin unffractionate...
C. Give intravenous opi...
D. Start high-dose vaso...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
A 30-year-old man with IgG4‑related disease on prednisone 5 mg daily, cervical spondylotic myelopathy with a chronic mildly spastic gait, and adhesive tape derm...
A. Replaced right hepat...
B. Accessory right hepa...
C. Replaced right hepat...
D. Replaced common hepa...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 34-year-old woman with primary myelofibrosis on ruxolitinib, cervical spondylotic myelopathy, prior squamous cell carcinoma of the forearm resected two years ...
A. Measure serum TSH re...
B. Obtain an iodine-123...
C. Order a technetium 9...
D. Measure serum thyrog...
Type: diagnostic_step Difficulty: hard Category: Unknown 📷 Includes Image
A 27-year-old man with known ornithine transcarbamylase deficiency is brought to the emergency department by friends for progressive confusion and vomiting afte...
A. Start IV dextrose wi...
B. Begin lactulose and ...
C. Give high‑protein en...
D. Start broad‑spectrum...
Type: management Difficulty: easy Category: Unknown 📷 Includes Image
During a busy evening in the emergency department, three adults present with suspected renal colic. All are afebrile, have stable vital signs, oxygen saturation...
A. Patient C, the woman...
B. Patient A, the woman...
C. Patient B, the man w...
D. All three patients, ...
Type: clinical_trials Difficulty: easy Category: Unknown
A 44-year-old man presents with abrupt bilateral leg weakness, a tight band-like thoracic sensation, urinary retention, and intractable hiccups with vomiting fo...
A. Aquaporin‑4–IgG–posi...
B. Seronegative neuromy...
C. Myelin oligodendrocy...
D. AQP4‑IgG–positive NM...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image
A 20-year-old woman comes to a community clinic because of a daily wet cough that has been present for as long as she can remember. She also has a stuffy nose m...
A. Primary ciliary dysk...
B. Cystic fibrosis with...
C. Asthma with reversib...
D. Simple smoking‑relat...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 61-year-old man with recurrent calcium‑oxalate nephrolithiasis and osteoporosis presents for evaluation of persistent hypercalcemia 6 months after bilateral n...
A. Proceed with additio...
B. Escalate cinacalcet ...
C. Repeat blind bilater...
D. Administer an intrav...
Type: treatment_failure Difficulty: hard Category: Unknown 📷 Includes Image
A 28-year-old woman presents to an advanced lung disease clinic with progressive exertional dyspnea and presyncope over 6 months. She has atopic dermatitis and ...
A. Adopt mean pulmonary...
B. Retain the historica...
C. Use echocardiographi...
D. Define pulmonary hyp...
Type: recent_changes Difficulty: moderate Category: Unknown 📷 Includes Image
A 12-year-old boy is evaluated at a mountain urgent‑care clinic during a windstorm that has closed roads for at least 18 hours. He developed sudden coughing and...
A. Obtain inspiratory a...
B. Order chest CT with ...
C. Repeat arterial bloo...
D. Start broad‑spectrum...
Type: diagnostic_failure Difficulty: moderate Category: Unknown 📷 Includes Image
A 94-year-old man is admitted to a small critical-access hospital after a displaced intertrochanteric hip fracture from a ground-level fall. According to EMS, n...
A. Begin active rewarmi...
B. Use passive cotton b...
C. Administer additiona...
D. Delay surgery until ...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 22-year-old man who works in construction comes to urgent care for sudden trouble pinching a screw between his right thumb and index finger that began this mo...
A. Anterior interosseou...
B. Radial nerve injury ...
C. Ulnar nerve compress...
D. C7 radiculopathy cau...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 24-year-old woman presents with a 6‑week history of an expanding, pruritic, faintly annular plaque with central clearing on the right thigh. It briefly improv...
A. Stop topical cortico...
B. Escalate to high‑pot...
C. Begin oral fluconazo...
D. Administer a 5‑day o...
Type: treatment_failure Difficulty: moderate Category: Unknown 📷 Includes Image
A 34-year-old man presents for a routine visit after several months of episodic pounding headaches, drenching sweats, palpitations, pallor, and anxiety that beg...
A. Catecholamine‑secret...
B. Essential hypertensi...
C. Renal artery stenosi...
D. Primary hyperaldoste...
Type: diagnosis Difficulty: moderate Category: Unknown 📷 Includes Image
A 24-year-old man presents for a routine visit to establish care. He reports intermittent wheeze with colds in childhood and persistent exertional breathlessnes...
A. Obstructive spiromet...
B. Obstructive spiromet...
C. Restrictive pattern ...
D. Normal spirometry wi...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 39-year-old woman who rotates day and night shifts in a regional hospital cafeteria arrives to the emergency department 18 hours after noticing cola-colored u...
A. Make the percentage ...
B. Define complete prot...
C. Use total eGFR slope...
D. Adopt a hard clinica...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
A 44-year-old man presents with 6 days of dark, tea-colored urine, fatigue, and low-grade fevers. Three weeks earlier he returned from Thailand, where he visite...
A. Continuing hydralazi...
B. Stopping hydralazine...
C. Attributing the acut...
D. Omitting inpatient S...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 26-year-old woman presents for a routine wellness visit. She has mixed connective tissue disease managed without immunosuppressants. She keeps several reptile...
A. Midline cyst that el...
B. Lateral neck cyst ov...
C. Fixed midline mass t...
D. Pulsatile midline sw...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 36-year-old man with no known kidney disease presents with 3 weeks of progressive ankle and facial puffiness, tighter shoes, and foamy urine. He notes a 12-lb...
A. Primary focal segmen...
B. Minimal change disea...
C. Membranous nephropat...
D. Diabetic kidney dise...
Type: diagnosis Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 32-year-old woman with hypoparathyroidism and Wolff–Parkinson–White syndrome presents with 4 months of recalcitrant, exquisitely painful erosive stomatitis in...
A. Indirect immunofluor...
B. Repeat ELISA quantif...
C. In situ hybridizatio...
D. Western blot limited...
Type: differential_testing Difficulty: hard Category: Unknown 📷 Includes Image
A 42-year-old Black man presents to his nephrology clinic for a routine follow-up to discuss progressive edema and heavy proteinuria that persisted despite thre...
A. Percutaneous native ...
B. Empiric high-dose or...
C. Comprehensive germli...
D. Intensified supporti...
Type: diagnostic_failure Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 28-year-old man with type 1 diabetes on an insulin pump and autoimmune adrenal insufficiency (hydrocortisone 10 mg morning, 5 mg afternoon; fludrocortisone 0....
A. Administer intraveno...
B. Begin an intravenous...
C. Perform synchronized...
D. Arrange inpatient el...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 28-year-old G2P1 at 22 weeks’ gestation presents with 12 hours of fever, severe headache, photophobia, and neck stiffness. She reports fetal movement and no l...
A. Explain risks, benef...
B. Provide a balanced e...
C. Seek a court order t...
D. Ask her husband to t...
Type: differential_comprehensive Difficulty: easy Category: Unknown 📷 Includes Image
A 34-year-old man with systemic lupus erythematosus on hydroxychloroquine, a childhood history of rheumatic heart disease with residual mild mitral regurgitatio...
A. Point‑of‑care ultras...
B. Natriuretic peptide ...
C. Immediate CT pulmona...
D. Formal echocardiogra...
Type: differential_testing Difficulty: moderate Category: Clinical Pathology > Therapeutic plasma exchange > TPE Innovations and Research 📷 Includes Image
A 58-year-old woman is brought to the emergency department after tripping over a curb and landing on her outstretched right hand. She has immediate radial-sided...
A. Place a short‑arm th...
B. Discharge with oral ...
C. Order immediate nerv...
D. Apply a removable el...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 46-year-old woman presents to urgent care with 10 hours of severe pain and progressive tightness in the left forearm after waking from sleep; she denies traum...
A. Make same-day urgent...
B. Perform an excisiona...
C. Prescribe oral antib...
D. Place a continuous p...
Type: legal_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 1-year-old boy with end-stage kidney disease from posterior urethral valves performs nightly automated peritoneal dialysis at home. During a severe ice storm ...
A. Secure airway as ind...
B. Accept the organ imm...
C. Start intraperitonea...
D. Obtain CT chest, PET...
Type: emergency_priorities Difficulty: hard Category: Unknown 📷 Includes Image
A 78-year-old woman presents to a hospitalist-run transitional care clinic 10 days after discharge for community-acquired pneumonia. During hospitalization she ...
A. Delirium commonly fl...
B. Delirium usually res...
C. Benzodiazepines gene...
D. Delirium must be pre...
Type: natural_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 56-year-old man is seen in nephrology clinic for routine follow-up. He reports ankle swelling last month that improved with salt restriction. He denies fever,...
A. Positive antigen‑spe...
B. Negative ANCA with n...
C. Dual positivity for ...
D. High anti‑dsDNA tite...
Type: features Difficulty: hard Category: Unknown 📷 Includes Image
A 30-year-old woman comes to clinic for a routine visit. For three months she has had loose stools 3–4 times daily with urgency, bright red blood on toilet pape...
A. Relapsing–remitting ...
B. Discontinuous, full-...
C. A brief self-limited...
D. A functional bowel d...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 5-year-old girl is evaluated for 6 weeks of early-morning headaches, projectile emesis, gait disequilibrium, and intermittent ocular misalignment. Parents des...
A. Medulloblastoma, WNT...
B. Medulloblastoma, WNT...
C. Medulloblastoma, WNT...
D. Medulloblastoma, WNT...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
A 53-year-old woman with a history of aortic stenosis and heavy alcohol use presents to the emergency department with acute dyspnea, fever 38.9°C at home, and h...
A. Hyaline membranes li...
B. Noncaseating granulo...
C. Intra‑alveolar hemos...
D. Caseating necrosis w...
Type: pathology Difficulty: moderate Category: Unknown 📷 Includes Image
A 54-year-old woman comes to clinic to talk about heavy, irregular periods every 6 to 8 weeks for about a year. Some episodes have large clots and dizziness whe...
A. Insert a levonorgest...
B. Start medroxyprogest...
C. Begin a combined ora...
D. Insert a copper intr...
Type: prevention Difficulty: easy Category: Unknown 📷 Includes Image
A 35-year-old man is brought to the emergency department by his partner after an abrupt coughing and choking episode during the night. He fell asleep supine on ...
A. Superior (posterior)...
B. Posterior segment of...
C. Lingular inferior se...
D. Apicoposterior segme...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
A 34-year-old Afro-Caribbean woman is seen in the nephrology clinic to discuss abnormal outpatient laboratory results. Six months ago her serum creatinine was 0...
A. Drug-induced acute i...
B. Drug-induced acute i...
C. Drug-induced acute i...
D. Drug-induced acute i...
Type: differential_comprehensive Difficulty: expert Category: Psychiatry > Geriatric Psychiatry 📷 Includes Image
During morning rounds the nephrology consult team is asked to evaluate two new admissions who arrived overnight with very high blood pressure. Patient A is a 5...
A. Patient A: Atheroscl...
B. Patient A: Atheroscl...
C. Patient A: Acute dec...
D. Patient A: Essential...
Type: diagnosis Difficulty: easy Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration 📷 Includes Image
A 27-year-old woman returns 10 days after starting outpatient therapy for suspected drug-associated tubulointerstitial nephritis. She had been taking high‑dose ...
A. Arrange an ultrasoun...
B. Increase prednisone ...
C. Start mycophenolate ...
D. Add lisinopril 10 mg...
Type: treatment_failure Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 28-year-old woman comes to clinic for persistent numbness and tingling in the thumb, index, and middle fingers of both hands, worse at night and when driving....
