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* NBME 13 question. Can someone help me?
 #681123  
  crazy4step1 - 06/11/12 20:20
 
  A 40-year-old woman is brought to the emergency department 30 minutes after sustaining severe chest injuries in a motor vehicle collision. Despite appropriate treatment, she dies 1 hour later. She had a 25-year history of a well-controlled seizure disorder. A photograph of a coronal section of the brain obtained at autopsy is shown. Which of the following is the most likely cause of this patient's seizure disorder?

Glioblastoma multiforme
Herpes simplex encephalitis
Mesial temporal sclerosis (wrong)
Neonatal ischemic stroke
Vascular malformation

Thx u in advance!
 
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* Re:NBME 13 question. Can someone help me?
#2678021
  canida - 06/11/12 20:35
 
  neonatal ischemic stroke?  
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* Re:NBME 13 question. Can someone help me?
#2678026
  crazy4step1 - 06/11/12 20:41
 
  21-year-old African American man with sickle cell disease is brought to the emergency department 2 hours after the sudden onset of severe pain in his abdomen and knees. He has had six similar episodes within the past 4 years; he was admitted to the hospital each time for treatment of the pain. His course has been complicated by two episodes of pneumonia and a small cerebral infarction in the past 2 years. The patient asks the physician for extra pain medication to "kill me because I can't take it anymore." Which of the following initial actions by the physician regarding the patient's request is most appropriate?

Contact the hospital ethics committee
Restrain the patient
Reevaluate the patient after his pain has been controlled
Administer general anesthesia for sedation (wrong)
Comply with the patient's request


A 25-year-old woman undergoes a radical mastectomy with removal of the axillary lymph nodes on the left side. After the operation, she develops painful edema of the left upper extremity. Which of the following therapies is most likely to decrease the swelling in this patient?

Application of heat (wrong)
Compression sleeve
Diuretic therapy
Exercise therapy
Passive movement


A cluster of three cases of nosocomial pneumonia caused by a highly resistant strain of Klebsiella pneumoniae occurs in a 13-bed intensive care unit (ICU). Each patient in the ICU is in a private, enclosed room. Which of the following infection control measures is most likely to decrease the spread of this organism to other patients in the ICU and elsewhere in the hospital?

Place infected patients in rooms with at least six air exchanges per hour
Place infected patients in rooms with negative air pressure (wrong)
Place infected patients in rooms with positive air pressure
Promote thorough hand cleansing before and after medical personnel visit each patient
Require medical personnel to wear masks when visiting infected patients

A 43-year-old woman with metastatic colon cancer has maintained remission by taking bevacizumab as a single agent. The ability to administer this agent despite it being a foreign protein is most likely a result of which of the following?

The agent being a humanized antibody
The agent containing the variable region of a murine antibody molecule directed against vascular endothelial growth factor
B-cell dysfunction
The immunosuppressive effect of previously administered chemotherapy
T-cell dysfunction (wrong)


A previously healthy 54-year-old man comes to the clinic because of light-headedness for 6 hours. His symptom began after skiing at a resort at an altitude of 2743 m (9000 ft). He has been taking a carbonic anhydrase inhibitor since 2 days before arrival at the resort. His blood pressure is 110/60 mm Hg while sitting and 95/50 mm Hg while standing. Physical examination shows no other abnormalities. Which of the following is the most likely cause of his orthostatic hypotension?

High-altitude sickness
Hypovolemia
Hypoxia
Impaired sympathetic nerve activity (wrong)
Respiratory alkalosis


A 59-year-old woman with metastatic renal carcinoma is receiving cyclophosphamide, paclitaxel, and interleukin-2 (IL-2). Which of the following is the reason for including IL-2 in the regimen?

Decreasing bone marrow suppression (wrong)
Decreasing the likelihood of hemorrhagic cystitis
Decreasing the likelihood of peripheral neuropathy
Decreasing nausea and vomiting
Stimulating T lymphocytes


Again, thx u in advance for your timr and your response.
Best regards!
 
