11-year-old girl presents With tanner stage one of the pubic hair, she has a flat left breast and the right breast is tender and a small mass
What is the best next step? - Answer Reassurance
This is normal thelarche and can be asymmetric
Order of maturation in female - Answer Thelarche, ...
Nbme 10 Midterm Exam Questions
Solved Correctly.
11-year-old girl presents With tanner stage one of the pubic hair, she has a flat left breast and the right
breast is tender and a small mass
What is the best next step? - Answer Reassurance
This is normal thelarche and can be asymmetric
Order of maturation in female - Answer Thelarche, pubarcge, growth spurt, menarche
27-year-old man presents with thrombocytopenia, eczema and recurrent infections - Answer Wiskott-
Aldrich, WAS gene,
Patient comes in with ulcerative colitis Treated with prednisone mesalamine and much more and the
doctor decides to add a regimen, due to the addition of the regimen what should be tested next -
Answer Tuberculosis screening, due to initiation of TNF alpha inhibitor
Patient with sickle cell disease comes in with vaso-occlusive crisis it is given pain control what else should
be given with the pain control? - Answer Intravenous fluids
Patient with a MI 10 years ago Comes to the hospital due to vomiting. The patient ends up getting a
transfusion and 30 minutes later starts developing shortness of breath, what is the most likely cause? -
Answer Transfusion associated circulatory overload
Remember: patience with ABO incompatibility present with flank pain and hypotension
Treatment of transfusion associate circulatory overload - Answer Oxygen and positive pressure
ventilation And possible directions
Can lead to psychosis, bizarre behavior, agitation, aggression, nystagmus and ataxia
treatment - Answer PCP intoxication
, Treatment: IM lorazepam or Midazolam
38-year-old woman comes in due to seizures, MRI demonstrates unilateral or bilateral temporal lobe
abnormalities, what is the next best step? - Answer Lumbar puncture: HSV encephalitis
If a patient has stroke like symptoms occurring less than 4 1/2 half hours Without signs of hemorrhage
what is administered? - Answer Alteplase
If the patient comes in with a stroke in the amount of time is unknown, with no evidence of hemorrhage
what is administered? - Answer Aspirin instead of alteplase
Bell's palsy Presents with facial nerve palsy causing facial paralysis that doesn't spread the forehead,
what is the next best step?
Treatment: - Answer It's diagnose clinically, no further testing indicated
Treatment: glucocorticoids and occasionally antiviral therapy
Patient after gastric bypass presents with ataxia, altered mental status and opthalmoplegia including
nystagmus, most likely cause? - Answer Vit B1 def
Immunocompetent child with cervical lymphadenitis presents with a purpleish hue, And presence of
multiple granulomas on excisional biopsy - Answer Purpleish hue: mycobacterium infection
Patient presents with a 2 cm ulcer on the foot and new mid back pain, what is the most likely cause and
what is the next best step to confirm the diagnosis? - Answer Vertebral osteomyelitis, MRI of the
lumbar spine.
Can occur through hematogenous spread
Patient with a history of inflammatory joint disease are at increased risk for - Answer Septic arthritis
An x-ray showing periosteal elevation is diagnostics for osteomyelitis, what is the next best step? -
Answer MRI before bone biopsy
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