docnikki
Forum Guru
Topics: 93
Posts: 680
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1) A 50-year-old man with a 20-year history of type
2 diabetes mellitus has had sensory neuropathy for 2 weeks.
Pulses are decreased at the ankle. There is no peripheral edema. His serum
glucose levels have been between 150 mg/dL and 200 mg/dL over the past 6
months. Which of the following is the most effective measure to prevent
serious foot infections?
A) Use of support hose
B) Use of well-fitted shoes
C) Prophylactic antibiotics
D) Daily aspirin and dipyridamole
E) Decrease in serum glucose level
2)2.) A 63-year-old woman comes to the emergency
department because of palpitations for 1 hour. She was diagnosed with
hyperthyroidism 2 months ago but has not received treatment. Three
hours before arrival, she drank two bottles of beer with dinner. Her blood
pressure is 90/60 mm Hg, and pulse is 85/min and irregularly irregular.
Examination shows a variation in intensity of S1. There is an absence of a
waves in the venous pulse. An ECG is shown. Which of the following is
the most likely cardiac rhythm disturbance?
A) Atrial fibrillation
B) Atrial flutter
C) Multifocal atrial tachycardia
D) Paroxysmal atrial tachycardia
E) Second-degree atrioventricular block, Wenckebach type
F) Sick sinus syndrome
G) Sinoatrial exit block, type II
H) Torsades de pointes
I) Wandering pacemaker
J) Wolff-Parkinson-White syndrome
3 A sexually active 20-year-old woman has had fever, chills, malaise, and pain of the
vulva for 2 days. Examination shows a vulvar pustule that has ulcerated and
formed multiple satellite lesions. Nodes are palpated in the inguinal and
femoral areas. A smear of fluid from the lesions establishes the diagnosis.
Which of the following is the most likely causal organism?
A) Chlamydia trachomatis
B) Haemophilus ducreyi
C) Neisseria gonorrhoeae
D) Streptococcus pyogenes (group A)
E) Treponema pallidum
4)A 5-year-old boy is brought to the physician 1 hour after
urinating bright red blood. He has been taking ibuprofen since injuring his
right flank while wrestling with friends yesterday; he also has been
taking penicillin for 3 days for streptococcal pharyngitis. His
temperature is 36.7 C (98 F), blood pressure is 90/48mm Hg, pulse is 108/min,
and respirations are 18/min. Examination shows purple ecchymoses over
the shins and right flank; there is tenderness of the right
costovertebral area. The abdomen is nontender. Genital examination shows no
abnormalities. There is no edema. Urinalysis shows gross blood;
microscopic examination shows 5–10 leukocytes/hpf and erythrocytes that
are too numerous to count. Which of the following is the most likely
explanation for this patient's hematuria?
A) Acute pyelonephritis
B) Ibuprofen-induced acute papillary necrosis
C) Post-streptococcal glomerulonephritis
D) Rhabdomyolysis
E) Traumatic injury to the kidney
5)
A 16-year-old girl comes to the physician for her first prenatal
visit at 12 weeks' gestation. She has not had any immunizations since
the age of 5 years. She has received the following immunizations at the
recommended ages:
5 Diphtheria-tetanus-pertussis
3 Hepatitis B
1 Measles-mumps-rubella
4 Oral poliovirus
Examination shows no abnormalities. Which of the following is the most
appropriate immunization to administer at this visit?
A) Diphtheria-tetanus-pertussis
B) Diphtheria (child)-tetanus toxoid
C) Diphtheria (adult)-tetanus toxoid
D) Haemophilus influenzae type b
E) Hepatitis B
F) Inactivated poliovirus
6)A 26-year-old man has had anxiety and insomnia since he lost his
job 1 month ago. He also has had palpitations, daily headaches, and
flatulence. He has no history of psychiatric disorders. His mother has
a history of bipolar disorder, mixed, and his father has alcoholism;
his younger sister had a history of drug abuse but has been abstinent
from drugs for 3 years. Which of the following is the most likely
diagnosis?
A) Adjustment disorder
B) Bipolar disorder, depressed
C) Generalized anxiety disorder
D) Major depressive disorder
E) Post-traumatic stress disorder
7)A 26-year-old man has had anxiety and insomnia since he lost his
job 1 month ago. He also has had palpitations, daily headaches, and
flatulence. He has no history of psychiatric disorders. His mother has
a history of bipolar disorder, mixed, and his father has alcoholism;
his younger sister had a history of drug abuse but has been abstinent
from drugs for 3 years. Which of the following is the most likely
diagnosis?
