NBCE Part III review questions with Verified Solutions

NBCE Part III review questions with Verified Solutions WHAT IS THE MOST LIKELY DIAGNOSIS IN A 45-YEAR-OLD MALE WEST INDIAN SEASONAL WORKER WITH DYSPNEA, HEMOPTYSIS AND NIGHT SWEATS FOR THE PAST THREE MONTHS? TUBERCULOSIS ASTHMA SARCOIDOSIS CONGESTIVE HEART FAILURE TB WHAT IS THE MOST LIKELY CAUSATIVE ORGANISM IN THIS PATIENT? CHLAMYDIA PNEUMONIAE PNEUMOCYSTIS JIROVECI STAPHYLOCOCCUS AUREUS MYCOBACTERIUM TUBERCULOSIS MYCOBACTERIUM TUBERCULOSIS WHICH IS THE BEST CULTURE MEDIUM FOR THE ABOVE CAUSATIVE ORGANISM IN THIS 45-YEAR-OLD WEST INDIAN WORKER WITH DYSPNEA, HEMOPTYSIS AND NIGHT SWEATS FOR THE PAST THREE MONTHS? LOWENSTEIN JENSEN SABOURAUD HEKTOEN AGAR MACCONKEY AGAR LOWENSTEIN JENSEN- for mycobacterium species/TB SABOURAUD- used for fungi/yeast/mold HEKTOEN AGAR- selective for gram NEGATIVE agents, as contents (salt/dye) prevent gram positive agents from growing. Selective for salmonella/Shigella MACCONKEY AGAR- selective for gram negative enteric bacteria such as E-coli/staph/enterococcus/pseudomonas EXAMINATION OF HIS CHEST REVEALS STONY DULL PERCUSSION NOTES IN THE BASE OF THE RIGHT LUNG. WHICH IS THE MOST LIKELY EXPLANATION OF THIS PHYSICAL FINDING IN HIS CHEST? CONGESTIVE HEART FAILURE PLEURAL EFFUSION MESOTHELIOMA SARCOIDOSIS PLEURAL EFFUSION WHAT IS THE UNDERLYING PATHOPHYSIOLOGY OF THE DYSPNEA IN THIS PATIENT? DIFFUSION PROBLEM INADEQUATE VENTILATION POOR LUNG PERFUSION ALTERED HIGHER CENTER CONTROL INADEQUATE VENTILATION WHICH RADIOLOGICAL FINDING WOULD SUPPORT THE CAUSE OF THE STONY DULLNESS IN THE BASE OF THE RIGHT LUNG OF THIS PATIENT WITH DYSPNEA AND HEMOPTYSIS? WIDENED SUPERIOR MEDIASTINUM OBLITERATION OF THE RIGHT COSTOPHRENIC ANGLE LARGE RETROSTERNAL WINDOW CARDIOMEGALY OBLITERATION OF THE RIGHT COSTOPHRENIC ANGLE