NBME PEDs 1 and 2 NBME MASTERY, (Answered) Complete Solution

NBME PEDs 1 and 2 NBME MASTERY, (Answered) Complete Solution 17yo girl brought to ED after found lying on the street. Outside temp is 40F. En route to hospital, paramedics administered O2 and ECG showed J-wave. She is lethargic and poorly responsive to verbal commands. Temp is 32 (89.6F). Puls = 60, RR = 12, BP = 90/60. There is an odor of ethanol on her breath. Which of the following is most likely explanation for the patient's cardiac findings? a. cocaine toxicity b. ethanol toxicity c. hyperkalemia d. hypocalcemia e. hypothermia f. increased intracranial pressure g. MI e. hypothermia (J wave = hypothermia) A 3 yr old comes to the ED after an episode of syncope followed by a tonic-clonic seizure. She becomes fully alert, then stops talking, closes her eyes, and has 3-4 rhythmic jerks of her arm. During this second episode, an ECG was recorded that showed P waves at 80/min with no QRS complexes. NSR resumes shortly thereafter. She becomes alert one minute after. Most likely diagnosis? A) Absence seizure B) Adams-Stokes attack C) Adverse effect of medication D) Breath-holding episode E) Carotid artery trauma F) Narcolepsy-cataplexy G) Vasovagal episode H) Ventricular tachyarrhythmia B) Adams-Stokes attack cause of recurrent infection impaired humoral immunity mixed metabolic acidosis and resp alkalosis salicylate poisoning patchy irregular uptake of radioisotope Multinodular goiter What is anotehr name for multinodular goiter lymphocytic thyroiditis/ infiltration 14 day feevr headache and green nasal discharge in a 14 yr old kid. Post pharyngeal wall is erythematous and covered with thin gray mucous Sinusitis SCID has an abscence of what cells T cells - leads to B cell impairment too. Both are low recurrent infection - bacterial, fungal and viral SCID Pt has foreign body, next step bronchoscopy - take it out kid has fever and right foot pain. itching rash stared between the second and third toes of both feel. PLays sports in highschool. Lymphnode in groin is tender Pseudomonas - becasue he has fever. Keep in mind that athletes foot, Trichophyton rubrum is a fungus that most common cause of athletes foot, jock itch and ringworm but IT DOES NOT HAVE FEVER or TENDER LYMPH NODE 2 days after delivery a male newborn has dribbling. on PE he has a 6 cm round midline suprapubic pelvic mass Posterior urethral valves Hep A ab + Hep B core Ab + Hep B surface ag + Hep B surface ab - Hep A virus - immune Hep B virus - not immune 2 yr olld boy with anorexia poor coordination and sporadic vomiting over teh last month. Lab shows hypochromic microcytic anemia. lead poisoning (not iron def) ashleaf spots - Skin hypopigmentation, four periventricular nodules - cortical tubers Tuberous sclerosis what can TMPSMX cause on labs neutropenia** ( low segmented neutrophils) 14 yr old girl pt with suprapubic tenderness for 6 mo. She has a red smooth bulge between the labia. Next step? impreforate hymen - do cruciate incision of the hymen pt with anorexia is at risk for what bone morphology? osteoporosis A low pitched vibratory murmur is heard through the cardiac cycle and is most prominent at the left upper sternal border when the child is in the sitting position. The murmur dissapears when his neck is rotated in the sitting position Venous hymm - when he turns his head left it cuts it off. Venous hum is when he blood goes through the internal jugular vein 5 ear old with fatigue for 3 weeks, acute onset of fever and chills for 2 hours. Traveled to asia 1 month ago and received chloroquine. Exam shows pallor and splenomegaly. HCT 22, leuko 18, platelets 80. assay for strep assay for heterophile measure PT and PTT Measure AST and ALT thick and thin blood smears thick and thin blood smears: to look for look at blood for heinz bodies and bite cells 14 yr old girl with downs is evaluated for polycythemia vera. she has cyanosis and clubbing. There is an S2 increased in intensity. she has a large ventricular septal defect and a dilated main pulmonary artery. What is causing the polycythemia? Pulmonary artery HTN fundoscopic examination shows an abscence of venous pulsations increased intercranial pressure, papillemdema, cerebral edema etc. A 5lb 5 oz newborn is delivered at 37 weeks gestation to a 32 year old women, gravida 1 para 1, following an uncomplicated delivery. The mom has history of IV drug use and received no prenatal care. She did not take any med during pregnancy. Rapid HIV testing of the mother after delivery is positive. Exam of newborn shows no abnormalities. Which of the following is the best next step to manage the newborn? A) A 6-week course of oral AZT beginning at the 2 week exam B) A 6-week course of oral AZT only if CD4 count decreases to less than 200/mm C) A 6-week course of oral AZT within 12 hours after delivery D) A 6-week course of triple antiretroviral therapy beginning at the 2 week exam E) A 6-week course of triple antiretroviral therapy if the CD4 T count decrease to less than 200/mm F) A 6-week course of triple antiretroviral therapy within 24 hours after delivery C) A 6-week course of oral AZT within 12 hours after delivery "click" or more precisely "clunk" in the hip may be detected. Ortolani maneuver and the Barlow maneuver main types are the result of either laxity of the supporting capsule or an abnormal acetabulum. "developmental dysplasia of the hip" (DDH) to "congenital dislocation of the hip" (CDH)- include subluxation, dysplasia, and dislocation U/S until 3 mo - then can do xray. xray cant visualize calcification 16 yr boy old with a painless lump in is right breast. 1cm smooth firm mass under right nipple. no nipple or skin retraction or lymphadenopathy Physiologic pubertal development diarrhea with chicken salmonella - cook meat properly An 18-month-old boy is brought to the physician because of diarrhea for 3 days. He attends day care, and several other children at the center have similar symptoms. The water source for the day-care center is a private well. The center has a pet turtle and two canaries. The patient's temperature is 37.7°C (99.9°F). He is well hydrated. The remainder of the examination shows no abnormalities. Examination of the stool for ova and parasites is negative. A stool culture grows no enteric pathogens. Rotavirus testing is positive.