A. Superior mesenteric artery
B. Inferior mesenteric artery
C. Common hepatic artery
D. Celiac artery
E. Right gastric artery

3. A 13-year-old boy is brought to the clinic because he has no signs of puberty. On examination, he has no pubic hair and testicular volume is consistent with a pre-pubertal stage. What condition could be responsible for this presentation?

A. Idiopathic precocious puberty
B. GnRH-independent puberty
C. Klinefelter syndrome
D. Constitutional delay of growth and puberty
E. Ovarian tumor

4. A 30-year-old male uses cannabis heavily and has been showing disorganized behavior, hallucinations, and flat affect for the past year. Brain imaging shows ventriculomegaly. What neurotransmitter alteration is most commonly associated with his condition?

A. Increased norepinephrine
B. Decreased serotonin
C. Altered dopamine activity
D. Decreased GABA activity
E. Increased acetylcholine

5. A 32-year-old male is prescribed an NSAID for chronic back pain. After two weeks, he presents with reduced urine output and elevated serum creatinine levels. Which of the following describes the mechanism by which NSAIDs could lead to these changes in renal function?

A. Constriction of the afferent arteriole, reducing RPF and GFR
B. Constriction of the efferent arteriole, increasing GFR
C. Dilation of the efferent arteriole, increasing RPF
D. Inhibition of the renin-angiotensin system, reducing GFR
E. Dilation of the afferent arteriole, increasing GFR

6. A 45-year-old woman with chronic pain is enrolled in a clinical therapeutic trial comparing the efficacy of a new pain reliever to a placebo. The study protocol uses a randomized, controlled, double-blind design. Which of the following best describes this type of study?

A. Subjects are assigned to the treatment or control group by the researchers analyzing the data.
B. Subjects and researchers analyzing the data are blinded to the assignments, but the researchers administering the treatments are not.
C. Subjects and all researchers, including those analyzing the data, do not know the group assignments.
D. Subjects serve as their own controls, and the order of treatments is randomized.
E. Subjects are analyzed according to the treatment they actually received, regardless of the original assignment.

7. A 28-year-old man comes to the emergency department after experiencing a serious car accident. Over the next month, he has persistent nightmares, flashbacks, and avoids driving or anything related to the accident. He feels increasingly agitated and has difficulty sleeping. Which of the following is the most appropriate initial treatment?

A. Benzodiazepines
B. Cognitive-behavioral therapy (CBT)
C. Selective serotonin reuptake inhibitors (SSRIs)
D. Antipsychotic medication
E. Prazosin

8. A 29-year-old woman with hyperthyroidism is brought to the emergency department with high fever, agitation, and confusion. Examination reveals tachycardia and a mild tremor. Her family mentions she had a recent upper respiratory infection. Which of the following treatments should be initiated immediately?

A. Benzodiazepines
B. Cognitive-behavioral therapy (CBT)
C. Selective serotonin reuptake inhibitors (SSRIs)
D. Antipsychotic medication
E. Prazosin

9. A 50-year-old male presents to the emergency department after a suspected overdose. He consumed a substance that causes metabolic acidosis with an elevated anion gap. Physical examination reveals hyperventilation. Which of the following treatments should be administered first to this patient?

A. Fomepizole
B. N-acetylcysteine
C. Methylene blue
D. Vitamin K
E. Atropine

10. A 30-year-old man with a longstanding history of cocaine abuse presents with chest pain and nosebleed. Physical examination reveals mydriasis and diaphoresis. Which of the following complications is most likely responsible for his symptoms?

A. Pulmonary embolism
B. Perforated nasal septum
C. Pneumothorax
D. Acute myocardial infarction
E. Esophageal rupture