nbme 2, block 1 - rizowana

[ArchivalUser]

34. E?

35.A, perforation

[ArchivalUser]

32-dd?
33-bb
34-ee
35-aa

[ArchivalUser]

yes, 32 is D, HTN is the greatest risk factor

36. An 18-year-old man comes to the physician
because of itchy
lesions on his penis for 2 weeks and itching around
his wrists and ankles
for 1 week. He is sexually active and does not
consistently use condoms.
Examination shows scattered, crusted lesions on the
penis and no
significant inguinal lymphadenopathy. There are
excoriated papules on the
wrists and ankles, a few papules between the fingers,
and excoriations
along the belt line. Which of the following is the
most likely
diagnosis?

A
) Disseminated primary herpes simplex

B
) Eczema

C
) Scabies

D
) Secondary syphilis

E
) Vasculitis


37. An asymptomatic 62-year-old man comes for a
follow-up visit.
One month ago, he had acute cystitis treated with
ciprofloxacin. At his
initial visit, a urine culture grew Klebsiella
pneumoniae. He has a
2-year history of chronic prostatitis and has had four
episodes of
cystitis over the past year. His temperature is 36.9
C (98.4 F).
Examination, including prostate examination, shows no
abnormalities. Which of
the following is the most appropriate measure to
prevent recurrent
episodes of cystitis in this patient?

A
) Trimethoprim-sulfamethoxazole prophylaxis

B
) Insertion of a Foley catheter

C
) Total prostatectomy

D
) Transurethral prostatectomy

E
) No treatment is available

[ArchivalUser]

36. C

37.A

[ArchivalUser]

38. A 32-year-old woman comes for a routine health
maintenance
examination. Examination shows a bloody discharge
from the nipple of her
left breast. There is no palpable mass. On
questioning, she says that
she never noted the discharge and does not perform
breast
self-examinations. Which of the following is the most
likely diagnosis?

A
) Breast abscess

B
) Breast cyst

C
) Breast hematoma

D
) Fibroadenoma

E
) Fibrocystic changes of the breast

F
) Intraductal adenoma


39. A 35-year-old woman is brought to the physician
by her husband
because of increasing memory loss and involuntary
"dancing" movements
over the past 6 weeks. She has had difficulty
remembering things,
particularly recent events. She has had no
disturbances in sleep or appetite.
Her medical history is unremarkable. She does not
remember her mother
who died 25 years ago, but her father told her that
her mother had
similar symptoms several years before her death.
Neurologic examination
shows involuntary choreiform movements. She has a
childlike affect. She
describes her mood as good. On recall testing, she
can remember one out
of three objects after 3 minutes with distraction; she
cannot remember
the other objects with prompting. She cannot remember
the date of her
marriage or her previous address. The most likely
cause of these
symptoms is a lesion at which of the following
locations?

A
) Caudate nucleus

B
) Parietal lobe

C
) Prefrontal lobe

D
) Putamen

E
) Temporal lobe

[ArchivalUser]

38. F

39. A huntington

[ArchivalUser]

36-CC
37-AA
38-FF
39-AA

[ArchivalUser]

40. A 67-year-old man comes to the physician
because of insomnia for
2 years. He goes to bed at 11:00 PM after taking a
bath but does not
fall asleep until midnight. He usually wakes up twice
each night: once
around 3:00 AM to void and again at 6:00 AM. He stays
in bed until his
alarm goes off at 7 AM. He is concerned because he
used to sleep 8
hours daily. He recently retired from his job as an
attorney. He takes
no medications. He drinks one beer with lunch 3 days
each week and one
glass of wine with dinner each evening. He walks 1
mile daily after
dinner. Physical examination shows no abnormalities.
His mood is
neutral, and cognition is intact. Urine toxicology
screening is negative.
Which of the following is the most likely cause of
this patient's
symptoms?

A
) Advanced sleep phase syndrome

B
) Alcohol abuse

C
) Delayed sleep phase syndrome

D
) Major depressive disorder

E
) Melatonin deficiency

F
) Poor sleep hygiene

G
) Normal aging


41. An asymptomatic 37-year-old woman comes for a
follow-up
examination 1 year after receiving a renal transplant.
Current medications
include felodipine, enalapril, cyclosporine,
pravastatin, and penicillin
G. She appears well. Her temperature is 36.8 C (98.2
F), blood
pressure is 160/95 mm Hg, pulse is 80/min, and
respirations are 12/min.
Examination shows no other abnormalities. Which of
the following
medications is the most likely cause of this patient's
hypertension?