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* Re:NBME 13 question. Can someone help me?
#2678044
  crazy4step1 - 06/11/12 21:17
 
  A previously healthy 6-year-old girl is brought to the emergency department because of severe abdominal pain, nausea, and vomiting that began 4 hours after attending a friend's birthday party. Cake and other pastries were served at the party. She appears acutely ill and mildly dehydrated. Her temperature is 37C (98.6F), pulse is 104/min, respirations are 20/min, and blood pressure is 96/60 mm Hg. Examination shows no abnormalities of the skin. Bowel sounds are hyperactive. Which of the following is the most likely cause of these findings?

Bacteremia
Enterotoxin ingestion
Intestinal mucosa inflammation
Lead toxicity
Villus atrophy (wrong, i though it was celiac ds)
Viremia

Please friends help me! My exam is this friday, and I really dont have clue to resolve this questions.
 
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* Re:NBME 13 question. Can someone help me?
#2809626
  ykoethe - 01/09/13 16:38
 
  21-year-old African American man with sickle cell disease is brought to the emergency department 2 hours after the sudden onset of severe pain in his abdomen and knees. He has had six similar episodes within the past 4 years; he was admitted to the hospital each time for treatment of the pain. His course has been complicated by two episodes of pneumonia and a small cerebral infarction in the past 2 years. The patient asks the physician for extra pain medication to "kill me because I can't take it anymore." Which of the following initial actions by the physician regarding the patient's request is most appropriate?


Reevaluate the patient after his pain has been controlled


A 25-year-old woman undergoes a radical mastectomy with removal of the axillary lymph nodes on the left side. After the operation, she develops painful edema of the left upper extremity. Which of the following therapies is most likely to decrease the swelling in this patient?

Compression sleeve

A cluster of three cases of nosocomial pneumonia caused by a highly resistant strain of Klebsiella pneumoniae occurs in a 13-bed intensive care unit (ICU). Each patient in the ICU is in a private, enclosed room. Which of the following infection control measures is most likely to decrease the spread of this organism to other patients in the ICU and elsewhere in the hospital?

Promote thorough hand cleansing before and after medical personnel visit each patient


A 43-year-old woman with metastatic colon cancer has maintained remission by taking bevacizumab as a single agent. The ability to administer this agent despite it being a foreign protein is most likely a result of which of the following?

The agent being a humanized antibody


A previously healthy 54-year-old man comes to the clinic because of light-headedness for 6 hours. His symptom began after skiing at a resort at an altitude of 2743 m (9000 ft). He has been taking a carbonic anhydrase inhibitor since 2 days before arrival at the resort. His blood pressure is 110/60 mm Hg while sitting and 95/50 mm Hg while standing. Physical examination shows no other abnormalities. Which of the following is the most likely cause of his orthostatic hypotension?

Hypovolemia

A 59-year-old woman with metastatic renal carcinoma is receiving cyclophosphamide, paclitaxel, and interleukin-2 (IL-2). Which of the following is the reason for including IL-2 in the regimen?

Stimulating T lymphocytes
 
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* Re:NBME 13 question. Can someone help me?
#2809646
  goal13 - 01/09/13 17:43
 
  A 40-year-old woman is brought to the emergency department 30 minutes after sustaining severe chest injuries in a motor vehicle collision. Despite appropriate treatment, she dies 1 hour later. She had a 25-year history of a well-controlled seizure disorder. A photograph of a coronal section of the brain obtained at autopsy is shown. Which of the following is the most likely cause of this patient's seizure disorder?

Glioblastoma multiforme
Herpes simplex encephalitis
Mesial temporal sclerosis (wrong)
Neonatal ischemic stroke
Vascular malformation

Answer ------------Vascular malformation


A cluster of three cases of nosocomial pneumonia caused by a highly resistant strain of Klebsiella pneumoniae occurs in a 13-bed intensive care unit (ICU). Each patient in the ICU is in a private, enclosed room. Which of the following infection control measures is most likely to decrease the spread of this organism to other patients in the ICU and elsewhere in the hospital?

