Which of the following cells produces testosterone (image below)?
A. Sertoli cell
B. Kulchitsky
C. Leydig cell
D. Alpha cell
E. Delta cell

Answer
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In which organ do you find the portal triad (see image below)?

A. Brain
B. Lung
C. Liver
D. Heart
E. Testis

Answer
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The image below is found in which of these disorders?

A. Alzheimer’s disease
B. Wilson’s disease
C. Parkinson’s disease
D. Huntington’s chorea
E. Rabies

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The EKG below shows which one of the following?

A. Ventricular fibrillation
B. Atrial flutter
C. QT prolongation
D. Torsades de Pointes
E. Atrial fibrillation

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Which of the following structures will be found in the inguinal canal of a female adult individual?

A. Cyst of the canal of Nuck
B. The pyramidalis muscle
C. The round ligament and the ilioinguinal nerve
D. Gartner’s duct cyst
E. Cooper’s ligament

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New Alzheimer’s Discovery

A new discovery in the brain may lead to a treatment for Alzheimer’s.

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Lacroisa is a 29 year old woman who has had two previous normal pregnancies and deliveries. She has been on oral contraception and is now concerned that she has not seen her menses. Urine pregnancy test performed today was positive. If her usual menstrual cycle length is 32 days and her last menstrual period was June 10, her EDD (expected date of delivery) will be:

A. March 21
B. March 12
C. March 19
D. October 10
E. October 21

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The EKG below is from a 70 year old woman with ischemic heart disease. The most likely diagnosis is:

A. Premature atrial contractions
B. Atrial flutter
C. Paroxysmal atrial tachycardia
D. Ventricular tachycardia
E. Sinus tachycardia

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A 51-year old smoker underwent cardiac catheterization procedure through the right femoral approach. A few months later, he came back with right lower extremity swelling and multiple varicosities were noted. Physical examination revealed a bruit over the right groin. This patient most likely had developed:

A. Deep vein insufficiency
B. Arteriovenous (AV) fistula
C. Pseudoaneurysm
D. Femoral artery thrombosis
E. Superficial venous insufficiency

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You are in pediatrics doing observership, and a child is presenting with difficulty walking. A diagnosis of DMD (Duchenne muscular dystrophy) was obtained. One of the medical students was asked the cause of this disease. She said: “DMD is caused by a nonsense mutation of the dystrophin gene.” Your preceptor (Dr. S) now asks you what a nonsense mutation is. Your correct answer is:

A. A mutation that is caused by insertions or deletions of a number of nucleotides in a DNA sequence that is not divisible by three leading to a completely different translation

B. A mutation that results in a premature stop codon leading to a truncated, incomplete, and usually non-functional protein product

C. A mutation where a single neucleotide is changed to cause substitution of a different amino acid

D. A mutation occurring in non-coding regions of the DNA

E. A mutation that results in a variation of a single base pair in a DNA sequence

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Which of the following concerning fetal heart rate variability is correct?

A. It is the oscillations of fetal heart rate around its mean level
B. Normal fetal heart rate ranges from 110-160 bpm
C. Normal fetal heart rate variability ranges from 5-25 bpm
D. Variability occurs as a result of the interaction between the nervous system, chemoreceptors,barorecptors & cardiac responsiveness.
E. All of the above

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Today you are in the OB/GYN (Obstetrics and Gynecology Clinic). The resident doctor just presented an interesting case of a woman who is in her third trimester and developing high blood pressure. She is G3P1011. The attending physician, Dr. S, asks you what G3P2011 stands for. You look dazed and clueless. Another smart premed student gave the right answer and Dr. S was impressed and congratulated the student. Dr. S was not pleased with you and advised you to read more patient notes and pay more attention during your observership. You should have given the correct response as:

A. Total of three pregnancies with the current one, one term, no preterm, one miscarriage and one child alive
B. Total of three pregnancies with the current one, one preterm, no term, one miscarriage and one child alive
C. Total of three pregnancies exclusive of the current one, one term, no preterm, one miscarriage and one child alive
D. Total of three pregnancies exclusive of the current one, one term, no preterm, one miscarriage and one child alive
E. Total of three pregnancies with the current one, one term, no preterm, two miscarriages and one child alive

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A 25-year old English literature student has used oral contraceptives (OCs) for the past 3 years. She wants to know some of the long-term consequences of using OCs. Which one of the following information will be correct?

A. Her risk of developing pelvic inflammatory disease is increased
B. Her risk of ectopic pregnancy is increased
C. Her risk of having a baby with birth defects is increased if taken while pregnant
D. Her risk of endometrial cancer is decreased
E. Her risk of ovarian cancer is elevated

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Today, you are in the Family Medicine Outpatient Clinic. A patient presented with signs and symptoms of middle ear infections. Dr. S wanted to know if you are conversant with basic human anatomy. He asked you about the smallest bone in the human body. Your answer should be:

A. Capitate
B. Scaphoid
C. Incus
D. Lunate
E. Stapes

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‪Which of the following theories have been postulated to explain the occurrence and physio-pathology of obesity?

A. Fat-cell theory
B. Thermogenesis-brown adipose tissue theory
C. Lipoprotein-lipase theory
D. All of the above
E. None of the above

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What is the prevalence of obesity in the United States?

A. 10%
B. 25%
C. 36%
D. 55%
E. 45%

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You are doing your observership in the occupational medicine outpatient clinic. As part of pre-employment screening, a 25-year old man offered his urine and Dr. S is now discussing the results. At the end, Dr. S concluded that the patient may be taking cocaine. One of the residents then asks you from your chemistry class which substance in the urine shows up in a case of cocaine consumption. You look dazed and speechless and everyone’s attention is on you. Finally, you gave up. Another pre-med student who just joined the discussion yelled out the correct response. Which of these substances did the student mention as the correct answer?

