The document contains a collection of recalled USMLE exam questions from 2021, covering a range of medical scenarios and diagnoses. Questions include topics such as psychotic symptoms, hyperthyroidism, postpartum complications, and various infectious diseases, along with the corresponding correct answers and management steps. It serves as a study resource for medical students preparing for the USMLE exams.

1. USMLE RECALL
COLLECTION 2021
Actual Exam Questions
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2. 1.There was question young boy completed childhood vaccination present jaw
swelling difficulty in swallow and testicular swelling, i ruled out option all option
confused between mumps bcz of vaccination status and othe metapneumoviria
something like that never heard of it so markes mumps
( immunity wanes over time ) mumps correct answer
2.Male with acute psychotic symptoms looks he tells FBI is spying midraisis, inc BP
and HR, slepts gor very few hours in past three days, says walls are chinging color
Cocain, Amphetamine, LSd (ca)
3.Pt has Achondroplasia now what is will you check cardio , pulmo fibrosis
,obesity
Check for Otitis media, OSA , obesity(correct), spinal stenosis , cervical medullary
compression
4.Young lady bleeding from catheter site and other too, d dimer fibrin level
normal increased ptt inr 2.5 on warfarin for aortic walve repair due to congenital
valve peoblem, urea 80, cr 2.7
Reason of bleeding i did uremia cuases platelets dysfunction
56 year old male smoker for 32 years , what is primary prevention for lung
cancer?
Smoking cessation, low dose ct scan
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USMLE 2021 RECALL COLLECTION

3. 5.Pt with left face weakness and right upper and lower limb hypertonic weakness.
Area of lesion.
Basal ganglia, medulla(correct), cerebral
6.Atrial flutter ecg , dont remeber full question Rx : rate control and then (correct
)
other options no treatment , rythym control
7.Question on toxic shock syndrome, female low bp fever, rashes.
Rx Clindamycin (correct )
8.question on epididymitis, i looked pain improved while moving scrotum, and
chlamydia culture +ve diagnosis was asked
other options orchitis , cystitis , testicular torsion
9.Young boy known IV drug abuser,
Cxr shows lower lung bilateral mild interstitial infiltrate and on ct scan lesion
given, cause,
Staph aurues, mycobacterium avium, strephpneumnia, check for P
jerovicii(Correct )
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4. 10.Boy with completed childhood vaccination, comes with right jaw swelling ,
fever, diffuculty in eating and testicular swelling,
Mumps
11 .question on postpartum foul smelling discharge lochia, i think they asked
about Rx
Post partum endometritis , Rx is IV clindamycin and Gentamycin
other options were oral or other wrong antibiotics choice
12 . known asthmatic pt now need more frequent albuletrol , question asked next
prescribed will have effect on which receptor, Glucocoticoid receptor
step up therapy
13 . patient with classical hyperthyroidism with Ecg on afib, hyperthyroid treat
the hyperthyroidism for ecg changes answer .
14. Old lady with dementia lives with her husband , admitted due to hospital for
infection needed to be moved to nursing care , husband refused for nursing care
and pt also wishes to go home what will be physician response,
Admit nursing home,
Ask home to take her home and bring for checkup in two weeks (correct ) if
patient demands
Dont remember other options
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5. 15.Pt ex smoker quit 25 ye ago, on ct scan mass 2.8 cm subplueral what is next
step
percutaneous skin biopsy (correct )
repeat ct scan in 3 months
FNA of mass
16.Man in 60z comes to ER With dysnea, ecg shows st elevation in v2 to v4, full
symptoms of congested heart failure, bp 75/45, bilateral crackles, s3, now what is
bext step of managment?
NSS, Furosamide(correct ) , morphine, metoprolol, hydralazine.
Q.Complication of colposcopy, in non pregnant :Dysparunia, cervical bleeding
(correct ), vaginal , miscarriage , perforation,
Q.Vulvar warts, DX on sole of feet .
Q. Husband with wife for premature ejaculation. Normal mood just no happy with
her problem, supportive wife brings him.
SSRI treatment ( correct ) other options TCAs , gabapentin
Q.Question on hidradenitis suppurata
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6. Rx Oral doxycycline (correct ) , other option oral isotretinoin , incision and
drainage
Q.Suspended from milatry, now for a year multiple sexual partners, cocain and
marijuana user, comes with fatigue, eythematic transilar no exudate, tender
lymphadenopathy, no rashes no weight loss,no diarrhea , cbc normal,
HIV test(correct ) , monospot test .
