YouTube.com/USMLELive - NBME Explanations by Amir
. A 49-year-old man comes to the physician because of increasingly severe pain in his left hip during the past
2 months. He was recently discharged from a rehabilitation facility for treatment of alcoholism. He says , "The pain
gets so bad at times that it even hurts my golf game. " He has pain with weight bearing. Physical examination shows
limited active and passive range of motion of the left hip . Hip x-rays show no abnormalities A coronal Trweighted
MRI is shown. Which of the following is the most likely cause of this patient's pain?
A) Avascular necrosis
B) Hyperparathyroidism
C) Osteitis deformans
D) Septic arthritis
E) Tuberculous osteomyelitis
, YouTube.com/USMLELive - NBME Explanations by Amir
A 16-year -old girl has pain and tingling in her left hand when she goes backpacking. The symptoms resolve 5 minutes after she takes off her backpack. Which of the following
abnormalities is the most likely cause?
A) C-7 to T-1 congenital fusion
B) Cervical rib
C) Diastematomyelia
D) Hemivertebra
E) Spina bifida occulta of C-7
, YouTube.com/USMLELive - NBME Explanations by Amir
A 48-year -old man comes to the physician because of fatigue, increasing shortness of breath on exertion, and decreased exercise tolerance over the past 4 months . An x-ray of the
chest shows cardiac enlargement and prominent pulmonary vasculature. He is treated pharmacologically but subsequently develops glucose intolerance, evidence of liver
dysfunction , and mild to moderate ascites. An older brother died at age 52 years with similar symptoms. Which of the following are the most important screening tests to perform on
this patient and his family?
A) Fasting serum gastrin and insulin measurements
B) Hepatitis B and hepatitis C antibody assays
C) HLA class I and class II typing
D) Serum thyroid-stimulating hormone and thyroxine (T measurements
E) ^
Transferrin saturation and serum ferritin measurements
, YouTube.com/USMLELive - NBME Explanations by Amir
A 32 - year - old woman begins to hyperventilate and then develops blurred vision and numbness around her mouth after being told her best friend has suddenly died . Her pulse is
95/min and blood pressure is 120/80 mm Hg. Which of the following is most likely decreased in this woman?
A) Arterial blood oxygen concentration
B) Arterial blood Po 2
C) Arterial pressure
D) Cerebral blood flow
E) Cerebral tissue pH
. A 49-year-old man comes to the physician because of increasingly severe pain in his left hip during the past
2 months. He was recently discharged from a rehabilitation facility for treatment of alcoholism. He says , "The pain
gets so bad at times that it even hurts my golf game. " He has pain with weight bearing. Physical examination shows
limited active and passive range of motion of the left hip . Hip x-rays show no abnormalities A coronal Trweighted
MRI is shown. Which of the following is the most likely cause of this patient's pain?
A) Avascular necrosis
B) Hyperparathyroidism
C) Osteitis deformans
D) Septic arthritis
E) Tuberculous osteomyelitis
, YouTube.com/USMLELive - NBME Explanations by Amir
A 16-year -old girl has pain and tingling in her left hand when she goes backpacking. The symptoms resolve 5 minutes after she takes off her backpack. Which of the following
abnormalities is the most likely cause?
A) C-7 to T-1 congenital fusion
B) Cervical rib
C) Diastematomyelia
D) Hemivertebra
E) Spina bifida occulta of C-7
, YouTube.com/USMLELive - NBME Explanations by Amir
A 48-year -old man comes to the physician because of fatigue, increasing shortness of breath on exertion, and decreased exercise tolerance over the past 4 months . An x-ray of the
chest shows cardiac enlargement and prominent pulmonary vasculature. He is treated pharmacologically but subsequently develops glucose intolerance, evidence of liver
dysfunction , and mild to moderate ascites. An older brother died at age 52 years with similar symptoms. Which of the following are the most important screening tests to perform on
this patient and his family?
A) Fasting serum gastrin and insulin measurements
B) Hepatitis B and hepatitis C antibody assays
C) HLA class I and class II typing
D) Serum thyroid-stimulating hormone and thyroxine (T measurements
E) ^
Transferrin saturation and serum ferritin measurements
, YouTube.com/USMLELive - NBME Explanations by Amir
A 32 - year - old woman begins to hyperventilate and then develops blurred vision and numbness around her mouth after being told her best friend has suddenly died . Her pulse is
95/min and blood pressure is 120/80 mm Hg. Which of the following is most likely decreased in this woman?
A) Arterial blood oxygen concentration
B) Arterial blood Po 2
C) Arterial pressure
D) Cerebral blood flow
E) Cerebral tissue pH
