MCCEE QBANK QUESTION OB GYN LATEST UPDATE WITH
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
Patient presents with frequent episodes of pelvic pain, urinary frequency urgency nocturia dyspareunia
but has a consistently negative urine culture. Antibiotics have been prescribed on multiple occasions to
no relief. what is it? - (ANSWER)Interstitial cystitis-
criteria - negative urine culture
Absence of genital infection or neoplastic disease and no history of radiation
tuberculous or chemical cystitis.
Where is necrotizing enterocolitis normally found - (ANSWER)•fnec -> intestinal inflammation associated
with focal or diffuse ulceration and necrosis
• primarily affecting terminal ileum and colon
Diagnosistic tests for cystitis - (ANSWER)Potassium sensitivity test ( a positive results = increased pain)
anesthetic bladder challenge and *cystoscopy*.
Treatments for cyctitis - (ANSWER)Pentosan hydroxyzine and amitriptyline
elderly man who is generally debilitated is in an extended care facility and experiences chronic e.coli
bacteriuria approx. 1 every 6 months
he develops a mild fever and urine cultures > 100,000/ml what is the best treatment - (ANSWER)* short
course of antimicrobial therapy and follow up*
this regime can eliminate bacteruria in most of these patients for at least a six month peroid
A man has a 0.5 cm adenomaatous polyp with low grade dysplasia, according to current guidlines when
should the paitent have the next colonscopy? - (ANSWER)* 5years* - Patients with one or two small <
1cm tubular adenomas
incidence of placenta previa at the second trimester ?
--Incidence at term ? - (ANSWER)20-24%- in the second trimester
0.4% at term.
,MCCEE QBANK QUESTION OB GYN LATEST UPDATE WITH
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
If a paitent presents with a placenta previa at 20 weeks gestataion with no vaginal bleeding what is the
next best step - (ANSWER)Order a follow up ultrasound at 28 weeks gestation.
- this is because many placenta previas resolve at term
and the descision for delivery should not be made until 36 weeks
in what patient risk factor group should a placenta previa be examined for placenta accreta -
(ANSWER)patients with precious incision a colow flow doppler study should be performed to evaluate
for a potential placenta accreta. Also MRI is helpful.
Infant Vitamin D intake recommendations - starting soon after birth what amount should be given -
(ANSWER)400 IU of vitamine D
What are the benefits of giving vitamin D to an infant - (ANSWER)maintaining innate imunity and
preventing diseases such as diabetes and cancer.
What is the best strategie for managing difficult patients - (ANSWER)Schedule regular follow up visits at
2-3 week intervals especially if high dependency needs are suspected
24 years old female presents to your clinic with a *5 day history of a fever at 39.4*. She has *no localized
symptoms* or overt physical findings -
Initial tests show an elevated WBC count with a disproportionate number of *reactive lymphocytes*
what does she have? - (ANSWER)Viral infection.
reactive lymphocytes will appear as distinctive lymphocytes on manual differential
What conditons cause an absolute increase in lymphocytes - (ANSWER)primary causes - neoplastic
hyperproliferation
secondary causes aka reactive.
reactive lymphocytes will appear as distinctive lymphocytes on manual differential - causes are virals
EBV, CMV.
,MCCEE QBANK QUESTION OB GYN LATEST UPDATE WITH
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
Which bacterial infection has been known to cause an absolute increase in lymphocytes counts up to 70,
000 u/L - (ANSWER)Bordetella pertussis
Patient comes for surgical clearance - has an anterior wall MI approximately 18 months ago
he now can exercise moderately without symptoms.
What test do you run - (ANSWER)12 lead EKG.
When do you preform a stress test as a pre surgical evaluation - (ANSWER)if the patient is experiencing
any unstable coronary syndroms, severe valvular disease uncompensated congestive heart failure or sig.
