FINAL EXAM FOR MEDICINE NBME 2023/2024

FINAL EXAM FOR MEDICINE NBME 2023/2024 wide based gait, progressive, alcohol abuse, preserved limb coordination - CORRECT ANSWER-cerebellar degeneration due to purkinje cell death trigem neuralgia, lower limb paralysis, upper limb sensory loss on different occasions - CORRECT ANSWER-MS management of BPH - CORRECT ANSWER-alpha 1 blockers to relax sm muscle and then 5 alpha reductase inh to reduce prostate size management of acute limb ischemia due to clot in artery - CORRECT ANSWER-start anticoag tx for ADHF - CORRECT ANSWER-diuretics and o2 tx for acetaminophen induced liver failure - CORRECT ANSWER-transplant what should you recommend for diabetic patients greater than 40? - CORRECT ANSWER-statin high homocysteine, what do you give? - CORRECT ANSWER-B6 and folate causes of AIN - CORRECT ANSWER-TMPSMX, cephalosporins, nsaids non healing, painless, skin ulcer on previous scar suggests - CORRECT ANSWERSCC asthma patient with muscle weakness.. why? - CORRECT ANSWER-hypokalemia due to beta agonist tx for cocaine associated chest pain - CORRECT ANSWER-benzos diplopia, tinnitus, HA, neuropathy, HSM, anemia points to? - CORRECT ANSWERwaldenstrom macroglobulinemia pain between 3/4 toes on plantar side with clicking - CORRECT ANSWER-morton neuroma hypokalemia, alkalosis, normotensive, hypochloruria - CORRECT ANSWER-vomiting microcytic anemia unresponsive to Fe tx - CORRECT ANSWER-B thalassemia tx for toxic megacolon induced by IBD - CORRECT ANSWER-steroids, abx, fluids, decompress normal pulse in the setting of high fever and a non productive cough - CORRECT ANSWER-atypical CAP tx for uncomplicated CAP vs comorbidities - CORRECT ANSWERazithromycin/doxycycline vs fluoroquinolones when should thoracentesis be performed? - CORRECT ANSWER-greater than 1cm on Lat dec film management for aortic dissection - CORRECT ANSWER-if stable- CT angiography if unstable- TEE essential vs parkinson tremor - CORRECT ANSWER-essential- bilateral, relieved by alcohol, worse with intentional mvts parkinsons- resting, dec with intentional mvts abn bleeding in context of kidney failure - CORRECT ANSWER-uremic coagulopathy resp weakness, swallowing difficulty, previously given a fluoroquinilone - CORRECT ANSWER-myasthenia crisis tick bit, anemia with intravascular hemolysis diagnose? - CORRECT ANSWER-babesiosis- peripheral smear diagnose diverticulitis - CORRECT ANSWER-contrast CT LE vs MG - CORRECT ANSWER-LE has absent DTRs and normally doesnt have facial weakness htn and hypokalemia - CORRECT ANSWER-primary hyperaldosteronism lethargic, confused pt with high sugar and potassium, dry membranes, tx? - CORRECT ANSWER-hyperosmolar hyperglycemic synd saline and insulin labs for exudative pleural effusion - CORRECT ANSWER-high ldh, low gluc, low ph tx for CAP hospitalized patient tx for HAP - CORRECT ANSWER-ceftriaxone plys azithromycin or levofloxacin cefepime/carbapenem/pip tazo fever, cirrhosis, AMS.. diagnose? - CORRECT ANSWER-SBP- paracentesis with PMNs>250 and pos culture most effective non pharmalogical tx for high bp - CORRECT ANSWER-weight loss sinusitis, otitis, auditory canal ulceration, anemia, hematuria - CORRECT ANSWERgranulomatosis with polyangitis requirements for COPD pt to have long term O2 - CORRECT ANSWER-arterial O2<55mmHg and pulse ox <88% inc PA and RA pressures with normal wedge pressure - CORRECT ANSWER-Pulm HTN dec VC in COPD due to? - CORRECT ANSWER-air trapping cause of PAH in systemic sclerosis - CORRECT ANSWER-hyperplasia of intimal sm muscle layer prophylatic tx for latent TB - CORRECT ANSWER-9mo INH if CXR is negative cells in bacterial vs aseptic meningitis - CORRECT ANSWER-bacterial- PMNs, asepticmono and lymphocytes hypokalemia and metabolic alkalosis in the context of diarrhea and melanosis coli - CORRECT ANSWER-laxative abuse 70 yo with muscle pain and stiffness, inc ESR.. tx? - CORRECT ANSWER-polymyalgia rheumatica, steroids inc ALP, hepatic tests normal, pos AMA.. tx? - CORRECT ANSWER-PBC, ursodeoxycholic acid chest pain.. what should you give initially? - CORRECT ANSWER-aspirin htn, palpable flank masses bilateral, hematuria.. at risk for? - CORRECT ANSWERADPKD at risk for berry aneurysms dec platelets with normal everything else - CORRECT ANSWER-immune thrombocytopenia endocarditis with recent UTI.. bug? - CORRECT ANSWER-enterococcus nitrates and esterase indicate? - CORRECT ANSWER-nitrates indicate enterobaceriacaeae and esterase indicates polyuria NNT equation? - CORRECT ANSWER-1/ARR polyarthritis, HA, rash, lymphopenia, thrombocytopenia, inc liver enzymes - CORRECT ANSWER-chikungunya fever attributable risk %? - CORRECT ANSWER-RR-1/RR male pelvic pain for > 3 months with sterile UA - CORRECT ANSWER-chronic prostatitis how does cirrhosis affect T3/4 - CORRECT ANSWER-dec total by dec SBG dacryocystitis - CORRECT ANSWER-infection of lacrimal sac urine osm less than serum osm with polyuria - CORRECT ANSWER-DI tx for acute glaucoma? - CORRECT ANSWER-mannitol, acetazolamide, pilocarpine, timolol when should you screen people for HIV - CORRECT ANSWER-16-65 isolated systolic HTN in elderly due to? - CORRECT ANSWER-inc stiffness of vessels diamond murmur that inc with inspiration - CORRECT ANSWER-pulm stenosis what 2 bugs cause deep infections after puncture wounds? - CORRECT ANSWERstaph and pseudomonas tx for cluster headaches - CORRECT ANSWER-100% O2 pleural effusion with inc amylase and chest pain after vomiting - CORRECT ANSWERBoerhaave synd cough with mucopurulent sputum, dyspnea, hemoptysis, crackles - CORRECT ANSWER-bronchiectasis HIV pt with severe intraocular inflammation with pain, see widespread pale peripheral lesions with necrosis - CORRECT ANSWER-HSV infection.. CMV is not painful first time seizure work up - CORRECT ANSWER-blood tests and toxicology D xylose test- what disease? - CORRECT ANSWER-celiac how does hypomg affect calcium - CORRECT ANSWER-hypocalcemia due to PTH resistance