Nbme form 7 - Study guides, Class notes & Summaries

Peds NBME Form 2 - Questions and Answers 1 hr after delivery - newborn in resp distress 28 wks gest mom: prenatal care; intrapartum AB ppx APGAR: 8, 8 PE: grunting, nasal flaring, and intercostal retractions CXR: granular appearance of parenchyma w/ air bronchograms most likely dx? RDS of newborn path: surfactant def > atelectasis infant - premature, presents w/ grunting CXR: low long volumes (hypoextended), uniform granular pattern tx: surfactant and mech ventilation if severe VS TTN path:...

Ob-Gyn NBME Form 1 - Questions and Answers 42 yo - G3P3 menses irregular at 2-3 month intervals, last 7-21 days LMP: 6 wks ago PMHx: T2DM (metformin) BMI: 32 PE: no other abnormalities pelvic exam: irregular enlarged uterus (12x8x6 cm) endometrial biopsy: atypical complex hyperplasia strongest predisposing factor for this pt's condition? anovulation endometrial proliferation is normal part of menstrual cycle BMI: 32 aka this woman is obese > excess adipose tissue = inc peripheral conversio...

Peds NBME Form 3 - Questions and Answers 18 month - 2 wks of URI PMHx: past 15 months - several episodes of AOM PE: L.TM bluish gray w/ visible landmarks; air-fluid level present behind inf 1/2 of TM; minimal movement on pneumatic otoscopy; R.ext ear, ear canal, and TM gucci most likely dx? serous otitis media pt prone to this considering they have had multiple AOM in the past air-fluid level = serous tx: probably tympanoplasty 6 month boy - difficulty breathing for 2 hrs low-grade fever, nasa...

Ob-Gyn NBME Form 4 - Questions and Answers 52 yo PMHx: mild hypoT (levothyroxine); stage I breast cancer (5 yrs ago; completed tamoxifen therapy 1 yr ago; still in remission) menopause: 4 yrs ago FHx: mom - femoral fx in bike collision at 55 yo SHx: smokes 2 cigs/week for 25 yrs BMI: 19 PE: no thyromegaly; small, well-healed surgical scar over upper outer quadrant of L.breast greatest risk factor for osteoporotic fx? BMI 22 yo - G2P1 - 38 wks gest intermittent, mild, low back pain BP: 130/90 m...

Ob-Gyn NBME Form 2 - Questions and Answers 37 yo - G8P8 - inc vag bleeding over last 5 hrs abd exam: gucci bimanual/rectal exams: 8 cm mass of upper cervix and R.parametrium no ovary palpated separately CT: R.hydroureter above level of mass most likely dx? squamous cell carcinoma of the cervix mass is clearly big and has spread due to ability to palpate mass and hydroureter present involvement of bowel/bladder (a) or distant mets (b) > stage 4 tx: surgery or chemo parametrium = fibrous/fatt...

Ob-Gyn NBME Form 3 - Questions and Answers 47 yo PSHx: TAH + BOS for leiomyomata uteri (6 wks ago) no hx of abnormal Paps PE: well-healing incision next step regarding future Paps? no longer indicated can stop screening at 65-70 yo, 3+ normal Pap tests in a row w/o CIN2/3 or higher in past 20 yrs, or if woman had TAH for benign indications and no hx of CIN2/3 or higher hx of CIN2/3 w/ TAH + 3 consecutive neg screening tests can stop 32 yo - 2 days of vag bleeding and lower abd cramps LMP: 7 wk...

Peds NBME Form 4 - Questions and Answers 13 yo boy no hx of serious illness past 2 yrs - brown urine when he has a cold; no dysuria or urinary urgency/incontinence CMP: inc BUN; Cr and C3 WNL UA: blood 4+, protein 3+ most likely dx? IgA nephropathy classic: "cola-colored urine" along w/ cold recurrent painless gross hematuria + URI 4 yo boy - fatigue, dec appetite, and 2.3 kg weight loss over past 2 months P: 80/min when supine; 105/min when standing BP: 85/60 mmHg when supine; 75/45 mmHg wh...

Surgery NBME Form 3 - Questions and Answers 3 wk old - 18 days of inc yellow skin/eyes born to 24 yo woman, G2P2, uncomplicated preg/delivery > 3175g at birth breast-fed exclusively today weights 3345g BR = 15 (direct - 13) most likely dx? biliary artesia suspected in 6-8 wk old babies - persistent, prog inc jaundice (more conj) dx: 1 wk of phenobarbital > HIDA scan if no bile reaches duodenum w/ phenobarbital > surgical exploration 22 yo - pain/edema of R.upper ext > 10 days after...