BASELINE EXAM 2025 QUESTIONS
AND ANSWERS
A 65-year-old man is seen for loose stools 3 times per day for 1 week. Two weeks
prior he began a 6-week course of ciprofloxacin for prostatitis. There is no blood
in his stool. His past medical history is notable for atrial fibrillation, hypertension,
and gout. He takes atenolol, warfarin, hydrochlorothiazide, and allopurinol. He
smoked 2 packs per day for 30 years but quit 10 years ago. He no longer drinks,
but he drank heavily until 10 years ago. He does not use drugs. He works as a
plumber. His mother and father both died of heart attacks in their 80s. He has not
noted any bruising, epistaxis, or bleeding gums.
His temperature is 36.7, heart rate 89, blood pressure 115/84, respiratory rate 16,
and oxygen saturation 98% on room air. He weighs 70kg. He is alert and oriented
and in no acute distress. His physical examination is normal, and he has no
ecchymoses.
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,His WBC count is 7,800/microliter, hemoglobin 14.6 g/ - ....ANSWER ...-4.
hold warfarin and recheck INR in 2-3 days
A 22-year-old man presents for a pre-marital evaluation. He is asymptomatic and
feels well. His past medical history is notable for sickle cell trait. He takes a
multivitamin and has no allergies. He does not smoke, drink, or use drugs. He is a
card dealer at a casino. His ROS and exam are negative. His fiancée is also
asymptomatic and has been diagnosed with alpha-thalassemia trait based on
hemoglobin electrophoresis. She is an immigrant from Kenya and works in public
relations.
What is the chance they will have a child with sickle cell disease?
1. 0%
2. 25%
3. 50%
4. 67%
5. 100% - ....ANSWER ...-1. 0%
A 64-year-old African American man presents with fatigue. His thyroid-stimulating
hormone level is normal, but he was found to have a normocytic anemia with a
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,hemoglobin level of 9 g/dL. He has a reticulocyte count of 4%, and his ferritin
level is normal. His lactate dehydrogenase level is modestly elevated, as is his
indirect bilirubin level. Haptoglobin levels are low. His history is significant for
mechanical mitral valve replacement in his 40s when he had severe mitral
regurgitation due to endocarditis.
A Coombs test is done and is negative. The hemoglobin electrophoresis is
negative. A peripheral blood smear shows numerous irregularly shaped, jagged,
asymmetric red blood cells.
Which of the following is the most likely cause of this patient's anemia?
1. microangiopathic hemolytic anemia
2. immune hemolysis
3. thalassemia
4. sickle cell anemia
5. hereditary spherocytosis - ....ANSWER ...-1. microangiopathic hemolytic
anemia
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, A 61-year-old man with a history of hypertension complains of nocturia for the
past several months. He also describes symptoms of urinary urgency, hesitancy,
and dribbling during the same time period. He denies polyuria, polydipsia, and
hematuria. He has no other complaints. DRE reveals a prostate of approximately 3
fingerbreadths wide. The prostate is soft, nontender, and there are no nodules. The
rest of the physical examination is unremarkable.
What is the next best step in the treatment of this patient?
1. order UA, urine culture, and PSA tests
2. order transurethral ultrasonography of the prostate
3. start alpha-1-receptor blockade
4. start 5-alpha-reductase inhibitor
5. expectant management with DRE and PSA annually - ....ANSWER ...-1.
order UA, urine culture, and PSA tests
A 32-year-old man complains of painful penile lesions. Physical examination
reveals tender, soft, putty-like ulcers (see image).
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AND ANSWERS
A 65-year-old man is seen for loose stools 3 times per day for 1 week. Two weeks
prior he began a 6-week course of ciprofloxacin for prostatitis. There is no blood
in his stool. His past medical history is notable for atrial fibrillation, hypertension,
and gout. He takes atenolol, warfarin, hydrochlorothiazide, and allopurinol. He
smoked 2 packs per day for 30 years but quit 10 years ago. He no longer drinks,
but he drank heavily until 10 years ago. He does not use drugs. He works as a
plumber. His mother and father both died of heart attacks in their 80s. He has not
noted any bruising, epistaxis, or bleeding gums.
His temperature is 36.7, heart rate 89, blood pressure 115/84, respiratory rate 16,
and oxygen saturation 98% on room air. He weighs 70kg. He is alert and oriented
and in no acute distress. His physical examination is normal, and he has no
ecchymoses.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,His WBC count is 7,800/microliter, hemoglobin 14.6 g/ - ....ANSWER ...-4.
hold warfarin and recheck INR in 2-3 days
A 22-year-old man presents for a pre-marital evaluation. He is asymptomatic and
feels well. His past medical history is notable for sickle cell trait. He takes a
multivitamin and has no allergies. He does not smoke, drink, or use drugs. He is a
card dealer at a casino. His ROS and exam are negative. His fiancée is also
asymptomatic and has been diagnosed with alpha-thalassemia trait based on
hemoglobin electrophoresis. She is an immigrant from Kenya and works in public
relations.
What is the chance they will have a child with sickle cell disease?
1. 0%
2. 25%
3. 50%
4. 67%
5. 100% - ....ANSWER ...-1. 0%
A 64-year-old African American man presents with fatigue. His thyroid-stimulating
hormone level is normal, but he was found to have a normocytic anemia with a
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,hemoglobin level of 9 g/dL. He has a reticulocyte count of 4%, and his ferritin
level is normal. His lactate dehydrogenase level is modestly elevated, as is his
indirect bilirubin level. Haptoglobin levels are low. His history is significant for
mechanical mitral valve replacement in his 40s when he had severe mitral
regurgitation due to endocarditis.
A Coombs test is done and is negative. The hemoglobin electrophoresis is
negative. A peripheral blood smear shows numerous irregularly shaped, jagged,
asymmetric red blood cells.
Which of the following is the most likely cause of this patient's anemia?
1. microangiopathic hemolytic anemia
2. immune hemolysis
3. thalassemia
4. sickle cell anemia
5. hereditary spherocytosis - ....ANSWER ...-1. microangiopathic hemolytic
anemia
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, A 61-year-old man with a history of hypertension complains of nocturia for the
past several months. He also describes symptoms of urinary urgency, hesitancy,
and dribbling during the same time period. He denies polyuria, polydipsia, and
hematuria. He has no other complaints. DRE reveals a prostate of approximately 3
fingerbreadths wide. The prostate is soft, nontender, and there are no nodules. The
rest of the physical examination is unremarkable.
What is the next best step in the treatment of this patient?
1. order UA, urine culture, and PSA tests
2. order transurethral ultrasonography of the prostate
3. start alpha-1-receptor blockade
4. start 5-alpha-reductase inhibitor
5. expectant management with DRE and PSA annually - ....ANSWER ...-1.
order UA, urine culture, and PSA tests
A 32-year-old man complains of painful penile lesions. Physical examination
reveals tender, soft, putty-like ulcers (see image).
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
