Surgery nbme form 4 - Study guides, Class notes & Summaries

Surgery NBME Form 4 - Questions and Answers obese 72 yo - ED 15 min after collapsed at home > wife reports he's had upper abd pain, n/v for past 24 hrs PMHx: HTN and CAD diaphoretic 97.7 F P: 115/min, irr irregular RR: 22/min palp sys BP: 80 mmHg PE: no JVD; lungs clear; no murmurs/gallops; abd tender/rigid pulm art cath: dec CI, mean pulm art pressure, PCWP; inc SVR predominant type of shock in this pt? hypovolemic shocks vs swan-ganz Cath parameters (cardiac index (CI), CVP, PCWP, SVR) 1...

Surgery NBME Form 2 - Questions and Answers 37 yo - ED 30 min after MVA arrival: abd pain vitals stable PE: abd - diffuse tenderness; dec bowel sounds supine X-ray shown - herniation of abd contents into thorax most likely dx? ruptured diaphragm hx of blunt trauma/MVA, abnormal CXR, left lower lung opacity, elevated hemidiaphragm, and mediastinal deviation MC on the left bc there's no liver to protect it CXR: herniation of abd contents into thorax 42 yo - 2 days of RU abd pain and gen itching...

Peds NBME Form 3 - Questions and Answers 18 month - 2 wks of URI PMHx: past 15 months - several episodes of AOM PE: L.TM bluish gray w/ visible landmarks; air-fluid level present behind inf 1/2 of TM; minimal movement on pneumatic otoscopy; R.ext ear, ear canal, and TM gucci most likely dx? serous otitis media pt prone to this considering they have had multiple AOM in the past air-fluid level = serous tx: probably tympanoplasty 6 month boy - difficulty breathing for 2 hrs low-grade fever, nasa...

NBME -OB/Gyn F1 (2023/ 2024 Update) Questions and Verified Answers|100% Correct| Grade A Q: 57 yo - routine exam PMHx: HTN, T2DM, gen anxiety disorder great aunt: hx of breast cancer tx: hormone therapy w/ estrogen and medroxyprogesterone daily since menopause 5 yrs ago meds: HCTZ, metformin, herbal meds breasts: no masses/nipple discharge what historical finding is greatest risk factor for breast cancer in this pt? Answer: hormone therapy pt has been taking estrogen and medrox...

Surgery NBME Form 1 - Questions and Answers 42 yo - hospital w/ piece of meat lodged in lower esophagus meat removed by esophagoscopy w/ difficulty evening - 101 F most app dx study? water-soluble contrast upper gastrointestinal study don't repeat what procedure damaged her esophagus water-soluble aka gastrograffin - dx esophageal rupture neck x-ray - if food/thing stuck in oropharynx upper GI study - if want to look at thorax if this procedure is non-dx > Ba study if perforation confirmed...

Surgery NBME Form 3 - Questions and Answers 3 wk old - 18 days of inc yellow skin/eyes born to 24 yo woman, G2P2, uncomplicated preg/delivery > 3175g at birth breast-fed exclusively today weights 3345g BR = 15 (direct - 13) most likely dx? biliary artesia suspected in 6-8 wk old babies - persistent, prog inc jaundice (more conj) dx: 1 wk of phenobarbital > HIDA scan if no bile reaches duodenum w/ phenobarbital > surgical exploration 22 yo - pain/edema of R.upper ext > 10 days after...

Ob-Gyn NBME Form 2 - Questions and Answers 37 yo - G8P8 - inc vag bleeding over last 5 hrs abd exam: gucci bimanual/rectal exams: 8 cm mass of upper cervix and R.parametrium no ovary palpated separately CT: R.hydroureter above level of mass most likely dx? squamous cell carcinoma of the cervix mass is clearly big and has spread due to ability to palpate mass and hydroureter present involvement of bowel/bladder (a) or distant mets (b) > stage 4 tx: surgery or chemo parametrium = fibrous/fatt...

Peds NBME Form 2 - Questions and Answers 1 hr after delivery - newborn in resp distress 28 wks gest mom: prenatal care; intrapartum AB ppx APGAR: 8, 8 PE: grunting, nasal flaring, and intercostal retractions CXR: granular appearance of parenchyma w/ air bronchograms most likely dx? RDS of newborn path: surfactant def > atelectasis infant - premature, presents w/ grunting CXR: low long volumes (hypoextended), uniform granular pattern tx: surfactant and mech ventilation if severe VS TTN path:...

Ob-Gyn NBME Form 3 - Questions and Answers 47 yo PSHx: TAH + BOS for leiomyomata uteri (6 wks ago) no hx of abnormal Paps PE: well-healing incision next step regarding future Paps? no longer indicated can stop screening at 65-70 yo, 3+ normal Pap tests in a row w/o CIN2/3 or higher in past 20 yrs, or if woman had TAH for benign indications and no hx of CIN2/3 or higher hx of CIN2/3 w/ TAH + 3 consecutive neg screening tests can stop 32 yo - 2 days of vag bleeding and lower abd cramps LMP: 7 wk...