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Peds NBME Form 4 Correct Questions & Answers; Latest 2023 / 2024
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Peds NBME Form 4 Correct Questions & Answers
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Peds NBME Form 4 3 yo boy - F/U after tx for ear infection PMHx: recurrent ear infections, sinusitis, and bacterial PNA (twice); 2 sets of tympanostomy tubes for AOM mom - HIV neg PE: small anterio r cervical lymph nodes most likely mechanism? Correct Answer: antibody deficiency MC: B -cell def present after 6 months w/ recurrent sinopulmonary, GI, and UTI infections w/ encapsulated organisms tx: IVIG, ppx AB 15 yo boy - 2 days of fever and inc sever HA and malaise PMHx: recurrent PNA (last episode 2 yrs ago) SHx: immigrated from Mexico T: 102.8F P: 120/min RR: 34/min BP: 146/94 mmHg PE: nuchal ridigity; crackles over LLL MSE: oriented to person LP - CSF ana lysis: inc opening pressure, proteins, leukocytes (85% segs, 15% lymphocytes), RBCs; dec glucose most likely dx? Correct Answer: pneumococcal meningitis def bacterial meningitis - very high cell count, dec glucose, inc protein, and PMNs (segs) make up th e WBCs for fungal and viral - would see majority lymphocytes cryptococcal meningitis - seen in those w/ AIDS and CD4 count < 200 based on the choices given - this is the only realistic bacterial choice 9 month boy - 2 months of "ignoring parents" doesn 't appear startled by loud noises born at term mom's blood: A, Rh - infant's blood: A, Rh+ at 2 days: TsB - 25 mg/dL; phototherapy for 2 days mildly jaundiced until 1 month serum studies and PE: gucci would would have prevented the baby's current condition? Correct Answer: exchange transfusion should have been done bc BR was severely elevated in the baby (>20 mg/dL) this is started earlier for premies (10 -15 mg/dL) babe probably has isoimmunization du e to incompatible blood types > unconj hyperBR w/ + Coombs major irreversible complication of unconj hyperBR = kernicterus baby prob has this due to his weird behavior 2 yo girl PE: 2/6, crescendo -decrescendo systolic murmur w/ musical quality heard best at lower L.sternal border w/ no radiation ECG: gucci next step in mgnt? Correct Answer: reassurance that this is a benign murmur innocent murmurs are never diastolic or > grade 3/6 these don't need workup unless they persist or no longer meet the ab ove criteria workup w/ CXR, EKG, and *echo* 6 hour female - cyanosis of arms/legs since birth 38 wks gest weight: 3090 g breast -feeding well T: 97.2F P: 112/min RR: 36/min BP: 80/45 mmHg O2sat: 96% PE: cyanosis of upper/lower ext but no circumoral cyanosis cap refill time: mildly delayed next step in mgnt? Correct Answer: placement of the newborn under warming lights the baby's vitals esp O2sat are all good baby needs to be stimulated and warmed up (bc 97.2 is a bit low)The benefits of buying summaries with Stuvia:
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