idx stringlengths 3 3 | question stringlengths 321 1.52k | options dict | answer stringclasses 4
values | explanation stringlengths 1.38k 5.51k | link stringlengths 22 48 |
|---|---|---|---|---|---|
301 | A 21-year-old woman presents to her primary care physician due to a history of abdominal pain. She states that she has had recurrent bouts of mood swings, bloating, and abdominal pain that occur together approximately every 4 weeks. She states that when these symptoms occur, she gets into frequent arguments at work, is... | {
"A": "Premenstrual dysophoric disorder",
"B": "Premenstrual syndrome",
"C": "Major depressive disorder",
"D": "Generalized anxiety disorder",
"E": ""
} | A | This patient with recurrent abdominal pain, bloating, and mood changes causing interpersonal difficulties related to the menstrual cycle likely has premenstrual dysphoric disorder. Premenstrual dysphoric disorder is a variant of premenstrual syndrome (PMS) characterized by prominent irritability and disruption of every... | https://step2.medbullets.com/testview?qid=216746 |
302 | A 62-year-old woman is brought to a physician by her husband for fluctuating changes in behavior and hallucinations over the past 2 years. On occasion, she becomes difficult to understand and her speech becomes disorganized. She also frequently sees "small people" and animals on the dining room table, which is disturbi... | {
"A": "Figure D",
"B": "Figure E",
"C": "Figure B",
"D": "Figure C",
"E": ""
} | D | This patient with fluctuating changes in behavior and cognition, visual hallucinations, memory loss, and extrapyramidal symptoms (bradykinesia, postural instability) most likely has Lewy body dementia. Lewy body dementia is characterized histologically by Lewy bodies, which are intracytoplasmic eosinophilic inclusions ... | https://step2.medbullets.com/testview?qid=217097 |
303 | A 55-year-old woman is brought to the emergency department by her husband with a 1 hour history of an unremitting headache. The headache started suddenly while she was eating dinner and she says it feels like the “worst headache of my life.” An emergent CT scan of the head without contrast confirms the diagnosis, and a... | {
"A": "Addison disease",
"B": "Cerebral salt wasting",
"C": "Diuretic overuse",
"D": "Syndrome of inappropriate anti-diuretic hormone",
"E": ""
} | B | This patient presents with a subarachnoid hemorrhage (“worst headache of my life”) which is treated and then subsequently develops nausea, vomiting, and altered mental status with reduced serum sodium concentration, indicative of symptomatic hyponatremia. In the setting of serum hypo-osmolality, urine hyper-osmolality,... | https://step2.medbullets.com/testview?qid=217155 |
304 | A 1-year-old girl is brought to a neurologist due to increasing seizure frequency over the past 2 months. She recently underwent a neurology evaluation which revealed hypsarrhythmia on electroencephalography (EEG) with a mix of slow waves, multifocal spikes, and asynchrony. Her parents have noticed the patient occasion... | {
"A": "Cardiac rhabdomyoma",
"B": "Glaucoma",
"C": "Optic glioma",
"D": "Polyostotic fibrous dysplasia",
"E": ""
} | A | This patient with a seizure disorder, ash-leaf spots (innumerable hypopigmented macules), Shagreen patch (elevated irregular plaque on the lower back), and West syndrome (hypsarrhythmia on EEG and movements consistent with infantile spasms) likely has tuberous sclerosis. Tuberous sclerosis is associated with cardiac rh... | https://step2.medbullets.com/testview?qid=217175 |
305 | A 72-year-old man with a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia presents to his primary care provider for concerns about his cognitive decline. His wife has noticed that he has a worsening ability to organize, plan, and exhibit impulse control over the last month. The patient states that ... | {
"A": "Normal aging",
"B": "Vascular dementia",
"C": "Pseudodementia",
"D": "Mild cognitive impairment",
"E": ""
} | B | This patient with cardiovascular risk factors (hypertension, type 2 diabetes mellitus, hyperlipidemia) who presents with sudden cognitive decline of executive function and neurologic symptoms consistent with vasculopathy and possible prior stroke given his neurologic exam likely has vascular dementia, which can be corr... | https://step2.medbullets.com/testview?qid=217241 |
306 | A 55-year-old woman presents to a primary care physician with persistent nausea and abdominal discomfort. She has experienced these symptoms daily for the past 3 months. She feels bloated and has episodic loose and watery stools. She has a history of hypertension and hyperlipidemia for which she takes amlodipine and at... | {
"A": "Lower endoscopy",
"B": "Bowel wall biopsy",
"C": "CT scan of the abdomen",
"D": "Stool ova and parasite assay",
"E": ""
} | D | This patient who presents with persistent abdominal discomfort, nausea, bloating, diarrhea, eosinophilia, and signs of malabsorption (thin-appearing, vitamin D deficiency) in the setting of immigration from a resource-limited country most likely has a gastrointestinal parasite infection (Ascaris lumbricoides). The most... | https://step2.medbullets.com/testview?qid=217603 |
307 | A 53-year-old African-American woman presents to her primary care doctor with increasing difficulty climbing the stairs. She noticed the weakness approximately 3 months ago. It has gotten progressively worse since that time. She has also noticed increasing difficulty combing her hair, standing from a seated position, a... | {
"A": "Serum creatine kinase",
"B": "Muscle biopsy",
"C": "Electromyography",
"D": "Serum aldolase",
"E": ""
} | B | This patient with insidious, subacute, progressive, symmetric proximal muscle weakness (difficulty climbing the stairs, combing her hair, standing from a seated position) without associated skin lesions most likely has polymyositis. The most accurate diagnostic test for polymyositis is muscle biopsy.
Polymyositis is c... | https://step2.medbullets.com/testview?qid=217661 |
308 | A 34-year-old man presents to the emergency room with pain behind his eyes. He had a similar episode about 1 month ago which resolved after a few hours. The pain feels like a stabbing sensation behind his right eye. He denies any symptoms on the left side. The last time he had an episode like this, his eye was tearing.... | {
"A": "Sumatriptan",
"B": "Verapamil",
"C": "Ibuprofen",
"D": "Propranolol",
"E": ""
} | B | This patient with a history of retro-orbital pain, unilateral miosis (2 mm pupil on the right), and history of lacrimation during a similar episode is likely experiencing cluster headaches. Verapamil may be used as prophylaxis in the treatment of cluster headaches.
Cluster headaches occur more commonly in men and pres... | https://step2.medbullets.com/testview?qid=217746 |
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