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nbme form 2 b1 2/2 - grazie
#21
i think CC makes sense
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#22
Nobody?

Well, I can't believe I miss this qs Sad We could perform a lot better if we could just focus on the question and not being so anxious about the score.



B) Sexual history

Now that I see this again, I definitely think this is Gonococcal arthritis, disseminated gonorrhea because it has the typical clinic: young girl
- Polyarticular involvement
- Tenosynovitis
- Petechial rash

Tx:
Ceftriaxone, Cefotaxime, Ceftizoxime (best for disseminated gonorrhea)

If recurrent gonorrhea, test for terminal complement deficiency.

If I am wrong please correct me and explain because I don't have the NBME right answer Sad
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#23
I marked C but it was wrong by NBME
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#24
Do we stick to B?
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#25
ya..
i think its sexual history.. dont think we will pustular lesions in RMSF. sorry!! my bad!!
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#26
ya it is B..explains tenosynovitis.
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#27
The following vignette applies to the next 3 items.

Item 1 of 3

24)

A 37-year-old industrial engineer comes to the office to discuss elevated serum urea nitrogen and creatinine results from a laboratory study obtained routinely at work as part of an employee health program. The patient's medical history is noncontributory. He is married and has two children under age 5 years. Family history is remarkable for polycystic kidney disease. Vital signs today are temperature 37.0°C (98.6°F), pulse 84/min, respirations 14/min, and blood pressure 145/98 mm Hg. Physical examination shows no abnormalities. Ultrasonography of the abdomen shows bilateral multicystic kidneys. The patient says he has family members with kidney disease according to the pedigree shown. The patient is marked by the arrow.

This patient's clinical picture is most indicative of which of the following patterns of disease inheritance?

A) Autosomal dominant
B) Autosomal recessive
C) Mitochondrial mutation
D) X-linked dominant
E) X-linked recessive



Item 2 of 3

25. Which of the following is the most appropriate pharmacotherapy?

A) Aspirin
B) Lisinopril
C) Methylprednisolone
D) Naproxen
E) No pharmacotherapy is indicated





Item 3 of 3

26. The patient says, "I am concerned about whether my children have inherited this condition. What should I do?" Which of the following is the most appropriate response?

A) "I recommend against testing your children."
B) "I will obtain blood samples from your children and send them for testing."
C) "We should do an ultrasonography of your wife's kidneys first; if the results are negative for polycystic kidney disease, your children will not be at risk."
D) "We will be able to ascertain your children's risk if we do an ultrasonography of their kidneys in the future."

End of Set
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#28
AA
BB
DD
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#29
A
B
D
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#30
24 A ( adult is autosomal dominant poly cystic kidney disease)
25 B ( target BP in PCKD is 130/ 80 mmhg, DOC - ACEI)
26 D
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