nbme que - nids111

[ArchivalUser]

A 42-year-old woman comes for a follow-up examination.
Two weeks ago,
her blood pressure was 152/94 mm Hg during a routine
visit. Her blood
pressure today is 150/94 mm Hg, pulse is 76/min, and
respirations are
14/min. Examination shows no other abnormalities.
Serum studies show:


Na+ 142 mEq/L
Cl– 105 mEq/L
K+ 4 mEq/L
HCO3– 26 mEq/L
Urea nitrogen (BUN) 12 mg/dL
Glucose 101 mg/dL
Creatinine 0.8 mg/dL

An ECG shows no abnormalities. Which of the following
is the most
appropriate next step in management?

A
) Measurement of plasma renin activity

B
) Serum lipid studies

C
) 24-Hour urine collection for measurement of
metanephrine level

D
) Echocardiography

E
) Captopril renal scan

[ArchivalUser]

33. A healthy 8-year-old girl is brought to the
physician in July
for a well-child examination. Her mother says that
her daughter is
spending the summer at a nearby lake. Over the past
month, she has had two
episodes of painful sunburn despite her mother's
efforts, including SPF
25 sunblock just before she goes swimming and urging
her to wear a hat
and long-sleeved garments. The child takes no
medications. She has
blond hair, blue eyes, and a fair complexion. The
mother seeks advice
about preventing further sun damage to her child's
skin. Which of the
following is the most appropriate recommendation?

A
) Prohibit swimming on cloudless days

B
) Apply the sunblock lotion 45 minutes before
swimming

C
) Change to a higher-level SPF lotion

D
) Apply Burrow's solution compresses after each
overexposure

E
) Daily use of antioxidant vitamin supplement

F
) Early treatment of any sun overexposure with
topical
corticosteroids

[ArchivalUser]

41. A 1-week-old newborn has had poor feeding,
vomiting, and
progressive lethargy over the past 4 days. She was
born at term; pregnancy,
labor, and delivery were uncomplicated, and she had no
congenital
anomalies. She is being breast-fed. She has a
healthy 2-year-old brother; a
sister died at 10 days of age after a full-term birth.
Examination
shows decreased muscle tone and poor responsiveness;
reflexes are normal.
Serum bicarbonate level is 8 mEq/L, pH is 7.15, and
plasma ammonia
level is 10 times the upper limit of normal. Which of
the following is the
most likely cause?

A
) Mitochondrial disorder

B
) Mucopolysaccharidoses disorder

C
) Organic acid metabolism disorder

D
) Renal tubular acidosis

E
) X-linked leukodystrophy

[ArchivalUser]

plz someone ans them with explanation

[ArchivalUser]

1 A
33 B
41 B guess

[ArchivalUser]

1:b it looks to me essential HTN since all electrolytes normal
33:a my reason is sun exposure avoidance is single most preventable factor acc to uworld sunblocks 2ndry
Also in essential HTN v do screen ppl for dm n urine analysis.

[ArchivalUser]

Could u please tell which nbme form is this?

[ArchivalUser]

1. B as said it seems like essential hypertension
33. B similar ques was in uw, with this answer.
41. C As ammonia is high shld be some amino acid met disorder. Other choices dont have hyperammonemia.

Think this is nbme2

[ArchivalUser]

which NBME??

[ArchivalUser]

B-no clues about secondary HTN
B-apply sun blockers 30-45 min before swimming(check usmleworld-same q)
C-urea cycle disorder, is a girl so should be CPS deficit(AR)