Medicine NBME 1 Thread

[JJB123]

Hi all. I had some questions about the NBME 1 thread:
1. older man w/dm2, unresponsive. high glucose -- due to HOGS/osmotic diuresis?

2. Older male w/fatigue and eosinophilia and weight loss. What's the next step in diagnosis?
a. ACTH stim test
b. 3 serial tests of stool for ova/parasites
c. measure urine ph
d. blood culture
e. hiv Ab test
f. renal US
g. bone marrow biopsy

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[JJB123]

3. Treatment for 62yo m w/prostatitis? Cipro?

4. 37yo f w/elevated BP, mild asthma treated with a ICS prn and IUD.
adverse effect of levonorgestrel (wrong)
cortisol excess
focal areas of renal ischemia
mineralocorticoid excess (guessing this one?)
Ne, epi and DA excess

5. tx for a 67 yo f w/podagra on HCTZ and aspirin, seems acute
acetaminophen (wrong)
allopurinol
indomethacin
prednisone (this?)
probenecid

6. prevent CVA in 77yo f w/afib and HTN on HCTZ and ACEi
aspirin (wrong)
clopidogrel (this?)
dipyridamole
warfarin
nothing

7. 48yo m w/chest pain to the left arm and back. AR murmur I think. nonspecific ST-T wave changes. CXR small left pleural effusion. dx?
aortic dissection
bacterial endocarditis
PE
ruptured pulmonary bleb
unstable angina pectoris

8. 37 yo f w/a 0.5cm slightly raised round brown nevus w/symmetric borders for 15 years. 4mm moveable inguinal lymph node. next step in diagnosis?
observation
biopsy of lymph node
excision biopsy of nevus w/rim of normal skin
incisional biopsy of nevus
needle biopsy of nevus

9. 42 yo f w/muscle weakness - was this ALS? I put polymyositis.

10. what prevents a relapse of asthma? oral CS?

11. the question about the f/u appt after a perforated diverticulitis. pt had a fever and eosinophilia and was on levo and metro. I saw that people said it was a drug allergy. Why is it that over an intra-abdominal abscess? no eosinophilia w/an abscess?