A. Offer definitive car...
B. Repeat corticosteroi...
C. Start formal postope...
D. Order routine MRI of...
Type: treatment_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 55-year-old man with cerebral palsy, bronchiolitis obliterans, HIV on therapy (undetectable viral load), dystonia, vasculitis in remission, and a documented o...
A. Obtain a stat plasma...
B. Send an extended aut...
C. Order an immediate n...
D. Repeat a whole‑body ...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 30-year-old active-duty servicemember with cluster headaches and a deviated nasal septum is starting an antipsychotic for acute mania during an involuntary ps...
A. Adopt handheld 6‑lea...
B. Mandate full 12‑lead...
C. Use a smartphone cam...
D. Defer all QT monitor...
Type: cost_effectiveness Difficulty: expert Category: Unknown 📷 Includes Image
A 56-year-old postmenopausal woman is referred for rapidly progressive hirsutism, deepening voice, new clitoromegaly, and rising serum testosterone over 6 month...
A. Continuous GnRH‑rece...
B. Immediate competitiv...
C. Selective blockade o...
D. Inhibition of aromat...
Type: mechanism Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
A 50-year-old man with a remote out‑of‑hospital ventricular fibrillation arrest and complete neurologic recovery presents with abrupt hematuria, tea‑colored uri...
A. Circulating anti‑GBM...
B. Pauci‑immune necroti...
C. Mixed cryoglobulinem...
D. Chronic‑active antib...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 50‑year‑old woman with biopsy‑proven membranous nephropathy in remission, relapsing polychondritis, protein C deficiency, cluster headaches, and Zollinger–Ell...
A. Overproduction of ga...
B. Subepithelial immune...
C. APOL1 G1/G2 high‑ris...
D. Primary alternative‑...
Type: features Difficulty: moderate Category: Unknown 📷 Includes Image
In a rural urgent care without on-site ultrasound or immediate radiography, a 38-year-old woman presents with sharp right-sided chest pain and mild dyspnea that...
A. Passing the needle a...
B. Entering approximate...
C. Targeting immediatel...
D. Aiming over the cost...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 46-year-old woman at 20 weeks’ gestation presents for shared nephrology–obstetrics care. She has chronic kidney disease with prior biopsy‑proven membranous ne...
A. Do not start SGLT2 i...
B. Start nifedipine ext...
C. Initiate targeted‑re...
D. Enroll immediately i...
Type: clinical_trials Difficulty: easy Category: Unknown 📷 Includes Image
A 28-year-old man presents to the emergency department with rapidly progressive erosions on his trunk and oropharyngeal discomfort. He denies new medications bu...
A. A robust association...
B. Pemphigus vulgaris s...
C. Linear IgA bullous d...
D. Dermatitis herpetifo...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
Emergency department, evening shift. A 66-year-old woman with biopsy-proven pauci-immune necrotizing crescentic glomerulonephritis 18 months ago (native-kidney ...
A. State that you recom...
B. State that she shoul...
C. State that glucocort...
D. State that cyclophos...
Type: patient_communication Difficulty: expert Category: Unknown 📷 Includes Image
During a youth sports physical day, four boys present from the same soccer club after weekend games. All are right‑hand dominant and otherwise healthy, with vit...
A. The child who cannot...
B. The child with numbn...
C. The child with wrist...
D. The child with noctu...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 34-year-old man presents to a United States emergency department with 2 weeks of progressive bilateral leg and scrotal swelling, morning facial puffiness, and...
A. Initiate emergent in...
B. Stabilize hyperkalem...
C. Start continuous IV ...
D. Administer IV methyl...
Type: treatment Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 58-year-old woman with long-standing obesity and hypertension presents with gradually increasing ankle swelling over 4 months, worse in the last 3 weeks, and ...
A. Maximize supportive ...
B. Maximize supportive ...
C. Start oral tacrolimu...
D. Administer rituximab...
Type: management Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 97-year-old man, two weeks after a deceased-donor kidney transplant, presents for early post-discharge follow-up at a rural critical access clinic 3 hours fro...
A. Initiate universal C...
B. Adopt a preemptive-o...
C. Start letermovir 480...
D. Provide no prophylax...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 29‑year‑old woman at 18 weeks’ gestation, three years after a living‑donor kidney transplant, presents with two days of new headaches and home blood pressures...
A. Treat as active anti...
B. Diagnose preeclampsi...
C. Assume calcineurin i...
D. Administer high‑dose...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 42-year-old woman presents to the emergency department after a fall onto her right chest while walking down stairs. She reports sharp right-sided chest pain t...
A. Insert a small-bore ...
B. Insert a chest tube ...
C. Place a large-bore t...
D. Insert the tube post...
Type: prevention Difficulty: easy Category: Unknown 📷 Includes Image
An 8-year-old girl presents for a routine outpatient visit to complete school health forms and to reconcile her chart. Past records from a children’s hospital d...
A. Chart the low finger...
B. Diagnose chronic hyp...
C. Delete the abnormal ...
D. Order arterial blood...
Type: legal_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 46-year-old man is brought to the emergency department by friends for somnolence after using unknown pills at a party. His history includes childhood cryptorc...
A. Synthetic opioids, e...
B. Prescription benzodi...
C. Powder cocaine and c...
D. Heroin alone, with m...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
A 31-year-old gravida 2 para 1 at 30 weeks 2 days’ gestation is seen in a combined maternal–fetal medicine–nephrology clinic for new-onset proteinuria and micro...
A. Defer native kidney ...
B. Proceed now with inp...
C. Defer native kidney ...
D. Start nifedipine ext...
Type: treatment Difficulty: hard Category: Unknown 📷 Includes Image
A 56-year-old man with chronic hepatitis C cured by direct-acting antivirals 2 years ago, hepatocellular carcinoma treated by transarterial chemoembolization 9 ...
A. Initiate sparsentan ...
B. Switch single‑pathwa...
C. Add targeted‑release...
D. Add an SGLT2 inhibit...
Type: contraindications Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 52-year-old woman is brought to the ED after family noticed new confusion for 10 hours and two falls. Past history includes prior histoplasmosis (treated), uv...
A. Do not start plasma ...
B. Begin a “diagnostic”...
C. Enroll her immediate...
D. Start red blood cell...
Type: clinical_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 12‑month‑old girl is brought to a routine well‑child visit. She lives with her parents; there is no tobacco exposure. Birth history was term without NICU stay...
A. Measure four‑extremi...
B. Order expedited outp...
C. Administer oral beta...
D. Proceed directly to ...
Type: emergency_priorities Difficulty: hard Category: Unknown 📷 Includes Image
A 50-year-old G2P1 at 11 weeks’ gestation after IVF presents to the antenatal day unit with severe morning-predominant nausea, intermittent vomiting (4–6 times/...
A. Begin doxylamine–pyr...
B. Start ondansetron or...
C. Recommend wrist acup...
D. Admit for inpatient ...
Type: recent_changes Difficulty: moderate Category: Unknown 📷 Includes Image
A 48-year-old woman presents to the emergency department with severe, brief, electric shock–like right facial pain in the maxillary area triggered by light touc...
A. Refer for microvascu...
B. Offer stereotactic r...
C. Start a bedtime tric...
D. Schedule percutaneou...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
An established patient is a 33-year-old G2P1 at 20 weeks’ gestation with 3 months of burning epigastric pain after meals, sour taste at night, and no hematemesi...
A. Defer eradication un...
B. Start 14-day bismuth...
C. Begin 14-day levoflo...
D. Switch to high-dose ...
Type: treatment_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 32-year-old gravida 1 para 0 woman at 18 weeks’ gestation presents for evaluation of a new, irregularly pigmented 8‑mm macule on her upper back that has enlar...
A. We can excise the ch...
B. Skin biopsy must be ...
C. Only a superficial s...
D. General anesthesia i...
Type: patient_communication Difficulty: easy Category: Unknown 📷 Includes Image
A 26-year-old transgender man (assigned female at birth; cervix retained) reports 6 months of progressive exertional dyspnea, chest tightness, and presyncope on...
A. Ventilation–perfusio...
B. Repeat dual‑energy C...
C. Contrast‑enhanced ca...
D. Proceed straight to ...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
An 88-year-old woman is brought to the emergency department for progressive dyspnea and grayish discoloration of her lips noted this morning at her skilled nurs...
A. Obtain stat arterial...
B. Defer co‑oximetry an...
C. Start a continuous m...
D. Proceed directly to ...
Type: diagnostic_failure Difficulty: hard Category: Unknown 📷 Includes Image
You are the on‑call gastroenterology consultant at a regional hospital. Three patients with overt gastrointestinal bleeding have already had nondiagnostic upper...
A. Select Patient B for...
B. Select Patient B for...
C. Select Patient A for...
D. Avoid Meckel scintig...
Type: diagnostic_failure Difficulty: hard Category: Unknown 📷 Includes Image
Four patients are seen in a tertiary endocrine clinic on the same day. All have recent ultrasound of the thyroid and cytology or histology, along with other inv...
A. The patient whose th...
B. The patient whose fi...
C. The patient whose lo...
D. The patient with a h...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
A 52-year-old woman who works in a high‑volume cafeteria presents to a rural clinic with 3 weeks of progressive palpitations, heat intolerance, anxiety, and uni...
A. Order a single TSH r...
B. Order both a TRAb (b...
C. Arrange urgent I‑123...
D. Start methimazole 10...
Type: cost_effectiveness Difficulty: expert Category: Unknown 📷 Includes Image
A 45-year-old woman comes to the emergency department after 1 week of dark urine, tiredness, shortness of breath, and two small episodes of coughing up blood. S...
A. Order urgent PR3-ANC...
B. Repeat the ANCA immu...
C. Use the normal compl...
D. Send only the anti‑b...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 10-year-old boy is brought to a metropolitan emergency department for 5 days of progressive generalized edema and a 3-kg weight increase. He notes morning fac...
A. Focal and segmental ...
B. Glomerulomegaly with...
C. Normal-appearing glo...
D. Diffuse glomerular b...
Type: pathology Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 34-year-old woman with SLE and prior ISN/RPS class IV/V lupus nephritis in partial remission presents for a routine preconception visit 10 months after an unc...
A. Continue hydroxychlo...
B. Continue hydroxychlo...
C. Continue hydroxychlo...
D. Keep current drugs b...
Type: prevention Difficulty: hard Category: Unknown 📷 Includes Image
A 3-year-old girl with kidney failure from congenital nephrotic syndrome, on nightly automated peritoneal dialysis while waiting for a kidney transplant, is bro...
A. Start intravenous ni...
B. Give intravenous lab...
C. Give immediate‑relea...
D. Perform a lumbar pun...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A 27‑year‑old woman presents with 10 days of fatigue, pleuritic chest tightness, red‑tinged sputum, ankle swelling, and dark urine. She works as a respiratory t...
A. Continue hydralazine...
B. Stop hydralazine imm...
C. Replace hydralazine ...
D. Switch hydralazine t...
Type: contraindications Difficulty: moderate Category: Unknown 📷 Includes Image
A 44-year-old man with atrial fibrillation (on apixaban 5 mg twice daily) presents in critical condition with rapidly progressive, painful, dusky erythema and f...
A. Direct immunofluores...
B. Serum ELISAs for des...
C. Tzanck smear from an...
D. Punch biopsy from th...
Type: differential_testing Difficulty: moderate Category: Unknown 📷 Includes Image
An 86-year-old man, 3 years after a deceased‑donor kidney transplant, is brought to the emergency department from home for lightheadedness and new confusion tha...
A. Obtain two sets of p...
B. Draw a random serum ...
C. Order an urgent tacr...
D. Send the patient imm...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 38-year-old woman attends a routine visit to establish care and asks about a dark speckled mole on her upper back that a coworker noticed. She works in constr...