A
) Cyclosporine

B
) Enalapril

C
) Felodipine

D
) Penicillin G

E
) Pravastatin


42. A 4080-g (9-lb) male newborn is delivered at
term to a
32-year-old woman, gravida 2, para 1. Apgar scores
are 8 and 9 at 1 and 5
minutes, respectively. Examination in the delivery
room shows fracture of
the right clavicle. Which of the following is the
most likely sequela
of this condition?

A
) Correction only with casting

B
) Correction only with physical therapy

C
) Left-hand dominance

D
) Permanent nerve damage

E
) Spontaneous healing without treatment


43. A 22-year-old man with schizoaffective disorder
is brought to
the emergency department 2 hours after the sudden
onset of neck and back
pain. The symptoms began after taking one of his
medications for his
psychiatric disorder. The dosage was increased
yesterday, but he does
not recall the names of either of his medications. He
has no other
history of serious illness. Physical examination
shows rigid contraction
of the neck and back muscles with arching. On mental
status
examination, he is alert and cooperative and hears a
faint voice that tells him to
wash windows. He is oriented to person, place, and
time. Which of the
following medications is most likely responsible for
this patient's
symptoms?

A
) Clozapine

B
) Haloperidol

C
) Lithium carbonate

D
) Trazodone

E
) Valproic acid

44. A 52-year-old woman, gravida 3, para 3, comes
to the physician
because of irregular vaginal bleeding over the past 2
months. She has
hypertension treated with enalapril and type 2
diabetes mellitus well
controlled with diet. Menopause occurred 2 years ago.
Her maternal aunt
had breast cancer at the age of 70 years. The patient
weighs 88 kg
(195 lb) and is 160 cm (63 in) tall. Examination
shows no other
abnormalities. An endometrial biopsy specimen shows
adenocarcinoma. Which of
the following is the most significant predisposing
factor for this
patient's endometrial cancer?

A
) Heredity

B
) Hypertension

C
) Parity

D
) Type 2 diabetes mellitus

E
) Weight


45. A 67-year-old man is brought to the emergency
department 2 hours
after the onset of weakness and double vision. He has
hypertension and
hyperlipidemia treated with metoprolol, captopril, and
atorvastatin.
His blood pressure is 190/106 mm Hg. Neurologic
examination shows
left-sided facial weakness including the forehead.
There is palsy of left
conjugate gaze, and the left eye fails to adduct on
right gaze.
Vertical eye movements are intact. Muscle strength is
3/5 in the right upper
and lower extremities. Deep tendon reflexes are
brisk, and Babinski's
sign is present on the right. Which of the following
is the most
likely location of this patient's lesion?

A
) Bilateral thalamic

B
) Left frontal

C
) Left pontine

D
) Right caudate

E
) Right midbrain


46. Six weeks after spontaneous drainage of an anal
abscess, a
32-year-old man has persistent blood-stained purulent
fluid on his
underwear. He has not had significant anal pain since
drainage of the boil.
Bowel movements are normal. Which of the following is
the most likely
diagnosis?

A
) Anal fissure

B
) Fistula in ano

C
) Pruritus ani

D
) Thrombosed external hemorrhoids

E
) Thrombosed internal hemorrhoids


47. A previously healthy 14-year-old girl is
brought to the
physician because of a 2-day history of fever and pain
and swelling of the
right knee. She remembers injuring the knee while
playing soccer last
week, but she was able to finish the game. She has no
history of rash or
joint pain. Her sister has inflammatory bowel
disease. The patient's
temperature is 39 C (102.2 F), blood pressure is
110/80 mm Hg, pulse is
95/min, and respirations are 20/min. Examination of
the right knee
shows swelling, tenderness, warmth, and erythema;
range of motion is
limited. Which of the following is the most
appropriate next step in
management?

A
) X-ray film of the right knee

B
) Gastrointestinal series with small-bowel

follow-through

C
) Nuclear scan of the right knee

D
) MRI of the right knee

E
) Antibiotic therapy

F
) Arthrocentesis

[ArchivalUser]

40.G

41. A? i really guessed this one as others r antihypertensive drug, smart one

42. E?

43. A, atypical, torticolis, s/e of typical

44. E, obase, peripheral estrogen conversion from adipose, unopposed

45. E or C? 3rd nerve is involved, so adduction i will go with midbrain

46. B

47. F

[ArchivalUser]

save this thread who wants to revise this thread before ur exam, its gonna be lost now.