NBME Q.25 BLOCK 2 (FORM 3)

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NBME Q.25 BLOCK 2 (FORM 3)

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11 Posts

frank100
Forum Guru

Topics: 48
Posts: 586

07/24/06 - 03:47 PM

An asymptomatic 57 y/o man come to the physician before begining a jogging program. He has a sedentary lifestyle and has smoked 2 packs of cigarretes daily for 30 years. His blood pressure is 150/88. Examination shows no other abnormalities. An EKG shows normal findings. His serum cholesterol level is 250. which of the following is the most appropriate next step in management?

a) referal to a supervised excersice program.
b) ambulatory blood presure montoring
c) ambulatory EKG monitoring
d) excersice stress test
e) Echocardiography

AAAAA
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Topics: 156
Posts: 1,991

07/24/06 - 03:50 PM

a

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frank100
Forum Guru

Topics: 48
Posts: 586

07/24/06 - 04:20 PM

BP is too high for me, first I would rule out hypertension (by doing 2 more measurements in different situations).

you would say: "but HTN can improve by doing excersice regularly", but as a doctor is my duty to diagnose the diseace and then treat it (can be either by excersice or drugs).

problem #2 hypercholesterolemia: but excersice and diet, are the best next step in this case (no risk).

PD: If I screen for risk factors and treat them. all that associated to an excersice program. this guy will live longer. but what if BP does not improve? even with excersice. this body will suffer the consequences.

my answer is B. (this measure will make me feel more comfortable, and then send him to the gym).

what do you think AAAAA?

drhyd
Forum Senior

Topics: 7
Posts: 82

07/24/06 - 07:24 PM

Hi frank, even i think its A, today i did this nbme test and i got 530/224,
howmuch did u get in this forum, please message me bye.

frank100
Forum Guru

Topics: 48
Posts: 586

07/24/06 - 08:54 PM

540/227, I took it on saturday. we fell almost in the same SD. But if it was an step 2 Q. i would go for B again.

frank100
Forum Guru

Topics: 48
Posts: 586

07/24/06 - 08:56 PM

but the problem is why is A for U? tell me please. perhaps i´m wrong. but I need to know why...

drhyd
Forum Senior

Topics: 7
Posts: 82

07/24/06 - 09:57 PM

Well frank, i think ur rt.
!st we have to rule out hypertension, so we need to do second bp check, but its not given here.
Ambulatory bp monitoring is used to detect white coat hypertension, as it is recorded by pt himself.
There are no comorbities in him for spl exercise training.
What do u say guys

drhyd
Forum Senior

Topics: 7
Posts: 82

07/24/06 - 10:00 PM

Frank when is ur examiam giving it on coming monday.

frank100
Forum Guru

Topics: 48
Posts: 586

07/24/06 - 10:44 PM

october, I did´t catch the actual aeligibility period

frank100
Forum Guru

Topics: 48
Posts: 586

07/24/06 - 10:49 PM

#10

thanks drhyd, I must admit I was wrong. I guess

frank100
Forum Guru

Topics: 48
Posts: 586

07/24/06 - 10:50 PM

#11

I´ll pray for you to do well in your exam.

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