c*******c
发帖数: 62 | 1 对 CK NBME 问题有疑问的朋友，欢迎你们贴问题上来，大家一同讨论。
发问时请记得註明 NBME Form 及题号，以供日後整理。建议发问时把题目 type 或
paste 上来，以便得到更多及更快的回复。
我会儘量试著每天上来回复,也欢迎任何知道答案的朋友一同参与协助讨论提供解答。 |
s**j
发帖数: 196 | 2 非常感谢。
【在 c*******c 的大作中提到】
: 对 CK NBME 问题有疑问的朋友，欢迎你们贴问题上来，大家一同讨论。
: 发问时请记得註明 NBME Form 及题号，以供日後整理。建议发问时把题目 type 或
: paste 上来，以便得到更多及更快的回复。
: 我会儘量试著每天上来回复,也欢迎任何知道答案的朋友一同参与协助讨论提供解答。
|
s***i
发帖数: 32 | 3 4 questions from Form 4
4-2-14 A 57-year-old women comes to the physician because of a 2 year
history of progressive cough productive of 2-3 tablespoons of yellow sputum
daily. It is worse in the mornings and now last all day. She can not walk
more than one block w/o becoming short of breath. She has not had fever,
hemoptysis, night sweats, or weight loss. She has smoked two packs of
cigarettes daily for 40 years. She is 160 cm tall and weighs 180lb; BMI is
32kg/m2. Her pulse is 96/min, respi |
c*******c
发帖数: 62 | 4 3-3-44
Both serum K and serum Ca are low. This pattern is highly suggestive of
hypomagnesemia. Given that the serum Mg is only 0.8mEq/L, this confirms our
suspicion; therefore, the answer is B.
I agree that theoretically hypomagnesemia should give hyperactive DTRs, but
this guy has probably got alcoholic peripheral neuropathy, so DTRs are not
very reliable at all.
3-3-26
I remember looking up this question as well. I think in early septic shock,
preload and afterload are decreased, and myocardia |
c*******c
发帖数: 62 | 5 4-2-14
Just by reading the first sentence, the alarm bell should be ringing for
chronic bronchitis. Remember the Dx is made clinically with a Hx of chronic
productive cough that occur most days for at least three months per year for
at least two years. Patient’s smoking Hx is highly consistent with this
condition as well. Answer is A.
Let’s look at some other answer choices:
B – usually has much earlier onset in childhood.
D – congenital
E – usually post-viral URTI, wouldn’t be as chronic
C is a |
w**m
发帖数: 4061 | 6 不懂，不过友情帮顶
最近还好吧？ ＝）
【在 c*******c 的大作中提到】
: 对 CK NBME 问题有疑问的朋友，欢迎你们贴问题上来，大家一同讨论。
: 发问时请记得註明 NBME Form 及题号，以供日後整理。建议发问时把题目 type 或
: paste 上来，以便得到更多及更快的回复。
: 我会儘量试著每天上来回复,也欢迎任何知道答案的朋友一同参与协助讨论提供解答。
|
e*****a
发帖数: 1334 | 7 Thanks for chihpengc's effort. |
L********g
发帖数: 17 | 8 NBME form 4 1 17
a 72 year old man is brought to the physician by his wife because of a 6
month history of difficulty walking, cognitive decline, and urinary
incontinence. he has not had dysuria or nocturia. his wife says that his
short-term memory is decreased and he has had internittent confusion. on
examination, he has a broad based, short stepped gait with some reduction of
step height. he is oriented to person and place but not to time. he learns
four words with some difficutly and recalls |
L********g
发帖数: 17 | 9 Form 4 section 1
a 10 month old infant is brought to the emergency department because of
labored breathing for 1 hour. she has had cough, coryza, and fever for 18
hours. her temperature is 39 C, pulse is 120/min, respirations are 54/min,
and blood pressure is 82/60 mmHg. Pulse oximetry shows an oxygen saturation
of 92%. bilateral wheezes and basilar crackles are heard. select the most
likely pathophysiology of the respiratory problem
a) allergen induced bronchospasm
b) barotrauma related alveola |
s******t
发帖数: 71 | 10 Thanks!
form2-1-21.
A previously healthy 85-year-old man has hadabdominal distention, decreased
caliber of stools, and decreasedappetite over the past 2 weeks and a 9-kg (
20-lb) weight loss over the past 3months. On sigmoidoscopy, he is found to
have a constrictingadenocarcinoma of the sigmoid colon; imaging studies show
three 1-cmmetastases to the liver. Which of the following is the most
appropriate nextstep in management?
