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NBME 4 STEP 3 PRACTICE EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE.
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NBME 4 STEP 3 PRACTICE EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE.
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NBME 4 STEP 3 PRACTICE EXAMQUESTIONS WITH CORRECT ANSWERS
LATEST UPDATE
65 uuyo uuF uuhas uua uu3 uumonth uuhx uuof uu*increasing uulow uuback uupain*. uuHad uulow
uuback uupain uufor uupast uu3 uuyrs uuthat's uubeen uutreated uuw/NSAIDs uuand uucodeine.
uuNow uurated uuas uu7/10 uuin uuseverity. uuPain uuradiates uuto uuboth uulegs, uuworsens
uuwhen uuwalking uuor uustanding uu& uuRelieved uuwhen uusitting. uu1 uuYEAR uuAGO: uuX
uuray uulumbosacral uuspine: uumild uuosteoarthritis. uuExam: uu4/5 uumm uustrength uuLE,
uuhyporeflexia uuof uuknees&ankles uub/, uuunsteady uugait uub/c uuof uupain. uuNo uuother
uuabnormalities. uuMost uuappropriate uudiagnostic uustudy uuof uulumbosacral uuspine uuto
uuorder uuat uuthis uutime? uu- uuAnswer uu*MRI*
-prly uub/c uuthis uupain uuis uuworse uuthan uuthe uuusual uupain uu& uuneuro uusx uuof
uuhyporeflexia, uudecreased uumm uustrength, uuand uuunsteady uugait
A uucouple uucomes uuto uudiscuss uuthe uuresults uuof uuprenatal uutesting uuin uucurrent
uupregnancy. uuScreening uutest uushowed uuincreased uurisk uufor uuhaving uua uuchild
uuw/Down uusyndrome. uuAmniocentesis uuis uusuggested uufor uuher. uuHusband uuasks
uu"When uucan uuwe uuschedule uuthe uuamniocentesis? uuI uuthink uuthat uuwe uushould
uujust uuget uuon uuw/it." uuWife uuresponds uuangrily, uu"That's uueasy uufor uuu uuto uusay. uuU
uuhaven't uubeen uucarrying uuthis uubaby uufor uu4 uumonths uu& uuu uuhaven't uufelt uuit
uumove uulike uuI uuhave. uuAppropriate uuresponse? uu- uuAnswer uu"I uuknow uuthis uuis
uudifficult uunews uufor uuboth uuof uuu. uuI uuwould uulike uuto uuknow uuwhat uuboth uuof uuu
uuare uuthinking uunow"
3 uuy.o. uuboy uuis uuat uu50th uu%tile uufor uuheight&weight. uuExam: uuhemihypertrophy uuof
uuleft uuside uuof uubody uuwhen uucompared uuto uuright. uuPalpable uumass uuin uuLLQ.
uuLabs: uuHgb uu12, uuHct uu36%, uuUrine: uuSG uu1.020, uuWBC uu0-1/hpf, uuRBC
uu10-20/hpf. uuU/S: uuleft uukidney uumass. uuDx? uu- uuAnswer uu*Wilms uutumor*
-most uucommon uuRENAL uumalignancy uuin uukids
-age uu<5
-*Unilateral, uuPAINFUL, uuabdominal uumass*
-HTN, uuhematuria
neuroblastoma uu- uuAnswer uumost uucommon uuextracranial uusolid uutumors uuin uukids
-painLESS uuabdominal uumass
-may uuhave uuHTN uuDue uuto uumass uucompressing uurenal uuartery uuand uuactivating
uurenin-angiotensin uusystem uu
-FLUSHING uu&SWEATING uudue uuto uucatecholamine uuhypersecretion
-neural uucrest uuorigin
-involves uuadrenal uumedulla, uusympathetic uuchain
-median uuage uu<2
, -*periorbital uuecchymoses(orbital uuMETASTASES)*
-spinal uucord uucompression uufrom uuepidural uuinvasion("dumbbell uutumor")
-opsoclonus-myoclonus uusyndrome
DX: uuelevated uucatecholamine uumetabolites, uusmall&round uublue uucells uuon
uuhistology, uuN-myc uugene uuamplification
58 uuyear uuold uuF uuhas uuheavy uusubsternal uuchest uupain uurelieved uuby uunitroglycerin
uu& uurest. uuPain uuoccurs uuw/exertion&accompanied uuby uusome uuSOB&sweating. uu6
uumonths uuago: uuCABG. uuVSS. uuECG: uuNSR uuw/*inverted uuT uuwaves uuNEW uuin
uuleads uuV4-V6.* uunext uustep uuin uuevaluation uuis uuto uudo uuwhich? uu- uuAnswer
uu*Repeat uucoronary uuartery uucatheterization*->NOT uuorder uuecho uuor uuMUGA uuscan
-maybe uub/c uuof uuNEW uuinverted uuT uuwaves?
