NBME 7 - Mod

Study online at quizlet.com/_1g2c62

1. 3 cm nontender fluctant mass in left Bartholin duct 10. acetylcholinesterase organophosphates/insecticides:

posterior vulva cyst poisoning SLUDGE: salivation, lacrimation,
urination, defecation, GI motility,
2. 4 days post-op, serosanguineous fluid wound
emesis and miosis; (treat with
dehiscence
atropine!)
(evisceration
would show 11. acne is from plugged pilosebaceous glands
abd contents)
12. Acute CHF LMNOP: Lasix, Morphine, Nitrates,
3. A 4 year-old boy develops chickenpox 8 Nothing; moms management Oxygen, Position UP
hours after visiting his newborn sister in were immune
13. acute gout attack first indomethacin (high dose NSAID);
the nursery. Six other full-term newborns so the babies
line steroids used when NSAIDS not
were also exposed; all of the mothers have are safe for 6
effective
a history of chickenpox prior to mos or so.
pregnancy. Which of the following is the 14. Additional vac to give Pneumococcal, NOT HEP A! THAT'S
most appropriate recommendation to AIDS person? FOR LIVER FAILURE PEOPLE
prevent chickenpox in the newborns? 15. Adult with molluscum VIRAL CULTURE; may have std
4. 18yo with a 3cm lymph node in the neck Increased LDH; contagiosum, do what
for 1 month and 3cm splenomegaly. what this is NHL next?
would you find on labs? 16. After ORIF and Fat embolism!
5. A 19 year old African American man Decreased respiratory issues,
comes to physician because of 9 month enzyme - think what?
history of 6-12 hour episodes of probably 17. alcoholic with 106 heat stroke
intermittent watery diarrhea associated lactose temp, high CK and
with abodominal cramps and bloating. he intolerant high AST
occasionally has had diarrhea after meals
18. alcoholic with neuro thiamine (B1) ataxic gait, bilateral
since the age of 12 years, but it has been
deficits after glucose rectus palsies, horizontal
worse since he started college 1 year ago.
infusion nystagmus
examination shows no abnormalities. which
of following is the most likely cause of this 19. ALS EMG signs? fibrillation potentials in multiple
pateints diarrhea muscles of multiple extremities
6. 27 primigravid woman with late decels who obs 20. Anorexic person with OSTEOPOROSIS
is dilating, 7cm at hour 5, do what? amenorrhea at what
risk compared to
7. 27 year old with crohn's on azathioprine ACUTE PANC!
people who
and high amylase, what should you think?
menstruate?
8. 28 week pregnant woman going into Betamethasone,
21. anticholinergic using meds (atropine, benadryl,
labor, do what? NOT
poisoning benztropine); hot, dry, blind, red,
CERCLAGE
mad (treat with physostigmine)
9. A 32 y/o women is brought to ER because Likely
of a 2-day history of vomiting, diarrhea, appendicitis
and right-sided pelvic pain. Her LMP was 3
weeks ago.. Her vitals are T 39' C, R
20/min, P 100/min, Bp 120/70 mm Hg,
abdominal examination shows right lower
quadrant tenderness with rehound. bowel
sounds are decreased, Pelvic examination
shows right adnexal tenderness. A serum
pregnancy tes is negative. What is this?
22. ) a previously healthy 67 year old man Bronchogenic 33. central retinal sudden, painless vision loss, assoc with
has had an ching burning snsation in the carcinoma vein occlusion HTN, swollen disk, venous stasis retinal
distal lower extremities for 3 weeks, the hemorrhages, cotton-wool spots, edema
symptoms are exacerbated by walking of macula
and relieved by elevation of the feet.