A. Recent indoor tannin...
B. Daily broad‑spectrum...
C. A high‑fiber diet ri...
D. Consistent long‑slee...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
A 17-year-old male is brought to the emergency department in mid-summer for 36 hours of high fever, agitation, vomiting, and worsening tremor. He reports 2 mont...
A. Thyroid storm precip...
B. Catecholamine crisis...
C. Malignant hypertherm...
D. Sepsis with neurolep...
Type: diagnosis Difficulty: hard Category: Unknown 📷 Includes Image
A 34-year-old man presents to the emergency department with pounding headache, mild dyspnea, and dark urine for 1 day. He has erectile dysfunction, primary myel...
A. Complete blood press...
B. Replace losartan wit...
C. Initiate iptacopan 2...
D. Start targeted‑relea...
Type: cost_effectiveness Difficulty: hard Category: Unknown 📷 Includes Image
A 39-year-old man presents with an enlarging pigmented macule on the left upper back that has changed shape and color over 6 months and intermittently itches. P...
A. Wide local excision ...
B. Mohs micrographic su...
C. Topical imiquimod 5%...
D. Immediate 2 cm wide ...
Type: management Difficulty: hard Category: Unknown 📷 Includes Image
A 29-year-old man with biopsy-proven primary focal segmental glomerulosclerosis presented 5 months ago with edema, urine protein-to-creatinine ratio 5,100 mg/g,...
A. Oral tacrolimus 0.05...
B. Oral tacrolimus 0.1 ...
C. Oral cyclosporine 6 ...
D. Continue high-dose p...
Type: treatment Difficulty: easy Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 29-year-old woman presents to a primary care clinic with 6 weeks of progressive bilateral leg swelling, increasingly foamy urine, and morning periorbital puff...
A. Primary focal segmen...
B. Primary focal segmen...
C. Minimal change disea...
D. Membranous nephropat...
Type: diagnosis Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 31-year-old woman with end-stage kidney disease from lupus nephritis has received in-center hemodialysis three times weekly for 2 years via a left brachioceph...
A. In-office insertion ...
B. In-office insertion ...
C. Interval laparoscopi...
D. Daily combined oral ...
Type: cost_effectiveness Difficulty: moderate Category: Pharmacology > Psychopharmacology 📷 Includes Image
A 50-year-old unemployed man presents to the ED from his part-time food service job after a brief episode of nonradiating chest pressure that resolved with rest...
A. Provide brief cessat...
B. Initiate a 21 mg/24 ...
C. Begin high-intensity...
D. Administer inactivat...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 31-year-old woman with minimal change disease (in remission), long-standing hypertension, rheumatic heart disease with mixed mitral stenosis/regurgitation, ke...
A. Right-sided Barbeau ...
B. Abnormal left modifi...
C. A small but patent r...
D. A prior history of s...
Type: contraindications Difficulty: expert Category: Unknown 📷 Includes Image
A 52-year-old man with multiple endocrine neoplasia type 2B status post total thyroidectomy (on levothyroxine) presents with sudden right-sided pleuritic chest ...
A. Right tension pneumo...
B. Large right simple p...
C. Massive right hemoth...
D. Cardiac tamponade du...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 54-year-old man is brought to the emergency department by EMS in January after being found on his bathroom floor by a neighbor. The neighbor last spoke with h...
A. Perform rapid sequen...
B. Initiate bilevel non...
C. Administer dobutamin...
D. Give empiric stress-...
Type: emergency_priorities Difficulty: hard Category: Unknown
A 44-year-old endurance runner with chronic fatigue syndrome, asthma (NSAID-sensitive), remote osteomyelitis of the right tibia (15 years ago), and basal cell c...
A. Catheter-based lower...
B. Resting CT angiograp...
C. High-resolution rest...
D. Neutral-position MR ...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 50-year-old woman is brought to the emergency department because of a sudden, severe bifrontal headache and blurred vision that began 2 hours ago. She reports...
A. Duplex Doppler ultra...
B. Non-contrast magneti...
C. CT angiography of th...
D. Measurement of plasm...
Type: differential_testing Difficulty: easy Category: Biochemistry > Clinical Biochemistry 📷 Includes Image
A 27-year-old at 28 weeks’ gestation with SLE and prior proliferative lupus nephritis presents to the emergency department with sudden dyspnea and orthopnea. Vi...
A. Perform bedside phas...
B. Obtain a spot protei...
C. Obtain an sFlt‑1/PlG...
D. Start oxygen and cau...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
A 34-year-old woman with chronic hepatitis C infection, biopsy-proven idiopathic pulmonary fibrosis, remote giant-cell (temporal) arteritis in remission on pred...
A. The blood specimen w...
B. The specimen was col...
C. Recent systemic cort...
D. After warm transport...
Type: clinical_pitfalls Difficulty: hard Category: Pharmacology 📷 Includes Image
A 36-year-old woman presents to a rural urgent care 6 hours after flash flooding washed out the only highway; county emergency management reports debris‑choked ...
A. Drug‑exposure–associ...
B. Immune checkpoint in...
C. Acute pyelonephritis...
D. Postrenal obstructio...
Type: differential_physical_history Difficulty: moderate Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 36-year-old woman with chronic hepatitis B, a history of normal pressure hydrocephalus treated conservatively, prior dengue fever, and relapsing polychondriti...
A. Chronic domestic or ...
B. Daily exposure to pe...
C. Short-term marijuana...
D. Prolonged keyboard u...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 50-year-old woman comes to urgent care for abrupt left-sided flank pain that began 2 hours ago while she was preparing dinner. The pain is colicky, makes her ...
A. Distal ureter adjace...
B. Ureteropelvic juncti...
C. Mid-ureter at the pe...
D. Minor calyx within a...
Type: differential_physical_history Difficulty: easy Category: Unknown 📷 Includes Image
A 59-year-old man is admitted to a rural ICU in the evening with fever to 41.5°C, progressive confusion, jaundice, and worsening shortness of breath. He was wel...
A. Quantify non‑cerulop...
B. Send only ceruloplas...
C. Start D‑penicillamin...
D. Pursue autoimmune he...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 4-year-old girl is seen for persistently high arm blood pressures noted on two visits. Her parents report occasional headaches and that her feet feel cold aft...
A. Coarctation of the a...
B. Renal artery stenosi...
C. Primary hyperaldoste...
D. Pheochromocytoma wit...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 58‑year‑old man with biopsy‑proven focal segmental glomerulosclerosis (primary, diagnosed 14 months ago), autoimmune hepatitis, Chiari I malformation, chronic...
A. Hold sertraline and ...
B. Initiate outpatient ...
C. Administer a supervi...
D. Send copeptin‑based ...
Type: cost_effectiveness Difficulty: expert Category: Unknown 📷 Includes Image
A 32‑year‑old man comes to the ED with a severe headache, shortness of breath, and chest tightness for 30 minutes. He has primary hyperaldosteronism, Factor V L...
A. Start an IV nicardip...
B. Start an IV nicardip...
C. Give sublingual nife...
D. Give oral captopril ...
Type: management Difficulty: easy Category: Unknown 📷 Includes Image
A 17-year-old girl presents to a United States emergency department with two days of fever, new periorbital swelling, and tea‑colored urine. She notes reduced e...
A. Stabilize and comple...
B. Invoke an emergency‑...
C. Obtain only the moth...
D. Start investigationa...
Type: legal_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 28‑year‑old man with recurrent nephrolithiasis and peptic symptoms is referred for persistent primary hyperparathyroidism despite prior focused exploration. H...
A. Four-dimensional CT ...
B. Proceed directly to ...
C. Whole-body positron ...
D. Repeat high-resoluti...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 41-year-old man presents with 10 weeks of migratory arthralgias, persistent nasal crusting with intermittent epistaxis, pleuritic chest discomfort, and a new ...
A. Obtain antigen-speci...
B. Rely on indirect imm...
C. Order myeloperoxidas...
D. Urgently check anti–...
Type: diagnostic_failure Difficulty: hard Category: Unknown 📷 Includes Image
During the same overnight shift, the nephrology consult team is asked to evaluate two patients admitted for hypertensive emergencies. Patient A is a 72-year-ol...
A. Fibromuscular dyspla...
B. Atherosclerotic osti...
C. Primary hyperaldoste...
D. Bilateral noncritica...
Type: diagnostic_failure Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Fibromuscular Dysplasia Insights 📷 Includes Image
An 82-year-old man with known coronary artery disease is brought to the emergency department with crushing substernal chest pressure, diaphoresis, and nausea be...
A. Proceed with emergen...
B. Delay PCI until a co...
C. Give fibrinolytics w...
D. Transfer solely to s...
Type: legal_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 33-year-old woman presents with new light patches on the cheeks and around the eyes that have slowly enlarged over 4 months. She reports mild itch but no pain...
A. Topical tacrolimus 0...
B. Mid‑potency topical ...
C. Whole‑body narrowban...
D. Oral prednisone 0.5 ...
Type: treatment Difficulty: easy Category: Unknown 📷 Includes Image
A 17-year-old girl with a vegan diet presents with 24 hours of fever, chest pain, vomiting, and profound fatigue after a recent febrile illness. She lives with ...
A. Initiate veno‑arteri...
B. Escalate catecholami...
C. Give high‑dose corti...
D. Perform diagnostic c...
Type: treatment_failure Difficulty: hard Category: Unknown 📷 Includes Image
A 20-year-old woman who is a college student presents to the emergency department after two brief episodes of lightheadedness in class. She felt her heart racin...
A. Choose the D-dimer–f...
B. Choose universal CT ...
C. Choose universal CT ...
D. Either strategy is a...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
An otherwise healthy 14-year-old boy is brought by his parent to a ski clinic at 3,050 m (about 10,000 ft) on the second day of a vacation. He lives at sea leve...
A. Administer low‑flow ...
B. Start oral acetazola...
C. Give inhaled albuter...
D. Begin high‑flow non‑...
Type: treatment Difficulty: easy Category: Unknown 📷 Includes Image
A 37-year-old woman with biopsy-confirmed pulmonary sarcoidosis and idiopathic pulmonary fibrosis is seen in an interstitial lung disease clinic for exertional ...
A. Adjusted prevalence ...
B. Adjusted odds ratio ...
C. Hazard ratio from a ...
D. Standardized mean di...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 29‑year‑old woman at 22 weeks’ gestation (gravida 1, para 0) presents with recurrent palpitations and episodic shortness of breath for one week. She works in ...
A. Therapeutic enoxapar...
B. Direct oral anticoag...
C. Warfarin throughout ...
D. No anticoagulation w...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 66-year-old woman with a 12-year history of biopsy-proven IgA nephropathy returns for evaluation of steadily worsening kidney function over 18 months. Her nat...
A. Persistent, time‑ave...
B. Albuminuria persiste...
C. An eGFR decline of a...
D. T1 chronicity with p...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 28-year-old African-American man presents to a university nephrology clinic for a scheduled 6‑month follow‑up after biopsy‑proven International Society of Nep...
A. African-American (Bl...
B. Hispanic/Latino ance...
C. American Indian/Alas...
D. Family history of di...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 2‑year‑old girl is brought to a small rural urgent‑care clinic during a winter storm that has closed roads for the next several hours. She has 1 day of watery...
A. Begin 0.18% sodium c...
B. Give 0.9% sodium chl...
C. Offer small, frequen...
D. Avoid beta‑lactam an...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 50-year-old man with a history of macular degeneration, esophageal varices, and a remote Boerhaave syndrome repair presents with hematemesis and altered menta...
