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* nbme 2 block 3
 #645432  
  rizowana - 01/08/12 00:28
 
  1. A 42-year-old woman, gravida 2, para 2, comes to
the physician
because of a 3-month history of swelling of her legs
and mild abdominal
pain and bloating. Abdominal examination shows no
abnormalities.
Rectovaginal examination shows fullness in the right
adnexa. Transvaginal
ultrasonography shows an irregular mass in the right
ovary with some
solid components to a predominantly cystic lesion.
Her serum CA 125 level
is 120 U/mL (N
 
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* Re:nbme 2 block 3
#2560201
  rizowana - 01/08/12 00:30
 
  1. A 42-year-old woman, gravida 2, para 2, comes to
the physician
because of a 3-month history of swelling of her legs
and mild abdominal
pain and bloating. Abdominal examination shows no
abnormalities.
Rectovaginal examination shows fullness in the right
adnexa. Transvaginal
ultrasonography shows an irregular mass in the right
ovary with some
solid components to a predominantly cystic lesion.
Her serum CA 125 level
is 120 U/mL (N
 
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* Re:nbme 2 block 3
#2560204
  rizowana - 01/08/12 00:31
 
  2. A 15-year-old girl is brought to the physician 3
months after she
had a blood pressure of 150/95 mm Hg at a routine
examination prior to
participation in school sports. She is asymptomatic
and has no history
of serious illness. Twelve months ago, she was
diagnosed with a
urinary tract infection and treated with oral
trimethoprim-sulfamethoxazole.
She currently takes no medications. Subsequent blood
pressure
measurements on three separate occasions since the
last visit have been: 155/94
mm Hg, 145/90 mm Hg, and 150/92 mm Hg. She is at the
50th percentile
for height and 95th percentile for weight. Her blood
pressure today is
150/90 mm Hg confirmed by a second measurement, pulse
is 80/min, and
respirations are 12/min. Examination shows no other
abnormalities. Her
hematocrit is 40%. Urinalysis is within normal limits.
Cardiac and
renal ultrasonography shows no abnormalities. Which
of the following is
the most appropriate next step in management?

A
) Exercise and weight reduction program

B
) Measurement of urine catecholamine levels

C
) Measurement of urine corticosteroid levels

D
) Captopril therapy

E
) Hydrochlorothiazide therapy



 
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* Re:nbme 2 block 3
#2560206
  rizowana - 01/08/12 00:32
 
  i can not post no 1 q, can someone pl do it for me. thanks  
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* Re:nbme 2 block 3
#2560208
  rizowana - 01/08/12 00:34
 
  2. C, CAH?

3. Over the past 4 years, a 40-year-old woman has
had increasing
episodes of loss of urine and difficulty emptying her
bladder. She has
had no dysuria. She has a 30-year history of type 1
diabetes mellitus.
She weighs 66 kg (145 lb) and is 175 cm (69 in) tall.
Pelvic
examination shows a moderate cystocele. Postvoiding
catheterization yields 700
mL of clear urine. Which of the following is the most
likely cause of
the patient's genitourinary symptoms?

A
) Carcinoma of the bladder

B
) Detrusor instability

C
) Neurogenic bladder

D
) Urethral diverticulum

E
) Uterine prolapse



4. A 57-year-old man comes to the emergency
department because of an
episode of confusion, nervousness, sweating, and
palpitations 1 hour
ago. He has had four similar episodes over the past 3
weeks; they last 2
to 3 minutes and are relieved by ingesting solid food
or liquids. His
blood pressure is 140/74 mm Hg, pulse is 76/min, and
respirations are
18/min. Examination shows no other abnormalities.
The most appropriate
next step in diagnosis is serum measurement of which
of the following?

A
) Fasting gastrin level

B
) Fasting insulin and glucose levels

C
) Glucagon level

D
) Glucose and somatostatin level

E
) Glucose and vasoactive intestinal
 
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* Re:nbme 2 block 3
#2560211
  rizowana - 01/08/12 00:37
 
  3. C, 30 yrs type 1 diabetic, neuropathy after 5 years

4.B, most probably insulinoma, checking glucose and insulin level,
 
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* Re:nbme 2 block 3
#2560221
  rizowana - 01/08/12 00:45
 
  5. An otherwise healthy 15-year-old girl is brought
to the physician
because she has never had a menstrual period. She
reports that breast
development started 1 year ago and pubic and axillary
hair development
began 6 months ago. Examination shows normal
genitalia. Breast
development is Tanner stage 4, and pubic hair
development is Tanner stage 3.
Which of the following is the most appropriate next
step in management?

A
) Reexamination in 1 year if the patient has not
had menarche

B
) Measurement of serum follicle-stimulating hormone
and luteinizing
hormone levels

C
) Measurement of serum thyroid-stimulating hormone
and prolactin
levels

D
) Karyotype analysis

E
) Progesterone withdrawal test

F
) Pelvic ultrasonographypolypeptide levels




 
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* Re:nbme 2 block 3
#2560408
  rizowana - 01/08/12 11:29
 
  what is the answer of this q? i think B  
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* Re:nbme 2 block 3
#2560410
  drguirand - 01/08/12 11:32
 
  Sorry rizowana...but the answer is A.

The age limit is 16!!
 
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* Re:nbme 2 block 3
#2560435
  rizowana - 01/08/12 12:24
 
  thanks.

6.

A 2-month-old boy is brought to the physician because
of a 6-week
history of persistent diarrhea and vomiting, most
pronounced after formula
feedings. He has had a 113-g (4-oz) weight loss since
birth. He
currently weighs 3100 g (6 lb 13 oz) and is 51 cm (20
in) in length. He
appears irritable. Examination shows jaundice. The
lungs are clear to
auscultation. No murmurs are heard. The liver is
palpated 2 to 3 cm
below the right costal margin, and the spleen is
palpated 1 to 2 cm below
the left costal margin. Laboratory studies show:


Serum
Glucose 35 mg/dL
Bilirubin (total) 2.3 mg/dL
Urine
Glucose negative
Reducing substances 3+

Which of the following is the most likely mechanism of
these findings?

A
) Decreased gluconeogenesis

B
) Decreased insulin secretion

C
) Increased glucagon secretion

D
) Increased gluconeogenesis

E
) Increased insulin secretion

F
) Insulin resistance



7. A 75-year-old man has had hypertension for 25
years. There is an
unusually prominent pulsation of the abdominal aorta
in the upper
midabdomen. A systolic bruit is heard at this site.
Femoral, popliteal, and
pedal pulses are present. Which of the following is
the most
appropriate initial diagnostic study?

A
) X-ray film of the abdomen

B
) Abdominal ultrasonography

C
) Doppler ultrasonography of the arteries of the
legs

D
) Abdominal aortography

E
) Intravenous pyelography



 
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* Re:nbme 2 block 3
#2560455
  asdrty - 01/08/12 13:12
 
  6; a 7:b  
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