09-07-2014, 03:54 PM
confirmation for which?
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Discuss NBME F3 B1 - grazie
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09-07-2014, 03:54 PM
26.
A 55-year-old woman who has just joined your health plan comes to the office for her periodic health evaluation. She is postmenopausal, and she has had screening mammography yearly for the past 5 years. The mammogram done last week shows a solitary cluster of microcalcifications measuring approximately 0.8 cm in the lower outer quadrant of the left breast. Physical examination, including breast examination, is normal. Which of the following is the most important initial step? A) Determine if she is taking estrogen B) Inquire regarding family history of breast cancer C) Obtain chest x-ray D) Order stereotactic core biopsy of the breast E) Order ultrasonography of the breast 27. A 12-year-old white boy who is the oldest of three children is brought to the office by his parents because he has tormented the neighbors' cats on several occasions. The boy states, "I was just having fun." You have been seeing this child and his family for many years, but these episodes are new. Your records indicate that the child has had problems with bed-wetting and has had some reading difficulties, which may indicate dyslexia. He has been taking imipramine for the past 6 months, which his parents say has mildly improved his bed-wetting. Although the mother provides emotional support for the boy, she says neither the father nor any of the siblings seem to engage in nurturing behavior. After further evaluation, which of the following is the most appropriate management for this child? A) Add methylphenidate therapy B) Admit him to the hospital for psychiatric treatment C) Initiate a program of play therapy D) Initiate behavioral treatment E) Stop the imipramine therapy 28. A 37-year-old woman, gravida 2, para 1, at 16 weeks' gestation undergoes amniocentesis for advanced maternal age. The patient's prenatal history has been uncomplicated. Medical history is significant for a seizure disorder that has been well controlled during her pregnancy with carbamazepine. She also takes prenatal vitamins. Vital signs are normal. Physical examination discloses a uterine size consistent with a 16-week gestation. The karyotype of the fetus is shown. Which of the following ultrasound findings is most likely in this fetus? A) Cystic hygroma B) Diaphragmatic hernia C) Duodenal atresia D) Holoprosencephaly E) Short femur 29. A 55-year-old man is brought to the office by his wife because of a 2-week history of abdominal discomfort and diarrhea. He also has had increasing irritability and a burning sensation in his mouth during this time. He has a history of alcoholism and has recently been drinking one and one-half bottles of gin daily. His wife notes that he has not been eating well and has lost 2 kg (5 lb) during the past 2 weeks. He takes no medications. Vital signs today are temperature 37.6°C (99.7°F), pulse 74/min, respirations 16/min and regular, and blood pressure 120/78 mm Hg. Physical examination shows an erythematous, hyperpigmented rash with scaling and fissuring over his face, neck, and forearms. The remainder of the physical examination is noncontributory. A deficiency of which of the following nutrients is the most likely underlying cause of this patient's condition? A) Vitamin A B) Niacin C) Pyridoxine D) Riboflavin E) Thiamine 30. A 40-year-old man is being treated for stage I thyroid cancer. His treatment has consisted of complete surgical excision of the tumor with negative margins. The patient's prognosis is excellent. Medical history is otherwise unremarkable. You receive a telephone call from the patient's supervisor who says he is considering termination of the employee because of concerns that the patient may not be able to do his duties as a midlevel supervisor in an advertising firm. Which of the following is the most appropriate response? A) Ask the supervisor to put his request for medical information in writing B) Contact the patient and advise him to hire an attorney C) Tell the supervisor that the patient's prognosis is excellent D) Tell the supervisor that written consent from the patient is necessary E) Tell the supervisor that you will send him a written report
09-07-2014, 03:56 PM
26D....as mammo shows micro calcification cluster
09-07-2014, 03:57 PM
26.
A 55-year-old woman who has just joined your health plan comes to the office for her periodic health evaluation. She is postmenopausal, and she has had screening mammography yearly for the past 5 years. The mammogram done last week shows a solitary cluster of microcalcifications measuring approximately 0.8 cm in the lower outer quadrant of the left breast. Physical examination, including breast examination, is normal. Which of the following is the most important initial step? A) Determine if she is taking estrogen B) Inquire regarding family history of breast cancer C) Obtain chest x-ray D) Order stereotactic core biopsy of the breast E) Order ultrasonography of the breast
09-07-2014, 04:02 PM
q26)
Ans: D D) Order stereotactic core biopsy of the breast nbme cert!!! • Core biopsy is the definitive evaluation of a solid breast mass. • Ultrasound can identify cystic lesions but cannot differentiate types of solid lesions (i.e., fibroadenomas versus cystosarcoma phyllodes). • Ultrasound can identify multiple fibroadenomas, which can be useful in developing a treatment plan.
09-07-2014, 04:04 PM
27.
A 12-year-old white boy who is the oldest of three children is brought to the office by his parents because he has tormented the neighbors' cats on several occasions. The boy states, "I was just having fun." You have been seeing this child and his family for many years, but these episodes are new. Your records indicate that the child has had problems with bed-wetting and has had some reading difficulties, which may indicate dyslexia. He has been taking imipramine for the past 6 months, which his parents say has mildly improved his bed-wetting. Although the mother provides emotional support for the boy, she says neither the father nor any of the siblings seem to engage in nurturing behavior. After further evaluation, which of the following is the most appropriate management for this child? A) Add methylphenidate therapy B) Admit him to the hospital for psychiatric treatment C) Initiate a program of play therapy D) Initiate behavioral treatment E) Stop the imipramine therapy
09-07-2014, 04:06 PM
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