Q.Old lady with osteoarthritis comes to ER WITH sever knee pain, swelling
tenderness. Arthocentasis shows 120000 neutrophils: septic arthritis
Q.Which of following relates to severity of multiple sceloris
Eye pain (correct )
, urinary incontinence, paraplagia, facial weakness
Q.Pic of breast, with dry rahes
Itchy dryness on breast, no mass palpable, mamo one yr ago was normal now
next step,
Reassurance, biopsy(correct )
, us
Q.Mother bring her daughter probably in teens atheleth for regular checkup,
scoliosis cob angle less than 10 xray was given mother asked prognosis: reassure
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7. Q.Colonoscopy old age man 78 year last colonoscopy 8years ago now duaghter
say to do conoscopy- no because we ll do after 2 years .
Q.Hand pic with rashes , old lady with proximal muscle weakness risk to develp
Malignancy - dermatomyositis
Q. Prostate cancer hx and bone pain , leg bone picture
Metastatic prostatic cancer (correct )
Osteoporosis
Fracture
Q.Child with bowel xray , rotation of bowel xray uw question and xray
Q.Girl develop type 1Dm she is at risk to develop: celiec disease(uw concept )
type 4 immune reactions
Q.Pt with diffuse goiter enlargement, thyroid antibodies -ve . Graves , hoshimotos
, silent thyroiditis correct
Q.Digoxin toxicity syptoms nausea , diarrhea , arrythmia and palpitations ,rx ?
Fab antibodies
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8. Q.Pt with severe headache , ct scan shows bleed at area of ant communicating
arteies bp was normal next step
Rx , coiling or clipping and then CCB
Q.Old pt with vescicuoar lesion few days ago, not treated now develop facial palsy
what could have prevented: herpes vaccine, valcyclovir (correct )
Ramsay Hunt syndrome - Acyclovir
Q.Old pt on oxycodone treatment develop contipation what Rx: docusate ,
naltrexone(correct ) , daily enema
Q. 14 months old boy develops measles goes to day care had already received
one dose of mmr, why he developed meales?
Break in heard immunity ,
First dose is not effective
incomplete immunity ( correct )
I think classic ADRENAL wala male tha tou usmain treatment k baad testrone
zyada hoga infertility nhi hoga
Q.Aspirin toxicity question treatment , sodium bicarbonate
Q.Diabetic patient HTN, already on one antihypertensive thiazide need other
drug for HtN bcz not controlled :
ACE -
Q .Ptsd case Rx: 2 questions
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9. for nightmare : prazosin (correct )
Trauma focus CBT , SSRI (correct )
Q.Lady after c section , lost 750 ml blood even after oxytosin next step
managment: ergotamime(correct )
Q.Question on serous otitis media, read presentation points: question asked next
best step,
Place wire, drain, reffer to ent , reassurance (correct )
Mother brings his son says live insect or fly in ear, physician also sees moving it
now what is next managment :
Irrigation, remove with tweezer (something like that) dont remember other
options
If removing an insect, instill mineral oil or 1 percent lidocaine to kill it prior to
irrigation
A variety of insects may take up temporary residence in the EAC (picture
6). Cockroaches are most commonly found, especially among inner city
children, as they prefer warm, dark environments. A live insect moving in a
child’s ear canal can cause considerable discomfort and occasionally may
damage the tympanic membrane and middle ear [20]. Insects should be
killed with mineral oil [21], ethanol or lidocaine [22] prior to attempted
removal to prevent excess insect movement during retrieval.