arrhythmia
WHAT is the target LDL for all patients with diabetes determined by the Canadian diabetes association. -
(ANSWER)Taget LDL Cholesterol of under 2.0mmol/L
-also recommended for patientents with
CAD, caroitde artery disease that is symptomatic, abdominal aortic aneuryms, peripheral vascular
disease
what is the acceptable LDL level for an individual with *two risk factors* for CAD and a 10 years CAD risk
*< 20%* - (ANSWER)3.5 mmol/L
What is the accpetable LDL level for a individual with *ONE risk factor for CAD *and a 10 year CAD risk of
*< 20%* - (ANSWER)4.0 mmol/L
First line treatment for uncomplicated cystitis in women acquired in the community -
(ANSWER)Trimethoprim/sulfamethoxazole
then fluoroquinolon or nitrofurantoin
* things to watch out for in a question stem are previous allergic reaction to -cillins or a community
resistance*
, MCCEE QBANK QUESTION OB GYN LATEST UPDATE WITH
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
Uti acquired in a hospital or nursing home, how does this change the management - (ANSWER)More
liekly to be antibiotic resistant gram negative bacilli
there for a fluoroquinolone, oral amocicllin/ clavulanate or oral 3rd gen. cephalosporin is the treatment.
Normal Cardiac Changes in pregnancy - (ANSWER)Cardiac output rises from 30 to 50 percent above
baseline
1. increase preload d/t rise in blood volume
2. reduced afterload d/t fall in systemic vascular resistance
3. rise in materal heart rate by 10 to 15 beats per minute
What happens to stroke volume during the first and second trimesters - (ANSWER)Increases during the
first and second trimesters but declines int he third trimester s/t caval compression by the gravid uterus
How much will blood pressure drop in a pregnancy - (ANSWER)---10 mmhg below baseline by the end of
the second trimester.
the decline in blood pressure is mediated by a fall in systemic vascular resistance induced by hormonal
changes and by the addition of a low resistance circuit through the uteroplacental bed.
How does primary prevention like measles vaccine affect prevalence and incidence -
(ANSWER)Decreases prevalence and incidence BUT it will not affect things like length of hospital stay for
those who acquire the disease
Treatment for gasoline poisoning - (ANSWER)there is no treatment you just provide support of the
cardiovascular and respiratory functions
*IMPORTANT DO NOT INDUCE EMESIS, use gastric lavage or give charcoal*
-catharsis with magnesium or sodium sulfate is OK
*if spontaneous vomiting occurs watch for signs of pulmonary aspiration.- which can lead to pneumonitis
*
Management of gasoline poisoning - (ANSWER)1st X-ray in the ED
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
Patient presents with frequent episodes of pelvic pain, urinary frequency urgency nocturia dyspareunia
but has a consistently negative urine culture. Antibiotics have been prescribed on multiple occasions to
no relief. what is it? - (ANSWER)Interstitial cystitis-
criteria - negative urine culture
Absence of genital infection or neoplastic disease and no history of radiation
tuberculous or chemical cystitis.
Where is necrotizing enterocolitis normally found - (ANSWER)•fnec -> intestinal inflammation associated
with focal or diffuse ulceration and necrosis
• primarily affecting terminal ileum and colon
Diagnosistic tests for cystitis - (ANSWER)Potassium sensitivity test ( a positive results = increased pain)
anesthetic bladder challenge and *cystoscopy*.
Treatments for cyctitis - (ANSWER)Pentosan hydroxyzine and amitriptyline
elderly man who is generally debilitated is in an extended care facility and experiences chronic e.coli
bacteriuria approx. 1 every 6 months
he develops a mild fever and urine cultures > 100,000/ml what is the best treatment - (ANSWER)* short
course of antimicrobial therapy and follow up*
this regime can eliminate bacteruria in most of these patients for at least a six month peroid
A man has a 0.5 cm adenomaatous polyp with low grade dysplasia, according to current guidlines when
should the paitent have the next colonscopy? - (ANSWER)* 5years* - Patients with one or two small <
1cm tubular adenomas
incidence of placenta previa at the second trimester ?
--Incidence at term ? - (ANSWER)20-24%- in the second trimester
0.4% at term.
,MCCEE QBANK QUESTION OB GYN LATEST UPDATE WITH
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
If a paitent presents with a placenta previa at 20 weeks gestataion with no vaginal bleeding what is the
next best step - (ANSWER)Order a follow up ultrasound at 28 weeks gestation.
- this is because many placenta previas resolve at term
and the descision for delivery should not be made until 36 weeks
in what patient risk factor group should a placenta previa be examined for placenta accreta -
(ANSWER)patients with precious incision a colow flow doppler study should be performed to evaluate
for a potential placenta accreta. Also MRI is helpful.
