NBME form 2--Qs, help forever and egydoc!! - for2011

[ArchivalUser]

41. A 49-year-old woman is admitted to the hospital because of renal failure. She has had episodes of flank pain over the past 20 years. She has also had nocturia 2 to 3 times nightly for 10 years. Her blood pressure is 160/100 mm Hg. Examination shows pale mucous membranes. A mass is palpated in the right flank. Which of the following is the most likely diagnosis?

A) Horseshoe kidney

B) Nephrolithiasis

C) Papillary necrosis

D) Polycystic kidney disease

E) Renal cell carcinoma


45. A 2-year-old girl has had fever and bloody diarrhea for 10 days. A stool culture obtained 7 days ago grew Salmonella species sensitive to amoxicillin. A blood culture was negative. Despite beginning oral amoxicillin therapy 4 days ago, her diarrhea has persisted. Current examination shows no other abnormalities except for a temperature of 38.6 C (101.5 F). Which of the following is the most likely explanation for the failure of amoxicillin to improve her symptoms?

A) Amoxicillin does not alter the course of Salmonella enteritidis(may be correct

B) Amoxicillin has caused pseudomembranous colitis

C) Amoxicillin is absorbed at the level of the jejunum, leaving no drug to be delivered to the colon

D) Oral amoxicillin is not absorbed into the systemic circulation in the presence of diarrhea

E) Salmonella has expressed an inducible ß-lactamase that inactivates amoxicillin

[ArchivalUser]

41, ans.. D, Polycystic kidney,
episodes of flank pain over the past 20 years. ,although bi lateral mass, if it is small cyst in other kidney, the size is not that enlarged and can't palpable per abdomen.

45, ans..B,
pseudomonas colitis can even occur with single dose of antobiotics. (a/t UW)
stool culture obtained 7 days ago grew Salmonella species sensitive to amoxicillin...It exclude E.
A is sure for not. This is Typhoid fever,not enteritis.

[ArchivalUser]

Thanks forever!. But some says the answer for #45 is A?

[ArchivalUser]

Hi i support forever07 ans for 41-d
n 45 -b