A 44-year-old lady presents to the clinic with shortening of the digits in her hands. She has a history of pallor of the extremities followed by pain and cyanosis on exposure to cold since her adolescence. Six months ago, she noticed puffiness of her fingers and face. An ANA test was positive with a Nucleolar pattern on immunofluorescence. What is the most likely diagnosis?

A 28-year-old graduate student presents with a chronic history of fluctuating moods that he feels have been present since his late teens. He reports numerous, distinct periods of heightened energy, reduced need for sleep, and racing thoughts, followed by periods of low mood, anhedonia, and fatigue. These symptoms have never been severe enough to meet the criteria for a hypomanic or major depressive episode but have caused significant social distress. Which of the following is a mandatory criterion for establishing a diagnosis of cyclothymic disorder?

A 29-year-old male with schizophrenia is being treated with a second-generation (atypical) antipsychotic. His physician explains that the medication's efficacy for both positive and negative symptoms is due to its dual action on two key neurotransmitter systems. In addition to its effect on dopamine D2 receptors, what is the principal antagonistic action that defines this class of medication?

A neonate is brought to the hospital with a bluish pigment on the buttock, present since birth. The lesion is flat, non-tender, and has indistinct borders. What is the underlying embryological cause for this lesion?

In a widely reported criminal case from Kerala, a woman was accused of serially poisoning six family members over several years. The investigation revealed that the primary poison used was cyanide, often mixed into food or drink. This poison is rapidly fatal because it halts cellular respiration. Which component of the mitochondrial electron transport chain does cyanide directly inhibit?

A 22-year-old male presents to the emergency department after falling backward onto his outstretched, hyperextended left wrist. He complains of severe wrist pain and swelling. A lateral radiograph reveals that the lunate maintains its normal articulation with the distal radius, but the capitate and the rest of the carpus are displaced dorsally. Which statement accurately describes this injury pattern?

A forensic pathologist is performing an autopsy on a deceased individual found in a locked, airtight room with an unlit gas stove turned on high. The deceased has cherry-red lividity, and toxicology confirms lethal levels of carboxyhemoglobin. No suicide note was found, and there were no signs of a struggle. The pathologist's official opinion is that the manner of death is suicide. The conclusion that the deceased intentionally turned on the gas is an example of what?

A 25-year-old G1P1 woman is being seen by a community health nurse on her fifth day after a normal vaginal delivery. When asked about her postpartum bleeding, she describes a moderate amount of pinkish-brown, watery discharge. What is the correct term for this expected physiological finding?

During a prolonged abdominal surgery under general anesthesia, the anesthesiologist observes a sudden and sustained increase in the patient's end-tidal CO2 (ETCO2) from 35 mmHg to 60 mmHg. This is accompanied by tachycardia, muscle rigidity, and a rapid rise in body temperature. Which of the following is the most likely cause of this sudden increase in ETCO2?

A 55-year-old woman is diagnosed with primary hyperparathyroidism after lab tests reveal elevated serum calcium and parathyroid hormone (PTH) levels. To plan for a minimally invasive parathyroidectomy, a localization study is ordered. Which of the following is the best initial investigation to identify the hyperfunctioning parathyroid gland?

The following statements are true regarding dry age-related macular degeneration (ARMD) except:

A 45-year-old musician complains of experiencing brief but intense episodes of vertigo and seeing the room spin whenever he is exposed to loud music during his concerts. This phenomenon of sound-induced dizziness and nystagmus is known as the Tullio phenomenon. This sign can be present in all of the following conditions EXCEPT:

A medical student is describing histology of an anaplastic carcinoma of thyroid, which of the following histological feature is not applicable for features of anaplasia in this patient?

A 66-year-old male presents with vivid visual hallucinations and memory loss. His family has noticed that his “internal clock” seems to be off because some days he will sleep all day and other days he is awake all day. His physical examination reveals mild rigidity in his upper extremities and slow finger taps. What is the likely diagnosis?

In the provided histological diagram of a bronchial wall, the ratio calculated by dividing the thickness of the mucous gland layer (distance b to c) by the thickness of the bronchial wall from the basement membrane to the cartilage (distance a to d) is known as the:

A 35-year-old female presents with a "thunderclap headache." What is the likely diagnosis based on the provided non-contrast CT scan of the head?

A child with a history of a highly restrictive diet presents with irritability and severe pain in their legs, refusing to stand. The pediatrician notes that the child's overall bone mineralization appears normal. Based on the provided X-ray of the child's knees, what is the most likely diagnosis?

A 48-year-old male with a history of chronic alcohol abuse is brought to the emergency department with confusion, ataxia, and nystagmus. On examination, he is disoriented to time and place and has difficulty with coordinated movements, such as the finger-to-nose test. Which of the following is the most appropriate initial treatment for this patient's suspected condition?

A 30-year-old woman presents to the emergency department on day 8 postpartum with a fever of 39°C and chills. She reports that her vaginal discharge, which had been lightening, has become heavier, darker, and foul-smelling. On examination, she has significant lower abdominal tenderness, and the uterine fundus is soft and exquisitely tender. What is the most likely diagnosis?