NBME4 discussion, every one is welcome! - grad1980

[ArchivalUser]

@gudducleveland, Q3, B makes sense since C is wrong.
Q33, ringer sounds right too, i wonder why i didnt pick it?

[ArchivalUser]

i was confused between B and C....I think for radiculopathy slrt has to be positive.

[ArchivalUser]

Q42, here, serum Fe is decreased. transferrin is normal, ferritin inc.

in anaemia of chronic disease like ch renal failure
TIBC is low
serum Fe is dec
serum ferritin is normal or increased.

i think H is right.
any one else wants to discuss this?

[ArchivalUser]

hey gudducleveland, do u wanna review scetion4 now?

[ArchivalUser]

6. A 2-year-old girl is brought to the physician because of shortness of breath for the past 2 hours. She has a 3-day history of runny nose, sneezing, and nasal congestion. She appears tired. Her temperature is 38.5°C (101.3°F), pulse is 130/min, and respirations are 48/min. Examination shows moderate dyspnea. There is audible stridor and moderate retractions with inspiration. The lungs are clear to auscultation. There is an occasional barking cough. Which of the following is the most likely causal organism?

A
) Bordetella pertussis

B
) Group A streptococcus

C
) Haemophilus influenzae type b

D
) Neisseria meningitidis

E
) Parainfluenza virus

[ArchivalUser]

The response options for the next two items are the same. You will be required to select one answer for each item in the set.
For each child with conjunctivitis, select the most likely diagnosis.


A
) Allergic conjunctivitis

B
) Chemical conjunctivitis

C
) Chlamydial conjunctivitis

D
) Gonococcal conjunctivitis

E
) Mucocutaneous lymph node syndrome (Kawasaki disease)

F
) Viral conjunctivitis


9. A previously healthy 6-year-old girl is brought to the physician because of right eye tearing and irritation over the past 2 days. The eye does not itch. She appears well. Her temperature is 37.1°C (98.8°F), pulse is 82/min, respirations are 20/min, and blood pressure is 100/64 mm Hg. The right conjunctiva is erythematous with clear discharge and crusting. Examination of the left eye shows no abnormalities. There is slight nasal congestion and erythematous mucosa. No other abnormalities are noted.



i read viral is bilateral, bacterial is initially unilateral
what it this one? he is too old for gonococcal n has no risk mentioned here for chlamydial(like coming from a 3 world country)
anybody?

[ArchivalUser]

23. A 42-year-old man comes to the physician because of a 3-month history of fatigue, generalized weakness, and depressed mood. He also has had cold intolerance, muscle aches, and constipation during this period. He follows a strict vegetarian diet. His wife has hypothyroidism treated with levothyroxine. His temperature is 36°C (96.8°F), pulse is 62/min, and blood pressure is 120/95 mm Hg. Examination shows dry skin. The thyroid gland is not enlarged. The testes are small. Achilles tendon reflex has a delayed relaxation phase. His serum thyroid-stimulating hormone (TSH) concentration is 0.1 μU/mL, and serum thyroxine (T4) concentration is 2.3 μg/dL. Which of the following is the most likely mechanism of these findings?

A
) Autoantibodies against thyroglobulin

B
) Deficient pituitary production of TSH

C
) Dietary deficiency of iodine

D
) Increased production of thyroid-binding globulin

E
) Surreptitious levothyroxine use

is it B?




42. A 62-year-old woman comes to the physician because of vaginal bleeding for 4 days. Menopause was 13 years ago. Examination shows an 8-cm, left adnexal mass that is freely mobile. Ultrasonography shows a thickened endometrial stripe and a 7-cm, solid, left ovarian mass. An endometrial biopsy specimen shows complex hyperplasia. Which of the following is the most likely cause of these findings?

A
) Dysgerminoma

B
) Endometrioma

C
) Granulosa cell tumor

D
) Mucinous cystadenoma

E
) Sertoli-Leydig cell tumor

[ArchivalUser]

46. A 47-year-old man comes to the physician because of a 2-year history of increasing left knee pain. He says he initially had pain only when playing basketball or running, but he now has pain all of the time. During the past 6 months, he has been awakening at night with pain. His pain is exacerbated with walking and prolonged standing. He used to participate in sports two to three times weekly but now has stopped participating. At the age of 16 years, he sustained fractures of the left proximal tibia while playing football and underwent open reduction and internal fixation at that time. On questioning, he says he occasionally has swelling of the knee but has not had locking or catching. Examination shows a varus deformity of the left knee. Anterior and posterior drawer tests are negative. Which of the following is the most likely explanation for these findings?

A
) Nonunion of his prior fracture

B
) Patella tendinitis

C
) Post-traumatic arthritis

D
) Tear of the anterior cruciate ligament

E
) Tear of the medial meniscus


is it C? but then why is it occuring so late?

[ArchivalUser]

Q6 E
viral is B/l, allergic has itch, too old for chlamydia or gonococcal...doesnt have other symptoms of kawasaki which involves both eyes.chemical would cause eye pain ...not sure about this

[ArchivalUser]

Q 23 B
Q 42 C
Q 46 C