PACKRAT 3 Question and answers
rated A+ 2025/2026
When performing a pre-participation sports physical in the adolescent population, a murmur with which
of the following qualities indicates a risk for sudden death during exercise?
A. Increases with the Valsalva maneuver
B. Increases with squatting maneuver
C. Associated with a mid-systolic click
D. Mid-systolic without radiation to the carotids - correct answer ✔A
At the time of ovulation in a normal menstrual cycle, there is a peak in the serum concentration of which
of the
following?
A. Luteinizing hormone
B. Prostaglandin
C. Progesterone
D. Prolactin - correct answer ✔A
A positive direct Coombs' test may be seen in which of the following conditions?
A. G6PD deficiency
B. Sickle cell anemia
C. Hereditary spherocytosis
D. Autoimmune hemolytic anemia - correct answer ✔D
In order to prevent the progression of diabetic nephropathy which of the following medications should
be instituted?
,A. Lisinopril (Prinipril)
B. Propanolol (Inderal)
C. Verapamil (Calan)
D. Hydrochlorothiazide (Diuril) - correct answer ✔A
A 5 year-old male presents with a history of recurrent episodes of acute bronchitis, characterized by
fever and productive cough. He has no known significant past medical history. His pulmonary
examination reveals crackles in the bilateral lower lobes. The remainder of his physical examination is
normal. Chest x-ray demonstrates platelike atelectasis and dilated, thickened airways in the middle and
lower lungs. Which of the following is the most likely diagnosis?
A. Acute bronchitis
B. Bronchiectasis
C. Pneumonia
D. Tuberculosis - correct answer ✔B
Which of the following clinical characteristics is associated with bicipital tendonitis?
A. Aggravated by resisted supination of the forearm
B. Bulging appearance to the proximal arm
C. Weakness of the arm with internal rotation and adduction
D. Pain that awakens the patient at night - correct answer ✔A
Which of the following antiarrhythmic drugs can be associated with hyper- or hypothyroidism following
long-term use?
A. Quinidine
B. Amiodarone
C. Digoxin
D. Verapamil - correct answer ✔B
,An 18 year-old male is involved in a motor vehicle accident with a question of cervical spine fracture.
What is the imaging test of choice to initially evaluate this patient and clear his cervical c-spine?
A. Positron emission tomography
B. Magnetic resonance imaging
C. Computed tomography
D. Lateral radiograph - correct answer ✔D
A 4 year-old boy presents with pain and irritation of his left ear. Otoscopic examination reveals an insect
in the left auditory canal. The tympanic membrane is not completely visualized. Which of the following is
the most appropriate management of this patient?
A. Debrox insertion with suction removal
B. Irrigation with room temperature saline
C. Insertion of 2% lidocaine solution with suction or forceps removal
D. Polymyxin drop insertion via wick - correct answer ✔C
A 62 year-old male is brought to the emergency department with acute hematemesis. The patient
denies a previous history of vomiting. His wife states he has chronic liver disease. Physical examination
reveals a distended abdomen without rebound, guarding or organomegaly. There is a fluid wave. Which
of the following is the most likely diagnosis?
A. Esophageal varices
B. Mallory-Weiss tear
C. Arteriovenous malformation
D. Perforated duodenal ulcer - correct answer ✔A
Which of the following is characterized by epidermal hyperplasia and an increase in the epidermal
turnover?
A. Atopic dermatitis
, B. Tinea corporis
C. Ecthyma
D. Psoriasis - correct answer ✔D
(u) A. Inflammation in atopic dermatitis results in lichenification of the skin from itching, which leaves
the skin dry and scaly when it resolves. The inflammation is the result of elevated T-lymphocyte
activation, defective cellmediated immunity, and IgE overproduction. Epidermal hyperplasia is not
involved in atopic dermatitis.
(u) B. Tinea corporis is a fungal infection and does not have epidermal hyperplasia.
(u) C. Ecythma is the result of an infection from group A beta-hemolytic streptococcus and contaminated
with staphylococci. Like atopic dermatitis and tinea corporis, ecthyma has no epidermal hyperplasia.
(c) D. Psoriasis is characterized by an increased epidermal cell turnover, increased numbers of epidermal
stem cells, and an abnormal differentiation of keratin. This leads to the classic scale associated with
psoriasis. - correct answer ✔D
Which of the following is the treatment of choice for benzodiazepine intoxication?
A. Flumazenil (Romazicon)
B. Naloxone (Narcan)
C. Chlordiazepoxide (Librium)
D. Clonidine (Catapres) - correct answer ✔A
A 56 year-old male with a known history of polycythemia suddenly complains of pain and paresthesia in
the left leg. Physical examination reveals the left leg to be cool to the touch and the toes to be cyanotic.
The popliteal pulse is absent by palpation and Doppler. The femoral pulse is absent by palpation but
weak with Doppler. The right leg and upper extremities have 2+/4+ pulses throughout. Given these
findings what is the most likely diagnosis?
