Genetic syndromes, toxicology, and disease processes that cut across organ systems. This category has 106 original questions in the full StepExamPrep bank — here are 3 samples with complete explanations.
Which of the following is the most common cause of Cushing syndrome overall (including all causes, not just endogenous)?
Exogenous (iatrogenic) corticosteroid use is actually the most common OVERALL cause of Cushing syndrome (when considering all causes, not just endogenous ones), given how widely corticosteroids are prescribed for various conditions.
A patient begins induction chemotherapy for Burkitt lymphoma and within 48 hours develops hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. Which of the following should have been given prophylactically to prevent this?
This is tumor lysis syndrome, occurring after chemotherapy for high-turnover malignancies; prophylactic allopurinol or rasburicase with aggressive IV hydration is used to prevent it.
A patient with longstanding rheumatoid arthritis develops proteinuria and is found to have renal amyloid deposits on biopsy. Which type of amyloid protein is most likely responsible?
Chronic inflammatory conditions like longstanding rheumatoid arthritis chronically elevate serum amyloid A (an acute phase reactant), which can deposit as AA amyloid in various organs including the kidney over time, causing this secondary (reactive) amyloidosis pattern.
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