A 45 year old firefighter was found collapsed in a building on fire. His oxygen saturation by pulse oximetry is 98%. What is expected to increase in his blood?

ABC company has plan to produce and market insulin gargling. What is the most important data to submit to FDA?

A 50 year old malnourished alcoholic man presented with fatigue for 2 months. Hb 9, Hct 28, WBC 5,000 (N60,L30,M6,E3,B1), Plt 150,000, MCV 110. Maccroovulocyte hypersegmented PMN

Which medication is likely affect iron absorption?

เด็กชายอายุ 1 ปี เกิดมาปกติ ไม่มีอาการอะไร แต่พออายุ 6 เดือน เริ่มมีอาการของ Anemia ได้รับการวินิจฉัยว่าเป็น homozygous β-thalassemia ถามว่าทำไมเพิ่งจะเกิดอาการตอนนี้

ชายอายุ 40 ปี นอนโรงพยาบาล เพื่อทำ autograft stem cell transplantation ถามว่า stem cell ของชายคนนี้ผลิตที่ใด

A 5 year old boy presents with bloody vomiting, bloody diarrhea, and petechiae. Examination: BT 38.0 $$\degree$$   $$C$$   , normal coagulogram, Hb 10 g/dl, Plt 212,000/mm³. What is the most likely diagnosis?

A 30 year old woman presents with abdominal blunt pain and severe blood loss. Hct drops to 28% from 33% after postoperative bleeding still remain, which of the following should be found in peripheral blood smear 3 days after post-operation.

Thrombosis at SMA, which organ is affected?

A 10 year old boy has hemophilia A. His mother’s brother suffers with the same condition. Who is the obligated carrier of this disease?

A 25 year old woman presents with 2 cm cut lesion on her hand. What substance help about platelet aggregation in hemostasis?

A 60 year old woman presents with lethargy, confusion and trunk pain เคยทำ modified radical ที่เต้านมข้างซ้าย (เป็นมะเร็ง) X-rays พบ lytic lesion ที่ femur ผลเลือดควรเป็นอย่างไร

เป็น acute MI ได้รับ streptokinase สารอะไรเพิ่ม

A 2 year old boy is brought to the hospital by his parents who are concerned about the multiple bruises on the boy’s body. Blood examination found PT 13 seconds and aPTT52 seconds. There is a history of similar conditions in male family members. Which of the following coagulation factors is most likely defect in this patient?

pH 7.33, PCO₂ 70, HCO₃ 36

Which one of the following is physiological compensation?

A 10 year old has headache, puffy eyelid and bilateral leg edema for 2 days. Two weeks ago, she had sore throat and fever relieved by consuming over the counter drug. PE: blood pressure 140/80. UA: protein 2+, RBC 5-10 /upfront, red cell cast 1-2/lpf. Which of the following condition is most compatible with the clinical presentation?

A 6 year old boy presents with protein uric. 4+, hypercholesterolemia, and hypoalbuminemia. What is the most likely finding when renal biopsy is performed.

พบ dysmorphic RBC, RBC 5-10/field, มี massive hematuria ถามว่าเกิดอะไรก่อนหน้านี้

กินกล้วยเยอะ โพแทสเซียมสูง ถามว่า กลไกใดที่ทำให้ โพแทสเซียมในเลือดยังมีค่าปกติ

มีอาการหูหนวก & อาการทางไต ถามว่าเสีย collagen type ใด

After eating high protein diet for 4 hours. Which mechanism causes high urine output?

A 25 year old man present with cough and dyspnea. He was diagnosed with lobar pneumonia. Sputum was collected for gram stain. Which immune component is involved?

มี erythmatous vesicular papule หลังจากสัมผัส rove beetle ต่อย ถาม immune mechanism

กิน analgesic drug แล้ว 30 นาทีต่อมาเกิด generalized urticaria, face and lips edema. What is the mechanism?

การติดเชื้อวัณโรคที่ทำให้เกิดเป็น Caseous necrosis ที่เป็นเช่นนี้เพราะ cytokine ชนิดใด

การติดเชื้อไวรัส cytokine ชนิดใดป้องกันการติดเชื้อให้แก่เซลล์ข้างเคียง

การติดเชื้อไวรัส เซลล์ชนิดใดจะตอบสนองเป็นลำดับแรก?

เด็กชายวัย 10 ขวบ ถูกมดแดงกัด สักพักมีอาการบวม,แดง,ร้อน เซลล์ใดเป็นต้นเหตุของอาการนี้

ผู้หญิงสวมสร้อยข้อมือที่เพิ่งซื้อมาใหม่ หลังจากนั้น 1 สัปดาห์ก็มีผื่นขึ้นบริเวณที่ใส่ เพราะกลไกใด

Prevalence of PKU = 1/40,000 ถาม frequency ของ PKU carrier

A 20 year old male presents with throbbing headache, nausea, palpitation and flushed on head, neck and trunk after drank 2 glasses of alcohol. Which of the following substances is the cause of his symptoms?

