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+--- Thread: nbme 1 - rizowana (/showthread.php?tid=641259)
nbme 1 - rizowana - ArchivalUser - 12-18-2011
13. A 6-month-old girl is brought to the physician for a routine health maintenance examination. She was born with a lumbosacral myelomeningocele which was successfully repaired at 2 days of age. The anterior fontanelle is 6 x 8 cm and bulging, and the posterior fontanelle is 3 x 4 cm and bulging. She has severe motor and sensory deficits involving both lower extremities. A head growth chart shows the following values:
Age
Head circumference (cm)
Birth
34.2
1 month
36.6
2 months
38
4 months
44
6 months
47
Which of the following is the most likely cause of increased intracranial pressure?
A ) Acute cerebral edema
B ) Decreased absorption of cerebrospinal fluid
C ) Dilation of cerebral arteries
D ) Intracranial mass lesion
E ) Obstruction of lateral sinus
F ) Obstruction of superior vena cava
G ) Obstruction of cerebrospinal fluid flow
H ) Overproduction of cerebrospinal fluid
0 - ArchivalUser - 12-18-2011
GG
0 - ArchivalUser - 12-18-2011
14. An 18-year-old primigravid woman comes for her initial prenatal visit at 16 weeks' gestation. She is not sure about the date of her last menstrual period but says that the pregnancy probably occurred immediately after she stopped taking oral contraceptives 5 months ago. Maternal serum α-fetoprotein (MSAFP) level is increased to 3 multiples of the median. Which of the following is the most appropriate next step in management?
A ) Repeat measurement of MSAFP level
B ) Triple screening for MSAFP, serum β-hCG, and serum estriol levels
C ) Ultrasonography
D ) Amniocentesis for measurement of α-fetoprotein level
E ) Amniocentesis for chromosomal analysis
0 - ArchivalUser - 12-18-2011
CC... for correct gestational age measurment or IUGR.............if us normal do AF-AFP
0 - ArchivalUser - 12-18-2011
16. A 6-year-old girl is brought to the physician because of a 4-week history of headache, fatigue, and decreased appetite. During this period, she has had nausea and vomiting. At the age of 4 years, she was diagnosed with poststreptococcal glomerulonephritis. She is at the 15th percentile for height and the 10th percentile for weight. Examination shows no abnormalities. Her serum urea nitrogen (BUN) level is 50 mg/dL. Which of the following is most likely to limit progression of this patient's renal failure?
A
) Increased potassium and sodium bicarbonate intake
B
) Decreased sodium and daily calorie intake
C
) Low-protein diet
D
) Strict fluid restriction
E
) Dialysis
0 - ArchivalUser - 12-18-2011
C.
0 - ArchivalUser - 12-18-2011
13..G
14..C
16..C
0 - ArchivalUser - 12-18-2011
WHY ..LOW PROTEIN DIET...WHILE Patient below 10th percentile...can you explain
0 - ArchivalUser - 12-18-2011
i think BB....LOW SODIUM LOW BP LOW GLOMERULAR DESTRACTION COZ MOST IMP.
DESTRUCTIVE OF GLUMERULI IN KIDNEY IS HT AND DM
CHO....INC. INSULIN SECRETION ...MORE K SHIFT INTRACELLULAR ..MORE HYDROGEN ENTER
EXTRACELLULAR SPACE ..MORE ACIDOSIS...MORE DETERURATION
...................................
0 - ArchivalUser - 12-18-2011
Damage to your kidneys
Your kidneys filter excess fluid and waste from your blood — a process that depends on healthy blood vessels. High blood pressure can injure both the blood vessels in and leading to your kidneys, causing several types of kidney disease (nephropathy). Having diabetes in addition to high blood pressure can worsen the damage.
Kidney failure. High blood pressure is one of the most common causes of kidney failure. That's because it can damage both the large arteries leading to your kidneys and the tiny blood vessels (glomeruli) within the kidneys. Damage to either makes it so your kidneys can't effectively filter waste from your blood. As a result, dangerous levels of fluid and waste can accumulate. You might ultimately require dialysis or kidney transplantation.
Kidney scarring (glomerulosclerosis). Glomerulosclerosis (glo-mer-u-lo-skluh-RO-sis) is a type of kidney damage caused by scarring of the glomeruli (glo-MER-u-li). The glomeruli are tiny clusters of blood vessels within your kidneys that filter fluid and waste from your blood. Glomerulosclerosis can leave your kidneys unable to filter waste effectively, leading to kidney failure.
Kidney artery aneurysm. An aneurysm is a bulge in the wall of a blood vessel. When it occurs in an artery leading to the kidney, it's known as a kidney (renal) artery aneurysm. One potential cause is atherosclerosis, which weakens and damages the artery wall. Over time, high blood pressure in a weakened artery can cause a section to enlarge and form a bulge — the aneurysm. Aneurysms can rupture and cause life-threatening internal bleeding