09-07-2014, 04:29 PM
09-07-2014, 04:31 PM
yes 29 B niacin!! grazie is responding she was confirming conduct disorder 
Got that right on NBME
Got that right on NBME09-07-2014, 04:33 PM
q27)
Ans: D)
D) Initiate behavioral treatment
by nbme feedback
But maybe he is just playing with the kiddis, not really being cruel? :?
Disruptive disorders: here we have
1) CONDUCT DIS & 2) OPPOSITIONAL DEFIANT DIS
Conduct Disorder
Sx: Bullying, fighting, cruelty to animals or people, rape, vandalism, fire setting, theft, robbery, running away, school truancy.
Tx: Healthy group identity and role models are provided by structured sports programs. Structural living settings that place value on group identification and cooperation.
OPPOSITIONAL DEFIANT DIS:
Sx: hostil and defiant behavior towards adults.
Tx: Reward desire behavior, be consistent in statements and deeds
Ans: D)
D) Initiate behavioral treatment
by nbme feedback
But maybe he is just playing with the kiddis, not really being cruel? :?
Disruptive disorders: here we have
1) CONDUCT DIS & 2) OPPOSITIONAL DEFIANT DIS
Conduct Disorder
Sx: Bullying, fighting, cruelty to animals or people, rape, vandalism, fire setting, theft, robbery, running away, school truancy.
Tx: Healthy group identity and role models are provided by structured sports programs. Structural living settings that place value on group identification and cooperation.
OPPOSITIONAL DEFIANT DIS:
Sx: hostil and defiant behavior towards adults.
Tx: Reward desire behavior, be consistent in statements and deeds
09-07-2014, 04:41 PM
28.
A 37-year-old woman, gravida 2, para 1, at 16 weeks' gestation undergoes amniocentesis for advanced maternal age. The patient's prenatal history has been uncomplicated. Medical history is significant for a seizure disorder that has been well controlled during her pregnancy with carbamazepine. She also takes prenatal vitamins. Vital signs are normal. Physical examination discloses a uterine size consistent with a 16-week gestation. The karyotype of the fetus is shown.
http://i42.photobucket.com/albums/e338/G...b3e160.png
Which of the following ultrasound findings is most likely in this fetus?
A) Cystic hygroma
B) Diaphragmatic hernia
C) Duodenal atresia
D) Holoprosencephaly
E) Short femur
Ans: D
nbme cert!
Trisomy 13 - Patau Sd
================
Findings:
Holoprosencephaly and other CNS defects
Severe MR
Microcephaly
Microphthalmia
Cleft lip, palate, both
Scalp defects in parietal-occipital area (cutis aplasia)
POLYDACTYLIA
VSD, PDA, ASD
Single umbilical Artery
Polycystic kidneys
Older maternal age.
A 37-year-old woman, gravida 2, para 1, at 16 weeks' gestation undergoes amniocentesis for advanced maternal age. The patient's prenatal history has been uncomplicated. Medical history is significant for a seizure disorder that has been well controlled during her pregnancy with carbamazepine. She also takes prenatal vitamins. Vital signs are normal. Physical examination discloses a uterine size consistent with a 16-week gestation. The karyotype of the fetus is shown.
http://i42.photobucket.com/albums/e338/G...b3e160.png
Which of the following ultrasound findings is most likely in this fetus?
A) Cystic hygroma
B) Diaphragmatic hernia
C) Duodenal atresia
D) Holoprosencephaly
E) Short femur
Ans: D
nbme cert!
Trisomy 13 - Patau Sd
================
Findings:
Holoprosencephaly and other CNS defects
Severe MR
Microcephaly
Microphthalmia
Cleft lip, palate, both
Scalp defects in parietal-occipital area (cutis aplasia)
POLYDACTYLIA
VSD, PDA, ASD
Single umbilical Artery
Polycystic kidneys
Older maternal age.
09-07-2014, 04:42 PM
yup 28 is D
09-07-2014, 04:45 PM
Yes.
Question 28 - correct answer is D per NBME feedback
Question 28 - correct answer is D per NBME feedback
09-07-2014, 04:46 PM
29.