Place infected patients in rooms with at least six air exchanges per hour
Place infected patients in rooms with negative air pressure (wrong)
Place infected patients in rooms with positive air pressure
Promote thorough hand cleansing before and after medical personnel visit each patient
Require medical personnel to wear masks when visiting infected patients

Answer----------------atleast six air exchanges/hr




21-year-old African American man with sickle cell disease is brought to the emergency department 2 hours after the sudden onset of severe pain in his abdomen and knees. He has had six similar episodes within the past 4 years; he was admitted to the hospital each time for treatment of the pain. His course has been complicated by two episodes of pneumonia and a small cerebral infarction in the past 2 years. The patient asks the physician for extra pain medication to "kill me because I can't take it anymore." Which of the following initial actions by the physician regarding the patient's request is most appropriate?

Contact the hospital ethics committee
Restrain the patient
Reevaluate the patient after his pain has been controlled
Administer general anesthesia for sedation (wrong)
Comply with the patient's request

Answer-------------Reevaluate after pain is controlled



A 25-year-old woman undergoes a radical mastectomy with removal of the axillary lymph nodes on the left side. After the operation, she develops painful edema of the left upper extremity. Which of the following therapies is most likely to decrease the swelling in this patient?

Application of heat (wrong)
Compression sleeve
Diuretic therapy
Exercise therapy
Passive movement


Answer----------------compression sleeve


A 43-year-old woman with metastatic colon cancer has maintained remission by taking bevacizumab as a single agent. The ability to administer this agent despite it being a foreign protein is most likely a result of which of the following?

The agent being a humanized antibody
The agent containing the variable region of a murine antibody molecule directed against vascular endothelial growth factor
B-cell dysfunction
The immunosuppressive effect of previously administered chemotherapy
T-cell dysfunction (wrong)

Answer------------humanised antibody


A previously healthy 54-year-old man comes to the clinic because of light-headedness for 6 hours. His symptom began after skiing at a resort at an altitude of 2743 m (9000 ft). He has been taking a carbonic anhydrase inhibitor since 2 days before arrival at the resort. His blood pressure is 110/60 mm Hg while sitting and 95/50 mm Hg while standing. Physical examination shows no other abnormalities. Which of the following is the most likely cause of his orthostatic hypotension?

High-altitude sickness
Hypovolemia
Hypoxia
Impaired sympathetic nerve activity (wrong)
Respiratory alkalosis

Answer--------------Hypovolemia


A 59-year-old woman with metastatic renal carcinoma is receiving cyclophosphamide, paclitaxel, and interleukin-2 (IL-2). Which of the following is the reason for including IL-2 in the regimen?

Decreasing bone marrow suppression (wrong)
Decreasing the likelihood of hemorrhagic cystitis
Decreasing the likelihood of peripheral neuropathy
Decreasing nausea and vomiting
Stimulating T lymphocytes

Answer-----------------------Stimulating T-lymphocytes


A previously healthy 6-year-old girl is brought to the emergency department because of severe abdominal pain, nausea, and vomiting that began 4 hours after attending a friend's birthday party. Cake and other pastries were served at the party. She appears acutely ill and mildly dehydrated. Her temperature is 37C (98.6F), pulse is 104/min, respirations are 20/min, and blood pressure is 96/60 mm Hg. Examination shows no abnormalities of the skin. Bowel sounds are hyperactive. Which of the following is the most likely cause of these findings?

Bacteremia
Enterotoxin ingestion
Intestinal mucosa inflammation
Lead toxicity
Villus atrophy (wrong, i though it was celiac ds)
Viremia

Answer------------------Enterotoxin ingestion



 
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* Re:NBME 13 question. Can someone help me?
#2809868
  alco - 01/09/13 22:18
 
  crazyforstep, what is your email address?
 
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* Re:NBME 13 question. Can someone help me?
#2810129
  ale333 - 01/10/13 12:28
 
  1 herpes 2 restrain the patien, because he has suicidal ideation  
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