nbme-7 Q - picu

[ArchivalUser]

Father is angry at daughter b/c of her behavior, Mother does not want to speak to father about their daughter ,even she tries to protect her from father,Family therapy helps the family focus less on the member who has been identified as ill and focus more on the family as a whole.

[ArchivalUser]

4-D. Doppler ultrasonography

[ArchivalUser]

I also did it doppler but it came wrong!

I think it might be associated patients age. Before puberty there is low probability to be epididymitis. So high probability for torsiyon. Than go for surgery. but still kinda weird!!

[ArchivalUser]

A 17-year-old girl is brought to the emergency department after a collision in which her motor vehicle crashed into a bridge abutment at high speed; she was the unrestrained driver. On arrival, she is immobilized on a backboard with a cervical collar in place. During attempts to administer 100% oxygen by face mask, the patient is combative. Examination shows obvious severe facial trauma with open fractures of her maxilla and mandible. Her chest is severely bruised. She remains combative and makes gurgling sounds when she breathes. Which of the following is the most appropriate initial step in management?

A.Elevation of the head of the bed

B.Arterial blood gas analysis

C.X-ray of the chest

D.Thoracostomy

E.Cricothyrotomy

it's not chest x-ray..

[ArchivalUser]

A previously healthy 6-year-old boy is brought to the emergency department because of cramping abdominal pain and right-sided scrotal pain for 4 hours. He vomited once on the way to the hospital. Examination shows a distended abdomen. Bowel sounds are decreased, and there is diffuse tenderness to palpation with involuntary guarding. The right hemiscrotum is slightly discolored with swelling and tenderness superiorly. The left hemiscrotum is normal; the testicle is normal. Which of the following is the most appropriate next step in management?

B.Valsalva maneuver

C.Urinalysis

D.Doppler ultrasonography

E.CT scan

F.Antibiotic therapy

G.Operative procedure


then it should be G, b/c of acute abdomen---Bowel sounds are decreased, and there is diffuse tenderness to palpation with involuntary guarding.

Thank you

[ArchivalUser]

TESTICULAR TORSION is a surgical emergency!! teh kid should be taken directly to the operating room without delay in order to save the testicle
pd:ultrasound is appropriate to rule out testicular torsion when all clinical signs point to epidymitis, but not in this clear presentation of testicular torsion

[ArchivalUser]

A 17-year-old girl is brought ...

gurgle sounds from respiratory track and QS say --> INITIAL STEP IN MANAGEMENT

[ArchivalUser]

management of severely injured patients A , B , C

MY ANSWER A , ELEVEATION OF HEAD
(SHE IS ALREADY W/CERVIVAL COLLAR)

[ArchivalUser]

A 43-year-old man comes to the physician because of a 3-day history of
temperatures to 38.4°C (101.1°F), left-sided chest pain, malaise, loss of appetite,
and a cough productive of yellow phlegm and a 36-hour history of increasing
shortness of breath. He has smoked two packs of cigarettes daily for 25 years. He
appears ill. His temperature is 38.8°C (101.8°F), pulse is 112/min, respirations are
22/min, and blood pressure is 118/72 mm Hg. Crackles and wheezes are heard at
the left base; breath sounds are decreased. There is increased left tactile fremitus
and dullness to percussion at the left base. Examination shows no other
abnormalities. X-rays of the chest are shown. Gram stain of sputum shows small
gram-negative bacilli and leukocytes. The most likely diagnosis is pneumonia
caused by which of the following organisms?

A) Escherichia coli
B) Haemophilus influenzae
C) Neisseria meningitidis
D) Pseudomonas aeruginosa
E) Streptococcus pneumonia

[ArchivalUser]

@fuser: I think crichothyrotomy is correct since she has severe maxillar and mandibular trauma. It make sense to keep airway open: A