United State Medical Licensing Examination (Step 1) Set 19

A 74-year-old man dies after a 4-day hospital course with a clinical diagnosis of adult respiratory distress syndrome. At autopsy a pathologic diagnosis of diffuse alveolar damage is rendered. Which of the following microscopic findings of the lung tissue is most expected at autopsy?

A 35-year-old lifeguard requests a consultation for a lesion on his upper back that his girlfriend first noticed about a year ago. He states that he is more concerned since it has increased in size. Your examination reveals a 15

A 45-year-old man is bitten by a poisonous snake the venom of which triggers the release of thromboplastin in his circulation. Which of the following would you most expect to see as a consequence of this event?

A 36-year-old man is now in his third year of steroid therapy since being diagnosed with a systemic vasculitis. Prior to initiating treatment in the acute phase of the disorder, he underwent a biopsy of a medium-sized artery. This biopsy specimen displayed fibrinoid necrosis of the media accompanied by a transmural acute inflammatory infiltrate. Significant negative clinical findings included a normal aortic arch, absence of giant cells in the artery biopsy, normal upper airway examination, and no history of tobacco use. Which of the following disorders best correlates with these findings?

A 34-year-old woman has a history of menorrhagia. Within the wall of her uterus are several solid nodules of various sizes. The histological appearance of one of the nodules is depicted in below figure. These nodules represent which of the following?

A 73-year-old man with a history of an MI 2 years ago has been experiencing gradually increasing shortness of breath over the past 4 weeks. Physical examination reveals bilateral crackles on pulmonary auscultation and 2+ pitting edema of the lower legs bilaterally. Which of the following most likely occurred in this patient to produce these changes?

A 28-year-old woman has an ultrasound examination during the second trimester of her third pregnancy. She is found to have greatly decreased amniotic fluid but the fetus appears to be the appropriate size for the gestational age. Her two previous pregnancies produced normal-term infants. The family history is otherwise unremarkable. Which of the following conditions most likely explains these findings?

A2-month-old girl with a history of persistent physiologic jaundice following birth is now reported by her parents to sleep excessively and display little activity. Physical examination reveals abnormal deep tendon reflexes, hypothermia, and muscular hypotonia. Based on this information, which of the following would be the best therapy for her condition?

On otoscopic examination, a patient is found to have a 2-cm mass protruding from a retraction pocket in his right tympanic membrane. The lesion is removed and determined to be a cystic mass lined by squamous epithelium containing desquamated cellular debris and a mononuclear infiltrate. Which of the following is the most likely cause of this lesion?

A 66-year-old man presents with a 3-month history of intermittent dysphagia that has now become constant and is accompanied by pain and some weight loss. X-rays of the esophagus with barium swallow show structural and filling defects, and reduced peristalsis. Abiopsy is taken and is shown in below figure. The best diagnosis is which of the following?