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+--- Thread: nbme 1 - rizowana (/showthread.php?tid=641259)
0 - ArchivalUser - 12-23-2011
i also think it is A
0 - ArchivalUser - 12-23-2011
19. A 3-year-old boy is brought to the physician because of a 7-day history of fever and a painful swollen lymph node in his groin. This is his sixth episode of lymph node swelling; the previous episodes resolved after drainage and prolonged antibiotic therapy. He also had pneumonia at the age of 12 months that required chest tube placement for drainage. A maternal uncle died during childhood of recurrent infections. The patient is at the 5th percentile for height and weight. His temperature is 38.5 C (101.3 F). Examination shows a warm, tender, erythematous lymph node in the right inguinal area. There are several healed incisions over the inguinal area and neck from old drainage sites. Laboratory studies show:
Hematocrit 35%
Leukocyte count 17,000/mm3
Segmented neutrophils 65%
Bands 10%
Lymphocytes 25%
Platelet count 350,000/mm3
A Gram's stain of the lymph node aspirate shows numerous segmented neutrophils filled with bacteria; cultures grow Staphylococcus aureus. Which of the following is the most likely mechanism for these findings?
A
) Adenosine deaminase deficiency
B
) Consumption of complement
C
) Defective opsonization
D
) Destruction of CD4+ T lymphocytes
E
) Developmental arrest of maturation of B lymphocytes
F
) Dysmorphogenesis of the third and fourth pharyngeal pouches
G
) Impaired chemotaxis
H
) Impaired phagocytic oxidative metabolism
0 - ArchivalUser - 12-23-2011
EE..............BROTON.........x-linked+LN
0 - ArchivalUser - 12-23-2011
this boy has 25% lymphocyte, but in bruton no B lymphocyte, no Ig
0 - ArchivalUser - 12-23-2011
and staph aurues catalase positive organism
0 - ArchivalUser - 12-23-2011
YOU MEAN..H....
0 - ArchivalUser - 12-23-2011
i think its H
0 - ArchivalUser - 12-23-2011
20. A 67-year-old woman has been intubated for 1 week after undergoing a left lobectomy for lung cancer. She has chronic obstructive pulmonary disease. Her preoperative functional vital capacity was 40% of predicted. She is awake and alert. Her blood pressure is 130/75 mm Hg, and pulse is 72/min. The ventilator settings are a synchronized intermittent mandatory ventilation of 8/min, FIO2 of 40%, and positive-end expiratory pressure of 5 cm H2O. Arterial blood gas analysis shows:
pH 7.42
PCO2 47 mm Hg
PO2 90 mm Hg
O2 saturation 96%
Which of the following is the most appropriate next step in management?
A
) Antibiotic therapy
B
) Bronchodilator therapy
C
) Chest physiotherapy
D
) Decrease inotropes
E
) Diuretic therapy
F
) Fiberoptic bronchoscopy
G
) Heparin therapy
H
) Incentive spirometry
I
) Increase FIO2
J
) Increase inotropes
K
) Increase respiratory rate
L
) Placement of thoracostomy tube
M
) Tracheostomy
N
) Wean from the ventilator
0 - ArchivalUser - 12-24-2011
hello, waiting for answer of this Q.
0 - ArchivalUser - 12-24-2011
i think answer is I, increase FIO2, 40% is low seems to me