nbme 1 - born2suffer

[ArchivalUser]

28. A 57-year-old man is brought to the emergency department 6 hours after the onset of weakness of his right face, arm, and leg. Three days ago, he had an episode of sudden visual loss in his left eye that he describes as "a shade coming down." The episode resolved completely within 10 minutes. He has hypertension and type 2 diabetes mellitus, both poorly controlled with lisinopril and glyburide. Examination shows expressive aphasia and right lower facial droop. There is moderate weakness on the right, worse in the upper extremity than the lower extremity. Deep tendon reflexes are 3+ in the right extremities and 2+ in the left extremities. Babinski's sign is present on the right. Sensory examination shows no abnormalities.

For each patient with weakness, select the most appropriate test to establish the cause of the condition.


A
) Brain stem auditory evoked potentials

B
) Carotid ultrasonography

C
) Chromosomal analysis for trinucleotide repeat

D
) Electroencephalography

E
) Electromyography and nerve conduction studies

F
) MRI of the spine


G
) Muscle biopsy

H
) Repetitive nerve stimulation

I
) Somatosensory evoked potentials

J
) SPECT scan

K
) Temporal artery biopsy

L
) Visual evoked potentials






diagnosis please

[ArchivalUser]

19. A 6-year-old boy is brought to the physician by his mother because of progressive visual loss over the past year. Over the past 2 years, he has had deterioration of his hearing, speech, writing, and intellectual performance. His maternal uncle had similar symptoms. Visual acuity is 20/200 bilaterally. Funduscopic examination shows optic atrophy. His hearing is markedly impaired. There is weakness and spasticity of all extremities. Deep tendon reflexes are extremely hyperactive. Babinski's sign is present bilaterally. On mental status examination, he is not oriented to place, year, month, or the names of his siblings. An MRI of the brain shows marked symmetric white matter disease involving all lobes. Diagnostic studies are most likely to show which of the following?

A
) Abnormally decreased serum cholesterol level

B
) Acanthocytes on blood smear

C
) An excess of very long chain fatty acids

D
) Normal nerve conduction studies

E
) Vitamin E deficiency





diagnosis please

[ArchivalUser]

18. A healthy 7-year-old boy is brought to the physician 1 week after he was exposed for several hours to a child with chickenpox. The patient and his healthy sister have not had chickenpox. They have not received varicella vaccine. Which of the following is the most appropriate management for the patient and his sister at this time?

A
) Administer acyclovir as prophylaxis

B
) Administer immune globulin, intravenously

C
) Administer aspirin therapy if vesicles appear

D
) Advise the parents to keep the siblings home from school to prevent exposing their classmates

E
) Inform the parents that a vesicular rash may appear at any time over the next 2 weeks





what is the concept

[ArchivalUser]

16. A 1-year study of a new drug to treat hypertension is conducted. One hundred patients with hypertension are enrolled; 50 patients are given the new drug and another 50 patients are given hydrochlorothiazide. All patients completed the trial. One noted unexpected effect is increased growth of scalp hair which occurred in those taking the new drug, a nonstatistically significant difference (p>0.10). This effect has also been reported in studies of other similar drugs in the new therapeutic class. The investigators of the study concluded that the new drug did not cause hair growth. Which of the following features of this study is most likely to affect the validity of this conclusion?

A
) Differential follow-up

B
) Lead time bias

C
) Length of the study

D
) Sample size

E
) Self-selection





please explain

[ArchivalUser]

28-B..?

[ArchivalUser]

dr 78--what is the diagnosis?

[ArchivalUser]

kilopascal .. please try

[ArchivalUser]

28.

This is Right hemiplgia secondary to an athero/embolic plaque probably in the left carotid artery. first presented with amaurosis fugax ie carotid artery emboli, then TIA now rt hemiplegia .
ANs:
Carotid ultrasound would localize the source of the embli /atheroma

[ArchivalUser]

Q 19.

Thia is metachromatic leucodystrophy. the juvnile type probably.

This is due to Arylsulfatase deficiency leading to a defect in myelin metabolism.

The answer is likely C

Ans: C

[ArchivalUser]

Q16

Ans :E

The incubatio period is from 10 to 14 days. It's ben a week already meaning the rash may appear within the next two weeks.

The kids are healthy so are not considered very high risk inorder to give IVIg. were they immunocompromized one may have had to give them the IVIG