A. Tube advanced into t...
B. Endotracheal tube sk...
C. Bronchial cartilage ...
D. Cricoid pressure red...
Type: mechanism Difficulty: easy Category: Unknown 📷 Includes Image
A 60-year-old woman with a history of rheumatic mitral stenosis and type 2 diabetes presents with 2 hours of palpitations and shortness of breath. She quit smok...
A. Atrial fibrillation ...
B. Multifocal atrial ta...
C. Atrial flutter with ...
D. Monomorphic ventricu...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 29-year-old man presents to a U.S. emergency department with pleuritic chest pain, dyspnea, and scant blood‑streaked sputum 4 days after returning from a trop...
A. With modern low‑ or ...
B. Because eGFR 60–89 m...
C. Cystatin C markedly ...
D. Iso‑osmolality iodix...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 42-year-old construction worker with type 2 diabetes, known Brugada syndrome (type 1 ECG pattern on prior testing, no ICD), and a remote inguinal hernia repai...
A. Begin IV nicardipine...
B. Give sublingual imme...
C. Start high‑dose IV n...
D. Administer full‑dose...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
A 49-year-old man comes to clinic for a routine visit and evaluation of a thyroid nodule detected on an employment physical. He feels well. Past medical history...
A. Papillary thyroid ca...
B. Benign follicular ad...
C. Medullary thyroid ca...
D. Hashimoto (chronic l...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
A 33‑year‑old primigravid woman at 22 weeks’ gestation is co‑managed by maternal–fetal medicine and nephrology for increasing proteinuria. Eighteen months befor...
A. Defer disease‑modify...
B. Initiate a dual endo...
C. Start an SGLT2 inhib...
D. Begin targeted‑relea...
Type: clinical_trials Difficulty: expert Category: Unknown 📷 Includes Image
A 20-year-old man presents with acute dyspnea and pleuritic chest pain after cleaning a moldy barn two days ago. He reports cough with scant sputum, low-grade f...
A. Loss of hypoxic pulm...
B. Suppression of centr...
C. Increased carbon dio...
D. Acute right–to–left ...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 28-year-old Black man presents to a large urban emergency department with 10 days of progressive orthopnea and exertional dyspnea atop 4 months of facial puff...
A. Ultrasound‑guided pe...
B. Ultrasound‑guided pe...
C. Transjugular native ...
D. Order serum anti‑PLA...
Type: diagnostic_step Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 50-year-old man presents to a rural critical-access emergency department at the edge of a winter storm that has grounded air transport and closed mountain pas...
A. Order low‑cost targe...
B. Send esoteric serolo...
C. Start targeted‑relea...
D. Request whole‑exome ...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
A 44-year-old woman is evaluated in a nephrology clinic for persistently elevated blood pressure despite therapy with amlodipine 10 mg once daily, chlorthalidon...
A. A common single-nucl...
B. Autosomal dominant m...
C. Autosomal dominant l...
D. Autosomal dominant m...
Type: epidemiology Difficulty: moderate Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Endocrine Hypertension Syndromes > Pheochromocytoma Hypertension 📷 Includes Image
Four patients present to the same nephrology clinic over one week with active urinary sediment and impaired kidney function. All four have no known allergies an...
A. C3 glomerulopathy (n...
B. Infection-related gl...
C. IgA nephropathy with...
D. Mixed cryoglobulinem...
Type: differential_comprehensive Difficulty: hard Category: Unknown 📷 Includes Image
A 30-year-old woman at 18 weeks of pregnancy is referred for a changing pigmented lesion on the right calf noted by her partner. She works as an accountant, exe...
A. Prospective multicen...
B. Randomized clinical ...
C. Case series of pregn...
D. Randomized trial usi...
Type: clinical_trials Difficulty: easy Category: Unknown 📷 Includes Image
A 53-year-old woman presents to a small critical access hospital during a regional wildfire response. The facility’s CT scanner is offline during rolling power ...
A. Ventilation–perfusio...
B. Predominant right‑to...
C. Primary diffusion li...
D. Primary alveolar hyp...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
A 36-year-old man is referred after an occupational health screen detected hypertension. He reports a 3‑month history of mild exertional headaches, reduced exer...
A. Hypertension typical...
B. Blood pressure often...
C. Anatomic stenosis fr...
D. Spontaneous regressi...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
You are triaging three healthcare workers seen the same day for abnormal workplace vitals. All are men with treated hypertension taking hydrochlorothiazide 25 m...
A. Patient A, whose sup...
B. Patient A, but the a...
C. Patient B, because h...
D. Patient C, presumed ...
Type: diagnosis Difficulty: moderate Category: Nephrology > Glomerulonephritis > Hematological Disorder GN 📷 Includes Image
A 9-year-old girl presents during a routine visit for a new pigmented lesion on the posterior left calf first noticed 3 months ago. There is no personal history...
A. A superficial tangen...
B. A narrow elliptical ...
C. A deep saucerization...
D. A 4‑mm incisional pu...
Type: contraindications Difficulty: expert Category: Unknown
A 20-year-old woman with end-stage kidney disease is undergoing pre-transplant workup. She has eosinophilic granulomatosis with polyangiitis in remission, chron...
A. Administer imlifidas...
B. Schedule five plasma...
C. Give rituximab 375 m...
D. Infuse sutimlimab 6....
Type: treatment Difficulty: expert Category: Unknown 📷 Includes Image
A 60-year-old woman with coronary artery disease, protein S deficiency, atopic dermatitis, retinitis pigmentosa, and nephrolithiasis presents for evaluation of ...
A. Aberrant mucosal pro...
B. APRIL‑driven expansi...
C. Soluble CD89–IgA1 co...
D. Neutral‑glycan IgA1 ...
Type: mechanism Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 36-year-old man who works in a rural metal-fabrication plant presents to a nurse-led clinic inside a community center during a 36–48 hour road closure after a...
A. Initiate renin–angio...
B. Begin targeted‑relea...
C. Start high‑dose syst...
D. Arrange emergent sno...
Type: differential_physical_history Difficulty: hard Category: Unknown 📷 Includes Image
A 41-year-old man presents to a hypertension clinic worried about repeatedly very low diastolic values on his validated upper-arm home monitor over the past 2 w...
A. Use teach-back to ex...
B. Provide similar coun...
C. Explain that oscillo...
D. Reassure that diasto...
Type: patient_communication Difficulty: hard Category: Nephrology > Glomerulonephritis > Hematological Disorder GN 📷 Includes Image
A 10-year-old girl is brought to the emergency department after a self-limited 1-minute generalized tonic–clonic seizure that was preceded by a severe bifrontal...
A. Magnetic resonance a...
B. Noncontrast MR angio...
C. Low-dose pediatric C...
D. Observation with esc...
Type: treatment_failure Difficulty: moderate Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques 📷 Includes Image
A 74-year-old man is brought to the trauma bay after a ground‑level fall onto his right side at home. He is oriented but hard of hearing. Vital signs are pulse ...
A. Radial nerve injury ...
B. Radial nerve transec...
C. Median nerve compres...
D. Axillary nerve injur...
Type: mechanism Difficulty: easy Category: Unknown 📷 Includes Image
A 32-year-old man is brought to the emergency department after suddenly collapsing while watching television. He has a history of heart failure with preserved e...
A. Without early restor...
B. In many young adults...
C. Blocking the anterio...
D. A tear in a single v...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 54-year-old man presents to a United States emergency department with 4 days of rapidly worsening dyspnea, orthopnea, and generalized edema. He returned from ...
A. Initiate emergent in...
B. Start continuous ven...
C. Perform isolated ult...
D. Administer temporizi...
Type: management Difficulty: expert Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
During a regional heat wave, you are covering a combined nephrology–hospitalist service and must sign therapy orders for four adults with biopsy‑proven primary ...
A. Order sparsentan 200...
B. Order empagliflozin ...
C. Order targeted‑relea...
D. Order lisinopril 5–1...
Type: contraindications Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 45-year-old woman with Sjögren’s syndrome, pulmonary hypertension, and central diabetes insipidus presents with three weeks of heavy irregular vaginal bleedin...
A. Uterine curettage or...
B. Proliferation of mar...
C. Triploid villous tis...
D. Invasive endometrial...
Type: features Difficulty: moderate Category: Unknown 📷 Includes Image
A 49-year-old woman establishes care to review heart disease prevention. She has type 2 diabetes with persistent albuminuria, treated with metformin 1000 mg twi...
A. Start moderate-inten...
B. Start daily aspirin ...
C. Intensify to high-in...
D. Rely on lifestyle on...
Type: prevention Difficulty: easy Category: Unknown 📷 Includes Image
A 55-year-old woman with bipolar disorder treated with lithium and stage 3 chronic kidney disease presents 30 minutes after the sudden onset of a rapid, forcefu...
A. Atrioventricular nod...
B. Sinoatrial node loca...
C. Right bundle branch ...
D. Purkinje fiber netwo...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 46‑year‑old man who works as a long‑distance truck driver is seen in a small community hospital where cystatin C testing is not available and transfer is dela...
A. Estimate GFR with th...
B. Prefer MDRD with rac...
C. Dose drugs by Cockcr...
D. Screen using urine d...
Type: recent_changes Difficulty: moderate Category: Unknown 📷 Includes Image
A 27-year-old woman with systemic lupus erythematosus and a recent flare of class 3 lupus kidney disease is counseled about risks if she joins a study testing a...
A. Serious infection—es...
B. Cataract formation r...
C. Fulminant hepatic fa...
D. Rapid, irreversible ...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 35-year-old woman presents with sudden right flank pain radiating to the groin with nausea and one episode of vomiting. She reports urinary frequency without ...
A. Low‑dose non‑contras...
B. Renal and pelvic ult...
C. Intravenous pyelogra...
D. MRI of the abdomen a...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 53‑year‑old woman is brought to the emergency department after two episodes of large‑volume hematemesis at home and one en route. She complains of dizziness a...
A. Secure the airway wi...
B. Order immediate high...
C. Send the patient dir...
D. Give oral sucralfate...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A 38-year-old man with a week of viral-like illness is admitted to the ICU for acute hypoxemic respiratory failure. He has a history of Zollinger–Ellison syndro...
A. Use a conservative o...
B. Use aggressive oxyge...
C. Stop arterial gases ...
D. Apply the same targe...
Type: clinical_trials Difficulty: moderate Category: Unknown 📷 Includes Image
A 24-year-old G2P1 at 33 weeks by dates comes to the emergency department from home because she became suddenly dizzy and short of breath after lying flat on he...
A. Place her in a left ...
B. Place her in a right...
C. Give a rapid 2‑liter...
D. Administer magnesium...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A 54-year-old man presents to a United States emergency department in midsummer after working outdoors laying sod in humid heat. He reports generalized fatigue ...
A. Common peroneal (fib...
B. Common fibular divis...
C. L5 radiculopathy fro...
D. Deep peroneal nerve ...
Type: differential_physical_history Difficulty: hard Category: Unknown 📷 Includes Image
A 46‑year‑old woman with Wolff–Parkinson–White (WPW) pattern documented at age 22 presents to an electrophysiology clinic after exertional near‑syncope while jo...
A. Your monitor showed ...
B. Because your pathway...
C. Given your tests, st...
D. Your resting ECG has...
Type: patient_communication Difficulty: expert Category: Unknown 📷 Includes Image
A 48-year-old man with biopsy‑proven IgA nephropathy (Oxford M1 E0 S1 T1 C0) and persistent proteinuria presents for management of treatment failure. Past medic...
A. Start sibeprenlimab ...
B. Replace losartan wit...
C. Begin oral iptacopan...
D. Repeat a second cons...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 67-year-old woman with psoriasis comes to the emergency department with 2 days of feeling unwell, an itchy red rash on the chest, mild pain in both flanks, an...
