,Question 1
A 58-year-old man presents for follow-up of hypertension. His blood pressure averages
152/94 mm Hg despite lifestyle modifications. Which medication is an appropriate first-line
treatment in the absence of contraindications?
A. Clonidine
B. Lisinopril
C. Hydralazine
D. Nitroprusside
Correct Answer: B. Lisinopril
Rationale: ACE inhibitors are recommended first-line agents for many adults with
hypertension because they reduce cardiovascular risk, protect renal function, and effectively
lower blood pressure.
Question 2
A 24-year-old woman presents with dysuria, urinary frequency, and urgency for 2 days. She
denies flank pain and fever. What is the most likely diagnosis?
A. Acute pyelonephritis
B. Interstitial cystitis
C. Acute uncomplicated cystitis
D. Nephrolithiasis
Correct Answer: C. Acute uncomplicated cystitis
,Rationale: Dysuria with frequency and urgency in the absence of systemic symptoms
strongly suggests uncomplicated cystitis.
Question 3
Which laboratory test best reflects long-term glycemic control in patients with diabetes
mellitus?
A. Fasting glucose
B. Random glucose
C. Serum insulin
D. Hemoglobin A1C
Correct Answer: D. Hemoglobin A1C
Rationale: Hemoglobin A1C reflects the average blood glucose level over
approximately three months.
Question 4
A patient presents with sudden unilateral facial drooping, inability to close one eye, and loss
of forehead movement. Which diagnosis is most likely?
A. Ischemic stroke
B. Trigeminal neuralgia
C. Bell's palsy
, D. Temporal arteritis
Correct Answer: C. Bell's palsy
Rationale: Bell's palsy causes peripheral facial nerve paralysis affecting both the
upper and lower face.
Question 5
Which lipid abnormality is the strongest predictor of atherosclerotic cardiovascular disease?
A. Elevated HDL
B. Low triglycerides
C. Elevated LDL cholesterol
D. Elevated albumin
Correct Answer: C. Elevated LDL cholesterol
Rationale: Elevated LDL cholesterol is a major contributor to plaque formation and
cardiovascular disease.
Question 6
Which finding is most consistent with iron deficiency anemia?
A. Increased MCV
B. Elevated ferritin
C. Low ferritin with microcytic anemia
A 58-year-old man presents for follow-up of hypertension. His blood pressure averages
152/94 mm Hg despite lifestyle modifications. Which medication is an appropriate first-line
treatment in the absence of contraindications?
A. Clonidine
B. Lisinopril
C. Hydralazine
D. Nitroprusside
Correct Answer: B. Lisinopril
Rationale: ACE inhibitors are recommended first-line agents for many adults with
hypertension because they reduce cardiovascular risk, protect renal function, and effectively
lower blood pressure.
Question 2
A 24-year-old woman presents with dysuria, urinary frequency, and urgency for 2 days. She
denies flank pain and fever. What is the most likely diagnosis?
A. Acute pyelonephritis
B. Interstitial cystitis
C. Acute uncomplicated cystitis
D. Nephrolithiasis
Correct Answer: C. Acute uncomplicated cystitis
,Rationale: Dysuria with frequency and urgency in the absence of systemic symptoms
strongly suggests uncomplicated cystitis.
Question 3
Which laboratory test best reflects long-term glycemic control in patients with diabetes
mellitus?
A. Fasting glucose
B. Random glucose
C. Serum insulin
D. Hemoglobin A1C
Correct Answer: D. Hemoglobin A1C
Rationale: Hemoglobin A1C reflects the average blood glucose level over
approximately three months.
Question 4
A patient presents with sudden unilateral facial drooping, inability to close one eye, and loss
of forehead movement. Which diagnosis is most likely?
A. Ischemic stroke
B. Trigeminal neuralgia
C. Bell's palsy
, D. Temporal arteritis
Correct Answer: C. Bell's palsy
Rationale: Bell's palsy causes peripheral facial nerve paralysis affecting both the
upper and lower face.
Question 5
Which lipid abnormality is the strongest predictor of atherosclerotic cardiovascular disease?
A. Elevated HDL
B. Low triglycerides
C. Elevated LDL cholesterol
D. Elevated albumin
Correct Answer: C. Elevated LDL cholesterol
Rationale: Elevated LDL cholesterol is a major contributor to plaque formation and
cardiovascular disease.
Question 6
Which finding is most consistent with iron deficiency anemia?
A. Increased MCV
B. Elevated ferritin
C. Low ferritin with microcytic anemia