A) No treatment
B) Radiation therapy
C) Chemotherapy
D) Combination ra |
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s******t
发帖数: 71 | 11 Form2-1-43
A 7-week-old boy is brought to the physicianbecause of fever, irritability,
and lethargy for 3 days. He has had novomiting, diarrhea, or symptoms of an
upper respiratory tractinfection. He always seems hungry to his mother
despite being fed 3 ounces offormula every 3 hours. His mother also notes
that he has many wetdiapers throughout the day and night. He currently
appears irritable. Histemperature is 37.8 C (100 F), blood pressure is 80/50
mm Hg, pulse is150/min, and respirations are |
L********g
发帖数: 17 | 12 NBME form 4 section 1
a 2month old boy is brought to the physician for a well child examination.
he was born at term following an uncomplicated pregnancy, labor and delivery
. he has been breast-feeding six to eight times daily since birth. he smiles
and lifts his head. he is at the 50th percentile for length, 75th
percentile for weight, and 25th percentile for head circumference.
examination show no abnomalities. his mother asks for nutritional
recommendations. which of the following is the mos |
s***i
发帖数: 32 | 13 先谢谢Chihpengc的耐心而详细的解答，我已经把你的解答附在我发的问题的下面了，
这样其他同学看的话也比较容易些。下面是5道FORM3的题，麻烦了。
3-1-10 On the fifth day of a 7-day cruise in the western Caribbean, a 37 yo
woman develops headaches, fever, chills, abdominal discomfort, and watery
diarrhea over a 12-hour period. Many other passengers and crew members have
had similar symptoms. Her temperature is 37C. Abdominal examination shows
diffuse tenderness without rebound; bowel sounds are hyperactive. Her
leukocyte count is 11,000/mm3.Gram’s stain of a stoo |
c*******c
发帖数: 62 | 14 wzxm - 最近还行，就是忙申请住院医的东西咯。我现在人在澳洲，九月底才回美国。
很久没看到你上线了，你有看到我前几天写的一篇文章吗?
http://www.mitbbs.com/article_t1/MedicalCareer/31283209_0_2.html
ericusa - 也感谢 eric 平日热心的解答大家的问题。 |
c*******c
发帖数: 62 | 15 4-1-17
E. Ataxia + dementia + urinary incontinence = normal pressure hydrocephalus. Urinary incontinence is a result of failure to inhibit the voiding reflex and subsequent detrusor overactivity
4-1-?
E. This is classic presentation of bronchiolitis (RSV infection). I don’t see why you wanted to ask this question in particular.
2-1-21
C. Colon cancer is not particularly radiosensitive.
2-1-43
This one is quite tricky. The presentation reminds me of congenital adrenal hyperplasia (salt wasting ty |
s******t
发帖数: 71 | 16 Thank you so much.
For 2-1-43, if you have to choose one, which one do u prefer? From history,
it seems the baby only has 3 days of diarrhea. Why do you consider he has
congenital adrenal hyperplasia?
What I am thinking is that he is definite in hypovolemic status, so I choose
D. But the answer I got is C.
Would you please rethink about this question? |
s***i
发帖数: 32 | 17 For 3-3-8
Is it also required to obtain consent to collect postmortem blood sample for genetic testing? For this case, the
death is from unexpected reason, is it possible that the autopsy should be mandatory?
Thank you! |
c*******c
发帖数: 62 | 18 slimfast:
I'd have to go with B.
His dehydration is not due to diarrhea, as the question stem stated that he
has not had vomiting, diarrhea, or symptoms of an upper respiratory tract
infection.
Also another clue to CAH is that has had many wet diapers throughout the day
and night. This is due to 21-hydroxylase deficiency -> low
mineralocorticoid -> decreased sodium reabsorption in the distal tubule ->
diuresis
sensi:
I don't know. Would you like to find out and let us know? |
s***i
发帖数: 32 | 19 chihpengc, thank you and I will ask ppl in pathology for 3-3-8
1-1- 4. A 21-year-old African American college student has had increasing
fatigue over the past 3 weeks. Since an episode of cystitis treated with
trimethoprim-sulfamethoxazole 3 weeks ago, he has been unable to keep up
with his physical education classes. For 6 months, he has been following a
vegetarian diet that has been supervised by student health services.
Examination shows no abnormalities. His hemoglobin level is 10 g/dL, mean |
c*******c
发帖数: 62 | 20 1-1-4
B. G6PD deficiency is usually acute to subacute and triggered by oxidative
stress, which is consistent with this pt’s presentation. SCD, on the other
hand, would be symptomatic from the age of 6 months (once HbF level drops
off).
1-1-5
C. The presentation is typical of aspiration pneumonia, which is predisposed
by a decreased gag reflex. Even if this case were about community-acquired
pneumonia, the Immune response usually involved (e.g. pneumococcus) would be
antibody-dependent (against p |
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s***i
发帖数: 32 | 21 首先，要谢谢chihpengc这几天来对我们的问题的耐心回复；
问这么多问题，的确没有想滥用你的善良的意思。毕竟应届医学院毕业生+step1/2超高
分得主+会来这个版上分享经验的同学不多，带着敬仰的心情想知道你的离标准最近的
答案是什么，叨扰了。
哦，对于 3-3-8，我今天问了一个病理三年级住院医，她个人认为B is better. |
c*******c
发帖数: 62 | 22 Thanks for the follow-up and feedback. |
M********e
发帖数: 2528 | 23 1-1-9. I. or B?
mainly because of this sentence in the stem " she has difficulty remembering
past events and seems unconcerned about her memory lapses. ".
It is said that usually depressive pts are more concerned about their memory
decrease, rather than unconcerned typically shown by AD pts. |
c*******c
发帖数: 62 | 24
Thanks
I agree. The answer is C. |
f****s
发帖数: 126 | 25 I think this is illegal. You have no right to paste NBME form questions here
. You may get issues later on. Please to be careful. |