A. Continuing the pain ...
B. Stopping naproxen bu...
C. Beginning high‑dose ...
D. Waiting to call the ...
Type: clinical_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 42-year-old woman with biopsy‑proven membranous nephropathy (nephrotic‑range proteinuria) is admitted for hypertensive emergency and worsening edema. She retu...
A. Begin high‑dose syst...
B. Empirically treat fo...
C. Optimize non‑immunos...
D. If ivermectin is una...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 35-year-old graduate student reports intermittent gross hematuria and a rise in albuminuria over several months. She has a history of medullary sponge kidney ...
A. Primary IgA nephropa...
B. IgA‑dominant infecti...
C. IgA vasculitis nephr...
D. C3 glomerulopathy wi...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image
A 45-year-old woman with a vegan diet, prior cigarette use (0.5 pack/day for 10 years, quit 15 years ago), and no known allergies is evaluated in nephrology cli...
A. Compared with PR3-AN...
B. After adjusting for ...
C. In MPO-ANCA remissio...
D. Glucocorticoid-spari...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
Four patients are seen during an urgent dermatology add‑on clinic. All bring outside records that include unrelated studies: CT abdomen/pelvis for prior abdomin...
A. The patient with a n...
B. The patient with a r...
C. The patient with mul...
D. The patient with a s...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
A 28-year-old at 9 weeks’ gestation presents with palpitations, tremor, heat intolerance, and a 4-kg unintentional weight loss. She has chronic sinus congestion...
A. Start propylthiourac...
B. Start methimazole 10...
C. Start levothyroxine ...
D. Arrange radioiodine ...
Type: treatment Difficulty: easy Category: Unknown 📷 Includes Image
A 35-year-old gravida 2 para 1 at 22 weeks’ gestation presents with her fourth episode of tea-colored urine that begins the same day as a self-limited upper-res...
A. Synpharyngitic hemat...
B. A latent 2–3‑week ga...
C. Intermittent hematur...
D. Confirmation of prim...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 28-year-old woman with no diabetes and no known autoimmune disease is referred for evaluation of difficult-to-control hypertension diagnosed 18 months ago. Ho...
A. Extracranial interna...
B. Extracranial vertebr...
C. Intracranial interna...
D. Proximal superior me...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 39-year-old woman with a remote history of dengue fever presents with 6 days of high fevers, profound fatigue, dyspnea on exertion, and diffuse abdominal disc...
A. Begin HLH-directed t...
B. Administer IVIG alon...
C. Start broad-spectrum...
D. Give rituximab monot...
Type: management Difficulty: hard Category: Unknown 📷 Includes Image
A term female neonate (birth weight 3.2 kg) is 24 hours old and has temperature 38.0°C with poor feeding and lethargy. Birth was an uncomplicated vaginal delive...
A. Start ampicillin 50 ...
B. Start ampicillin 50 ...
C. Start ampicillin 50 ...
D. Start ampicillin 75 ...
Type: treatment Difficulty: expert Category: Unknown 📷 Includes Image
A 47-year-old woman from a high‑altitude Andean farming district presents to a rural health post with 3 months of throbbing headaches, intermittent blurred visi...
A. Start enalapril 2.5 ...
B. Start valsartan 40 m...
C. Initiate lisinopril ...
D. Optimize non‑RAAS th...
Type: prevention Difficulty: expert Category: Unknown 📷 Includes Image
An 89-year-old man is brought to the emergency department after a brief syncopal episode at home. He reports palpitations for several minutes before losing cons...
A. Early afterdepolariz...
B. Delayed afterdepolar...
C. Decreased funny curr...
D. Phase 0 upstroke acc...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
A 76-year-old woman with psoriasis (treated with topical corticosteroids), peripheral neuropathy, osteoporosis with a prior L1 vertebral compression fracture, t...
A. Avacopan, an oral C5...
B. Tocilizumab, an anti...
C. Eculizumab, a termin...
D. Belimumab, a BAFF-li...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
A 30-year-old woman with SLE and a history of class III lupus nephritis in sustained remission for 18 months presents for routine prenatal care at 10 weeks’ ges...
A. Live birth is likely...
B. Maternal renal failu...
C. Live birth is likely...
D. Quiescence eliminate...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 26-year-old woman is referred for 6 weeks of persistent dysuria with sterile pyuria, metallic taste, intermittent bilateral flank heaviness, and progressive f...
A. Arrange expedited ul...
B. Obtain gallium‑67 re...
C. Send a noninvasive p...
D. Withhold potential o...
Type: diagnostic_failure Difficulty: hard Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 20-year-old primigravida at 14 weeks’ gestation with a history of adolescent scoliosis and compensated congestive heart failure presents to a tertiary obstetr...
A. Continue non‑teratog...
B. Start sparsentan 200...
C. Begin targeted‑relea...
D. Add dapagliflozin 10...
Type: clinical_trials Difficulty: expert Category: Unknown 📷 Includes Image
A 60-year-old woman with autosomal dominant polycystic kidney disease (baseline eGFR 52 mL/min/1.73 m²), ulcerative colitis in remission, and prior hepatocellul...
A. Recent national guid...
B. Older endocrine guid...
C. Limit emergency ster...
D. Race‑based eGFR equa...
Type: recent_changes Difficulty: hard Category: Unknown 📷 Includes Image
A 38-year-old man with 12 years of extensive, left-to-transverse ulcerative colitis presents for scheduled dysplasia surveillance and review of recent biopsy re...
A. Loss-of-function TP5...
B. Biallelic APC loss w...
C. Primary MLH1 promote...
D. Early activating KRA...
Type: mechanism Difficulty: hard Category: Unknown 📷 Includes Image
A 56-year-old woman presents to urgent care for 2 weeks of fatigue, decreased urine output, and a new itchy red bumpy rash across the trunk and upper arms. She ...
A. Drug‑induced acute i...
B. Ischemic acute tubul...
C. Poststreptococcal gl...
D. Acute bacterial pyel...
Type: diagnosis Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 23-year-old woman is seen two days after total thyroidectomy performed for a compressive multinodular goiter. She had long-standing gastroesophageal reflux di...
A. External branch of t...
B. Recurrent laryngeal ...
C. Hypoglossal nerve ex...
D. Glossopharyngeal ner...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 49-year-old man presents to a small rural U.S. hospital clinic operating on generator power after a regional ice storm severed supply routes; commercial couri...
A. DNA methylation anal...
B. Chromosomal microarr...
C. Next-generation sequ...
D. Trio whole-exome seq...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 75-year-old woman is referred for “treatment failure” of presumed primary IgA nephropathy after 10 months of maximized supportive therapy. Over that period sh...
A. Reclassify this as s...
B. Treat as primary IgA...
C. Start pulse methylpr...
D. Add urgent plasmaphe...
Type: treatment_failure Difficulty: hard Category: Unknown 📷 Includes Image
A 60-year-old man employed in a chemical plant presents with intermittent right-sided flank pain for 18 hours. The pain comes in waves and has migrated toward t...
A. Distal ureter at the...
B. Mid-ureter at the cr...
C. Ureteropelvic juncti...
D. A renal papillary du...
Type: differential_comprehensive Difficulty: easy Category: Unknown
A 48-year-old woman comes to clinic for numbness and tingling in the thumb, index, and middle fingers of her dominant right hand for 3 months. Symptoms wake her...
A. Normal light touch o...
B. Reduced two‑point di...
C. Loss of sensation in...
D. Isolated weakness of...
Type: clinical_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 33-year-old man presents to a U.S. emergency department with 3 weeks of progressive bilateral leg swelling, abdominal distention, and orthopnea that worsened ...
A. Defer an inpatient n...
B. Perform an inpatient...
C. Defer an inpatient b...
D. Defer both kidney bi...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
Emergency department, daytime in March. A 56-year-old woman with obesity hypoventilation syndrome and focal segmental glomerulosclerosis presents with sudden ri...
A. Obtain low-dose nonc...
B. Start with ultrasoun...
C. Order contrast-enhan...
D. Schedule MRI urograp...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 31-year-old man with chronic hepatitis B (diagnosed 4 years ago, incomplete hepatology follow‑up), kyphosis, aortic regurgitation with a small thoracic aortic...
A. “Some infections, in...
B. “Your urine blood is...
C. “This is almost cert...
D. “We can wait a year ...
Type: patient_communication Difficulty: easy Category: Unknown 📷 Includes Image
A 28-year-old woman with biopsy-proven FSGS has persistent heavy proteinuria despite an adequate course of high-dose prednisone with taper, sodium restriction, ...
A. A woman who is pregn...
B. A woman with well-co...
C. A woman with a histo...
D. A woman with stable ...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 33‑year‑old man returns from a 2‑week work trip to Thailand and Vietnam with abrupt onset of fever to 38.5°C, abdominal cramps, tenesmus, and six loose stools...
A. Avoid rifaximin 200 ...
B. Treat with azithromy...
C. Treat with azithromy...
D. Provide oral rehydra...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 48-year-old woman with a history of hookworm infection presents for counseling after an incidental finding of bubbles crossing the atrial septum on transthora...
A. Functional closure o...
B. Anatomic fusion of t...
C. The ductus venosus a...
D. Physiologic right‑to...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 52-year-old woman presents with 3 weeks of intensely pruritic blisters on the abdomen and proximal thighs that began as urticarial plaques. She describes diff...
A. Apply clobetasol 0.0...
B. Begin oral prednison...
C. Administer rituximab...
D. Start dapsone 1 mg/k...
Type: management Difficulty: moderate Category: Unknown 📷 Includes Image
A winter storm has delayed the second apheresis machine and on‑call nurse. The hospital can start only one therapeutic plasma exchange (TPE) in the next two hou...
A. Start therapeutic pl...
B. Start therapeutic pl...
C. Transfuse one aphere...
D. Prioritize therapeut...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A 31-year-old man presents to the ED after an episode of sudden chest tightness, facial flushing, and shortness of breath that began seconds after a rapid IV pu...
A. Transient flushing, ...
B. Severe, immediate an...
C. Progressive blue‑gra...
D. Gingival hyperplasia...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 38-year-old man presents for a routine physical and asks basic questions about congenital heart defects because his partner’s sister was born with a heart def...
A. Ventricular septal d...
B. Atrial septal defect...
C. Patent ductus arteri...
D. Tetralogy of Fallot,...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
A 38-year-old food-service worker with antiphospholipid antibody syndrome (previous intermittent prophylactic anticoagulation, none currently) and binge-eating ...
A. Transmural post-emet...
B. Mallory–Weiss mucosa...
C. Primary spontaneous ...
D. Posterior duodenal u...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A tertiary pediatric nephrology case conference reviews four biopsy-proven cases of primary IgA nephropathy in 5-year-old boys referred from different regional ...
A. Patient C, given sus...
B. Patient B, because m...
C. Patient D, because i...
D. Patient A, because r...
Type: differential_comprehensive Difficulty: expert Category: Unknown 📷 Includes Image
A 27-year-old man with pediatric‑onset microscopic hematuria and biopsy‑proven IgA nephropathy at age 13 presents for mechanistic counseling about biomarker str...
A. Glomerular staining ...
B. Serum galactose‑defi...
C. Dominant glomerular ...
D. Markedly abnormal se...
Type: mechanism Difficulty: expert Category: Unknown 📷 Includes Image
A 24‑year‑old woman with a history of dilated cardiomyopathy and mitral stenosis arrives with brief, sharp chest pain that began at rest and resolved during tri...
A. Use high-sensitivity...
B. Order routine CK-MB ...
C. Admit all low-risk c...
D. Send patients for im...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
A 39-year-old woman with genetically confirmed Alport spectrum disease arrives for a scheduled nephrology follow‑up at a hospital‑based clinic. During check‑in ...