70 uuyo uuhas uu1 uuwk uuhx uuleft uueyelid uudroop. uuPMG uuCOPD&Quit uusmoking uu5 uuyrs
uuago. uuTroublesome uupain uuradiating uudown uuleft uuarm. uuLeft uuptosis uuw/small uupupil
uuon uuexam. uuDiagnostic uustudy? uu- uuAnswer uu*CT uuscan uuthorax*
-prly uupancoast uutumor
65 uuyo uuF uuhad uu2 uumin uugeneralized uutonic-clonic uuseizure uuthat uuoccured uuwhen
uuasleep. uuPMH: uuHTN, uubreast uucancer uu2 uuyrs uuago uus/p uulumpectomy, uuradiation
uutherapy, uuadjuvant uuchemo uu1 uuyr uuago. uuMeds: uulisinopril, uutamoxifen.Pt uuis
uudrowsy, uunot uuoriented uuto uuperson,place,time. uuBP uu160/95. uuPulse uuox
uu95%.Exam: uuright uulower uuface uudrooping. uuEyes uuconjugately uudeviated uuto uuleft.
uuBriskly uuwithdraws uuLUE uu& uuboth uuLE uuto uunoxious uustimuli; uuthere's uuno
uumovement uuof uuRUE. uuFingerstick uuBG uu70, uuserum uusodium uuconcentration uu130.
uuCAUSE uuof uuseizure? uu- uuAnswer uu*Brain uumetastasis* uuprly uufrom uubreast
uucancer
-looks uulike uushe uugot uua uustroke
strongest uupredisposing uufactor uufor uuprostate uucancer uu- uuAnswer uuage uu(old)
32 uuyo uuF uu6 uuday uuf/u uufor uu12 uucm uulipoma uuremoval uufrom uuleft uulateral uuthigh.
uuFor uupast uu2 uudays, uushe uuhad uuswelling uu&mild uuincrease uuin uutenderness uuon
uuand uuaround uuincision uusite. uuExam uuof uuincision uusite: uububble-like uuswelling
uuunderneath uuincision uuw/o uuerythema, uudrainage uuor uulymphadenopathy. uuArea uuis
uuballotable uu& uufluid uuwave uuon uupalpation.DX? uu- uuAnswer uu*Seroma*=pocket uuof
uuclear uuserous uuFLUID uu-common uuafter uusurgery
-ballotable uumeans uusignificant uueffusion
28 uuyo uuF uuG1P1 uuat uu33 uuwks uugestation uuin uuactive uulabor. uuRR uu22. uuExam:
uunontender uuabdomen. uufundal uuheight uu36 uucm. uupelvic uuultrasound uushows
uupocket uuof uuamniotic uufluid uu91.5 uumm. uuUnderlying uucause? uu- uuAnswer uu*Fetal
uuesophageal uuatresia* uu(not uufetal uupolycystic uukidneys)
66 uuyo uuIrish uuAmerican uuman uuhas uuSOB uuon uuexertion uufor uupast uu6 uumonths,
uubut uunow uupresent uuwhen uuclimbing uu1 uuflight uuof uustairs. uu+Dry uucough. uuRetired
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