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NBME 6 block 2 q1.. to.. 50 - maryam2009
#31


29..BB GIANT CELL ARTERITIS....
Temporal arteritis is inflammation and damage to blood vessels that supply the head area, particularly the large or medium arteries that branch from the neck and supply the temporal area, symptoms are :

•Excessive sweating

•Fever

•General ill feeling

•Jaw pain that comes and goes or occurs when chewing

•Loss of appetite

•Muscle aches

•Pain and stiffness in the neck, upper arms, shoulder, and hips

•Throbbing headache on one side of the head or the back of the head

•Scalp sensitivity, tenderness when touching the scalp

•Vision difficulties

•Blurred vision

•Double vision

•Reduced vision (blindness in one or both eyes)


•Weakness, excessive tiredness

•Weight loss (more than 5% of total body weight)

TREATMENT ARE STEROIDS.. AND LAB THERE IS INCREASE ESR..
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#32
30-D- Renal cell carcinoma-weight loss, increased incidence with smoking,Hct 52%(41-53%),( most likely inappropriate polycyhemia:ectopic EPOe.g:renal disease-RBC mass increase,normal SaO2,normal plasma volume- in this question- BUN normal), hematuria.Late metastasis, 70% of cases do not have metastasis.
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#33
hey nice job.. do continue... please.. its v helpful...
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#34
Hi there, this is the question,

A 23 yr old female has a 6 yr history of intermitent episodes of fever, crampy abdominal pain and frequent loose stools, a section of bowel resected after a recent episode is shown. Wich of the following is the most likely dx?

a. acute appendecitis.

b. adenocarcinoma

c. celiac disease

d. chron disease

e.ulcerative colitis.

ps.. i marked eee since it looks like colon and chron disease is most frequent in the ileum, and i got it wrong therefore is ddd..
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#35
FORGOT TO MENTION IS THE NUMBER 31.....
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#36
@betssy1470
hi there

could you please discribe a little bit about the picture that you have seen in the Q?
if there is transmural inflammation,cobblestone mucosa,creeping fat and bowel wall thickening.....>STRING SIGN OF BARIUM SWALLOW X-RAY
LINEAR ULCER,
FISSURES
FISTUALA
RECTAL SPARING

DS...Crohn's

and if there is continous colonic leisions with rectal involvement
mucusal and submucusal inflammation,
friable mucousal psudopplyps with freely anging mesentry......>lead pipe appearance

Ds....Ulcerative colitisl
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#37
http://en.wikipedia.org/wiki/File:Patterns_of_CD.svg

http://www.arielscrohns.zoomshare.com/al...0/%3aalbum?

http://altair.chonnam.ac.kr/~swjuhng/pat...isease.JPG

ulcerative

http://altair.chonnam.ac.kr/~swjuhng/pat...olitis.JPG
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#38
32.CC

inhibin inhibits FSH production and GnRH release from the hypothalamus....so drug X inhibits inhibin ...............>inc. serum FSH production concentration.

33.EE

Mumps viral infections in adolescent and adult males carry an up to 30% risk that the testes may become infected (orchitis or epididymitis), which can be quite painful; about half of these infections result in testicular atrophy, and in rare cases sterility can follow.

Painful swelling of the salivary glands (classically the parotid gland) is the most typical presentation. Painful testicular swelling (orchitis) and rash may also occur. The symptoms are generally not severe in children. In teenage males and men, complications such as infertility or subfertility are more common, although still rare in absolute terms.The disease is generally self-limited, running its course before receding, with no specific treatment apart from controlling the symptoms with pain medication.

The vaccine may be given separately or as part of the MMR immunization vaccine which also protects against measles and rubella.
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#39
34.EE

35.AA

Fetal macrosomia has been defined in several different ways, including birth weight of 4000-4500 g (8 lb 13 oz to 9 lb 15 oz) or greater than 90% for gestational age after correcting for neonatal sex and ethnicity.

Factors associated with fetal macrosomia include genetics; duration of gestation; presence of gestational diabetes; and diabetes mellitus.

Hyperglycemia in the fetus results in the stimulation of insulin, insulinlike growth factors, growth hormone, and other growth factors, which, in turn, stimulate fetal growth and deposition of fat and glycogen. Advanced gestational age results in a larger birth weight at delivery by allowing the growth process to continue in utero.

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#40
36.CC

The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems like a failing left ventricle as in dilated congestive heart failure (CHF).

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