nbme f2 b2 - grazie

[ArchivalUser]

14.

A 31-year-old man with HIV infection is admitted to the hospital because of a 2-week history of nonproductive cough and shortness of breath on exertion. His most recent CD4+ T-lymphocyte count was 174/mm3. He takes no medications. On admission, the patient is awake but confused. Vital signs are temperature 39.1°C (102.4°F), pulse 112/min, respirations 26/min, and blood pressure 107/62 mm Hg. Examination of the skin shows no abnormalities. Auscultation of the lungs discloses diffuse bilateral crackles and rhonchi. Neurologic examination discloses no focal deficits. Results of arterial blood gas analysis while the patient breathes room air are shown:
Po2 54 mm Hg
Pco2 31 mm Hg
pH 7.41

Chest x-ray is shown. Which of the following is the most appropriate diagnostic study to order at this time?
http://i42.photobucket.com/albums/e338/G...b8cffd.png


A) Bronchoalveolar lavage

B) Culture of the sputum

C) Gallium scan

D) High-resolution CT scan of the chest

E) Transthoracic needle biopsy

[ArchivalUser]

14) A (by NBME)
A) Bronchoalveolar lavage

PCP is a very well known opportunistic infection when HIV pt has CD4

[ArchivalUser]

15.
A 60-year-old white woman is admitted to the hospital because of weakness, anemia, and melanotic stools for the past 2 days. She has not had any dyspepsia or heartburn and has been in otherwise good health. She is single and is no longer sexually active, but she says that she did have bisexual relationships when she was in her 20s. She rarely drinks alcoholic beverages because she was told in the past that she has hepatitis. Today she is 168 cm(5 ft 6 in) tall and weighs 62 kg (136 lb); BMI is 22 kg/m2. Vital signs are temperature 37.4°C (99.4°F), pulse 88/min, respirations 16/min, and blood pressure 112/70 mm Hg. Results of initial laboratory studies are shown:

Serum Blood
ALT 120 U/L Hematocrit 28%
AST 56 U/L Hemoglobin 9.2 g/dL
Urea nitrogen 30 mg/dL WBC 4000/mm3 
Creatinine 0.7 mg/dL MCV 102 μm3
K+ 5.2 mEq/L Platelet count 112,000/mm3
Proteins Prothrombin time 16 seconds
Total 6.0 g/dL INR 1.6
Albumin 3.2 g/dL

Emergency esophagogastroscopy is done and shows esophageal varices with a small leak from one of the vessels. Endoscopic ligation is done and the patient's condition stabilizes. In determining this patient's long-term prognosis, it is most appropriate to evaluate which of the following factors?

A) Coinfection with Helicobacter pylori

B) Degree of cirrhosis and portal hypertension

C) Hepatitis C viral load

D) Improvement of clotting factors with treatment

E) Response to β-blocking medications and aldosterone antagonist

[ArchivalUser]

q14 - AA PCP

if you guys dont mind i'll post few, not few, many qs to review

[ArchivalUser]

open up a new topic jusupjoseph ...since grazie is following his sequence, it'll throw him off..

[ArchivalUser]

A 66-year-old postmenopausal woman comes to the office for her periodic health evaluation. During the visit she says she has had continuous vaginal bleeding for the past
3 months. Her uterus and ovaries have been normal to palpation on previous yearly examinations, and she is taking cyclic hormone replacement therapy with estrogen and
progesterone. Physical examination today, including pelvic examination, discloses no abnormalities. Which of the following is the most appropriate next step?
A) Do endometrial sampling
B) Order a serum estrogen concentration
C) Order serum follicle-stimulating hormone (FSH) and serum luteinizing hormone (LH) concentrations
D) Order ultrasonography of the pelvis
E) Schedule colposcopy


A 9-month-old boy is brought to the office for treatment of failure to thrive. His medical history includes a birth weight of 3620 g (8 lb), recurrent episodes of vomiting and
dehydration, poor weight gain, and feeding problems. Findings on physical examination today include a weight of 4530 g (10 lb), a thready pulse, low blood pressure, muscle
wasting, and hyperpigmentation around the genitalia, nipples, and axilla. Which of the following is the most likely cause of this patient’s failure to thrive?
A) Hypofunction of the adrenal cortex
B) Hypofunction of the adrenal medulla
C) Hypopituitarism
D) Hypothyroidism
E) Poor parent-infant interaction

A 28-year-old man with schizoaffective disorder comes to the office because of restlessness and nervousness since being discharged from the hospital 2 weeks ago following
6-day admission for treatment of a manic episode. He says, "I'm not really worried but I just can't sit still. The only time I get any rest is when I sleep. I haven't had a cigarette or
a drink since I left the hospital, but I'm thinking I need to have one soon!" He forgot to bring a list of his discharge medications, but he says, "I'm back on lithium and they gave
me a shot they said would last a month." Vital signs are normal. During the physical examination he moves around on the examination table and occasionally stands up,
shuffles his feet, and sits down again. At this time which of the following is the most likely explanation for this patient's symptoms?
A) Adverse effect of medication
B) Dysthymia
C) Nicotine withdrawal
D) Prolonged alcohol withdrawal
E) Residual hypomania


You are about to leave the office for a 2-week vacation with your family when you receive a telephone call from a 78-year-old long-time patient. The patient has type 2 diabetes
mellitus and has just been discharged from the hospital following debridement of a foot ulcer. She is now having difficulty ambulating because of obesity and an inability to bear
weight on the affected foot. She lives alone, and she says she is having difficulty cooking for herself and caring for the wound. She is not scheduled to see the surgeon who
performed the debridement for another week. She asks for your help. Which of the following is the most appropriate intervention at this time?
A) Admit the patient to the hospital
B) Advise the patient to see the surgeon sooner
C) Arrange home assessment by a visiting nurse
D) Notify the patient's neighbors of her condition
E) Schedule a home visit when you return from vacation

more to go

[ArchivalUser]

these were already discussed i think

[ArchivalUser]

@jusupjoseph
Please don't post any other questions, if they are not from block 2 of form 2 NBME
I want to solve only those questions in this thread I don't want to mislead the subject on this post

[ArchivalUser]

this is not new topic , this is NBME 2

[ArchivalUser]

Those questions are from block 1 of Format 2, please check the thread before, the block 1 has been all discussed