+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 2 CK (https://www.usmleforum.com/forumdisplay.php?fid=3)
+--- Thread: nbme 1 - rizowana (/showthread.php?tid=641259)
0 - ArchivalUser - 12-24-2011
28.
A 37-year-old man is brought to the emergency department 6 hours after the onset of constant, increasingly severe abdominal pain and nausea. His symptoms awoke him from sleep, and he has vomited once since that time. He has no history of similar symptoms, and he does not take any medications or use alcohol or illicit drugs. Family history is noncontributory. He is in acute distress and lying in the fetal position. Any movement exacerbates the pain. His temperature is 37.8 C (100 F), blood pressure is 108/68 mm Hg, pulse is 112/min, and respirations are 24/min. The lungs are clear to percussion and auscultation. Examination shows a rigid abdomen; bowel sounds are absent. Laboratory studies show:
Hemoglobin 14 g/dL
Leukocyte count 18,200/mm3
Platelet count 150,000/mm3
Serum
Urea nitrogen (BUN) 34 mg/dL
Creatinine 1.9 mg/dL
Total bilirubin 1.2 mg/dL
An x-ray film of the chest shows a small amount of free air under the left diaphragm. Administration of antibiotics and fluids is begun. Which of the following is the most appropriate next step in management?
A
) Barium swallow
B
) CT scan of the abdomen
C
) Intravenous administration of an H2-receptor blocking agent
D
) Upper endoscopy
E
) Laparotomy
0 - ArchivalUser - 12-24-2011
25- bb ......... every year
27-dd
28-EE.....perforated DU
0 - ArchivalUser - 12-24-2011
in a healthy person flu shot is recommended after 65 yr and offcourse every year but this person is 55
0 - ArchivalUser - 12-24-2011
i think the answer is E here as u need booster of DT every ten years to be immune
0 - ArchivalUser - 12-24-2011
29. A 52-year-old woman with alcoholism comes to the physician after a serum cholesterol level of 290 mg/dL was found on a routine screening. She drinks a pint of vodka daily. She takes captopril for hypertension and glyburide for type 2 diabetes mellitus. She also has intermittent episodes of gout. Fasting serum studies show:
Total cholesterol 252 mg/dL
HDL-cholesterol 80 mg/dL
Triglycerides 300 mg/dL
Glucose 118 mg/dL
Thyroid-stimulating hormone 4.5 μU/mL
Which of the following is the most appropriate next step in management?
A
) Alcohol cessation
B
) Better control of diabetes
C
) Switch from captopril to calcium-channel blocking agent therapy
D
) Gemfibrozil therapy
E
) Thyroid replacement therapy
0 - ArchivalUser - 12-24-2011
30. A 23-year-old woman has pain, cramping, and swelling of the right calf 3 days after an uncomplicated labor and delivery. The right foot is swollen, and there is marked tenderness with dorsiflexion and palpation of the right calf. Examination shows no other abnormalities. A complete blood count and serum electrolyte levels are within normal limits. Which of the following is the most likely cause of this condition?
A
) Hypercoagulable state of pregnancy
B
) Hyperuricemia
C
) Peripheral artery aneurysm
D
) Platelet embolus
E
) Prolonged pressure on the vena cava during delivery
0 - ArchivalUser - 12-24-2011
29...DD
30-AA
0 - ArchivalUser - 12-24-2011
yup, 29 is D AND 30 is A
0 - ArchivalUser - 12-24-2011
31. A 2-month-old boy is brought to the physician for a well-child examination. He smiles spontaneously and vocalizes without crying, but he does not appear to laugh or squeal. He will not work for a toy that is out of his reach. Which of the following is the most appropriate assessment of language and psychosocial development?
Language
Psychosocial
development
development
A
)
Normal
normal
B
)
Normal
delayed
C
)
Delayed
normal
D
)
Delayed
delayed
0 - ArchivalUser - 12-24-2011
32. A previously healthy 24-year-old woman comes to the physician because of a low-grade fever and a nonproductive cough for 7 days. She has been able to continue her daily activities. Her temperature is 37.7 C (99.9 F). A few scattered inspiratory crackles are heard in the thorax. An x-ray film of the chest shows patchy infiltrates in both lungs. Which of the following is the most appropriate initial pharmacotherapy?
A
) Amoxicillin
B
) Cefaclor
C
) Ciprofloxacin
D
) Erythromycin
E
) Trimethoprim-sulfamethoxazole