nbme 1 - rizowana

[ArchivalUser]

BB........DIVERTICULITIS

[ArchivalUser]

. A previously healthy 3-month-old girl is brought to the emergency department because of a 3-day history of grunting and increasing difficulty breathing. She appears ill. Her temperature is 36.7 C (98 F), pulse is 160/min, and respirations are 76/min. Examination shows grunting, nasal flaring, and marked intercostal retractions. Bronchial breath sounds and occasional bilateral crackles are heard on auscultation. Serum studies show:

Ca2+ 5.6 mg/dL
Phosphorus 11 mg/dL
Alkaline phosphatase 250 U/L

Capillary blood gas analysis on 100% oxygen:

pH 7.36
PCO2 38 mm Hg
PO2 46 mm Hg

An x-ray film of the chest shows bilateral, diffuse interstitial infiltrates and absence of the thymic shadow. Bronchoalveolar lavage is positive for numerous Pneumocystis carinii. Which of the following is the most likely mechanism of these findings?

A ) Adenosine deaminase deficiency

B ) Consumption of complement

C ) Defective opsonization

D ) Destruction of CD4+ T lymphocytes

E ) Developmental arrest of maturation of B lymphocytes

F ) Dysmorphogenesis of the third and fourth pharyngeal pouches

G ) Impaired chemotaxis

H ) Impaired phagocytic oxidative metabolism

[ArchivalUser]

F... DiGeorge Syndrome

[ArchivalUser]

FF

[ArchivalUser]

22. A 3-year-old girl is brought to the physician after her mother noted blood on her underpants. Examination shows genital condylomata acuminata in the perineal, peri-introital, labial, and anal areas. Some of the pedunculated condylomata appear to have caused the bleeding. She has no visible intravaginal condylomata or vaginal or anal tears. Her mother has a palmar wart on her hand but no history of condylomata acuminata. Her mother has a boyfriend who does not live with them and who has never been left alone with the girl. They live with the mother's 27-year-old brother who only baby-sits the children when they are asleep. Which of the following is the most appropriate next step in management?

A
) Psychiatric assessment of the mother

B
) DNA typing of the mother's palmar wart for papillomavirus

C
) Treatment of the mother's palmar wart

D
) Vaginal, anal, and throat cultures for Chlamydia trachomatis and Neisseria gonorrhoeae in the child

E
) Laser therapy of the condylomata acuminata in the child

[ArchivalUser]

what is the answer of this Q? D right?

[ArchivalUser]

YES....DD.

[ArchivalUser]

20. A 72-year-old man comes to the physician because of a 7-month history of leg weakness and dry eyes and mouth. He also has had a 10.4-kg (23-lb) weight loss over the past 4 months despite no change in appetite. He has smoked one and a half packs of cigarettes daily for 50 years. He drinks 4 oz of alcohol daily. He has peptic ulcer disease and emphysema. Medications include cimetidine, theophylline, and low-dose prednisone. Examination shows mild ptosis. He has a barrel-shaped chest. Breath sounds are distant. There is moderate weakness of the proximal muscles of the lower extremities. Reflexes are absent. He has difficulty rising from a chair. Sensory examination shows no abnormalities. An x-ray film shows a hyperinflated chest and a 3 x 4-cm mass in the right hilum. His neurologic findings are most likely due to a lesion involving which of the following?

A
) Muscle membrane

B
) Parasympathetic nervous system

C
) Peripheral nerve

D
) Presynaptic neuromuscular junction

E
) Sympathetic nervous system

[ArchivalUser]

is there any possibility that A is the answer?

[ArchivalUser]

DD....autoantibody attack calcium receptors in presynapsis