Infant Vitamin D intake recommendations - starting soon after birth what amount should be given -
(ANSWER)400 IU of vitamine D
What are the benefits of giving vitamin D to an infant - (ANSWER)maintaining innate imunity and
preventing diseases such as diabetes and cancer.
What is the best strategie for managing difficult patients - (ANSWER)Schedule regular follow up visits at
2-3 week intervals especially if high dependency needs are suspected
24 years old female presents to your clinic with a *5 day history of a fever at 39.4*. She has *no localized
symptoms* or overt physical findings -
Initial tests show an elevated WBC count with a disproportionate number of *reactive lymphocytes*
what does she have? - (ANSWER)Viral infection.
reactive lymphocytes will appear as distinctive lymphocytes on manual differential
What conditons cause an absolute increase in lymphocytes - (ANSWER)primary causes - neoplastic
hyperproliferation
secondary causes aka reactive.
reactive lymphocytes will appear as distinctive lymphocytes on manual differential - causes are virals
EBV, CMV.
,MCCEE QBANK QUESTION OB GYN LATEST UPDATE WITH
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
Which bacterial infection has been known to cause an absolute increase in lymphocytes counts up to 70,
000 u/L - (ANSWER)Bordetella pertussis
Patient comes for surgical clearance - has an anterior wall MI approximately 18 months ago
he now can exercise moderately without symptoms.
What test do you run - (ANSWER)12 lead EKG.
When do you preform a stress test as a pre surgical evaluation - (ANSWER)if the patient is experiencing
any unstable coronary syndroms, severe valvular disease uncompensated congestive heart failure or sig.
arrhythmia
WHAT is the target LDL for all patients with diabetes determined by the Canadian diabetes association. -
(ANSWER)Taget LDL Cholesterol of under 2.0mmol/L
-also recommended for patientents with
CAD, caroitde artery disease that is symptomatic, abdominal aortic aneuryms, peripheral vascular
disease
what is the acceptable LDL level for an individual with *two risk factors* for CAD and a 10 years CAD risk
*< 20%* - (ANSWER)3.5 mmol/L
What is the accpetable LDL level for a individual with *ONE risk factor for CAD *and a 10 year CAD risk of
*< 20%* - (ANSWER)4.0 mmol/L
First line treatment for uncomplicated cystitis in women acquired in the community -
(ANSWER)Trimethoprim/sulfamethoxazole
then fluoroquinolon or nitrofurantoin
* things to watch out for in a question stem are previous allergic reaction to -cillins or a community
resistance*
, MCCEE QBANK QUESTION OB GYN LATEST UPDATE WITH
COMPLETE VERIFIED SOLUTIONS!!!! ALREADY GRADED A+
LATEST UPDATE!!!
Uti acquired in a hospital or nursing home, how does this change the management - (ANSWER)More
liekly to be antibiotic resistant gram negative bacilli
there for a fluoroquinolone, oral amocicllin/ clavulanate or oral 3rd gen. cephalosporin is the treatment.
Normal Cardiac Changes in pregnancy - (ANSWER)Cardiac output rises from 30 to 50 percent above
baseline
1. increase preload d/t rise in blood volume
2. reduced afterload d/t fall in systemic vascular resistance
3. rise in materal heart rate by 10 to 15 beats per minute
What happens to stroke volume during the first and second trimesters - (ANSWER)Increases during the
first and second trimesters but declines int he third trimester s/t caval compression by the gravid uterus
How much will blood pressure drop in a pregnancy - (ANSWER)---10 mmhg below baseline by the end of
the second trimester.
the decline in blood pressure is mediated by a fall in systemic vascular resistance induced by hormonal
changes and by the addition of a low resistance circuit through the uteroplacental bed.
How does primary prevention like measles vaccine affect prevalence and incidence -
(ANSWER)Decreases prevalence and incidence BUT it will not affect things like length of hospital stay for
those who acquire the disease
Treatment for gasoline poisoning - (ANSWER)there is no treatment you just provide support of the
cardiovascular and respiratory functions
*IMPORTANT DO NOT INDUCE EMESIS, use gastric lavage or give charcoal*
-catharsis with magnesium or sodium sulfate is OK
*if spontaneous vomiting occurs watch for signs of pulmonary aspiration.- which can lead to pneumonitis
*
Management of gasoline poisoning - (ANSWER)1st X-ray in the ED
