11-18-2011, 09:11 AM
3.B
20.C
41.B
42.B
44.C Htn is risk factor Aortic aneurysm??
20.C
41.B
42.B
44.C Htn is risk factor Aortic aneurysm??
NBME4 discussion, every one is welcome! - grad1980
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11-18-2011, 09:11 AM
3.B
20.C 41.B 42.B 44.C Htn is risk factor Aortic aneurysm??
11-18-2011, 09:38 AM
@clotbuster, smoking is a risk factor for it not HTN, i just added it there to provoke a discussion
11-18-2011, 09:40 AM
42 B is wrong, extended feedback!!!
11-18-2011, 09:52 AM
now moving to section2
11-18-2011, 09:53 AM
19. One hour after undergoing a splenectomy for injuries sustained in a motor vehicle collision, a 42-year-old man has severe shortness of breath. Additional injuries include left rib and pelvic fractures. His temperature is 36.3°C (97.4°F), pulse is 133/min, respirations are 35/min, and blood pressure is 80/60 mm Hg. Breath sounds are absent on the left. Abdominal examination shows slight distention; bowel sounds are absent. Which of the following is the most appropriate next step in management?
A ) X-ray of the chest B ) Transfusion of type-specific uncrossmatched blood C ) Intravenous heparin therapy D ) Fiberoptic bronchoscopy E ) Endotracheal intubation F ) Placement of vena cava filter G ) Needle thoracostomy is it G?
11-18-2011, 09:54 AM
The response options for the next two items are the same. You will be required to select one answer for each item in the set. For each patient with a parasitic infection, select the most appropriate next step in diagnosis. A ) Aspiration of the lesion B ) Examination of duodenal aspirate for ova and parasites C ) Examination of stool for ova and parasites D ) Serum antibody titer for Entamoeba histolytica E ) Serum antibody titer for Plasmodium species F ) Serum antibody titer for Strongyloides stercoralis G ) Serum antibody titer for visceral larva migrans H ) Skin test for Trichinella spiralis I ) Thick and thin blood smears for malaria 22. A 37-year-old immigrant from Pakistan comes to the physician because of fever and pain in the right upper quadrant of the abdomen for 2 weeks. His temperature is 38.6°C (101.5°F). The liver edge is palpable with deep inspiration 4 cm below the right costal margin. Laboratory studies show: Hemoglobin 10 g/dL Serum Total bilirubin 1.4 mg/dL Alkaline phosphatase 120 U/L AST 40 U/L Ultrasonography of the right upper quadrant shows a single, right cystic mass of the liver.
11-18-2011, 09:55 AM
For each patient with a parasitic infection, select the most appropriate next step in diagnosis. A ) Aspiration of the lesion B ) Examination of duodenal aspirate for ova and parasites C ) Examination of stool for ova and parasites D ) Serum antibody titer for Entamoeba histolytica E ) Serum antibody titer for Plasmodium species F ) Serum antibody titer for Strongyloides stercoralis G ) Serum antibody titer for visceral larva migrans H ) Skin test for Trichinella spiralis I ) Thick and thin blood smears for malaria 23. A 37-year-old man comes to the physician because of fever and bilateral flank pain 1 month after returning to the USA from a 2-year stay in Kenya. He takes no medications. His temperature is 39°C (102.2°F). The spleen tip is palpable with deep inspiration 2 cm below the left costal margin. His hemoglobin concentration is 9 g/dL, reticulocyte count is 5%, and serum lactate dehydrogenase activity is 300 U/L.
11-18-2011, 09:56 AM
37. A 62-year-old woman with hypertension comes to the physician for a follow-up examination. Her hypertension was well controlled until 1 year ago; during the past year, her blood pressure has ranged between 160/100 mm Hg and 180/120 mm Hg. Treatment with maximal doses of an ACE inhibitor, a diuretic, and a β-adrenergic blocking agent for 10 months has not controlled her hypertension. She has a 2-year history of increasing leg pain with walking that improves with rest; she is otherwise asymptomatic. Her last menstrual period was 7 years ago. She smoked one to two packs of cigarettes daily for 40 years but quit 1 year ago. Her exercise capacity has improved during the past year. She is 152 cm (5 ft) tall and weighs 48 kg (105 lb); BMI is 21 kg/m2. Her pulse is 85/min and regular, and blood pressure is 160/100 mm Hg in the right arm, 175/105 mm Hg in the left arm, and 155/90 mm Hg in the right leg. Cardiac examination shows a nondisplaced point of maximal impulse; there is an S4 but no murmurs, heaves, or thrills. Abdominal examination shows no abnormalities. Pulses are 2+ in the upper extremities; the femoral and dorsalis pedis pulses are 1+ bilaterally. Serum studies show a potassium concentration of 4.5 mEq/L, urea nitrogen concentration of 20 mg/dL, and creatinine concentration of 1.2 mg/dL. Which of the following is the most likely cause of this patient's hypertension?
A ) Atherosclerotic renal artery stenosis B ) Coarctation of the aorta C ) Fibromuscular hyperplasia of the renal artery D ) Polycystic kidney disease E ) Primary hyperaldosteronism is it C?
11-18-2011, 09:58 AM
40. A previously healthy 37-year-old woman, gravida 2, para 2, comes to the physician because of painful, irregular menses and intermittent vaginal spotting for 3 months. Menses occur at 26- to 28-day intervals. Her last menstrual period was 1 week ago. She is not sexually active. An endometrial biopsy 1 month ago showed secretory endometrium. Pelvic examination shows a 10-cm, soft, tender uterus. The ovaries cannot be palpated. There are no masses. Saline infusion ultrasonography shows a diffusely enlarged uterus and no other abnormalities. Which of the following is the most likely diagnosis?
A ) Adenomyosis B ) Anovulatory bleeding C ) Endometrial cancer D ) Leiomyomata uteri E ) Uterine polyp is it D?
11-18-2011, 10:04 AM
hey clotbuster, don't u think Q17 in section 1 should be E?
he has parkinsinism n prone to urge incontinence. |
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