Sunday, March 20, 2022

Recalled USMLE Questions Step 1- 4

 Q- A physician forgot to ask a patient about his allergies. He subscribes a certain medication that caused anaphylactic shock to the patient. 

Which of the following is the most accurate description of this medical error? 

A- Lapse resulting in adverse event 

B- Slip resulting in disability 

C- Violation resulting in injury

D- Violation resulting in near miss


This is a case of failure of memory which is called lapse. It results in adverse event which is prophylaxis. Slip is a failure of attention to an observation. The physician fails to look at or ask the patient about his allergies. Violation means the act of not-following the rules and policies which may lead to injury or near miss. Anaphylactic shock is not considered a disability. 

The correct answer is A 


Q- For treatment of Parkinson disease, which one of the following medications acts centrally to inhibit the breakdown of dopamine? 

A- Amantadine 

B- Bromocriptine

C- Selegiline

D- Trihexyphenidyl 


Selegiline acts post-blood brain barrier to inhibit the breakdown of dopamine. Amantadine increases dopamine release and decreases reuptake. Bromocriptine is an ergot dopamine agonist while trihexyphenidyl is an antimuscarinic which improves tremor and rigidity. 

The correct answer is C

Q- Which one of the following conditions is NOT a feature of CREST syndrome? 

A- Calcinosis

B- Raynaud phenomenon

C- Esophageal dysmotility

D- Spherocytosis

E- Telangiectasia 


CREST syndrome is scleroderma characterized by Calcinosis, Raynaud phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasia. Spherocytosis is not a part of CREST syndrome. 

The correct answer is D


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