A. Administer calcium g...
B. Administer calcium g...
C. Administer calcium c...
D. Administer calcium g...
Type: emergency_priorities Difficulty: expert Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification 📷 Includes Image
A 59-year-old woman presents with 7 months of insidiously progressive gait difficulty and urinary urgency that has progressed to intermittent retention requirin...
A. Without definitive f...
B. Untreated course is ...
C. Natural history refl...
D. Most cases follow a ...
Type: natural_history Difficulty: hard Category: Unknown 📷 Includes Image
A 40-year-old woman presents to dermatology for 3 months of painful oral erosions and new flaccid blisters on the chest and axillae. She reports odynophagia, di...
A. Rituximab 1,000 mg I...
B. High-dose oral predn...
C. Mycophenolate mofeti...
D. Intravenous immunogl...
Type: treatment Difficulty: moderate Category: Unknown
An 18-year-old man presents to the emergency department with acute chest pain that began this morning after waking with a low‑grade fever. The pain is sharp, wo...
A. Acute pericarditis w...
B. Acute anterior ST‑el...
C. Costochondritis from...
D. Primary spontaneous ...
Type: differential_physical_history Difficulty: easy Category: Unknown 📷 Includes Image
A 38-year-old man arrives 15 minutes after developing sudden itching, hives, throat tightness, and wheezing that began while eating shrimp, mixed nuts, and chip...
A. Acute onset of pruri...
B. Immune complex (Type...
C. Delayed T-cell–media...
D. Non-IgE, direct mast...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 49-year-old man presents to a rural urgent-care clinic on day 3 of worsening dyspnea and dry cough after a viral prodrome. He is alert and speaking in full se...
A. Administer 100% insp...
B. Order contrast-enhan...
C. Start empiric antibi...
D. Schedule outpatient ...
Type: diagnostic_failure Difficulty: moderate Category: Unknown 📷 Includes Image
A 99-year-old man arrives at a 12-bed critical-access hospital in a snowbound mountain region during a blizzard that has closed roads and halted regional transf...
A. Central line–associa...
B. Primary bloodstream ...
C. Central line–associa...
D. Bloodstream infectio...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 57-year-old man is brought to the emergency department with 2 days of fever and painful dusky targetoid macules that coalesce into sheets of epidermal detachm...
A. Starting routine pro...
B. Immediate cessation ...
C. Urgent ophthalmology...
D. Nonadherent dressing...
Type: contraindications Difficulty: expert Category: Unknown 📷 Includes Image
A 57-year-old man from an assisted-living facility is brought to the ED for sudden unresponsiveness noted 20 minutes earlier. Staff report he had back pain this...
A. Start two ‑ rescuer ...
B. Apply nasal cannula ...
C. Send immediately for...
D. Start chest compress...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
A pulmonary research network plans a randomized, double‑blind, placebo‑controlled trial of an antifibrotic for progressive pulmonary fibrosis in adults without ...
A. Enroll the patient w...
B. Enroll the patient w...
C. Enroll the patient w...
D. Enroll the patient w...
Type: clinical_trials Difficulty: easy Category: Unknown 📷 Includes Image
A 58-year-old woman with sarcoidosis, chronic obstructive pulmonary disease, remote cryptococcal meningitis, abdominal aortic aneurysm under surveillance, and p...
A. Continue IV acyclovi...
B. Stop acyclovir now a...
C. Switch to oral acycl...
D. Delay all repeat tes...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
You are triaging three patients with chest discomfort during a surge in ED imaging. Radiology reports that multiple trauma cases from a highway collision have o...
A. Use the available co...
B. Use the available co...
C. Use the available co...
D. Defer use of the cor...
Type: recent_changes Difficulty: easy Category: Unknown 📷 Includes Image
A 36-year-old woman is evaluated for swelling and weight gain. She has periorbital puffiness and bilateral pitting edema; lungs and heart are normal. Past histo...
A. Do not share on soci...
B. Post the image after...
C. Email the image to y...
D. Ask a classmate to u...
Type: legal_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN 📷 Includes Image
A 60-year-old transgender man (assigned female at birth) with laparoscopically diagnosed endometriosis before transition presents from a rural area for review o...
A. Progression to corpu...
B. Duodenal disease wit...
C. Enhanced somatostati...
D. Sustained increase i...
Type: natural_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 56-year-old man presents with 18 hours of acutely painful right knee swelling, erythema, and warmth without trauma. He works in healthcare. Triage recorded a ...
A. Perform urgent bedsi...
B. Start empiric intrav...
C. Perform ultrasound-g...
D. Begin oral prednison...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 37-year-old transgender man (assigned female at birth; prior ectopic pregnancy) is brought to the ED by EMS for abrupt, tearing retrosternal pain radiating to...
A. Abrupt, maximal ches...
B. Sharp, pleuritic pai...
C. Sudden unilateral pl...
D. Crushing substernal ...
Type: differential_physical_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 30-year-old woman is brought to the emergency department after collapsing at home. Prehospital blood pressure was 58/32 mm Hg; after 2 L isotonic crystalloid ...
A. An intensely pruriti...
B. New bilateral pittin...
C. Absence of rash or f...
D. Painful facial edema...
Type: differential_physical_history Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 24-year-old man, 14 months after a living‑donor kidney transplant for congenital obstructive uropathy, presents with 8 weeks of rising creatinine, low‑grade f...
A. Crisp nuclear immuno...
B. Patchy SV40 large T ...
C. RNAscope BK viral RN...
D. Positive immunostain...
Type: pathology Difficulty: expert Category: Unknown 📷 Includes Image
A 49-year-old gravida 2 para 1 at 22 weeks’ gestation is co-managed for biopsy-proven IgA nephropathy. Comorbidities include polymyalgia rheumatica now off gluc...
A. Neutralization of AP...
B. Ligand trapping of b...
C. Oral inhibition of c...
D. Enteric targeted‑rel...
Type: mechanism Difficulty: hard Category: Unknown 📷 Includes Image
A 56-year-old woman is brought to a small critical-access hospital in rural Wyoming in midwinter. Roads are closed for at least 8 hours after an ice storm, and ...
A. Start nadolol 40 mg ...
B. Start amiodarone 200...
C. Give verapamil 120 m...
D. Discontinue all beta...
Type: prevention Difficulty: easy Category: Unknown 📷 Includes Image
A 44-year-old woman with biopsy-proven primary IgA nephropathy returns to nephrology clinic to decide on an immediate addition to therapy and to discuss out-of-...
A. Add dapagliflozin 10...
B. Switch from lisinopr...
C. Start targeted‑relea...
D. Defer any medication...
Type: cost_effectiveness Difficulty: moderate Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 42-year-old man presents to a congenital cardiology clinic with 8 months of exertional dyspnea that has become positional over the last 6 weeks. He reports wo...
A. Failure of developme...
B. Abnormal incorporati...
C. Incomplete fusion of...
D. Patency of the foram...
Type: mechanism Difficulty: expert Category: Unknown 📷 Includes Image
A 9-year-old boy is brought to clinic by his parents after a coughing spell during dinner last night. He briefly choked on a piece of hot dog and then fell asle...
A. Posterior right lowe...
B. Posterior segment le...
C. Medial segment right...
D. Apicoposterior segme...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 70-year-old woman living in assisted living presents to the ED with 6 hours of dyspnea, pleuritic chest pain, and several episodes of hemoptysis. She was diag...
A. Oral rivaroxaban 20 ...
B. Oral warfarin titrat...
C. Escalation to high‑i...
D. Long‑term low‑molecu...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 44-year-old pregnant woman (G3P1 at 27 weeks) is admitted with severe frontal headaches, visual blurring, right upper quadrant discomfort, and increasing clin...
A. A single 1.0–plasma-...
B. A single 1.0–plasma-...
C. A single 1.0–plasma-...
D. A single 1.0–plasma-...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
A 105-year-old man is brought to the emergency department from home for sudden trouble breathing that began while he was sitting at the dinner table. He lives w...
A. Immediate bedside th...
B. Immediate repeat por...
C. CT pulmonary angiogr...
D. Tilt‑table testing w...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
A 10-year-old boy falls from playground equipment onto an outstretched right hand. He has elbow pain and cannot make an “OK” sign with the right hand; thumb int...
A. Anterior interosseou...
B. Ulnar nerve neurapra...
C. Radial nerve palsy c...
D. Musculocutaneous neu...
Type: epidemiology Difficulty: hard Category: Unknown 📷 Includes Image
A 36-year-old woman is evaluated in the hypertension clinic for persistently elevated blood pressures despite maximally tolerated or guideline-recommended doses...
A. Balloon angioplasty ...
B. Primary stent placem...
C. Open surgical aorto‑...
D. Given the contrast a...
Type: patient_communication Difficulty: hard Category: Unknown 📷 Includes Image
A 35-year-old woman in the third trimester of pregnancy reports 2 weeks of severe pruritus and the recent appearance of tense vesicles and bullae that began aro...
A. Pemphigoid gestation...
B. Polymorphic eruption...
C. Intrahepatic cholest...
D. Atopic eruption of p...
Type: diagnosis Difficulty: moderate Category: Unknown 📷 Includes Image
A 48-year-old retired woman with idiopathic pulmonary fibrosis (IPF) is scheduled for ambulatory arthroscopic shoulder debridement. She reports exertional dyspn...
A. Delay the deep plexu...
B. Proceed at 48 hours ...
C. Proceed at 48 hours ...
D. Perform the block at...
Type: recent_changes Difficulty: expert Category: Unknown 📷 Includes Image
A 50-year-old man living in an assisted-living facility presents 18 hours after sudden substernal chest pressure with diaphoresis and nausea that began while wa...
A. Coagulative necrosis...
B. Abundant macrophage‑...
C. Dense collagenous sc...
D. Well‑formed granulat...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
A 34‑year‑old woman is brought to the ED in winter with progressive confusion, lethargy, constipation, and cold intolerance. Past history includes pulmonary sar...
A. Hydrocortisone 100 m...
B. Hydrocortisone 100 m...
C. Liothyronine 50 mcg ...
D. Dexamethasone 4 mg I...
Type: treatment Difficulty: hard Category: Unknown 📷 Includes Image
A 38-year-old woman with diffuse cutaneous systemic sclerosis (diagnosed 3 years ago), paroxysmal nocturnal hemoglobinuria monitored without eculizumab, a repai...
A. Start captopril 25 m...
B. Begin intravenous la...
C. Administer high‑dose...
D. Restrict fluids aggr...
Type: clinical_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 52-year-old woman is admitted to the intensive care unit with abrupt worsening of previously well-controlled hypertension. She has coronary artery disease sta...
A. Catheter-based renal...
B. Contrast-enhanced CT...
C. Repeat duplex Dopple...
D. Selective renal vein...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
A 62-year-old man comes to a small rural outpatient clinic for follow-up of high blood pressure. For the last 5 years his home blood pressure readings have usua...
A. Continue his current...
B. Recommend renal arte...
C. Refer for open surgi...
D. Start long-term intr...
Type: clinical_trials Difficulty: easy Category: Biochemistry > Clinical Biochemistry 📷 Includes Image
A 42-year-old man is referred to a multidisciplinary obesity medicine clinic for severe, longstanding obesity with prominent hyperphagia. At check-in, an automa...
A. Initiate setmelanoti...
B. Initiate setmelanoti...
C. Initiate setmelanoti...
D. Begin metreleptin by...
Type: management Difficulty: hard Category: Unknown
A 54-year-old man with Takayasu arteritis on prednisone 10 mg/day, benign prostatic hyperplasia, remote biopsy‑proven acute interstitial nephritis that resolved...
