T-67 Q. #Usmle #Prostate

Q. Which of the following statements regarding carcinoma of the prostate is true?

a. It has a higher incidence among American blacks than other American ethnic groups

b. A single microscopic focus of prostate cancer discovered on transurethral resection of the prostate
(TURP) is an indication for radical prostatectomy

c. It arises initially in the gland’s central portion

d. It commonly produces osteoclastic bony metastases

e. Screening for prostate-specific antigen, although easily done, offers no advantage over simple rectal examination in the detection of the disease

T-67 #Usmle Q.Following correction of the patient’s hypercalcemia

Q1.Following correction of the patient’s hypercalcemia with
hydration and gentle diuresis with furosemide, the most likely therapeutic
approach would be
a. Administration of maintenance doses of steroids
b. Radiation treatment for bony metastases
c. Neck exploration and resection of three out of four parathyroid glands
d. Neck exploration and resection of a parathyroid adenoma
e. Avoidance of sunlight, vitamin D, and calcium-containing dairy products

Q2. This 30-year-old woman presented with weakness, bone pain, an elevated parathormone level,
and a serum calcium level of 15.2 mg/dL. Skeletal survey films were taken, including the hand films and
chest x-ray shown.

The most likely cause of these findings is
a. Sarcoidosis
b. Vitamin D intoxication
c. Paget’s disease
d. Metastatic carcinoma
e. Primary hyperparathyroidism

T-66 #Usmle Q. A patient comes to clinic and describes progressive muscle weakness over several weeks

A patient comes to clinic and describes progressive
muscle weakness over several weeks. He has also experienced
nausea, vomiting, and diarrhea. One month ago he
had been completely healthy and describes a bear hunting
trip in Alaska, where they ate some of the game they
killed. Soon after he returned, his gastrointestinal (GI)
symptoms began, followed by muscle weakness in his jaw
and neck that has now spread to his arms and lower back.
Examination confirms decreased muscle strength in the
upper extremities and neck. He also has slowed extraocular
movements. Laboratory examination shows panic
values for elevated eosinophils and serum creatine phosphokinase.
Which of the following organisms is most
likely the cause of his symptoms?

A. Campylobacter
B. Cytomegalovirus
C. Giardia
D. Taenia solium
E. Trichinella

T-65 #Usmle #Neurology A 50 y/o man complains of weakness...

A 50-year-old man complains of weakness. His
symptoms began as difficulty with buttoning his shirt and
using keys to open doors about 2 years ago. He was
treated empirically with nonsteroidal anti-inflammatory
medications for arthritis, but responded only minimally.
His symptoms have slowly progressed to the point where
he has weakness in both hands and feet. He avoids going
outside because of frequent falls. On examination, he has
weakness and atrophy of the foot extensor and finger flexors.
Proximal muscle strength is normal. Reflexes are normal,
and sensation is intact. He is able to rise out of a
chair, but the Romberg test is not able to be performed
due to weakness once standing. Cranial nerves are intact.
Serum creatine kinase is 600 U/L. Complete blood count,
differential, electrolytes, and thyroid-stimulating hormone
(TSH) are normal. Based on the clinical presentation,
what is the most likely diagnosis?

A. Dermatomyositis
B. Eosinophilic myofasciitis
C. Inclusion body myositis
D. Polymyositis
E. Hyperthyroidism