A. Venous thrombosis
B. Arterial thrombosis
C. Thromboangiitis obliterans
rated A+ 2025/2026
When performing a pre-participation sports physical in the adolescent population, a murmur with which
of the following qualities indicates a risk for sudden death during exercise?
A. Increases with the Valsalva maneuver
B. Increases with squatting maneuver
C. Associated with a mid-systolic click
D. Mid-systolic without radiation to the carotids - correct answer ✔A
At the time of ovulation in a normal menstrual cycle, there is a peak in the serum concentration of which
of the
following?
A. Luteinizing hormone
B. Prostaglandin
C. Progesterone
D. Prolactin - correct answer ✔A
A positive direct Coombs' test may be seen in which of the following conditions?
A. G6PD deficiency
B. Sickle cell anemia
C. Hereditary spherocytosis
D. Autoimmune hemolytic anemia - correct answer ✔D
In order to prevent the progression of diabetic nephropathy which of the following medications should
be instituted?
,A. Lisinopril (Prinipril)
B. Propanolol (Inderal)
C. Verapamil (Calan)
D. Hydrochlorothiazide (Diuril) - correct answer ✔A
A 5 year-old male presents with a history of recurrent episodes of acute bronchitis, characterized by
fever and productive cough. He has no known significant past medical history. His pulmonary
examination reveals crackles in the bilateral lower lobes. The remainder of his physical examination is
normal. Chest x-ray demonstrates platelike atelectasis and dilated, thickened airways in the middle and
lower lungs. Which of the following is the most likely diagnosis?
A. Acute bronchitis
B. Bronchiectasis
C. Pneumonia
D. Tuberculosis - correct answer ✔B
Which of the following clinical characteristics is associated with bicipital tendonitis?
A. Aggravated by resisted supination of the forearm
B. Bulging appearance to the proximal arm
C. Weakness of the arm with internal rotation and adduction
D. Pain that awakens the patient at night - correct answer ✔A
Which of the following antiarrhythmic drugs can be associated with hyper- or hypothyroidism following
long-term use?
A. Quinidine
B. Amiodarone
C. Digoxin
D. Verapamil - correct answer ✔B
,An 18 year-old male is involved in a motor vehicle accident with a question of cervical spine fracture.
What is the imaging test of choice to initially evaluate this patient and clear his cervical c-spine?
A. Positron emission tomography
B. Magnetic resonance imaging
C. Computed tomography
D. Lateral radiograph - correct answer ✔D
A 4 year-old boy presents with pain and irritation of his left ear. Otoscopic examination reveals an insect
in the left auditory canal. The tympanic membrane is not completely visualized. Which of the following is
the most appropriate management of this patient?
A. Debrox insertion with suction removal
B. Irrigation with room temperature saline
C. Insertion of 2% lidocaine solution with suction or forceps removal
D. Polymyxin drop insertion via wick - correct answer ✔C
A 62 year-old male is brought to the emergency department with acute hematemesis. The patient
denies a previous history of vomiting. His wife states he has chronic liver disease. Physical examination
reveals a distended abdomen without rebound, guarding or organomegaly. There is a fluid wave. Which
of the following is the most likely diagnosis?
A. Esophageal varices
B. Mallory-Weiss tear
C. Arteriovenous malformation
D. Perforated duodenal ulcer - correct answer ✔A
Which of the following is characterized by epidermal hyperplasia and an increase in the epidermal
turnover?
A. Atopic dermatitis
, B. Tinea corporis
C. Ecthyma
D. Psoriasis - correct answer ✔D
(u) A. Inflammation in atopic dermatitis results in lichenification of the skin from itching, which leaves
the skin dry and scaly when it resolves. The inflammation is the result of elevated T-lymphocyte
activation, defective cellmediated immunity, and IgE overproduction. Epidermal hyperplasia is not
involved in atopic dermatitis.
(u) B. Tinea corporis is a fungal infection and does not have epidermal hyperplasia.
(u) C. Ecythma is the result of an infection from group A beta-hemolytic streptococcus and contaminated
with staphylococci. Like atopic dermatitis and tinea corporis, ecthyma has no epidermal hyperplasia.
(c) D. Psoriasis is characterized by an increased epidermal cell turnover, increased numbers of epidermal
stem cells, and an abnormal differentiation of keratin. This leads to the classic scale associated with
psoriasis. - correct answer ✔D
Which of the following is the treatment of choice for benzodiazepine intoxication?
A. Flumazenil (Romazicon)
B. Naloxone (Narcan)
C. Chlordiazepoxide (Librium)
D. Clonidine (Catapres) - correct answer ✔A
A 56 year-old male with a known history of polycythemia suddenly complains of pain and paresthesia in
the left leg. Physical examination reveals the left leg to be cool to the touch and the toes to be cyanotic.
The popliteal pulse is absent by palpation and Doppler. The femoral pulse is absent by palpation but
weak with Doppler. The right leg and upper extremities have 2+/4+ pulses throughout. Given these
findings what is the most likely diagnosis?
A. Venous thrombosis
B. Arterial thrombosis
C. Thromboangiitis obliterans
