United State Medical Licensing Examination (Step 1) Set 21

A 3-day-old male infant is diagnosed with meconium ileus. You should be concerned that he has which of the following conditions?

A 29-year-old woman presents with weakness, fatigue, easy bruising, and nosebleeds. Analysis of her blood reveals a reciprocal translocation between chromosomes 22 and 9, and low leukocyte alkaline phosphatase levels. These findings confirm a diagnosis of which of the following?

A 35-year-old apparently healthy man undergoes a medical examination while applying for life insurance. He is not anemic. His hemoglobin electrophoresis is reported as: HbA, 62%; HbS, 35%; HbF, 1%; HbA2, 1%; no variant C, D, G, or H bands detected. The most likely diagnosis is which of the following?

A 37-year-old man visiting a third world country drinks from a fecally contaminated source of water. During the next week he has gradually increasing fever, anorexia, myalgia, and headache. He subsequently develops a maculopapular rash on his abdomen and his fever increases to 104

Aretroperitoneal mass was discovered during exploratory surgery on a 49-year-old woman. A photomicrograph of a section taken from the mass is shown in below figure. Which of the following terms would be most appropriate to describe its appearance?

Parents of an 18-month-old boy bring their child to their pediatrician as they are concerned about their son's recurring skin and lung infections. Biopsy of one of the boy's current skin lesions reveals the presence of neutrophils, lymphocytes, and scattered epithelioid cell granulomas. Culture of the lesion is positive for Staphylococcus aureus. Which of the following would best account for this patient's condition?

A 57-year-old man has just returned from an overseas trip and reports having had severe substernal chest pain 3 days ago. Which of the following is the most appropriate laboratory test to order for this patient?

A 48-year-old man with a long history of chronic viral hepatitis secondary to chronic hepatitis B virus (HBV) infection presented with a 2-month history of weight loss. Physical exam showed a cachectic man in mild distress. Scleral icterus and abdominal distension were present. Workup showed the presence of two mass lesions within the liver on ultrasound, which were confirmed on CT scan. Laboratory values revealed the following: AST 161 U/L; ALT U/L 188; total bilirubin 6.8 mg/dL; direct bilirubin 4.9 mg/dL; alkaline phosphatase 245 U/L; total protein 5.9 g/dL; albumin 2.8 g/dL; HBsAg positive; anti-HBs negative; anti- HCV negative; alpha-fetoprotein 7200 ng/mL. Aneedle biopsy of one of the mass lesions was performed under CT guidance. Which of the following is the most likely diagnosis?

A 14-year-old, severely physically disabled individual is now on a respirator. His first 4 years of life were medically uneventful. Over the last 10 years, he has suffered from increasing symmetric muscle weakness that first affected the pelvic girdle and now involves almost all muscle groups. Several years ago, the calf portion of his legs appeared enlarged and on biopsy demonstrated fatty pseudohypertrophy with random alternating muscle fiber atrophy and hypertrophy. Which of the following is the most likely diagnosis?

A 64-year-old man presents to his family physician with hematuria and flank pain. A radiology study identifies a renal mass. Aphotograph of this renal lesion's histology is displayed in below figure. The kidney mass is most likely which of the following?