NBME Block 5 - Please Answer Exam in two days - grad2008

[ArchivalUser]

1,E,2 E,3 E,4D, 5E, 6 A, 7 C

[ArchivalUser]

1.E
2.E
3.B
4.D
5.E
6.D
7.C

[ArchivalUser]

1 e (girl dont remember the events)
2 e (normal finding so must do conservative managment first)
3 e (Urinary obstruction, so must get an Image to see if cancer is cause or other cause, PE show mass up to umbilicus, which could be full bladder or cancer mass)
4 c (not sure on this one, but think Ca blocker = peripheral edema)
5 e (most common site of secondary cyst is Liver in pt with APKD)
6 D (Over weight + no Estrogen hormone + old + Female = fracture waiting to happen)
7 c (old age + change in eating habits + weight loss + low energy = must ask about Bowel habbits, aka Cancer or Thyroid problems)

Hey, if I'm wrong its b/c its 2am here and I haven't studied in awhile. But i'm sure most should be correct.

Good Luck with Steps and Match

[ArchivalUser]

The Abd pain was from the constipation and Diarrhea from 2wks ago, it was a follow up visit!! Yes she probably has IBD, and you should prob start conservative treatment via change in diet first (meds have too much risk of S/E, vs diet change)

Steriods can cause bone loss = high blood calcium level = edema or she can have a Thyroid issue and I think you can have high bone loss also (this one I'm not sure on)

[ArchivalUser]

1e
2e
3e
4d
5e
6d
7e

am i right ??? exam in 2 weeks ??!?!

[ArchivalUser]

Thank you so much guys

[ArchivalUser]

For The First Question*******************
The answer will be clearly "Nightmares" I disagree with Night Terror.
It is clearly saying what the girl sees in her dream “about a figure in a dark cape who is chasing after her and wants to turn her into stone.” If she was in Delta sleep [when the night terror happens] she could not be able to describe her "Nightmare" so nicely.

[ArchivalUser]

1) E. Night terrors. Don't let her description of the shadowy figure fool you. She's screams it about it WHILE she's asleep, but once she woke up she no longer remembers.

2) E. Fiber supplementation. Usually first step in management. Not sure though.

3) B. Do a cervical biopsy. Looks like cervical cancer. Next step is the diagnostic step--biopsy. Stage later. Don't need the ultrasound; you already know the mass is there, and again, you stage after you have the diagnosis.

4) D. Increased glucose concentration. Steroids use leading to insulin resistance. Sodium and potassium would be tho opposite of what they have listed here.

5) E. She should be monitored for development of liver disease. Most common extrarenal complication are hepatic cysts.

6) D. Stress fractures. Agreed with other explanations.

7) E. "What has been going on in your life recently?" Might be depression. Start with an open-ended question in a situation like this.