A 20 year old woman with poorly-controlled type 1 diabetes presents with nausea and vomiting, fruity scanted breath and Kussmaul breathing pattern. Her blood sugar is 500 mg/dL. Which of the following is associated with this condition?

A 30 year old presents with a shortness of breath for 3 hours, PE: RR 23/min, using accessory muscles to his respiration, wheezing both lung fields. Which of the following substances mostly mediates with his condition?

ผู้หญิงอายุ 30 ปี มี dysmenorrhea แท้งเมื่อ 5 ปีก่อน พบ numerous hemorrhagic lesions 0.2-0.5 cm at perineal membrane over ovary ถาม DX

เด็ก term normal labor คลอดออกมา cyanosis หายเขียวหลังร้องไห้PE ปกติ กลไกอะไรทำให้หายเขียว

Preterm newborn postpartum have a dyspnea and cyanosis

CXR: seen multiple bowel in chest cavity and seen mediastinum shift the opposite. What mechanism is defected?

A 20 year old female presented with easy fatigue and dyspnea for 3 months. She had a history of 20 year poor controlled diabetes millitus. Recently, she was diagnosed with diabetic retinopathy and neuropathy. Physical examination showed pale conjunctiva. Complete blood count showed Hb 9g/dL, Hct 28%, MCV 90 fL, MCH 30 pg (normal range 27-33), RDW 13.5% (normal range 11.5-14.5), WBC 8,500/mm³, platelet 200,000/mm³, HbA1C 12%. Which of the following was the most likely cause of anemia?

A 52 year old man presented to his physician for a routine check up. He reported increasing fatigue and has a smooth, sore tongue. He was a strict vegan and had undergone bariatric surgery 3 years ago. Physical examination was notable for decreased vibration sensation and proprioception. Laboratory studies demonstrated a macrocytic anemia with reticulocytopenia. Peripheral blood smear was shown. Which was the most likely cause?

A 20 year old male presented with easy fatigue and dyspnea for 2 months. He was then diagnosed with iron deficiency anemia. Ferrous sulfate was administered. Which of the following diet should be taken with the agent to facilitate absorption?

A 68 year old man presented to his primary care physician with complaints of weakness and fatigue over the past half year. Physical examination revealed moderately pale, no jaundice, no hepatosplenomegaly. Blood test showed Hb 7g/dL, MCV 70 fL, WBC 5,600/mm³, Reticulocyte count 1%. A fecal occult blood test was shown to be positive for blood in the stool. Which of the following agents should be administered?

A 26 year old male was initially admitted to a hospital with a 10 day history of intermittent fever, headaches, rigors, and chills, and a 1 day history of nausea, vomiting, and diffuse abdominal pain. His symptoms began 5 months after returning from a 10 day camp in the forest in Thailand which he has received multiple mosquito bites. On admission, the patient was alert and oriented with a temperature of 38 $$\degree C$$  , heart rate of 124 bpm, and blood pressure of 93/44 mm/Hg. Physical examination findings were significant for diffuse abdominal tenderness and petechial rash on the lower extremities bilaterally. After chloroquine and primaquine was taken, his urine turned dark brown. Supravital stain of his blood showed Heinz body. Which of the following substances decreased in RBC?

A 50 year old male presented with dyspnea for 2 months. Physical examination revealed markedly pale conjunctiva. Other examinations were unremarkable. Complete blood count revealed CBC: Hb 7 g/dL, Hct 20%, MCV 70 fL, reticulocyte 1%, WBC 5,000/mm³ (neutrophil 70%, lymphocyte 30%). Hb typing: HbA₂A, HbA₂ 2%. Which of the following was the most likely cause?

A 30 year old male presented with abdominal pain and melena for 3 months. Physical examination was unremarkable except for markedly pale conjunctiva. Complete blood count showed Hct 23%, WBC 3,200/mm³ (N30%, L70%), platelet 50,000/mm³, MCV 89 fL. Which was the most likely pathogenesis？

A 20 year old female was diagnosed with hemolytic jaundice since she was born. Physical examination revealed splenomegaly. Blood smear showed small-sized RBC without central pallor. Her mother had similar finding. Which of the following was the most likely pathogenesis?

A 40 year old female presented with pale and easy fatigue. Physical examination showed none of hepatosplenomegaly or lymphadenopathy. Complete blood count showed Hb 8 g/dL, Hct 25%, MCV 70 fL, reticulocyte 1%. She was treated appropriately. After the treatment, which of the following parameters would change first?

A 50 year old female presented with easy fatigue for 3 months. Physical examination revealed pale conjunctiva without icteric sclerae. Liver and spleen were not enlarged. Complete blood count showed Hb 6 g/dL, MCV 120 fL, WBC 3,800/mm³ (N70%, L30%), platelet 180,000/mm³. Which of the following laboratory was most appropriate for the case?