boost3
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25. they showed a funduscopic image of a 72yo woman with blurring of near and distance vision in the left eye and a small blind spot in the center of left eye. anyone know what this diagnosis is? Glaucoma? other options were macular degeneration, optic atrophy, optic neuritis, retrobulbar neuritis.
35. A 67-year-old man with severe congestive heart failure and edema has gained 9.1 kg (20 lb). Which of the following is most likely to contribute to renal sodium retention?
A) Decreased extracellular fluid volume
B) Decreased plasma aldosterone concentration
C) Increased effective arterial blood volume
D) Increased plasma atrial natriuretic peptide concentration
E) Increased renal sympathetic nerve activity
E? not sure tho
38. 15 month old boy brought in bc his mother is concerned about his small stature. mother says he has had 6 resp infections past year. He has normal appetite, eats finger foods, and has frequent loose stools. He walks independently. Examination shows a thin, active toddler. Crackles are heard over both lung bases. No cardiac murmur. Abdominal exam is normal. Growth cure is shown (graph shows he is below avg). which is the most likely cause of these findings?
a. cardiomyopathy
b. celiac sprue
c. cystic fibrosis
d. developmental delay
e. lactose intolerance
f. normal growth and development
g. parental neglect
i said E??
44. A 20-year-old woman who has had oligomenorrhea for 3 years has the sudden onset of heavy vaginal bleeding. She is moderately obese and has increased amounts of hair on the face, arms, and legs. Examination of an endometrial biopsy specimen shows hyperplasia without atypia. Laboratory studies show increased serum concentrations of luteinizing hormone, androgens, and estrogens; follicle-stimulating hormone concentration is decreased. Histologic examination of the ovaries is most likely to show which of the following?
A ) Mucinous cystadenomas
B ) Multiple persistent corpora lutea
C ) Multiple subcortical cysts lined by granulosa cells
D ) Normal histology
E ) Serous cystadenomas
C?
45. A male newborn delivered to a mother with type 1 diabetes mellitus at 30 weeks' gestation has profound hypoglycemia and is difficult to arouse. He requires a glucose infusion. An umbilical venous catheter is utilized as a central line for glucose administration with the tip directed for placement in the right atrium. In order to reach its destination, the catheter must pass through which of the following vessels?
A ) Azygos vein
B ) Ductus venosus
C ) Left hepatic artery
D ) Right portal vein
E ) Superior epigastric vein
B?
what do you guys think?
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| ssrpk
Forum Fanatic
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25 - macular degenration [central scotoma is characteristic]
35 - E) Increased renal sympathetic nerve activity
38 - c. cystic fibrosis [ Hx of resp. infections do not correlate with any other dz mentioned]
44 - C - multiple cysta [PCOD]
45 - B ) Ductus venosus
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| boost3
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ah yes. #25=macular degeneration. looked up pictures on google. you can also use the symptoms to rule out glaucoma, as you have loss of peripheral vision first. macular degen you have central vision loss. duh, and i knew that too!
some more that i am stuck on and are bothering me:
39. B?
41. no clue. horrible at images--answer with explanation please?
46. A 60-year-old woman has a serum calcium concentration of 7.0 mg/dL and a serum potassium concentration of 2.8 mEq/L. Her serum parathyroid hormone (PTH) concentration is decreased. The decreased PTH is most likely related to a severe depletion of which of the following?
A ) Iodine
B ) Iron
C ) Magnesium
D ) Selenium
E ) Zinc
it's A right?
47. A 50-year-old man comes to the physician's office for a routine health maintenance examination. He had radiation therapy for treatment of a benign thymic enlargement when he was 8 days old. Which of the following aspects of the physical examination is most likely to identify a long-term complication of this therapy?
A ) Auscultation over the cardiac apex
B ) Auscultation over the cardiac base
C ) Auscultation over the trachea and upper airways
D ) Indirect laryngoscopy
E ) Inspection of the hypopharynx
F ) Nasopharyngoscopy
G ) Palpation of the thyroid gland
I know this has been discussed before, but i'm still not sold. radiation to the head and neck gives you thyroid cancer, but the thymus is in the mediastinum. also, i have this bizarre idea that thymomas affected the larynx (recurrent laryngeal n??) so i picked D. am i totally off?
Attached Files:
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| surfdog97
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Magnesium deficiencey causes HYPO PTH ism
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| surfdog97
Forum Junior
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When do you take your exam?
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| surfdog97
Forum Junior
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Also it is palpation of the thyroid, on the USMLE when you see head and neck radiation therapy, automatically think THYROID CANCER, even though you could probably justify hald of the answers given, the one they want is radiation increases the chances of thyroid malignancies in a patient
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| boost3
Forum Newbie
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ok, thanks.
i take the test in about 2.5weeks  you?
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| ssrpk
Forum Fanatic
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yeah for 39, its B, as the graph shows competitive inhibition!
good luck for ur test!
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| drfax
Forum Elite
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Posts: 262
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25. macular degenaration most probably in old patients
35.E. increase in sympathetic will increases Na retention
38.Cystic fibrosis is most likely
39. Cimetidine blocks histamine action of acid secretion reversibly
44.C. Polycystic overian disease
45. ductus venosus
46. Magnesium
48.Thyroid palpation
Good luck
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