34. central scotoma optic neuritis
The cetatarsalphalangeal joints and
and pupillary
ankles are warm swolle, tender and
defect
erythematoud. There is clubbing of the
fingers and toes. which of the following is 35. Cholangitis from ERCP (both diagnostic and therapeutic)
the most likely diagnosis? CBD injury-- test
to do
23. ARDS Acute onset;
Radio of 36. cholecystitis vs. cholecystitis: pericholecystic fluid;
PaO2/FiO2 cholangitis on cholangitis: dilated bile duct
<200; Diffuse ultrasound
infiltration 37. Chronic gastritis in fundus due to autoantibodies to
bilateral with with B12 parietal cells, causes pernicious anemia
cephalization of deficiency (assoc with other autoimmune disorders)
pulmonary increased risk of gastric adenocarcinoma
vasculature and
38. claudication femoropopliteal arteries
perihilar
arteries
fullness, Swan-
Ganz wedge < 39. complement Classic pathway activated by IgG and
18mmHg deficiency and B IgM made by B cells
cell dysnfnx
24. ARDS treatment low tidal
volume, use 40. cor pulmonale JVD, ascites, LEE
PEEP to recruit 41. cryoglobulinemia INF-alpha
alveoli with HepC
25. Ascites woman with mass in the culdesac, Ovarian cancer; 42. destruction and emphysema
what is it and do what? need ex lap to dilation of distal
stage it airways
26. ATN findings renal tubular 43. Diabetes Urine specific gravity <1.006; serum osm
epithelial cells Inspidus >290; Hypernatremia; comatose after
and pigmented meningioma surgery
granular casts
44. Enlarged Finasteride, not doxasozin
27. back pain that increases with spondylothesis prostate in
hyperextension geezer with
28. Bilateral nystagmus, not being PCP- may not obstructive sx?
aggressive, stiff and not talkative- think always be 45. ERCP ductal problems (gallstones, strictures
what? aggressive! [primary sclerosing cholangitis], leaks,
29. Can botulism have CN effects? How does Yes! It inhibits cancer)
it work? ACh release at 46. ERCP vs MRCP MRCP is less invasive and allows for
NMJ imaging around the surrounding
30. Can ibuprofen do pill induced yes! structures
esophagitis? 47. Etiology of UTI urinary stasis from decreased ureteral
31. Can it have bilateral pulmonary YES! in pregnancy tone with increased urinary tract volume
infiltrates? 48. factors renal failure (decreased exretion)
32. causes of watery infectious diarrhea ETEC, vibrio predisposing to hypokalemia (dig can bind at K site on
cholerae, toxicity of Na/K/ATPase, quinidine (decreases dig
Giardia, crypto, digoxin clearance)
rota, noro 49. first test for stress test
angina after EKG
50. Fussy newborn who is sedated and Give more analgesia; 65. Myasthenia gravis vs. MG: decreased receptors
mechanically ventilated after kid can't talk botulism from Ab attack; Botulism:
surgery, do what? decreased release
51. HIDA scan eval of gallbladder, 66. naloxone vs naltrexone naloxone: Emergency
used for biliary naltrexone: withdrawal
atresia (Hepatobiliary
67. newborn in respiratory Rh incopatability; they're not
IminoDiacetic Acid)
distress with necessarily stillborn!
52. High dilute urine output in comatose DIABETES INSIPIDUS hepatosplenomegaly high
woman, after meningioma removal, indir bili and petechia after
should make you think? term delivery and
uneventful pregnancy, what
53. HSIL, next step colpscopy
is it?
54. hypothyroid in elderly can mimick dementia
68. nystagmus drug of abuse PCP
(forgetfulness, slow
gait) 69. Ovarian mass removed Abdo U/S
person w/renal failure, do
55. If person with PPD greater than 16 Tx for latent Tb (INH
what first?
