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Discuss NBME Form 2 Block 5/5 - grazie
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08-29-2014, 03:20 PM
Q1 is not D for sure
Q10 is not B for sure so , we need the answers , Grazi i agree with u for Q 10 , but Q1 , d is wrong so what do u think other than D Thanks
08-29-2014, 04:03 PM
08-29-2014, 04:06 PM
I think I will stick to E
q10) E) Major depressive episode A little review... MAJOR DEPRESSIVE DISORDER ------------------------------------- DSM-IV DIAGNOSTIC CRITERIA FOR MAJOR DEPRESSIVE EPISODE: DIAGNOSIS: 2 weeks with Depressed Mood + at least 4 of "SIG: E CAPS" symptoms ♠ DEPRESSED MOOD (core symptom—can be irritable mood in children or adolescents) + ♠ At least 4 of "SIG: E CAPS" symptoms • Sleep disturbances (insomnia or hypersomnia—S) • Interest/pleasure in activities diminished (core symptom—I) • Guilt/feelings of worthlessness (G) • Energy decreased/fatigue (E) • Concentration diminished or indecisiveness © • Appetite or weight disturbed (increased or decreased) (A) • Psychomotor agitation or retardation (P) • Suicidal thoughts or thoughts of death or dying (S) Stern: Massachusetts General Hospital Comprehensive Clinical Psychiatry, 1st ed. Copyright © Mosby, An Imprint of Elsevier * * * * ... For our patient, she definitely has a Depressed mood (with emotional lability) and from the SIGECAPS, we have: Sleep disturb + Concentration impaired + Appetite decrease + Psychomotor agitation + I think she made it for MDD dx.
08-29-2014, 04:08 PM
Grazie....yah 10 is most likely...E i reviewed the qs thanks
08-29-2014, 04:11 PM
@ missionimpossible
I already fixed the q1 answer in another post of this thread for Block 5, somebody confirmed it was answer C C) No treatment I was between both options, but now they confirmed C by nbme answers. ----------------------------------------------------------------------------------------------------- 1. A 15-year-old Anglo-American girl comes to the office with her mother for a routine physical examination. She participates in track and field sports, rowing, and bicycling. Her menstrual periods are regular, and she consumes the equivalent of two quarts of whole milk daily. Her mother is worried that all of her daughter's activities will put "undue stress on her daughter's bones." She wonders if there is anything special that her daughter should do to "protect her bones." You know that recent studies have suggested the rate of postmenopausal bone loss is influenced by a number of factors, including activity, calcium intake, vitamin D intake, and estrogen replacement. Further research supports the benefits of exercise during young adult life, but exercise-induced anorexia has been shown to have a deleterious effect on bone mass. Which of the following is the most appropriate therapeutic regimen for this patient? A) Calcium supplementation B) Estrogen supplementation C) No treatment D) Vitamin D3 supplementation E) Restriction of activity to two sports
08-29-2014, 04:15 PM
Thank you perception
 I can't believe I forgot to record my good answers, they kind of buzz in my head but without a real paper with my answers that were good for sure, this will be a missionimpossible just like our friend's nickname Ok, let's continue, I should finish this today. I get caught in the reading of topics  but no more, let's move forward
08-29-2014, 04:22 PM
11.
