MCCQE Exam Question 91

A 40-year-old man presents to the emergency department with a 24-hour history of severe abdominal pain and recurrent vomiting. He has a long-term history of alcohol use disorder. His blood pressure is 90/60 mm Hg, and his heart rate is 120/min. The pain is located mostly in the epigastrium but radiates to the right upper quadrant and to his back. Radiographs of the abdomen and chest reveal some distended small bowel loops in his upper abdomen. Laboratory work results are pending. After fluid resuscitation, which one of the following is the best next step?
  • MCCQE Exam Question 92

    A 42-year-old woman presents with a 2-day history of a low-grade fever and a painful left breast mass. On examination, there is a fluctuant erythematous tender mass with surrounding induration in the left breast and enlarged lymph nodes in the left axilla. An ultrasound shows a loculated cystic mass. Which one of the following is the most likely diagnosis?
  • MCCQE Exam Question 93

    A 24-year-old nulligravid woman presents to the office with an absence of menstruation since discontinuing her oral contraceptives 8 months ago. She previously had a regular menstrual cycle when taking oral contraceptives for the past 10 years but stopped because of headaches, which have only gotten worse since.
    She also noticed mild breast discharge for the past several months. Which one of the following examination findings is most likely?
  • MCCQE Exam Question 94

    A 12-year-old boy initially presents with a 4-month history of left knee pain. He denies any obvious history of trauma, but he plays basketball frequently and notes his pain is worse after playing. On physical examination the patient has a prominent tibial tubercle, which is swollen and tender. There is full range of motion in the knee. A radiograph of the left knee reveals an ossicle anterior to the tibial tuberosity. Which one of the following is the most likely diagnosis?
  • MCCQE Exam Question 95

    You are meeting an otherwise healthy 10-year-old boy in your office for the first time. His BMI is at the 80th percentile. He has no symptoms and his physical examination is normal. Which one of the following is the best next step?