NBME 9
Kid with bed wetting problems + constipation
tx?(Ans- administration of an osmotic laxative
Multiple myeloma is marked by proliferation of ______ B cells (Ans- monoclonal
In patients with bipolar disorder that are suffering from acute depression + stopped taking meds, what do you give them?(Ans- bipolar medication like lithium, lamotrigine, quetiapine, and lurasidone
SSRIs in bipolar patients can be bad because?(Ans- it can precipitate mania or convert depression to mania
Patient with afib with a history of TIA or stroke
Tx?(Ans- warfarin
Patient without afib with history of TIA or stroke
Tx?(Ans- aspirin
T/F: Aspirin and clopidogrel are anticoagulants
(Ans- false
1st line therapy for mild to moderate acne vulgaris
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Tx?(Ans- topical retinoids
Patient with juvenile idiopathic arthritis may present with what extraarticular manifestation?(Ans- uveitis (screen with slit-lamp exam)
In adults, the presence of a destructive bone lesion is more commonly caused by ______ disease rather than primary bone malignancy (Ans- metastatic
T/F: Osteosarcoma is most common in patients ____ years of age
(Ans- <30
Patients with severe AS with symptoms or systolic dysfunction (EF <50%) should receive what tx?(Ans- aortic valve replacement
Patients with HF (EF < 50%) who have AS + asymptomatic in terms of SOB on exertion, should receive what treatment?(Ans- Afterload reduction
32 yo woman with bcg vaccine as a child + emigrated from China + PPD skin test of 12 mm
risk status and next step?(Ans- High risk; isoniazid
92 yr old with left mandibular mass that has enlarged + x ray is normal + smoker + normal VS
next step?(Ans- biopsy
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77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 + edema + signs of kidney injury
Dx and next step?(Ans- fluid overload; hemodialysis
In diabetic patients, foot injuries can be prevented with?(Ans- wearing shoes when standing or walking
In diabetic patients, worsening of foot injuries can be prevented with?(Ans- daily foot checks
37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear with atypical glandular cells
potential dx and next step?(Ans- endometrial malignancy; colposcopy with endocervical curettage
37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear with atypical glandular cells
After colposcopy with endocervical curettage, what can be considered as a next step?(Ans- hysteroscopy
T/F: Neonate that improved with PPV can be taken off of PPV immediately
after (Ans- true
If there is suspected FSGS, what is the next step?(Ans- renal biopsy
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