Exam (elaborations)
NBME 10 REVIEW COMPLETE SOLUTIONS
- Course
- Institution
NBME 10 REVIEW COMPLETE SOLUTIONS
[Show more]
Content preview
NBME 10 REVIEW COMPLETE SOLUTIONS Why do you need to screen for TB before starting TNF -alpha inhibitor TNF -alpha is important for granuloma formation - when you inhibit this, granulomas break down and release contents --> active TB Treatment of sickle cel l pain crisis Aggressive pain control (with opiates and nonopioids), IV fluid resuscitation (to treat hypovolemia), supplemental oxygen Treatment of TACO (transfusion -associated cardiac overload) Oxygen or positive pressure ventilation if necessary Stop tra nsfusion Diuresis Reaction formation defense mechanism Changing an unacceptable impulse into its opposite (i.e. hating your sister --> intense love with buying lots of extravagant gifts for her) Delusional parasitosis treatment Rule out medical causes of symptoms Treat with antipsychotic and psychotherapy Unilateral or bilateral temporal lobe abnormalities on brain MRI, suspect what? HSV encephalitis Signs of HSV encephalitis Fever, AMS, seizure, focal neurologic deficits How to diagnose HSV encephalitis Lumbar puncture --> HSV -1 in CSF When is a stroke patient a candidate for alteplase If symptoms began less than 4.5 hours ago If not a candidate for alteplase, what should a stroke patient get? Aspirin Are anti -coagul ants used in the acute management of stroke? NO! Unilateral cervical lymphadenopathy with overlying purplish hue Mycobacterium lymphadenitis *would see caseating granulomas and organisms on acid -fast stain on biopsy Treatment of Mycobacterium lymphadenit is Surgical excision is definitive Sometimes antibiotics alone is enough in kids - treat with a macrolide and ethambutol with or without rifampin Most common causes of osteomyelitis S. aureus, Strep viridans, aerobic gram -negative bacilli Treatment of osteomyelitis IV antibiotics for 6 -12 weeks Suspected osteosarcoma on X -ray; next steps 1. MRI - evaluate extent of local invasion and allow for local staging 2. Bone biopsy 3. Aggressive surgical resection + chemo Signs of hypocalcemia Perioral paresthesia, carpopedal spasm, laryngospasm, prolonged QT interval Signs of hypomagnesiemia Typically asymptomatic, but if severe can lead to cardiac arrhythmias, seizures or tetany Signs of hyponatremia Nausea, malaise, lethargy, coma, seizures secondary to cerebral edema Signs of hypokalemia Muscle weakness, cramps, ileus, paresthesia, hyporeflexia, cardiac arrhythmias When to give IV fluids when a patient with heart failure, cirrhosis or ESRD has infection (like pneumonia)? If they are showing signs of hypovolemia (i.e. hypotension, AMS) *otherwise, do not give fluids! Right -heart MI on EKG ST elevation in II, III, avF What is contraindicated in right heart MI? Nitrates and opioids (lower preload even further - bad!) Acute management of right heart MI IV fluids !!! heparin, dual antiplatelet therapy, statinThe benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Estudyr. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
73918 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now