TEST PRACTICE EXAM NEWEST VERSION
2025 ACTUAL EXAM
1.
A 56-year-old man has burning epigastric pain that improves with
eating. Most likely diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. GERD
D. Pancreatitis
Answer: B
Rationale: Duodenal ulcer pain typically improves with food (acid
buffered), while gastric ulcer often worsens with food. GERD causes
heartburn; pancreatitis causes epigastric pain radiating to back.
2.
Best initial test for suspected appendicitis in a 12-year-old?
A. Abdominal X-ray
B. CT with contrast
C. Ultrasound
D. MRI
Answer: C
Rationale: Ultrasound is first choice in children to avoid radiation and
visualize appendix.
,3.
A patient on hydrochlorothiazide develops flattened T waves on ECG.
Lab abnormality?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Answer: A
Rationale: Thiazide diuretics cause potassium loss → hypokalemia;
flattened T waves are characteristic.
4.
A 72-year-old with a harsh systolic murmur radiating to carotids. Exam
finding?
A. Bounding pulses
B. Widely split S2
C. Pulsus parvus et tardus
D. Early diastolic murmur
Answer: C
Rationale: Aortic stenosis ⇒ delayed carotid upstroke (pulsus parvus et
tardus).
5.
First-line treatment for asymptomatic bacteriuria in pregnancy?
A. Ciprofloxacin
B. Doxycycline
C. Nitrofurantoin
D. Sulfonamides
,Answer: C
Rationale: Nitrofurantoin is pregnancy-safe for asymptomatic bacteriuria
(avoids harm to fetus).
6.
75 grams 2-hour glucose tolerance test result of 190 mg/dL at 2 hours
— interpretation?
A. Normal
B. Impaired glucose tolerance
C. Diabetes
D. Hypoglycemia
Answer: B
Rationale: 140–199 mg/dL at 2h indicates impaired tolerance; ≥200
mg/dL indicates diabetes.
7.
A teenager with sore throat, fever, no cough, tender cervical nodes,
negative rapid strep — next step?
A. No further testing
B. Throat culture
C. Start antibiotics
D. Monospot & send home
Answer: B
Rationale: A negative rapid strep test in high suspicion → confirm with
culture before antibiotics.
8.
, Most appropriate treatment for acute gout flare?
A. Allopurinol
B. NSAIDs
C. Probenecid
D. Febuxostat
Answer: B
Rationale: NSAIDs relieve acute inflammation; allopurinol is for chronic
prophylaxis, not acute flare.
9.
Best test to diagnose C. difficile infection?
A. Stool culture
B. Stool toxin assay
C. Colonoscopy
D. Abdominal X-ray
Answer: B
Rationale: Stool toxin assay is most specific and sensitive.
10.
A child with barking cough worse at night — likely diagnosis?
A. Bronchiolitis
B. Croup
C. Asthma
D. Pneumonia
Answer: B
Rationale: Croup (laryngotracheobronchitis) produces a barking cough,
especially at night.