nbme 1 - rizowana

[ArchivalUser]

thank you

[ArchivalUser]

37. A 14-year-old boy is brought to the physician by his parents because of a 2-year history of increasing academic problems. His parents say that he has always been hyperactive and distractible, but now his academic performance has deteriorated to the point that he is failing ninth grade. His teachers say that his hyperactivity is disrupting the classroom. He weighs 54 kg (120 lb) and is 152 cm (60 in) tall. Sexual development is Tanner stage 5; examination shows macro-orchidism, which was not shown on previous examinations. He has a high forehead and long, protruding ears. He exhibits poor eye contact during the examination. Psychoeducational testing shows an IQ of 70. Which of the following is the most likely diagnosis?

A
) Attention-deficit/hyperactivity disorder

B
) Autistic disorder

C
) Down syndrome

D
) Fetal alcohol syndrome

E
) Fragile X syndrome

F
) Lesch-Nyhan syndrome

G
) Pervasive developmental disorder, not otherwise specified

H
) Prader-Willi syndrome

I
) Rett's disorder

J
) Seminiferous tubule dysgenesis (Klinefelter's syndrome)

38. A 32-year-old woman comes to the physician because of vaginal discharge for 2 weeks. She has been sexually active with one female partner for 5 years. She has not been treated with antibiotics over the past 2 years. Her last Pap smear was 6 years ago when she was sexually active with a male partner. She has not used illicit drugs or alcohol. Examination shows a grayish vaginal discharge with a pH greater than 4.5. A wet mount preparation of the vaginal discharge is most likely to show which of the following?

A
) Budding yeast

B
) Clue cells

C
) Ferning

D
) Leukocytes in sheets

E
) Trichomonas vaginalis

[ArchivalUser]

for 37. its fragile x, E
for 38. its B gardonella vaginosis

[ArchivalUser]

E
B

[ArchivalUser]

42. A previously healthy 16-year-old high school wrestler comes to the physician because of a rash on his forearms and the back of his legs for 1 week. He is allergic to pollen and dust. Examination shows patches of erythema with mild lichenification over the antecubital and popliteal fossae. There are clusters of painful umbilicated vesicles at sites of active skin inflammation. Which of the following is the most likely diagnosis?

A
) Eczema herpeticum

B
) Herpes zoster

C
) Keratosis pilaris

D
) Lichen planus

E
) Pityriasis rosea

[ArchivalUser]

UMBILICATED.......AA

[ArchivalUser]

i was thinking it would be A, but what is that skin lession happen in celiac dis? something herpeticum

[ArchivalUser]

44. A 28-year-old woman is hospitalized after taking a massive overdose of acetaminophen tablets in a suicide attempt. She has type 1 diabetes mellitus and major depressive disorder refractory to tricyclic antidepressant therapy. Despite appropriate therapy, she develops rapidly progressive hepatic failure and becomes progressively encephalopathic. On the 6th day of hospitalization, she is comatose. A CT scan of the brain shows mild diffuse swelling. An appropriately crossmatched, size-appropriate donor liver is available. Which of the following is the most appropriate course of action regarding transplantation?

A
) Do not proceed with the transplantation because diabetes mellitus is a contraindication

B
) Do not proceed with the transplantation because hepatic function is likely to return over the next week

C
) Do not proceed with the transplantation because major depressive disorder places the patient at risk for another suicide attempt

D
) Do not proceed with the transplantation because the onset of encephalopathy and CT findings suggest bacterial meningitis

E
) Proceed with the transplantation

[ArchivalUser]

45. A 3-year-old boy who is HIV positive is brought for a routine examination. His diet is appropriate for age. His medications include three antiretroviral drugs and trimethoprim-sulfamethoxazole for Pneumocystis carinii prophylaxis. Laboratory studies show:

Hemoglobin 8.6 g/dL
Mean corpuscular hemoglobin 38 pg/cell
Mean corpuscular hemoglobin concentration 30% Hb/cell
Mean corpuscular volume 101 μm3
Leukocyte count 5600/mm3
Segmented neutrophils 60% (many hypersegmented)
Bands 3%
Lymphocytes 37%
Red cell distribution width 21% (N=10–16)

Which of the following is most likely to have prevented this patient's anemia?

A
) Folic acid supplementation

B
) Iron supplementation

C
) Thyroid supplementation

D
) Vitamin B12 (cyanocobalamin) supplementation

E
) Monthly intravenous immune globulin therapy

[ArchivalUser]

45....AA....................TRIMETHPRIM IS ANTIMETABOLITE