NBME Q.28 BLOCK 2 (FORM 3)

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NBME Q.28 BLOCK 2 (FORM 3)

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8 Posts

frank100
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Topics: 48
Posts: 586

07/23/06 - 06:43 PM

A 1 YEAR OLD GIRL IS BROUGHT TO THE PHYSICIAN BY HER GRANDMOTHER BECAUSE OF A 1 WEEK HISTORY OF CRYING IMMEDIATELY BEFORE AND DURING BOWEL MOVEMENTS . SHE IS OTHERWISE ASYMPTOMATIC. EXAMINATION SHOWS NO ABNORMALITIES EXCEPT FORAN ANAL FISSURE. WHICH OF THE FOLLOWING IS THE MOST APPROPRIATE INITIAL STEP IN MANAGEMENT?

A) NOTIFICATION OF CHILD PROTECTIVE SERVICES.
B) STOOL SOFTENER THERAPY.
C) ANAL DILATATION IN THE OFFICE
D) EXCITION OF THE FISSURE.
E) SPHINTERECTOMY.

mazinger
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Topics: 46
Posts: 918

07/23/06 - 08:31 PM

b

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drk1980
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Topics: 147
Posts: 1,038

07/24/06 - 01:56 AM

agree, one of the initial managements.

fongch
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Topics: 71
Posts: 316

05/13/07 - 06:46 PM

Some people choose A - is anal fissure in young child indicative of sexual abuse?

Justice
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Topics: 117
Posts: 2,324

05/13/07 - 07:00 PM

Could be (B)
Hate this borderline ethical Qs...

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premonition
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Topics: 48
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05/14/07 - 08:51 PM

My experience says that if it is supposed to be child abuse there would be more clear cut clues. I would go for B.

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docnikki
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Topics: 93
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05/18/07 - 11:21 PM

go for B

sera
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Topics: 14
Posts: 141

05/19/07 - 01:42 AM

is it ok to give stool softeners to 1 yr. old child???

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