Q14.A 30-year-old woman presents with a heart murmur. There is a history of recurrent episodes of arthritis, skin rash, and glomerulonephritis. Blood cultures are negative. Laboratory tests for antinuclear antibodies (ANA) and anti–double-stranded DNA are positive. Which of the following is the most likely cause of heart murmur in this patient?
(A) Libman-Sacks endocarditis
(B) Mitral valve prolapse
(C) Myocardial infarct
(D) Mitral valve prolapse
(E) Rheumatic fever

Q15 .A 62-year-old man with a history of hypertension is brought to the emergency room with severe left chest and back pain. His blood pressure is 80/50 mm Hg. Physical examination shows pallor, diaphoresis, and a murmur of aortic regurgitation. An ECG does not show myocardial infarction. An X-ray film of the chest reveals mediastinal widening. Which of the
following is the most likely diagnosis?
(A) Bacterial endocarditis
(B) Dissecting aneurysm
(C) Pericarditis
(D) Pulmonary thromboembolism
(E) Ruptured myocardial wall

حاولت نغطي مواضيع متنوعة من cvs ب cases نزلت 15 case ، حنبدا توا نزل مجموعة على neoplasia 💜

Q1. A 65-year-old man complains of muscle weakness and a dry cough for 4 months. He has smoked two packs of cigarettes daily for 45 years. A chest X-ray shows a 4-cm central, left lung mass. Laboratory studies reveal hyperglycemia and hypertension. A transbronchial biopsy is diagnosed as small cell carcinoma. Metastases to the liver are detected by CT scan.
Which of the following might account for the development of hyperglycemia and hypertension in this patient?
(A) Adrenal metastases
(B) Paraneoplastic syndrome
(C) Pituitary adenoma
(D) Pituitary metastases
(E) Thrombosis of the renal artery

Q2. A 35-year-old woman complains of nipple discharge and irregular
menses of 5 months duration. Physical examination reveals a milky discharge from both nipples. MRI shows an enlargement of the anterior pituitary. Which of the following is the most likely histologic diagnosis of this patient’s pituitary tumor?
(A) Adenoma
(B) Choristoma
(C) Hamartoma
(D) Papilloma
(E) Teratoma

Q3. A 63-year-old woman with chronic bronchitis presents with shortness of breath. A chest X-ray reveals a 2-cm “coin lesion” in the upper lobe of the left lung. A CT-guided lung biopsy is obtained. Which of the following describes the histologic features of this lesion if the diagnosis is hamartoma?
(A) Benign neoplasm of epithelial origin
(B) Disorganized normal tissue
(C) Ectopic islands of normal tissue
(D) Granulation tissue
(E) Granulomatous inflammation

Q4. A 20-year-old woman has an ovarian tumor removed. The surgical specimen is 10 cm in diameter and cystic. The cystic cavity is found to contain black hair and sebaceous material. Histologic examination of the cyst wall reveals a variety of benign differentiated tissues, including skin, cartilage, brain, and mucinous glandular epithelium. What is the diagnosis?
(A) Adenoma
(B) Chondroma
(C) Hamartoma
(D) Teratocarcinoma
(E) Teratoma

Q5. A 45-year-old woman presents with abdominal pain and vaginal bleeding. A hysterectomy is performed and shows a benign tumor of the uterus derived from a smooth muscle cell.
What is the appropriate diagnosis?
(A) Angiomyolipoma
(B) Leiomyoma
(C) Leiomyosarcoma
(D) Myxoma
(E) Rhabdomyoma

Q6. A 60-year-old man presents with a 6-month history of increasing
weight loss and fatigue. Physical examination reveals conspicuous hepatomegaly. An abdominal CT scan reveals multiple “canon ball” nodules in the liver . A CT-guided biopsy reveals a mucous-secreting adenocarcinoma.
This patient’s metastatic liver cancer most likely originated in which of the following anatomic locations?
(A) Adrenal medulla
(B) Bone marrow
(C) Brain
(D) Pancreas
(E) Urinary bladder

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