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Discuss NBME F3 B1 - grazie
Thanks Kat:

q24
it's a medical emergency because the testes are there. You need to remove them as an Elective survey to save the testes. all other hernias can wait till after 2 years of age
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25 C...pagets disease

thank you....katmd
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25.
A 55-year-old African American woman, gravida 4, para 4, comes to the office because of a rash across both breasts that first appeared approximately 2 months ago. The patient says that initially she was not concerned about the rash because it appeared after she became sunburned during a trip to the Caribbean. She has tried treating the rash with over-the-counter moisturizers without success. Medical history is remarkable for hypothyroidism, for which she takes levothyroxine. She underwent tubal ligation 10 years ago. Menopause occurred 4 years ago. She has smoked two packs of cigarettes daily for the past 40 years. Vital signs are normal. Physical examination discloses mild bilateral breast tenderness and the findings shown. Mammogram obtained 2 weeks ago discloses no abnormalities.
http://i42.photobucket.com/albums/e338/G...5d5956.png
Which of the following is the most appropriate next step?

A) Bilateral breast ultrasonography
B) Potassium hydroxide scraping for yeast
C) Punch biopsy of the nipple
D) Repeat mammography
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I think its C as well!! at the moment i couldn't figure it out and put B so i know its wrong
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grazie...24 is B....testes are okay, but hernia needs surgery to avoid strangulation of gut or omentum etc.
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I thought that it was due to the testes and strangulation of the gut that it became an elective surgery?? thank you for telling me that!! Uworld told me this explanation so i wasn't sure which one is more important
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q25)

Ans: C
C) Punch biopsy of the nipple
nbme cert!

Paget's Disease; Biopsy of the nipple
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where is alexa...we need confirmation of answ...??
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I told graze that hehe so my bad Sad
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Thank you perception Wink
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