NBME 2 Qs
|
 
|
|
| |
|
 |  |
| Author | 7 Posts |
dr_jojo
|
7…………... A 5-year-old girl is brought to the physician
because of a 2-day
history of temperatures to 39.5 C (103.1 F) and pain
in the right side.
She has had two episodes of vomiting during this
period but no diarrhea
or symptoms of upper respiratory tract infection. She
has
vesicoureteral reflux and a history of recurrent
urinary tract infections. She
appears ill. Her temperature is 39.8 C (103.6 F),
blood pressure is
110/60 mm Hg, pulse is 150/min, and respirations are
25/min. Examination
shows right-sided costovertebral angle tenderness. In
addition to
obtaining urine cultures, which of the following is
the most appropriate next
step in management?
A
) Intravenous pyelography
B
) Renal ultrasonography
C
) Voiding cystourethrography
D
) Intramuscular antibiotic therapy and
reexamination in 24 hours
E
) Intravenous antibiotic therapy
8……………….A 10-year-old boy is brought to the physician
because of
weakness and decreased appetite for 3 months. He
weighs 30 kg (66 lb) and is
142 cm (56 in) tall; he has had a 2.3-kg (5-lb) weight
loss since his
last examination 6 months ago. He appears thin. Deep
tendon reflexes
are brisk. Chvostek's sign is positive. His serum
calcium level is 6.5
mg/dL, and serum intact parathyroid hormone level is
190 pg/mL
(N=9��"65). In addition to calcium supplementation,
which of the following is
the most appropriate next step in management?
A
) Oral phosphate supplementation
B
) Oral vitamin D supplementation
C
) Intranasal calcitonin therapy
D
) Parenteral bisphosphate therapy
E
) Parenteral parathyroid hormone therapy
9…………… A healthy 8-year-old girl is brought to the
physician in July
for a well-child examination. Her mother says that
her daughter is
spending the summer at a nearby lake. Over the past
month, she has had two
episodes of painful sunburn despite her mother's
efforts, including SPF
25 sunblock just before she goes swimming and urging
her to wear a hat
and long-sleeved garments. The child takes no
medications. She has
blond hair, blue eyes, and a fair complexion. The
mother seeks advice
about preventing further sun damage to her child's
skin. Which of the
following is the most appropriate recommendation?
A
) Prohibit swimming on cloudless days
B
) Apply the sunblock lotion 45 minutes before
swimming
C
) Change to a higher-level SPF lotion
D
) Apply Burrow's solution compresses after each
overexposure
E
) Daily use of antioxidant vitamin supplement
F
) Early treatment of any sun overexposure with
topical
corticosteroids<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
10………….. 2325-g (5 lb 2 oz) male newborn is delivered
at 33 weeks'
gestation; Apgar scores are 7 and 8 at 1 and 5
minutes, respectively. The
13-year-old mother had no prenatal care and did not
know how much
weight she gained. During the pregnancy, the mother
smoked marijuana and
took over-the-counter vitamins occasionally; she did
not drink alcohol
and had no illness except for an upper respiratory
tract infection 4
months ago. She did not know she was pregnant until 2
weeks ago; her
family is unaware of her condition. She has had one
sexual partner. During
the hospital stay, the newborn and his mother have no
complications.
The newborn is at greatest risk for morbidity and
mortality from which
of the following?
A
) Child abuse
B
) Congenital syphilis
C
) Hypocalcemia
D
) Lead poisoning
E
) Seizures
11…………..A 2-month-old girl is brought to the physician
because of a
2-week history of progressive difficulty breathing and
poor feeding. She
has had rapid and labored breathing and sweating
during feedings. There
is no history of fever or viral illness. Her
temperature is 37 C (98.6
F), blood pressure is 80/60 mm Hg, pulse is 130/min,
and respirations
are 40/min. Bilateral crackles are heard at both lung
bases. A grade
4/6 holosystolic murmur is heard along the left
sternal border; the
precordium is hyperdynamic. The liver edge is
palpated 4 cm below the
right costal margin. An x-ray film of the chest shows
cardiomegaly and
pulmonary congestion. Which of the following is the
most likely
underlying mechanism for this child's condition?
A
) Decreased systemic vascular resistance
B
) Increased pulmonary vascular resistance
C
) Increased systemic vascular resistance
D
) Intracardiac left-to-right shunt
E
) Intracardiac right-to-left shunt
Edited by dr_jojo on 03/19/07 - 03:16 PM
|
| vanshita
Forum Guru
Topics: 21
Posts: 805
|
E
B
B
E
D
|
| rn
Forum Senior
Topics: 30
Posts: 80
|
E
B
A
A
d
|
| dr.shailu
Forum Senior
Topics: 26
Posts: 192
|
1 I V antibiotics
2 oral vit d supplmntn
3 apply sun block lotion 45min before swimming
4 child abuse
5 intracardiac left to right shunt
|
| webjeee
Forum Guru
Topics: 99
Posts: 349
|
4. can anyone explain
child abuse and seisure
|
| fongch
Forum Elite
Topics: 71
Posts: 316
|
7 B
8 B
9 B
10 A
11 D
|
| lq2006
Forum Elite
Topics: 16
Posts: 339
|
E B A E D
|
|
| |
| | | | | | | |
You don't have permission to post.
|
