01-02-2012, 09:56 AM
34. E?
35.A, perforation
35.A, perforation
nbme 2, block 1 - rizowana
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01-02-2012, 09:56 AM
34. E?
35.A, perforation
01-02-2012, 10:50 PM
32-dd?
33-bb 34-ee 35-aa
01-03-2012, 04:13 PM
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
01-03-2012, 04:14 PM
36. C
37.A
01-03-2012, 05:15 PM
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
01-03-2012, 05:16 PM
38. F
39. A huntington
01-03-2012, 05:45 PM
36-CC
37-AA 38-FF 39-AA
01-03-2012, 10:21 PM
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
01-03-2012, 10:36 PM
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
01-03-2012, 10:54 PM
save this thread who wants to revise this thread before ur exam, its gonna be lost now.
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