A. Initiate high‑volume...
B. Start standard‑volum...
C. Use albumin dialysis...
D. Initiate high‑volume...
Type: management Difficulty: hard Category: Unknown 📷 Includes Image
A 49-year-old male hospitalist presents through the emergency department with rapidly progressive fatigable ptosis, bulbar dysarthria, neck flexor weakness, and...
A. Randomized data show...
B. IVIG produces consis...
C. TPE is clearly super...
D. Sequential combined ...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
A 29-year-old woman with a 4-year history of treatment-resistant hypertension presents to the emergency department with worsening occipital headaches and interm...
A. Renal artery perfora...
B. Contrast-induced acu...
C. Atheroembolic renal ...
D. Allergic interstitia...
Type: complications Difficulty: moderate Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging 📷 Includes Image
A 7-day-old term male neonate is brought to the emergency department for poor feeding, repeated non-bilious emesis, decreased urine output, and progressive slee...
A. Administer 0.9% sodi...
B. Administer 0.9% sodi...
C. Obtain a cosyntropin...
D. Prioritize correctio...
Type: emergency_priorities Difficulty: expert Category: Unknown 📷 Includes Image
An 81-year-old man is referred to a multidisciplinary obesity genetics conference after decades of severe obesity and progressive multisystem disease, with the ...
A. Implement a kidney-r...
B. Implement a cardiomy...
C. Implement a vision-l...
D. Implement an obstruc...
Type: prevention Difficulty: expert Category: Unknown 📷 Includes Image
A 42-year-old man comes for a routine primary care visit to establish care after moving. He feels well and walks his dog daily without symptoms. Past history in...
A. Order a 1–2 week ext...
B. Schedule permanent d...
C. Refer for urgent inv...
D. Obtain a brain MRI f...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 33-year-old hospital employee brings his 18‑month‑old son to a combined nephrology–genetics clinic for counseling about a renal mass seen on recent imaging du...
A. Heterozygous deletio...
B. Imprinting defects a...
C. Germline loss of RB1...
D. Biallelic inactivati...
Type: pathology Difficulty: moderate Category: Unknown 📷 Includes Image
A 30-year-old man who works in food service and attends evening classes presents with 6 weeks of progressive exertional dyspnea and intermittent dry cough. Vita...
A. Obtain high-resoluti...
B. Proceed directly to ...
C. Order PET-CT and a w...
D. Start long-term oral...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
You lead a hospital‑based lung cancer screening program aligned with the current United States Preventive Services Task Force (USPSTF) recommendation: annual lo...
A. Patient A: Order an ...
B. Patient B: Proceed w...
C. Patient C: Proceed w...
D. Patient D: Proceed w...
Type: differential_comprehensive Difficulty: hard Category: Unknown 📷 Includes Image
A 31-year-old woman with end-stage kidney disease presents to a rural outreach clinic for a pre–kidney transplant visit during a week of intermittent power outa...
A. Progression risk is ...
B. Progression risk is ...
C. A normal pre-transpl...
D. Progression to activ...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 20-year-old male with known primary adrenal insufficiency (autoimmune, diagnosed at 17) is brought to the emergency department from a supervised group residen...
A. Give hydrocortisone ...
B. Complete ACTH stimul...
C. Begin vasopressors f...
D. Administer dexametha...
Type: legal_pitfalls Difficulty: expert Category: Unknown 📷 Includes Image
A 22-year-old man with biopsy-proven IgA nephropathy presents for a scheduled follow-up. Since his mid-teens he has had episodic tea-colored urine within 12–48 ...
A. His 5‑year probabili...
B. Risk is moderate on ...
C. Risk is high due to ...
D. Risk remains uncerta...
Type: natural_history Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 23-year-old woman comes to clinic for two weeks of eyelids that droop more as the day goes on, double vision when reading, a nasal-sounding voice, and chewing...
A. Generalized myasthen...
B. Lambert–Eaton myasth...
C. Guillain–Barré syndr...
D. Foodborne botulism w...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 20-year-old woman presents with a severe throbbing headache, transient blurred vision, and nausea since this morning. She reports fatigue over the last week a...
A. Hypertensive emergen...
B. Diffuse expiratory w...
C. Soft S3 gallop at th...
D. Benign positional ve...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 57-year-old man is brought to a U.S. urban ED by EMS after collapsing at home. On arrival he is pulseless; advanced life support is performed and return of sp...
A. Proceed immediately ...
B. Proceed under the em...
C. Obtain a two-physici...
D. Forego contrast CT a...
Type: legal_pitfalls Difficulty: expert Category: Unknown 📷 Includes Image
A 30-year-old woman of Afro-Caribbean ancestry is seen in an advanced heart-failure clinic for progressive exertional dyspnea that limits her to climbing one fl...
A. Tachycardia‑induced ...
B. Tachycardia‑induced ...
C. Tachycardia‑induced ...
D. Tachycardia‑induced ...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image
A 23-year-old gravida 1 para 0 woman at 28 weeks gestation presents with 14 hours of severe constant epigastric pain radiating to the back, persistent vomiting,...
A. Initiate therapeutic...
B. Proceed with therape...
C. Start high‑dose pres...
D. Begin full‑dose intr...
Type: management Difficulty: expert Category: Unknown 📷 Includes Image
A 40-year-old woman in her second trimester (22 weeks by dates) presents with acute pleuritic chest pain and shortness of breath that began 3 hours ago while wa...
A. Start therapeutic lo...
B. Delay all treatment ...
C. Give warfarin by mou...
D. Use D‑dimer alone to...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
A 50-year-old woman with rheumatoid arthritis, recurrent nephrolithiasis due to medullary sponge kidney, prior ventricular tachycardia ablation, and a sedentary...
A. Iodine-induced thyro...
B. Subacute (de Quervai...
C. Graves disease with ...
D. Amiodarone-induced t...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image
A 40-year-old woman with primary myelofibrosis (JAK2 V617F), Sheehan syndrome on replacement therapy, HPV infection, and polymyalgia rheumatica presents to the ...
A. Rocuronium 1.2 mg/kg...
B. Succinylcholine 1.5 ...
C. Mivacurium 0.2 mg/kg...
D. Cisatracurium 0.2 mg...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 32-year-old woman presents to the ED with palpitations, generalized weakness, and intermittent chest pressure for 6 hours. She lives with her parents and repo...
A. Give intravenous cal...
B. Administer a continu...
C. Start an unfractiona...
D. Treat with oral sodi...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 26-year-old woman with new-onset PR3‑ANCA–positive granulomatosis with polyangiitis was admitted 10 days ago with rapidly progressive glomerulonephritis and m...
A. Switch to cyclophosp...
B. Add plasma exchange ...
C. Repeat rituximab ind...
D. Add methotrexate 20–...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 48-year-old gravida 3 para 1011 at 26 weeks’ gestation presents to the cardio-obstetrics clinic for evaluation of episodic exertional dyspnea and lightheadedn...
A. A persistent, wide, ...
B. An inspiratory augme...
C. A harsh holosystolic...
D. A delayed, diminishe...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
Four patients arrive to a regional hospital during a heatwave with rolling blackouts that intermittently disrupt laboratory analyzers. A rapid triage bay is fun...
A. Patient C: Distribut...
B. Patient A: Cardiogen...
C. Patient B: Hypovolem...
D. Patient D: Obstructi...
Type: pathology Difficulty: expert Category: Unknown 📷 Includes Image
Two inpatient nephrology consults arrive on the same weekday afternoon at a U.S. academic medical center with on‑site interventional radiology and monitored rec...
A. For Patient A, imple...
B. For Patient A, proce...
C. For Patient A, proce...
D. For Patient B, hold ...
Type: treatment Difficulty: hard Category: Unknown 📷 Includes Image
A 71-year-old man (78 kg) with diffuse cutaneous systemic sclerosis, hypertensive retinopathy, and remote clear‑cell renal cell carcinoma status post partial ne...
A. Endoscopic band liga...
B. Radiofrequency ablat...
C. Nonselective beta‑bl...
D. Transjugular intrahe...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 5-year-old girl is brought to the emergency department by her mother for refusal to bear weight on the right leg that began yesterday after three weeks of a l...
A. Begin nonoperative c...
B. Proceed with early v...
C. Adopt observation on...
D. Use prolonged skin t...
Type: treatment Difficulty: moderate Category: Unknown 📷 Includes Image
A 44-year-old woman is in the apheresis unit for a second therapeutic plasma exchange (TPE) session for biopsy-proven membranoproliferative glomerulonephritis w...
A. Acquired coagulopath...
B. Suspected citrate re...
C. Acute TRALI during r...
D. Severe IgA-mediated ...
Type: differential_comprehensive Difficulty: moderate Category: Unknown 📷 Includes Image
An 88-year-old woman living on a fixed income presents for a blood pressure follow-up in a community clinic after relocating from a rural area during a winter s...
A. Adopt home sodium re...
B. Start a daily vitami...
C. Begin gentle chair y...
D. Increase plain water...
Type: prevention Difficulty: easy Category: Unknown 📷 Includes Image
A 19-year-old college student with type 1 diabetes (diagnosed at age 14) is brought to the emergency department with abdominal pain, nausea, and fast deep breat...
A. Use a balanced cryst...
B. Base severity gradin...
C. Treat all DKA exclus...
D. Administer routine i...
Type: recent_changes Difficulty: hard Category: Unknown 📷 Includes Image
A 56‑year‑old man is brought to the ED with sudden pounding heartbeat, dizziness, and shortness of breath. He lives with family, smokes 1 pack/day, and has a re...
A. Give immediate synch...
B. Give a third adenosi...
C. Start amiodarone 150...
D. Deliver an immediate...
Type: treatment_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 30-year-old man with essential thrombocythemia, prior gastric adenocarcinoma resected in remission, opioid use disorder on buprenorphine–naloxone, heavy alcoh...
A. Immediately disconti...
B. Order a serum seroto...
C. Send cerebrospinal f...
D. Pursue emergent brai...
Type: diagnostic_step Difficulty: moderate Category: Unknown 📷 Includes Image
A 47-year-old man is transferred to a medical ICU for worsening edema, dyspnea requiring 3 L/min nasal oxygen, and new orthopnea. He reports 6 weeks of progress...
A. Electron microscopy ...
B. Electron microscopy ...
C. Immunofluorescence d...
D. A full‑house immunof...
Type: features Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 91-year-old woman is brought to the emergency department by her spouse for rapidly progressive, exquisitely painful skin and mouth lesions that began 24 hours...
A. Immediately disconti...
B. Give high-dose IV me...
C. Start cyclosporine 3...
D. Administer empiric b...
Type: emergency_priorities Difficulty: hard Category: Unknown 📷 Includes Image
A 48-year-old woman with long-standing asthma and type 1 diabetes managed with a continuous subcutaneous insulin pump comes to the emergency department because ...
A. Computed tomography ...
B. Ventilation–perfusio...
C. Transthoracic echoca...
D. Outpatient exercise ...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 42-year-old woman is transferred to a tertiary emergency department after 36 hours of relentless emesis, watery diarrhea, progressive presyncope, and pleuriti...
A. Admit her to the med...
B. Admit her to the med...
C. Admit her to the med...
D. Admit her to the med...
Type: complications Difficulty: expert Category: Psychiatry > Geriatric Psychiatry 📷 Includes Image
A 64-year-old woman presents for a routine visit because of 3 months of heel pain. The pain is worst with the first steps out of bed and after long car rides; i...
A. Plantar fasciitis ch...
B. Tarsal tunnel syndro...
C. Insertional Achilles...
D. Morton neuroma with ...
Type: differential_physical_history Difficulty: easy Category: Unknown 📷 Includes Image
A 76-year-old man is brought to a remote rural clinic because of progressively worsening shortness of breath for 3 weeks. He now must stop to rest after walking...