Q.Allergic rhinitis, pale blue nasal, treatment: nasal steroids (correct )
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10. Q.Male comes with brown spot at back never noticed before, brown irregular
margin, pt does not know since when it is there: next step managment:
Excision biopsy(correct )
, punch biopsy, reassure observer
Q.Old pt with depression and weight loss BMI 17: Rx mitrazapine(correct )
appetite increase
, SSRI
Q.Panic disorder, lady has chest pain, diaphoresis, same symptoms many times
ago, in emergency every test normal: Rx
Seretonin
if acute Benzodiazepines
Lady hospitalised, post open cholesytectomy complain of abdominal pain, and
fever, on xray air under daiphargm ,
Bowel perforation (correct )
Parkinson disease :
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11. <65 : pramipixole
>65: carbidopa and levodopa
Q. he was 57 year old so i gave pramipixole
Q.Father brings young boy becuase of shortness of breath after playing games:
PFT before dilator and after dilator given
Asthma daignosed on PEFR
Q.MOTHER brings her 6yr old dayghter for weight loss and increased hunger , bed
wetting, DM type 1
Q. Polymyalegia rheumatica classical scenerio with muscle weakness in promixal
muscles , increase ESR . TX : low dose steroids
Q>Aphemtamine abuse and toxicity:
Police arrest boy who crossed red signal and was verbal abusive with police and
grandiosity, blood and urine toxicology showed amphetamine:TX benzodiapine
(correct )
Q.Neonate fever : parents bring their 10days old baby, with fever lethargy DX
meningitis
Q>Elder abuse probably: neice bring her aunt who recently moved with her son,
bruises and painful arm, one bruise at buttock and one at back.
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12. Influenza viral :
Old lady brought by husband with myalgia headache. Had not received vaccine for
years, smoker for years. Also daignose copd . answer was influeza (correct )
Question DDH, palpable clung, asymmetrical, Rx pavlik harness
[CCS
Lady hospitalised, post open cholesytectomy complain of abdominal pain, and
fever, on xray air under daiphargm , consult surgery
Treatment of osteogenesis imperfecta.....calcium or vitamin d
if dietry intake is low then ca and vit d before bisphoshonates (correct in exam )
if diet is good nd ca level is normal then bisphosphoates
Q.Tetanus vaccination...
3 questions very easy from uw table
Q. classical post flu Pericardtiis..on ecg pr segment depression Dx asked
next stem treatment : NSAIDS
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13. Q. Child taking albuterol for asthma not in control now next treatment will act on
steroid receptor (correct )
Q> Age 18 months 3 episodes of uti....management renal usg(correct )
or cystoscopy.
then ask which test will tell about cause VCUG .
2 consecutive question...
Q. CHF pt lisinopril , diuretics still symptoms...which you will give...digoxin....
same UWorld concept
In acute cases digoxin has no role
Q. Pt has pneumonia using azithromycin now develop polymorphic ventricular
tachycardia...which drug caused...azithromycin (correct )
Q. Clopidogrel side effect bleeding (correct )
Q. Ash leaf spot.pic..question what pt most likely develop....axillary frecking
or skin cancer other options too, Cadiac tumour (correct )
.
Q. Classical sepsis with low bp , high grade fever , nbs IV fluids 0.9 % saline
Q. Autistic child most likely develop....major depression(correct )
or odd or ADHD
Q. Ball hits on index finger...finger now bent...how will you manage.. Splint
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14. Q. Scaphoid fracture managemnt... spica cast and repeat xray after 2 weeks
Q. Major depression...after husband died...sertraline
Q. 50 year old male with pelvic pain and fever and history of UTIs tx : prostatis
tmp SMX for 6 weeks
Q. Prostate cancer diagnosed surgery was done follow up with
weekly U/S
Digital rectal examination
PSA level (correct)
Q. emergency old age male with active smoking history for 30 years with sudden
abdominal pain classical Ruptured abdominal aortic aneurysm..NBS operative
repair(correct )
U/S
CT scan
MRI
Q. Bp increased in obese male 3 times high blood pressure measurements most
effective way to decrease BP is Weight loss (correct )
Q.patient with low ef and symptoms of pulmonary edema tx
furosemide (correct )
thiazide
digoxin
Q.Celiac disease case diarhea sensitive ti gluetin , skin rashes first line treatment
dietry modification (correct )
Multiple sclerosis ...prognosis.... Eye pain (correct ) , paraplegia , incontinence
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15. Acute hbs....pt develops hepatic encephalopathy..inr deranged...liver
transplantation....
Recall indications of LIver transplantation .
CCS cases (Same from recalls ) easy
1)Pulmonary embolism
2) Baby with left thigh abscess
3)Cellulitis
4)PKD
5)G6PD Deficiency
6)4 year Baby with Fever
7) Rhabdomyolysis
8)Ruptured aortic aneurysm
9)Newly diagnosed DM
10)Trichomonas Vaginalis with elder abuse
11) Barrets Esophagus
12)Subarachnoid Haemorrhage
13)Acute Sinusitis
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