nbme 1 - rizowana

[ArchivalUser]

ok, not invasive but shouldnt we start antibiotic first before we do anything else?

[ArchivalUser]

sever pain you can not imagine how sever ..aspiration take just 10 minutes then immediatly proced to antibiotic

[ArchivalUser]

36. An 18-year-old man comes for an examination prior to participation in school sports. He states that he has had a dull ache in the scrotum since being hit in that area during a basketball game 2 months ago. Examination shows a 2-cm, hard, nontender mass in the right testicle. The mass does not transilluminate or change in size when the patient is placed in the supine position. Which of the following is the most likely cause?

A
) Cystic dilations of the efferent ductules

B
) Dilated pampiniform venous plexus

C
) Fluid accumulation within the tunica vaginalis testis

D
) Germinal cell tumor

E
) Vascular trauma

[ArchivalUser]

DD. ........TUMOR USUALY DIAGNOSED ACCEDENTALY

[ArchivalUser]

yes its D, hard, does not transilluminate or change in size because its not fluid inside.

[ArchivalUser]

39. A 57-year-old woman with breast cancer comes to the physician because of increasing neck pain over the past 3 days. She has fallen frequently because of muscle weakness. Vital signs are within normal limits. Examination shows hyperreflexia of all extremities. There is tenderness over the cervical spine. Serum calcium level is 11 mg/dL. X-ray films show metastases to the cervical spine. Which of the following is the most appropriate next step in management?

A
) Application of a soft cervical collar

B
) Physical therapy

C
) Mithramycin therapy

D
) Tamoxifen therapy

E
) Spinal cord decompression and cervical stabilization

[ArchivalUser]

AA......PRESENTATION IS JUST NECK PAIN

[ArchivalUser]

i am thinking that it is A. by the way its not tamoxifen b/c if breast ca is not ER PR positive then we dont give tamoxifen right?

[ArchivalUser]

40. A 57-year-old man comes to the physician because of intermittent urinary incontinence over the past 6 months. He has loss of small amounts of urine when he coughs or sneezes. He has not had pain or blood with urination. He has a 15-year history of type 2 diabetes mellitus with peripheral neuropathy, retinopathy, and gastroparesis. Current medications include metoclopramide and glyburide. He appears well. Rectal examination shows a normal-sized prostate. Neurologic examination shows decreased sensation in a stocking-glove distribution. Achilles tendon reflexes are absent bilaterally. Test of the stool for occult blood is negative. Urinalysis shows 2+ protein with no leukocytes or erythrocytes. His postvoid residual volume is 500 mL. Which of the following is the most likely mechanism of this patient's incontinence?

A
) Central nervous system disorder

B
) Functional incontinence

C
) Intrinsic sphincter deficiency

D
) Overflow incontinence from acontractile bladder

E
) Overflow incontinence from bladder outlet obstruction

F
) Pelvic floor muscle weakness

G
) Retroperitoneal fibrosis

H
) Retroperitoneal lymphadenopathy

I
) Urinary tract infection

[ArchivalUser]

I would say E....
pain, tenderness, metastasis on x-ray...ooo .....do something