A 20-year-old man comes to the office for treatment of skin lesions on his elbows and knees that have been present for the past 6 months. He is otherwise healthy and takes no medications. Physical examination discloses the skin lesions shown and a scaly rash on the scalp. Appropriate therapy is prescribed. http://i42.photobucket.com/albums/e338/G...2b9875.png The patient returns to the office 4 weeks later and reports that he has had no response to the prescribed topical therapy. Which of the following is the most appropriate diagnostic study at this time? A) Culture of the lesion for bacterial infection B) Culture of the lesion for fungal infection C) Skin biopsy D) Tzanck test E) No test is needed 12. A 15-year-old girl is brought to the office by her mother because of an episode of moderately heavy, painless, irregular vaginal bleeding that lasted 10 days and ended 3 days ago. Menarche was at age 12 years. Physical examination, including pelvic examination, shows no abnormalities. Hemoglobin concentration is 15 g/dL and urine pregnancy test is negative. Which of the following is the most appropriate management plan for this patient? A) Combination oral contraceptive therapy for 3 to 6 months B) Medroxyprogesterone therapy C) Observation for 3 to 6 months D) Oral iron therapy E) Progestin-only oral contraceptive therapy for 3 to 6 months 13. A 41-year-old married attorney comes to the office for an initial visit. She has just moved to the area. Medical history is significant for hypertension and panic disorder. Her panic disorder has been well controlled for 3 years with fluvoxamine. Medications also include atenolol. Blood pressure is 100/70 mm Hg. You are aware that fluvoxamine is not approved by the FDA for treatment of panic disorder. Which of the following is the most appropriate next step in pharmacotherapy? A) Notify the FDA of the inappropriate use of fluvoxamine B) Refer the patient to a psychiatrist to prescribe the fluvoxamine C) Review risks and benefits of continuing to prescribe fluvoxamine D) Switch fluvoxamine to alprazolam E) Switch fluvoxamine to sertraline 14. A 12-year-old girl is brought to the office by her parents because of a 6-month history of progressive blurring of vision in her right eye. Three months ago, an optometrist fitted her with corrective lenses, which improved but did not correct her visual acuity. Medical history is otherwise unremarkable. She takes no medications. She is at the 90th percentile for height and the 75th percentile for weight. Vital signs are normal. Physical examination discloses mild pallor of the right optic nerve head. Pupils measure 4 mm in diameter and constrict better to a bright light shone in the left eye than in the right eye. Visual acuity with corrective lenses is 20/20 in the left eye and 20/80 in the right eye. MRI of the brain discloses thickening of the right optic nerve. Examination of the skin is most likely to show which of the following? A) Facial angiofibromas B) Hemangioma C) Hyperpigmented macules D) Linear sebaceous nevi E) Telangiectasias 15. A 20-year-old man sustained an inversion injury of his left ankle in a basketball game 2 weeks ago. At that time he had pain, swelling, and discoloration over the lateral malleolus and tenderness on palpation over the anterolateral corner of the ankle joint. Routine x-rays and stress views of the ankle were normal. He is now asymptomatic at this follow-up visit. This is his third such injury. Which of the following is the most appropriate management? A) A 3-week program of hydrotherapy B) Ankle strengthening exercise program C) Application of a short leg cast for 3 weeks D) Protected weight bearing E) Surgical repair of the ankle ligaments
08-29-2014, 04:54 PM
Q11
Ans) E E) No test is needed This patient has typical lesions and location of Psoriasis. Treating Psoriasis is not an easy cake, we need to constantly change and add medications until something works for the patient. =========================================================== PSORIASIS ESSENTIAL OF DIAGNOSIS: Silvery scales on bright red, well-demarcated plaques, usually on the knees, elbows, and scalp. Nail findings including pitting and onycholysis (separation of the nail plate from the bed). Mild itching (usually). May be associated with psoriatic arthritis. Psoriasis patients are at increased risk for Metabolic syndrome and lymphoma. Histopathology is not often useful and can be confusing. There are many therapeutic options in psoriasis to be chosen according to the extent (body surface area BSA affected) and the presence of other findings (for example, arthritis). Certain drugs, such as β-blockers, antimalarials, statins, and lithium, may flare or worsen psoriasis. Even tiny doses of systemic corticosteroids given to patients with psoriasis may lead to severe rebound flares of their disease when they are tapered. McPhee, Stephen. CURRENT Medical Diagnosis and Treatment 2013, (LANGE CURRENT Series) (p. 107). McGraw-Hill. Kindle Edition.
08-29-2014, 04:57 PM
12.
A 15-year-old girl is brought to the office by her mother because of an episode of moderately heavy, painless, irregular vaginal bleeding that lasted 10 days and ended 3 days ago. Menarche was at age 12 years. Physical examination, including pelvic examination, shows no abnormalities. Hemoglobin concentration is 15 g/dL and urine pregnancy test is negative. Which of the following is the most appropriate management plan for this patient? A) Combination oral contraceptive therapy for 3 to 6 months B) Medroxyprogesterone therapy C) Observation for 3 to 6 months D) Oral iron therapy E) Progestin-only oral contraceptive therapy for 3 to 6 months
08-29-2014, 05:03 PM
Somebody posted this answer:
Q5: C. Observation for 3 to 6 months What do you think guys? |
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