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Discuss NBME F3 B1 - grazie
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09-07-2014, 10:13 AM
8) due to DEXA score
9) children between the ages of 3-5 are scared of pooping.. so they are most likely constipated. You treat them with Mag sulf
09-07-2014, 10:15 AM
I got a 760 score on NBME 3 - got 22 questions wrong. I will help with the correct answers as you move along with all the blocks.
Thanks grazie!
09-07-2014, 10:27 AM
Q8
A) Add colchicine B) Add ibandronate C) Add lisinopril D) Add raloxifene E) Switch atorvastatin to pravastatin For q8 I was between B and D for tx of OP according to her Dexa scan. DEXA> -2.5 =OP but I had to pick the wrong >( arrrgghhh! OP TX: ==== - 1st line tx: BISPHOSPHONATES (Alendronate, Risedronate, Ibandronate) these inhibit Osteoclast Cells - 2nd line tx: Raloxifene, these increase bone density - ESTROGEn replacement is the last resort because increases hypercoagulable states Lifestyle modif: Vit D and Ca Weight bearing exercise, as tolerated Smoking cessation Stop Alcohol consumption DEXA SCAN In post menop women: W/O Risk Factors, start at >65 yo With Risk Factors: start at 60-64 yo In men: With RF start at >65 W/O RF start at >80
09-07-2014, 10:27 AM
That is great Alexa!
Kat, thanks for the explaination 
09-07-2014, 10:30 AM
9.
A 5-year-old girl is brought to the health center by her parents because of a long-standing history of constipation. The father says, "This problem seemed to have started when she was 2 years old, after she was potty trained." The mother reports that in the early stages of the problem she had noticed a couple of blood drops in her daughter's stool in the toilet. She says that her daughter has a bowel movement only once or twice per week, usually after a suppository or an enema is given, and that her stools are large and occasionally "block" the toilet bowl. The child frequently soils her underwear. Which of the following is the most likely cause? A) Cystic fibrosis B) Gluten enteropathy C) Habit constipation D) Hirschsprung disease E) Intestinal pseudo-obstruction Ans: C C) Habit constipation children between the ages of 3-5 are scared of pooping.. so they are most likely constipated. You treat them with Mag sulfate. Thanks Girls!
09-07-2014, 10:31 AM
10.
A 76-year-old woman who has been your patient for the past 10 years comes to the office because of fatigue. She has had health evaluations on an irregular basis; her last visit was 2 years ago. At that visit she was healthy and results of laboratory studies were normal. Today she tells you that she has noted a 4.5-kg (10-lb) weight loss during the past 6 months, although she has followed no special diet or exercise regimens. Past history is remarkable for borderline hypertension and osteoarthritis. She had herpes zoster 6 months ago that was treated conservatively. The patient was previously a physical therapist. She was divorced 15 years ago and has three grown children by that marriage. She remarried 10 years ago. She reports that she had sexual intercourse several times with a long-term friend during the interim between her marriages. The friend has subsequently died of pneumonia. Vital signs today are normal. Physical examination shows a tired-appearing, elderly woman. There is candidiasis of the oral mucosa. Lung, cardiac, and abdominal examinations are normal. Results of laboratory studies are shown: Blood Hemoglobin 8 g/dL WBC 1200/mm3 Platelet count 100,000/mm3 Which of the following is the most likely diagnosis? A) Epstein-Barr virus (EBV) infection B) HIV infection C) Iron deficiency anemia D) Mycobacterial infection E) Pernicious anemia
09-07-2014, 10:35 AM
q10)
Ans: B nbme cert! It seems like her secret 'friend with benefits' died from a "pneumonia" and her clinic, HIV most likely.
09-07-2014, 10:36 AM
11.
A 16-year-old African American boy who has been your patient since birth comes to the office because of back pain. He has sickle cell disease, and he has a history of multiple hospital admissions for vaso-occlusive crises, fever, and suspected sepsis. Current medications include daily penicillin and folic acid. Today he states that he is seldom free of discomfort, that the pain is worse in the morning, and that it is exacerbated by long periods of inactivity. He rates his pain as a 3 on a 10-point scale. He says the pain does not limit his daily activities but it is almost always present and is causing him to be short-tempered with family and peers. Vital signs are temperature 37.0°C (98.6°F), pulse 70/min and regular, respirations 14/min, and blood pressure 118/74 mm Hg. Physical examination is remarkable for tenderness over the back at approximately the level of T8 and there is some limitation of flexion. Which of the following is the most appropriate pharmacotherapy at this time? A) Amitriptyline B) Carbamazepine C) Codeine D) Ibuprofen E) Meperidine |
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