A) Adjustment disorder
B) Bipolar disorder, depressed
C) Generalized anxiety disorder
D) Major depressive disorder
E) Post-traumatic stress disorder
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| muna
Forum Senior
Topics: 17
Posts: 126
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E,A,B,E,C?,C?
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| ManuNastai
Transilvanian..
Topics: 55
Posts: 838
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B
A
B
E?
?C
?E
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| fongch
Forum Elite
Topics: 71
Posts: 316
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1 E
2 A
3 B - chancroid
4 E
5 C (or B? not sure)
6 A
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| sera
Forum Senior
Topics: 14
Posts: 141
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B
A
B
E
C
A
___________________
syra
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| nadiabarati
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but UW says systemic symptoms are seen in lymphogranuloma venereum!!! I mean Q 3 !
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| usmle12
Forum Senior
Topics: 19
Posts: 194
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E
A
B
E
C
A
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| fongch
Forum Elite
Topics: 71
Posts: 316
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What is the difference between adult and child form of DT vaccine?
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| ashfaque
Forum Newbie
Topics: 0
Posts: 142
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E
A
B
E
A
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| mister
Forum Newbie
Topics: 0
Posts: 5
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EABECA
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
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1. E
2. cannot answer
3. B
4. E
5. C
6. A
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The Key to Succeed is Patience.
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| docnikki
Forum Guru
Topics: 93
Posts: 680
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thanks everyone.
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| Sisdoc
Forum Senior
Topics: 28
Posts: 58
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can someplz tell me why for the 1st ques do u choose E . is B not the rt answer?? ....also is sensory neuropathy REVERISBLE in DM ???
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| anne09
Forum Newbie
Topics: 9
Posts: 30
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for first qusetion, I think it is B. Because good glysemic control only prevents microvascular comlications(nephropathy, peripheral neuropthy, retinopathy). Foot infections are from macrovascular comlications.
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| dr in trouble
Forum Guru
Topics: 62
Posts: 601
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B
Dont know
B
E
C
A
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If u want to do something, do it today as there is no tomorrow.
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| Justice
Forum Fanatic
Topics: 106
Posts: 2,139
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B
A
B
E
C
A
___________________
Don't live in a town where there are no doctors
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| Justice
Forum Fanatic
Topics: 106
Posts: 2,139
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anne09 wrote:
Foot infections are from macrovascular comlications.
Well, to be specific, foot problems in diabetics are due to traumas which they do not sense... Well-fitted shoes help avoid those... Glycemic control (A) has nothing to do with preventing the foot damage...
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| elitoki
Forum Guru
Topics: 54
Posts: 508
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nadiabarati wrote:
but UW says systemic symptoms are seen in lymphogranuloma venereum!!! I mean Q 3 !
it is painless.
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| elitoki
Forum Guru
Topics: 54
Posts: 508
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fongch wrote:
What is the difference between adult and child form of DT vaccine?
adult DT vaccine is indicated after 11yrs old. and it should complete 3 dosis of vaccine
child form is indicated for those who r allegic to pertussi component. Usually more than 7 yrs old and less than 11 yrs old.
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| elitoki
Forum Guru
Topics: 54
Posts: 508
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Sisdoc wrote:
can someplz tell me why for the 1st ques do u choose E . is B not the rt answer?? ....also is sensory neuropathy REVERISBLE in DM ???
pte already has irreversible neuropathy. the only way to prevent is using well-fitted shoes.
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| dr in trouble
Forum Guru
Topics: 62
Posts: 601
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yes--neuropathy is irreversible as nerves cannot regenerate.
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| tamerbashir
Forum Elite
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Posts: 284
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4-
WHY NOT Ibuprofen-induced acute papillary necrosis ?
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| neurom
Forum Senior
Topics: 3
Posts: 126
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1st Q: It could be sensory neuropathy or vascular neuropathy which both would lead to foot infection. Pt's ankle pulse is low, so I think this is vascular neuropathy and the answer is B.
Drug - induced papillary necrosis can cause hematuria but it is unlikely that it is a cause in this particular case.
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| filatino
Forum Newbie
Topics: 5
Posts: 25
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tamerbashir wrote:
4-
WHY NOT Ibuprofen-induced acute papillary necrosis ?
there would be pyuria plus hematuria in acute papallary necrosis
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| docamz
Forum Newbie
Topics: 0
Posts: 1
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i understand tht trauma to kidney wud prod hematuria but y wud u not chose post strep glomerulonephritis?
Is it becoz of the hypotension, rapid pulse, n other signs of hypovolemic shock?
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