mm shows up, and has no other for 9 mos)
signs, do what? 70. Pelvic fracture guy with PRBC; pelvic fractures can
negative fast, what does he bleed a lot retroperitoneally
56. IgA Deficiency blood transfusion anaphylactic
need? and not show up on FAST
rxn MOA transfusion reaction
of IgE antibodies 71. Person with gerd sx and not gerd trial, if not >50, not >5
against anti-IgA cancery, do what? years, and no
melena/anemia/wt
57. indications for C-section (maternal) prior CS, ACTIVE
loss/melena/hematemesis
herpes, cervical
carcinoma, maternal 72. Post-CABG: pressures drop, tamponade - need to
trauma, HIV infection UOP decreases, CO drops, surgical explore
Pulmonary artery diastolic
58. Intermittent urine loss plus cystic Urethral diverticulum,
pressure UP
mass in midthird of vagina, what is not fistula
this? 73. prevention of myoglobinuria NS IVF
renal failure
59. Kid with cramping abdo pain and r. This is strangulation,
sided scrotal pain with discolored so operation 74. proximal muscle weakness myositis (inflamm infiltrate
hemiscrotum with swelling and with myopathic changes and
tenderness superiorly; do what replacement by adipose and
next? collagen)
60. Kid with low back pain, worse in JRA 75. rheumatic fever most 1. mitral (stenosis/regurg) 2.
morning/inactivity, stooped common valves 1 and 2 aortic (stenosis/regurg)
gait/limping? MARF
61. Kid with staph aureus issuess? NEUTROPHILS; the 76. Rh vs ABO Hemolytic Rh: stillborn, severe anemia
chronic Disease of Newborn and mod/severe jaundice,
granulomatous has strong positive Coombs, NO
issue with schistocytes (RBC's
NEUTROPHIL completely phagocytosed)
oxidative burst
77. sarcoidosis SOB, painful bumps on legs
62. Lesion with HSIL in 27 year old, do colpo (erythema nodosum),
what? bilateral hilar fullness,
hypercalcemia/hypercalcuria
63. male infertility, ill-defined soft bilateral varicoceles
masses high in scrotum 78. SBO no passage of stool (flatus yes if only
partial)
64. mildly itchy rash from face to This is parvo B 19
extremities in a 10 year old, do (THAT WAS SLAPPED 79. short bowel syndrome, rash zinc deficiency
what? CHEEK RASH), so do and hair loss on TPN
nothing
80. Single greatest Hypertension 96. Which structure is Pilosebaceous follicle
risk factor for involved with the
stroke production of acne?
81. Slipped CFE, first x-ray, not MRI 97. Why does hypoMag Mag usually inhibits Ca release
step? cause HypoCa? from sarcoplasmic reticulum;
increases intracellular Ca levels
82. three of more ventricular tachycardia (amiodarone if
which decreases PTH,
consecutive PVC's, stable, cardiovert if unstable)
decreasing Calcium
wide QRS in
regular rapid 98. Widened mediastinum Surg exploration of mediastinum
rhythm after CABG, decreased
UOP and BP, increased
83. tocolytics CCB (Nifedipine); B-mimetics
pulm diastolic pressure,
(terbutaline, ritodrine); Magnesium!;
do what?
84. Torsion when to if high clinical suspicion go right to
99. Woman on oral morphine Administer it q3 orally, not subq
get US vs Surgery surgery (negative Prehn's, pain remains
with pain not controlled
with elevation) Need to fix within 6hrs
q4, do what?
85. Transhepatic visualizes anatomy of biliary tree; used
100. Zenker vs achalasia bad breath for Zenker
cholangiography AFTER ERCP has been unsuccessful;
mainly therapeutic as less invasive
techniques for diagnosis exist (MRCP,
CT, US)
86. Treatment of carotid endarectomy
stroke if carotids
over 70% stenosis
87. TTP pentad Thrombocytopenia, Schistocytes, Fever,
Renal, Neuro
88. Tx impetigo? Topical mupirocin
89. Uneventful SVD UTERINE ATONY
and heavy
bleeding one hour
later, what is it
most likely?
90. upper anterior thymoma
mediastinal mass
91. urinary urethral diverticulum
incontinence with
outpouching of
urethra into
anterior vaginal
wall
92. urine sodium over SIADH
50; urine osm >50;
serum osm <290
with LOW sodium
93. Wehre do ACE Cap receptor sites on macula densa of
inhibitors work in the JGA
kidney?
94. What else does Pancreatitis, liver tox, bone marrow
azathioprine do? suppression
95. When to eval for 15-18 months
child not walking