A 55-year-old man is brought to the office by his wife because of a 2-week history of abdominal discomfort and diarrhea. He also has had increasing irritability and a burning sensation in his mouth during this time. He has a history of alcoholism and has recently been drinking one and one-half bottles of gin daily. His wife notes that he has not been eating well and has lost 2 kg (5 lb) during the past 2 weeks. He takes no medications. Vital signs today are temperature 37.6°C (99.7°F), pulse 74/min, respirations 16/min and regular, and blood pressure 120/78 mm Hg. Physical examination shows an erythematous, hyperpigmented rash with scaling and fissuring over his face, neck, and forearms. The remainder of the physical examination is noncontributory. A deficiency of which of the following nutrients is the most likely underlying cause of this patient's condition?
A) Vitamin A
B) Niacin
C) Pyridoxine
D) Riboflavin
E) Thiamine
Ans: B
nbme cert
B 3 (niacin)
Neurologic Syndrome or Syndromes:
Pellagra: confusion, dementia, weakness, ataxia, spasticity, myoclonus, glossitis, dermatitis, photosensitivity
Supporting Tests:
Erythrocyte NAD, plasma niacin, urinary N 1-methylnicotinamide
Treatment:
Nicotinic acid, 50 mg PO tid or 25 mg IV tid; nicotinamide, 50-100 mg IM or PO tid
Causes (Other Than Malnutrition):
Alcoholism, corn- or cereal-based diet, Hartnup's syndrome, carcinoid syndrome
Ferri's Clinical Advisor 2015
A 55-year-old man is brought to the office by his wife because of a 2-week history of abdominal discomfort and diarrhea. He also has had increasing irritability and a burning sensation in his mouth during this time. He has a history of alcoholism and has recently been drinking one and one-half bottles of gin daily. His wife notes that he has not been eating well and has lost 2 kg (5 lb) during the past 2 weeks. He takes no medications. Vital signs today are temperature 37.6°C (99.7°F), pulse 74/min, respirations 16/min and regular, and blood pressure 120/78 mm Hg. Physical examination shows an erythematous, hyperpigmented rash with scaling and fissuring over his face, neck, and forearms. The remainder of the physical examination is noncontributory. A deficiency of which of the following nutrients is the most likely underlying cause of this patient's condition?
A) Vitamin A
B) Niacin
C) Pyridoxine
D) Riboflavin
E) Thiamine
Ans: B
nbme cert
B 3 (niacin)
Neurologic Syndrome or Syndromes:
Pellagra: confusion, dementia, weakness, ataxia, spasticity, myoclonus, glossitis, dermatitis, photosensitivity
Supporting Tests:
Erythrocyte NAD, plasma niacin, urinary N 1-methylnicotinamide
Treatment:
Nicotinic acid, 50 mg PO tid or 25 mg IV tid; nicotinamide, 50-100 mg IM or PO tid
Causes (Other Than Malnutrition):
Alcoholism, corn- or cereal-based diet, Hartnup's syndrome, carcinoid syndrome
Ferri's Clinical Advisor 2015
09-07-2014, 04:46 PM
Yup B 29)
09-07-2014, 04:47 PM
30.
A 40-year-old man is being treated for stage I thyroid cancer. His treatment has consisted of complete surgical excision of the tumor with negative margins. The patient's prognosis is excellent. Medical history is otherwise unremarkable. You receive a telephone call from the patient's supervisor who says he is considering termination of the employee because of concerns that the patient may not be able to do his duties as a midlevel supervisor in an advertising firm. Which of the following is the most appropriate response?
A) Ask the supervisor to put his request for medical information in writing
B) Contact the patient and advise him to hire an attorney
C) Tell the supervisor that the patient's prognosis is excellent
D) Tell the supervisor that written consent from the patient is necessary
E) Tell the supervisor that you will send him a written report
A 40-year-old man is being treated for stage I thyroid cancer. His treatment has consisted of complete surgical excision of the tumor with negative margins. The patient's prognosis is excellent. Medical history is otherwise unremarkable. You receive a telephone call from the patient's supervisor who says he is considering termination of the employee because of concerns that the patient may not be able to do his duties as a midlevel supervisor in an advertising firm. Which of the following is the most appropriate response?
A) Ask the supervisor to put his request for medical information in writing
B) Contact the patient and advise him to hire an attorney
C) Tell the supervisor that the patient's prognosis is excellent
D) Tell the supervisor that written consent from the patient is necessary
E) Tell the supervisor that you will send him a written report
09-07-2014, 04:49 PM
yah 30C