MCCQE I Exam Questions And Answers(SCORED A+)

Pt is competent and agrees to a procedure but his proxy refuses, what do you do ? - ANSWER Do procedure, PT is competent and overrides the proxy CPSS (Canadian perinatal surveillance system) - ANSWER Abuse during preggy results in poor fetal and maternal outcome Violence was measured on the basis of the conflicts tactics scale low birth weight and early birth Pt O/D on opiates, what should you set up before discharge? - ANSWER Next day meeting with her own PCP MCC hearing loss in children? - ANSWER Bacterial meningitis Lady with HTN on CCB, what side effect can she have? - ANSWER Galactorrhea....PRL Referral to an audiologist in child when: - ANSWER No babbling sound by 12 no rxn to sound by 3 months no resposne to smiles or interactions by 6 months no single words by 16 months no two word phrases by 24 months speech hard for strangers to understand no following of directions by 4-5 years In terms of breast masses, what would you think of a coarse popcorn type calcification - ANSWER Not malignant, most likely fibroadenoma What are scary calcifications to see? - ANSWER Microcalcifications less than 0.5 mm in size fine or branching Wing scapula after mastectomy - ANSWER LTN Tamoxifen effect on osteoporosis? Side effects? - ANSWER In breast it's an antagonist of ER, elsewhere it is an agonist of ER: osteoprotective Increases risk of DVT, endometrial carcinoma, hot flushes increased risk of CATARACTS When to use Tamoxifen vs Anastrozole - ANSWER before and after menopause ovary vs fat estrogen (aromatase) What receptor is a negative prognostic factor in breast Ca? - ANSWER HER-2/neu ER is a positive prognostic factor Mild vs severe preecclampsia difference? - ANSWER Severe has pulmonary edema, fetal growth restrictions, thrombocytopenia, headache, abd pain, visual changes (basically severe has Sx`s whereas mild is detected only by tests) What risk factors increase the risk of preeclampsia? - ANSWER chronic HTN, twin gestation, maternal age 35+, obesity, AA ethnicity, socioeconomical status, nulliparity Cause of urinary incontinence in multiple sclerosis? Rx? - ANSWER Detrusor muscle hyperactivity Give oxybutynin and bladder training Pt in accident with full bladder, urine seen in peritoneumÉ where was injury? - ANSWER Dome or anterior wall of bladder (they are covered by peritoneum) 9-12 month old kid with fever then erythrematous maculopapular rash, 15% of them have febrile seizure,Dx? Rx? - ANSWER Roseola infantum HHV-6/ 6th disease Rx is supportive, no serious sequelae Conjunctivitis and coryzea with rash on face: - ANSWER Measles-----Give VitA Possible rare complication? Subacute sclerosing panencephalitis What is erythrema infectiosum? - ANSWER Fifth disease of slapped cheek appearance (ParvoB19) Also remember the school teacher with joint pains Aplastic crisis possible Moderate acute radiation dermatitis results form what? (itching skin rash and burning pain with sloughing off of epithelium and vesicle formation) How do you prevent it? How do you treat this? - ANSWER Exposure of subdermal lymphatics Intensity modulate radiation therapy Gentle washing with soapy water BRCA 1 positive risk of ovarian and breast? - ANSWER Breats Ca 65%, ovarian Ca 40% do total mastectomy and oophorectomy How long after ACL repair (using tissue to repair) do you have to wait to return to normal activity? - ANSWER 6 months Remember Lachman test and anterior drawer signs - ANSWER 30-40 flexion laying back Ant drawer sign: 6mm+ traction = positive If both these are positive then MRI not necessary to make Dx ***** Acute gout DOC between indomethacin and colchicine^ - ANSWER Indomethacin (NSAIDs) which of the following is NOT a risk factor for gout? Obesity etOH