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NBME 7 ideas - vladrasputin
#21
Ok @amulya if Q18(F) is wrong which do you think is right? @dh1026621 thanks for the feedback, thats what i thut too but if you look at the question the patient has a history of upper GI bleeding from salicylate ulcer along with a sliding hernia. If the patient has uncomplicated GERD or Uncomplicated sliding hernia i feel observation is appropriate but when there is already ulceration with healing and hernia it seems to me like fundoplication would be the choice but i maybe over thinking it. Guess were not perfect Smile
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#22
Am still racking my head for a rational answer to Q18 this Q is just annoying. Any suggestions?
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#23
@dh1026621
I did some research and for Q6 (A) is the right answer. Someone chose fundoplication and got it wrong. GERD can have upper GI bleeding as a complication (which is severe/refractory) enough to require fundoplication and symptomatic type 1 sliding hernia is treated with medical therapy and life style modification to reduce GERD symptoms. But the upper GI bleeding here is from salicylate so no correlation to GERD. Thanks
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#24
Am beginning to suspect that Q18 is (G) Exploratory laparotomy. Ascitic fluid from malignant tissue is the probable cause of the abdominal girth increase but if paracentesis is wrong its got to be laparotomy. Any ideas people??
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#25
18) G
Paracentesis won't help here as the cause is her previous malignancy and the nodule that is noted in cul de sac. So nothing else makes sense except that.
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#26
I agree thanks doc0610
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#27
Is NBME 7 similar to NBME 2? Pl reply.
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