A. Benzoylecgonine
B. Tetrahydrocannabinol
C. EDDP (2-ethylidene-1,5-dimethyl1-3,3-diphenylpyrrolidine)
D. Normeperidine
E. MDA (3,4-methylenedioxyamphetamine (MDA)

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You are premed and you just got yourself an observership in psychiatry. Dr. S is your preceptor and he is now on a teaching round for the residents. At the end of the round, one of the residents asked you to verify whether patient X is taking any narcotic agent. You went through a list of medications that the patient is actively taking. Which of the following medications will confirm that the patient is on a narcotic agent?

A. Diazepam (Valium)
B. Fentanyl
C. Carbamazepine
D. Gabapentin
E. Phenytoin

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Which of the following is the recommended treatment for paroxysmal supraventricular tachycardia (PSVT) with hemodynamic compromise?

A. IV verapamil
B. Synchronized cardioversion
C. Direct-current countershock
D. IV digoxin
E. IV adenosine

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Wakotoso is a 67-year old employee in a chemical processing plant in Dahoka. He presents today in your office with a cyanotic tender right big toe. The patient denies fever, chills or night sweats. The peripheral arteries are bilaterally patent. The patient has no history of cardiovascular disease. Your most likely diagnosis will be:

A. Raynaud syndrome
B. Digital atherosclerosis
C. Atheroembolism
D. Lupus vasculitis
E. Cardiac embolus

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You are in trauma doing observership and there is a patient being taken for a head CT Scan. The doctors keep on repeating the word “the pterion”, and you are confused since that language is new to you. However, you realize that you need to know what that means to understand the medical conversation going on. You ask another smart pre-med student that has been answering questions correctly all day, and who seems to be comfortable understanding what is going on. The student gives you the correct answer as:

A. The back of the skull
B. The middle of the skull
C. The frontal end of the skull
D. The weakest part of the skull
E. The strongest part of the skull

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A 47-year old man presents high level of cholesterol and generalized skin deposits. Your diagnosis is:

A. Hyperkeratosis
B. Xanthelasma
C. Juvenile xanthoma
D. Xanthoma disseminatum
E. Xeroderma pigmentosa

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A 20-year old male with a diagnosis of sickle cell anemia presents to the ECC (Emergency Care Clinic) in your hospital with acute shortness of breath. The immediate management of the patient encompasses all of the following except:

A. Allopurinol
B. Oxygen
C. Hydration
D. Blood gases
E. Analgesia

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A 37-year old man with a diagnosis of HIV presents today at your urgent care clinic with severely decreased vision in the right eye. You immediately examined him and sent him to the ophthalmology service across the street because of the likelihood of which one of the following eye conditions?

A. Staphylococcal infection
B. CMV retinitis
C. Retro-bulbar tumor
D. Glaucoma
E. Chlamydial infection


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During your observership in OB/GYN you were asked to prepare a presentation on a 30-year old woman who has had treatment for infertility. You came across the image below in her files which is likely to be:

A. A magnetic resonance image of two uteri
B. An ultrasound image of two uteri
C. An ultrasound image of two fibroid tumors
D. A magnetic resonance image of the two ovaries
E. An ultrasound image of twins

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You are in the STI (sexually transmissible infections) clinic and a young man of about 24 years of age is complaining of sore throat. The patient had non-protective sexual intercourse with a stranger and engaged in receptive MouthAction. Gram staining of the smear of the exudates from the patient’s throat shows organisms that resemble the picture below. The resident supervising you asks you whether you still remember your microbiology and you answered in the affirmative. You told him you completed your microbiology course with an A+++. You answered his question correctly and your supervising resident was very pleased and impressed. The correct response you gave was:

A. Staphylococcus aureus
B. Neisseria gonorrhoeae
C. Chlamydia trachomatis
D. Human papilloma virus
E. Klebsiella granulomatis (causes granuloma inguinale or donovanosis)

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Which of the following is unlikely to be the cause of ovarian failure?

A. Ovarian surgery
B. Chemotherapy
C. Radiation
D. Turner’s syndrome
E. Use of oral contraceptive pills

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You were in the delivery room and observed the delivery of the patient who had features as in the picture above. The chief resident doctor asked you “what do you think?” You looked, were confused and replied “what?” Then she said: “What do we call this?” Unfortunately, you did not care to read the prenatal notes and you uttered some staccato kind of speech, and the entire delivery room was surprised you were so ignorant about a delivery you participated in. Then the chief resident turned to the other premed student who easily answered and everyone was relieved. The chief resident asked you to see her in the resident’s room for a special talk. Apparently, everyone was not happy with you. What a bad day. The correct answer as given by the other premed student is:

A. Anancephaly
B. Anophthalmia
C. Anotia
D. Arrhinia
E. Aphasia

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What percentage of pregnancies are affected by third trimester vaginal bleeding?

A. 50%
B. 10%
C. 25%
D. 3%
E. 75%

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Dr. S, your preceptor, is about to go in for a major surgery that he calls BSO (bilateral salpingo-oophorectomy). You wanted to go in and observe. Dr. S would let you in only if you can answer the following question: “What structure attaches the ovary to the uterus?”

A. Fallopian tube
B. Utero-sacral ligament
C. Ovarian ligament
D. Round ligament of the uterus
E. Douglas pouch

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