NBME 9, Answered
Kid with bed wetting problems + constipation
tx? - administration of an osmotic laxative
Multiple myeloma is marked by proliferation of ______ B cells - monoclonal
In patients with bipolar disorder that are suffering from acute depression + stopped
taking meds, what do you give them? - bipolar medication like lithium,
lamotrigine, quetiapine, and lurasidone
SSRIs in bipolar patients can be bad because? - it can precipitate mania or convert
depression to mania
Patient with afib with a history of TIA or stroke
Tx? - warfarin
Patient without afib with history of TIA or stroke
Tx? - aspirin
T/F: Aspirin and clopidogrel are anticoagulants - false
1st line therapy for mild to moderate acne vulgaris
Tx? - topical retinoids
Patient with juvenile idiopathic arthritis may present with what extraarticular
manifestation? - uveitis (screen with slit-lamp exam)
In adults, the presence of a destructive bone lesion is more commonly caused by
______ disease rather than primary bone malignancy - metastatic
,T/F: Osteosarcoma is most common in patients ____ years of age - <30
Patients with severe AS with symptoms or systolic dysfunction (EF <50%) should
receive what tx? - aortic valve replacement
Patients with HF (EF < 50%) who have AS + asymptomatic in terms of SOB on
exertion, should receive what treatment? - Afterload reduction
32 yo woman with bcg vaccine as a child + emigrated from China + PPD skin test
of 12 mm
risk status and next step? - High risk; isoniazid
92 yr old with left mandibular mass that has enlarged + x ray is normal + smoker +
normal VS
next step? - biopsy
77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on
diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 +
edema + signs of kidney injury
Dx and next step? - fluid overload; hemodialysis
In diabetic patients, foot injuries can be prevented with? - wearing shoes when
standing or walking
In diabetic patients, worsening of foot injuries can be prevented with? - daily foot
checks
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
, potential dx and next step? - endometrial malignancy; colposcopy with
endocervical curettage
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
After colposcopy with endocervical curettage, what can be considered as a next
step? - hysteroscopy
T/F: Neonate that improved with PPV can be taken off of PPV immediately after -
true
If there is suspected FSGS, what is the next step? - renal biopsy
If there is suspected FSGS, what is the next step after confirming it with renal
biopsy? - prednisone therapy
1st line tx for Merniere's disease - antihistamines (e.g. Meclizine)
2nd line tx for refractory Merniere's disease - methylprednisolone
T/F: Initial step to controlling allergic rhinitis can include use of pillow and
mattress covers - true
COPD exacerbations can be treated with? - supplemental oxygen, SABA, steroids,
antibiotics, and nebulizers
COPD daily management should include? - LABA, tiotropioum, steroids
T/F: Oral steroids are the main daily treatment for chronic COPD patients. - false
T/F: LABA are the main daily treatment for chronic COPD patients. - true
What chemical can cause osmotic diarrhea, bloating, and abdominal discomfort
when used in excessive quantities? - sorbitol
Kid with bed wetting problems + constipation
tx? - administration of an osmotic laxative
Multiple myeloma is marked by proliferation of ______ B cells - monoclonal
In patients with bipolar disorder that are suffering from acute depression + stopped
taking meds, what do you give them? - bipolar medication like lithium,
lamotrigine, quetiapine, and lurasidone
SSRIs in bipolar patients can be bad because? - it can precipitate mania or convert
depression to mania
Patient with afib with a history of TIA or stroke
Tx? - warfarin
Patient without afib with history of TIA or stroke
Tx? - aspirin
T/F: Aspirin and clopidogrel are anticoagulants - false
1st line therapy for mild to moderate acne vulgaris
Tx? - topical retinoids
Patient with juvenile idiopathic arthritis may present with what extraarticular
manifestation? - uveitis (screen with slit-lamp exam)
In adults, the presence of a destructive bone lesion is more commonly caused by
______ disease rather than primary bone malignancy - metastatic
,T/F: Osteosarcoma is most common in patients ____ years of age - <30
Patients with severe AS with symptoms or systolic dysfunction (EF <50%) should
receive what tx? - aortic valve replacement
Patients with HF (EF < 50%) who have AS + asymptomatic in terms of SOB on
exertion, should receive what treatment? - Afterload reduction
32 yo woman with bcg vaccine as a child + emigrated from China + PPD skin test
of 12 mm
risk status and next step? - High risk; isoniazid
92 yr old with left mandibular mass that has enlarged + x ray is normal + smoker +
normal VS
next step? - biopsy
77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on
diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 +
edema + signs of kidney injury
Dx and next step? - fluid overload; hemodialysis
In diabetic patients, foot injuries can be prevented with? - wearing shoes when
standing or walking
In diabetic patients, worsening of foot injuries can be prevented with? - daily foot
checks
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
, potential dx and next step? - endometrial malignancy; colposcopy with
endocervical curettage
37 yr old woman with no hx of abnormal pap smears + current visit shows pap
smear with atypical glandular cells
After colposcopy with endocervical curettage, what can be considered as a next
step? - hysteroscopy
T/F: Neonate that improved with PPV can be taken off of PPV immediately after -
true
If there is suspected FSGS, what is the next step? - renal biopsy
If there is suspected FSGS, what is the next step after confirming it with renal
biopsy? - prednisone therapy
1st line tx for Merniere's disease - antihistamines (e.g. Meclizine)
2nd line tx for refractory Merniere's disease - methylprednisolone
T/F: Initial step to controlling allergic rhinitis can include use of pillow and
mattress covers - true
COPD exacerbations can be treated with? - supplemental oxygen, SABA, steroids,
antibiotics, and nebulizers
COPD daily management should include? - LABA, tiotropioum, steroids
T/F: Oral steroids are the main daily treatment for chronic COPD patients. - false
T/F: LABA are the main daily treatment for chronic COPD patients. - true
What chemical can cause osmotic diarrhea, bloating, and abdominal discomfort
when used in excessive quantities? - sorbitol
