NBME 9
Kid with bed wetting problems + constipation
tx?
administration of an osmotic laxative
Multiple myeloma is marked by proliferation of ______ B cells
monoclonal
In patients with bipolar disorder that are suffering from acute depression +
stopped taking meds, what do you give them?
bipolar medication like lithium, lamotrigine, quetiapine, and lurasidone
SSRIs in bipolar patients can be bad because?
it can precipitate mania or convert depression to mania
Patient with afib with a history of TIA or stroke
Tx?
warfarin
Patient without afib with history of TIA or stroke
Tx?
aspirin
T/F: Aspirin and clopidogrel are anticoagulants
false
1st line therapy for mild to moderate acne vulgaris
Tx?
topical retinoids
Patient with juvenile idiopathic arthritis may present with what extraarticular
manifestation?
uveitis (screen with slit-lamp exam)
In adults, the presence of a destructive bone lesion is more commonly caused by
______ disease rather than primary bone malignancy
metastatic
T/F: Osteosarcoma is most common in patients ____ years of age
<30
Patients with severe AS with symptoms or systolic dysfunction (EF <50%) should
receive what tx?
aortic valve replacement
Patients with HF (EF < 50%) who have AS + asymptomatic in terms of SOB on
exertion, should receive what treatment?
Afterload reduction
32 yo woman with bcg vaccine as a child + emigrated from China + PPD skin test
of 12 mm
risk status and next step?
, High risk; isoniazid
92 yr old with left mandibular mass that has enlarged + x ray is normal + smoker +
normal VS
next step?
biopsy
77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on
diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 +
edema + signs of kidney injury
Dx and next step?
fluid overload; hemodialysis
In diabetic patients, foot injuries can be prevented with?
wearing shoes when standing or walking
In diabetic patients, worsening of foot injuries can be prevented with?
daily foot checks
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
potential dx and next step?
endometrial malignancy; colposcopy with endocervical curettage
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
After colposcopy with endocervical curettage, what can be considered as a next
step?
hysteroscopy
T/F: Neonate that improved with PPV can be taken off of PPV immediately after
true
If there is suspected FSGS, what is the next step?
renal biopsy
If there is suspected FSGS, what is the next step after confirming it with renal
biopsy?
prednisone therapy
1st line tx for Merniere's disease
antihistamines (e.g. Meclizine)
2nd line tx for refractory Merniere's disease
methylprednisolone
T/F: Initial step to controlling allergic rhinitis can include use of pillow and
mattress covers
true
COPD exacerbations can be treated with?
supplemental oxygen, SABA, steroids, antibiotics, and nebulizers
COPD daily management should include?
LABA, tiotropioum, steroids
T/F: Oral steroids are the main daily treatment for chronic COPD patients.
Kid with bed wetting problems + constipation
tx?
administration of an osmotic laxative
Multiple myeloma is marked by proliferation of ______ B cells
monoclonal
In patients with bipolar disorder that are suffering from acute depression +
stopped taking meds, what do you give them?
bipolar medication like lithium, lamotrigine, quetiapine, and lurasidone
SSRIs in bipolar patients can be bad because?
it can precipitate mania or convert depression to mania
Patient with afib with a history of TIA or stroke
Tx?
warfarin
Patient without afib with history of TIA or stroke
Tx?
aspirin
T/F: Aspirin and clopidogrel are anticoagulants
false
1st line therapy for mild to moderate acne vulgaris
Tx?
topical retinoids
Patient with juvenile idiopathic arthritis may present with what extraarticular
manifestation?
uveitis (screen with slit-lamp exam)
In adults, the presence of a destructive bone lesion is more commonly caused by
______ disease rather than primary bone malignancy
metastatic
T/F: Osteosarcoma is most common in patients ____ years of age
<30
Patients with severe AS with symptoms or systolic dysfunction (EF <50%) should
receive what tx?
aortic valve replacement
Patients with HF (EF < 50%) who have AS + asymptomatic in terms of SOB on
exertion, should receive what treatment?
Afterload reduction
32 yo woman with bcg vaccine as a child + emigrated from China + PPD skin test
of 12 mm
risk status and next step?
, High risk; isoniazid
92 yr old with left mandibular mass that has enlarged + x ray is normal + smoker +
normal VS
next step?
biopsy
77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on
diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 +
edema + signs of kidney injury
Dx and next step?
fluid overload; hemodialysis
In diabetic patients, foot injuries can be prevented with?
wearing shoes when standing or walking
In diabetic patients, worsening of foot injuries can be prevented with?
daily foot checks
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
potential dx and next step?
endometrial malignancy; colposcopy with endocervical curettage
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
After colposcopy with endocervical curettage, what can be considered as a next
step?
hysteroscopy
T/F: Neonate that improved with PPV can be taken off of PPV immediately after
true
If there is suspected FSGS, what is the next step?
renal biopsy
If there is suspected FSGS, what is the next step after confirming it with renal
biopsy?
prednisone therapy
1st line tx for Merniere's disease
antihistamines (e.g. Meclizine)
2nd line tx for refractory Merniere's disease
methylprednisolone
T/F: Initial step to controlling allergic rhinitis can include use of pillow and
mattress covers
true
COPD exacerbations can be treated with?
supplemental oxygen, SABA, steroids, antibiotics, and nebulizers
COPD daily management should include?
LABA, tiotropioum, steroids
T/F: Oral steroids are the main daily treatment for chronic COPD patients.
