NBME 12 questions and answers 2023

NBME 12 questions and answers 2023 contraindication to pancreatic cancer resection encasement of SMA pancreatic cancer in head or tail improved prog head retinal arteriolar narrowing chronic HTN Tylenol or ibuprofen for OA (1st line) with GERD/GI bleeding or CKD tylenol power and errors in table pulm rehab for mod to severe COPD reduces hospital admissions ... txt gastroparesis metoclopramide, erythromycin NF1 vs tuberous sclerosis - study ... sex cord stromal tumors in children - precocious puberty. remove them, FNA will seed abdomen ... txt tinea capitis and do you need to treat close contacts oral griseofulvin/terbinafine, and no txt close contacts what do you use topical selenium sulfide for antifungal - pityriasis versicolor, dandruff, seborrheic dermatitis lymphatic invasion occurs in cutaneous and oropharyngeal squamous cell carcinoma ... txt slipped capital femoral epiphysis surgical stabilization of femoral head age of early onset aortic stenosis 40-60, bicuspid valve E. coli O157:H7 vs Enterotoxigenic E coli O157:H7 causes hemorrhagic diarrhea -> can cause hemolytic anemia enterotoxigenic e coli causes watery diarrhea changes in breastfeeding location or freq doesnt affect galactocele ... routine hep A vaccine in which populations MSM, international travelers, HIV positive, homelessness, IVDU Hypertrophic osteoarthropathy Characterized by chronic proliferative periostitis of long bones, clubbing of fingers and synovitis, Its asso with Squamou cell carcnimoa and Adenocarcinoma of the lung. caused by abnormal fibrovascular proliferation neurogenic bladder overflow incontinence (impaired filling sensation), infrequent urination with incomplete emptying, weakened stream femoral aneurysm size for surgery >/= 3cm ILD -> lung biopsy ... txt IgA deficiency nothing respiratory distress following thyroidectomy without s/s hematoma recurrent laryngeal nerve damage (bilateral paralysis) when do you do iodine scintography if TSH is low (hyperthyroid) eval of thyroid nodule if TSH normal US guided FNA Opsoclonus-myoclonus syndrome non-rhythmic conjugate eye movement and myoclonus associated with neuroblastoma Neuroblastoma S/S Enlarged abdominal mass FTT Sweating tachy neuroblastoma tissue derivation neoplasm of neuroendocrine cells of the sympathetic nervous system oversimplification of MYCN oncogene think of neuroblastoma as being an adrenal tumor bc it is catecholamines - can also be in sympathetic chain mass that crosses the midline, diastolic HTN neuro = neuroendocrine inc serum catecholamine metabolites hearing loss permanent complication of bacterial meningitis in infants ... pityriasis rosea is self resolving in 6-8 weeks and then can be treated symptomatically with topical corticosteroids in the meantime ... cholestatic hepatic disease secondary to TPN, increased bilirubin and jaundice. txt = discontinuing TPN, providing enteral feeding caused by decreased biliary motility (usually triggered by oral intake) pre-eclampsia is associated with increased risk of placental abruption ... first febrile UTI in children w/evidence of hydronephrosis or renal scarring = get voiding cystourtherography ... continuous abx prophylaxis in child with VUR ... ABO incompatibility Hemolytic disease that occurs when the mother's blood type is O and the newborn's is A, B, or AB presents in newborn rather than fetus hemolysis, jaundice, anemia prolonged incubation can cause respiratory muscle atrophy. txt with exercises and physiotherapy, repositioning ... velopharyngeal insufficiency VP insufficiency occurs due to an anatomical or structural defect. This is most commonly associated with cleft palate. The primary effects of the VP insufficiency are air-flow escape and hypernasality. Secondary effects are disorders in speech articulation (distortions, substitutions and omissions) acute chest syndrome vast-occlusion within the pulmonary microvasculature, presents as pulmonary infiltrate nearly impossible to distinguish from bacterial pneumonia get blood cultures to identify bacteremia hypertensive retinopathy diabetic retinopathy Laryngeal carcinoma-presentation hoarseness, cough, stridor dx with indirect laryngoscopy PCOS - check luteinizing hormone ... second HTN agent after ACEi HCTZ / loop diuretic safe rate of sodium correction 6-12 mEq per day aortic dissection doesnt have to have hemodynamic instability ... txt bell palsy corticosteroids, if severe antivirals mesna reduces risk of hemorrhagic cystitis in patients taking cyclophosphamide ... tumor lysis syndrome prophylaxis = allopurinol or rasburicase uric acid -> nephropathy or AKI vaccines for impaired spleen function pneumococcal, Hib, meningococcal Crohn disease -> enter-cutaneous fistulas ... Vesicoureteral reflux treatment In most cases of VUR, conservative, nonoperative therapy is effective in controlling infection; surgery to correct the anatomy if severe (continued UTIs despite prophylaxis), give fluids, LOW DOSE LONG TERM ABX (>1 UTI) aspergillosis labs increased IgE, eosinophilia if dysplastic polyp is completed removed on colonoscopy, when is repeat screening? 3 yrs renal artery stenosis in children fibromuscular dysplasia, NF1 txt with CCB or angioplasty (if failed CCBs) if cv risk score >10% or LDL >190, statin. if >5%, no statin ... pericarditis -> get echo to evaluate for effusion ... salicylate poisoning stimulates hyperventilation, causing respiratory alkalosis then causes uncoupling -> lactic acidosis, ketones -> metabolic acidosis ... use anticholinergic agents to help with airway secretions in hospice care (scopolamine, glycopyrrolate) ... Management of hyphema Ophthalmology consult, 45° bed elevation, bed rest, bilateral eye patch, analgesia, sedation, topical cycloplegic, and topical steroids in sickle cell: surgery if IOP not controlled within 24 hrs Febuxostat gout pseudo gout txt NSAIDs (not febuxostat)