NBME4 discussion, every one is welcome! - grad1980

[ArchivalUser]

Page 4 answer.

19. g, 22, d. 23. I, 37. a, 40, a.

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Block 3

3. B
6. J
13. C
33. D
42. H

Block 4

6. E
9. F
23. B
42. C
46. C

[ArchivalUser]

Block 3

3. DM- Peripheral neuropathy- may be asymmetrical.

42. CRF- Erythropoetin def normocytic normochromic anemia with decreased reticulocyte count

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wat is most common cause of osteomyelitis in sickle cell disease? salmonella or staph?

[ArchivalUser]

sickle cell is salmonella,
else its staph

[ArchivalUser]

1. A 23-year-old man comes to the physician because of a 2-day history of abdominal pain. Initially, the pain was diffuse and colicky, but over the past 24 hours, it has become sharp and has localized to the right lower quadrant; he has had nausea and has vomited three times. His last bowel movement was 2 days ago. His temperature is 38.1°C (100.6°F), pulse is 95/min, and blood pressure is 130/75 mm Hg. The lungs are clear to auscultation. Heart sounds are normal. Abdominal examination shows right lower quadrant tenderness with guarding. Which of the following is the underlying mechanism of the shift in location of this patient's pain?

A
) Arterial occlusion

B
) Inflammation to the parietal peritoneum

C
) Progressive increase in intraluminal pressure

D
) Transmigration of bacteria through the visceral wall

E
) Visceral perforation

what about this one?

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26. A 52-year-old man is brought to the emergency department by his brother because of fever and muscular rigidity for 24 hours. He has been taking chlorpromazine for 4 days for agitation and insomnia. He was well until 2 days ago when he began to sweat profusely and feel agitated. He went to bed and began to have visual hallucinations. On examination today, he is agitated, disheveled, and yelling. His temperature is 39.2°C (102.5°F), pulse is 120/min, respirations are 24/min, and blood pressure is 150/100 mm Hg. Physical examination shows clammy skin and rigid extremities. Deep tendon reflexes are 2+ bilaterally. Hoffmann and Babinski signs are absent. On mental status examination, he appears to be having visual hallucinations. He is not oriented to person, place, or time. In addition to hydration, which of the following is the most appropriate next step in management?

A
) Add acyclovir to the regimen

B
) Add benztropine to the regimen

C
) Add ceftriaxone to the regimen

D
) Administer intravenous physostigmine

E
) Discontinue chlorpromazine
is it E?

[ArchivalUser]

@4usmlee, yes we agree to ur answers on section 2 Qs

[ArchivalUser]

@vatsalshruti,
regarding the conjuctivitis question,
this pateint has unilateral eye symptoms n non itchy
viral is bilateral n itchy.

[ArchivalUser]

@gudducleveland and vatsalshurti,
can u guys explain why C for 46?
he had trauma so long ago, why is he having arthritis now?
if its oseto, why is it swelling?