A. Acute exacerbation o...
B. Acute exacerbation o...
C. Community‑acquired b...
D. Panic attack with hy...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 34-year-old man comes to the emergency department with 48 hours of severe throat pain, muffled voice, drooling, and painful neck stiffness. He struggles to tu...
A. Contrast‑enhanced CT...
B. Noncontrast CT of th...
C. Focused bedside intr...
D. MRI of the neck with...
Type: differential_testing Difficulty: moderate Category: Unknown 📷 Includes Image
A 29‑year‑old pregnant kidney‑transplant recipient at 24 weeks’ gestation presents for follow‑up of persistent BK polyomavirus (BKPyV) DNAemia and rising creati...
A. Further reduce maint...
B. Hold azathioprine an...
C. Convert tacrolimus t...
D. Keep tacrolimus at 4...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
Four 60‑year‑old men present over one month with newly noticed anterior neck lumps found while shaving. All have normal CBC, comprehensive metabolic panel, and ...
A. Patient A with a mid...
B. Patient B with a lat...
C. Patient C with a pul...
D. Patient D with a fir...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 45-year-old woman with a germline MEN1 pathogenic variant confirmed by next‑generation sequencing presents for surveillance counseling. She reports intermitte...
A. Primary hyperparathy...
B. Hyperparathyroidism ...
C. Pheochromocytoma is ...
D. Overall MEN1 penetra...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 20-year-old college student is evaluated for episodic palpitations and near-syncope during exercise. Past medical history includes infectious mononucleosis, h...
A. Document explicit wr...
B. Proceed with germlin...
C. Obtain parental or g...
D. Order calcitonin‑gui...
Type: legal_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 51-year-old man with chronic kidney disease stage 3, long-standing hypertension, generalized anxiety disorder treated with sertraline, epilepsy, and benign pr...
A. The Cardiovascular O...
B. The African American...
C. The Randomized Aldac...
D. The Systolic Blood P...
Type: clinical_trials Difficulty: easy Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Endocrine Hypertension Syndromes > Pheochromocytoma Hypertension 📷 Includes Image
A 69-year-old woman who works as an inpatient nurse presents to primary care for a routine after-work medication reconciliation and refill review. She is a form...
A. Activate EMS for eme...
B. Initiate EMS transfe...
C. Arrange direct ICU a...
D. Start a nicardipine ...
Type: management Difficulty: expert Category: Unknown 📷 Includes Image
A 58-year-old man is brought to the emergency department for rapidly worsening painful rash, mouth soreness, and eye irritation two days after starting lamotrig...
A. Full‑thickness epide...
B. Suprabasal acantholy...
C. Subepidermal blister...
D. Parakeratosis with n...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
A 29‑year‑old G2P1 at 30 weeks by ultrasound dating presents during a regional heat wave with two days of malaise and one reported fever at home. At triage, for...
A. Avoid live attenuate...
B. Use the live attenua...
C. Give an MMR booster ...
D. Defer all influenza ...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 45‑year‑old woman with a prior basal cell carcinoma (BCC) of the right midface treated by Mohs surgery presents with 4 months of burning paresthesia and numbn...
A. Deliver postoperativ...
B. Observe after margin...
C. Begin cemiplimab 350...
D. Restart vismodegib 1...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 62-year-old African-American woman with limited cutaneous systemic sclerosis complicated by stage 3b chronic kidney disease (baseline estimated glomerular fil...
A. Cystatin C is genera...
B. Because cystatin C e...
C. Early cystatin C ele...
D. Systemic modifiers—s...
Type: pathology Difficulty: expert Category: Unknown 📷 Includes Image
A 59-year-old woman with known coronary artery disease, a rare asthma‑predominant vasculitis (also called eosinophilic granulomatosis with polyangiitis), chroni...
A. Outpatient coronary ...
B. Outpatient coronary ...
C. Immediate invasive c...
D. Transesophageal echo...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 20-year-old gravida 1 para 0 at 24 weeks with systemic lupus erythematosus and previously quiescent class III lupus nephritis presents with 1 week of increasi...
A. Pulse methylpredniso...
B. Start mycophenolate ...
C. Administer cyclophos...
D. Use voclosporin 23.7...
Type: treatment Difficulty: moderate Category: Unknown 📷 Includes Image
A 31‑year‑old gravida 1 para 0 at 10 weeks by certain last menstrual period presents with 3 weeks of palpitations, heat intolerance, fine hand tremor, increased...
A. Order a serum thyroi...
B. Schedule a radioacti...
C. Obtain a thyroid ult...
D. Start antithyroid me...
Type: diagnostic_step Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
A 30-year-old woman presents with a first episode of acute painful swelling of the left first metatarsophalangeal joint beginning overnight 8 hours ago. She is ...
A. Treat the acute mono...
B. Start naproxen 500 m...
C. Administer intramusc...
D. Begin febuxostat 80 ...
Type: contraindications Difficulty: moderate Category: Unknown 📷 Includes Image
A 35‑year‑old woman with hypothyroidism and polycystic ovary syndrome reports recurrent epigastric discomfort, early satiety, and intermittent nausea. She works...
A. Stop proton pump inh...
B. Order H. pylori IgG ...
C. Repeat stool antigen...
D. Begin clarithromycin...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 32-year-old woman at 14 weeks’ gestation (G1P0) presents for joint nephrology–maternal–fetal medicine follow-up. She works in education, lives with her spouse...
A. Continue pregnancy-s...
B. Initiate targeted-re...
C. Start systemic methy...
D. Switch antihypertens...
Type: clinical_trials Difficulty: moderate Category: Unknown 📷 Includes Image
A 27-year-old woman with a 3-year history of hypertension unresponsive to a low-sodium diet, regular aerobic exercise, and adherence to amlodipine 10 mg daily, ...
A. Percutaneous translu...
B. Initiate lisinopril ...
C. Add hydrochlorothiaz...
D. Continue lifestyle m...
Type: failing_management Difficulty: easy Category: Unknown 📷 Includes Image
A 28-year-old man presents to the emergency department with 12 hours of weakness, shortness of breath walking across the room, and decreased urine output. He ha...
A. Give intravenous 10%...
B. Give intravenous reg...
C. Give intravenous 10%...
D. Start oral sodium po...
Type: complications Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 12-year-old girl with genetically confirmed multiple endocrine neoplasia type 2B is referred to pediatric nephrology for intermittent cola-colored urine and n...
A. Adopt a tiered, outp...
B. Adopt a tiered, outp...
C. Proceed to early kid...
D. Use an outpatient-fi...
Type: cost_effectiveness Difficulty: expert Category: Unknown 📷 Includes Image
A 48-year-old man with class III obesity and a history of Budd–Chiari syndrome presents to the emergency department with progressive leg swelling and exertional...
A. Begin intravenous lo...
B. Start high‑dose pred...
C. Initiate dual renin–...
D. Arrange urgent nativ...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
An 81‑year‑old retired man living with his spouse presents for evaluation of long‑standing loose, nonbloody stools three to five times daily with urgency and oc...
A. Eluxadoline 75 mg or...
B. Rifaximin 550 mg ora...
C. Loperamide up to a p...
D. Alosetron 0.5 mg ora...
Type: contraindications Difficulty: expert Category: Unknown 📷 Includes Image
A 103-year-old man is brought to the emergency department from a skilled nursing facility for sudden confusion before breakfast. Staff report he received his us...
A. Give 25 g IV dextros...
B. Give 1 mg intramuscu...
C. Start insulin glargi...
D. Observe without trea...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 37-year-old man is eating a handful of mixed nuts while sitting upright at home when he suddenly begins coughing violently and develops shortness of breath. H...
A. Right lower lobe bro...
B. Right mainstem bronc...
C. Left lower lobe bron...
D. Right upper lobe bro...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
Four patients arrive to the emergency department within one hour of each other for hematemesis or melena. All are hemodynamically monitored and receive large-bo...
A. The patient with dai...
B. The patient with pos...
C. The patient with rep...
D. The patient with cir...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
A 74-year-old man with a history of pauci-immune crescentic glomerulonephritis diagnosed 18 months ago by native kidney biopsy presents to nephrology clinic for...
A. Initiate an SGLT2 in...
B. Add finerenone 10 mg...
C. Begin high-dose oral...
D. Start dual renin–ang...
Type: prevention Difficulty: moderate Category: Unknown 📷 Includes Image
Four adults with cirrhosis and new or worsening ascites are evaluated in an urgent-care area of a general hospital. Selected background and test data are availa...
A. Patient A, the 55-ye...
B. Patient C, the 48-ye...
C. Patient B, the 62-ye...
D. Patient D, the 58-ye...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 37-year-old woman with compensated cirrhosis (portal hypertensive splenomegaly; baseline platelets 86×10^3/µL), essential thrombocythemia previously treated b...
A. Continue nonselectiv...
B. Maintain carvedilol ...
C. Switch to nadolol 20...
D. Arrange early preemp...
Type: management Difficulty: expert Category: Unknown 📷 Includes Image
A 45-year-old man is brought to the emergency department with acute shortness of breath and coughing up bright red blood that began overnight. Over the past wee...
A. Autoantibodies targe...
B. Autoantibodies targe...
C. Autoantibodies targe...
D. Autoantibodies targe...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
A 44-year-old pregnant woman (G2P1 at 26 weeks) presents with 8 hours of pleuritic chest pain worse with inspiration and mild dyspnea. She has a history of tinn...
A. Ventilation–perfusio...
B. Computed tomographic...
C. No imaging and start...
D. Magnetic resonance p...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
During a 6-week interval, three patients with established systemic sclerosis are admitted to a tertiary nephrology service for abrupt oligo-anuric acute kidney ...
A. Anti–RNA polymerase ...
B. Anti–centromere anti...
C. Anti–topoisomerase I...
D. Anti–U1 ribonucleopr...
Type: epidemiology Difficulty: expert Category: Pharmacology 📷 Includes Image
A 22-year-old woman reports 3 weeks of photophobia, eye pain, and blurred vision, followed by 10 days of fatigue, polyuria, and dull bilateral flank discomfort ...
A. Tubulointerstitial n...
B. Drug‑induced acute i...
C. IgG4‑related tubuloi...
D. Sarcoidosis with gra...
Type: differential_comprehensive Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 48-year-old retired woman presents to a small rural clinic during a severe ice storm with sudden, painless loss of vision in her right eye that began about 3 ...
A. Begin ocular first‑a...
B. Defer all ocular mea...
C. Administer full‑dose...
D. Treat as an ocular a...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
You are the admitting hospitalist responding to simultaneous pages about four patients on a step‑down unit. Index Patient A: A 27‑year‑old man (current smoker ...
A. For Index Patient A ...
B. For Index Patient A,...
C. For Index Patient A,...
D. For Patient D with p...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 33-year-old garment factory worker presents to a rural clinic in the mountains during a multi-day road closure. She reports 8 months of hand paresthesia that ...
A. Use CTS-6 to confirm...
B. Defer therapy until ...
C. Begin serial landmar...
D. Treat presumed cervi...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
A 41-year-old woman reports 10 days of blurred central vision in her right eye. Straight lines look wavy and there is a small gray spot that makes reading diffi...
A. Observation and trig...
B. Immediate intravitre...
C. Urgent focal macular...
D. Start a systemic cor...
Type: natural_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 9-year-old girl comes to a hospital clinic for a routine check with her mother. Since infancy she has had mild hereditary spherocytosis with a stable hemoglob...
A. Do not give tranexam...
B. Give tranexamic acid...
C. Encourage oral fluid...
D. Start an oral antibi...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image