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nbme 2qs - ommani7
#1
1.) A 50-year-old man with a 20-year history of type
2 diabetes mellitus has had sensory neuropathy for 2 weeks.
Pulses are decreased at the ankle. There is no peripheral edema. His serum
glucose levels have been between 150 mg/dL and 200 mg/dL over the past 6
months. Which of the following is the most effective measure to prevent
serious foot infections?

A) Use of support hose

B) Use of well-fitted shoes

C) Prophylactic antibiotics

D) Daily aspirin and dipyridamole


E) Decrease in serum glucose level

9. A 57-year-old man has been hospitalized for 2
days for treatment
of unstable angina pectoris. He is currently
receiving intravenous
heparin and undergoing evaluation for coronary artery
bypass grafting.
His blood pressure is 160/90 mm Hg, pulse is 88/min,
and respirations are
16/min. Laboratory studies show:

Platelet count 90,000/mm3
Prothrombin time 12 sec (INR=1.1)
Partial thromboplastin time 35 sec

Which of the following is the most likely cause of
these findings?

A
) Excessive platelet destruction

B
) Factor VIII deficiency

C
) Inadequate platelet production

D
) Uncontrolled activation of coagulation and
fibrinolytic cascades

E
) Vitamin K deficiency
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#2
26. A 57-year-old man with multiple myeloma comes
to the physician
because of a 12-hour history of fever, sharp chest
pain with deep
inspiration, and cough productive of blood-tinged
sputum. His temperature is
38.3 C (101 F), blood pressure is 120/78 mm Hg, pulse
is 112/min, and
respirations are 28/min. Crackles are heard at the
right lung base.
His hemoglobin level is 9.2 g/dL, leukocyte count is
2600/mm3, and
platelet count is 96,000/mm3. Empiric antibiotics
should be directed against
which of the following organisms?

A
) Listeria monocytogenes

B
) Neisseria meningitidis

C
) Pseudomonas aeruginosa

D
) Streptococcus bovis

E
) Streptococcus pneumoniae
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#3
1. B
I know E is tempting, but I think it's B


9. D
Sounds like heparin-induced thrombocytopenia

26. E?
My logic is that the most common cause of community acquired pneumonia is strep pneumo...BUT I'm not sure if the pt is considered immunocompromised? Which makes me debate between E and pseudomonas
Reply
#4
1.B
9.A
26.E
Reply
#5
thanks aprilck99 but for qs number 9 is it HIT type 1?and for 26 i gave pseudomonas as i thought pt is immunocomprosmised but i dont know whether it is right or wrong coz didnot take extended one.
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#6
thanks peds22
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#7
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