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NBME

Nbme notes for usmle

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Namrah Syed
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85 views101 pages

NBME

Nbme notes for usmle

Uploaded by

Namrah Syed
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
Repetitive Nerve Stimulation Studies diagnostic for B. toxin VeStibular Neuritis : Acute, Nausea Ga pocphos! OTA in kids < 16: Slit Eye Exam Look for Uveitis CAD can cauSe angina even after meats: Valve replacement iS 1St Line. Valuotomy is 2nd ti Mass in neck: FNA require Surgery Must wear shoes if diabetic DALY: Disabitity adjusted Lig 5 YPLL: Only mortality — HAtypicat gtandutar cetts on Pap-————S—™ Cotposcopy w/ endocervical curettage 1 month of diarrhea, bloating & weight Loss after returning from trip - Giardia Cyanotic baby right after birth - ppv & Sti tion HR ; g lizes tt ust ob$ -i¢- HO15cm or persistent ter 2 5 oF age wilt St Likel entarge voluutus-Omphalocele Postpartum endometritis- iv antibiotics Post Roux-en-Y gaStric bypass, nausea, iti Sion & Falling- B41 Cthiamine)-desici hich is abSorbed i jejunum Age-Greatest risk factor for dementia DOH oF hip- ultrasound in <6 months Learn to identify V-tach __Ng tube/ trachea deviated to right. ~ spec sorte dazeetan Pain Crisis in SCO-94%.02- 02 Supplementation- Impending Acute chest Hypotension + acute abdominat pains crampey — pain w/ bowel movements- Ischemic Cotitis Post-cholecystectomy biliary Leak iS diagnosed by ERCP Renat art stenosis ci ith MR Hypoxia, oliguria, low hematocrit post-op in which 500 mt was lost- Give packed OF Submandible - FNA in mid pote oF tert kidney about 2.5 cm. enhancing & cyStic in nature with internat necrosis- Lest nephrectomy Placenta accreta riSk increased by placenta ia & prior C Secti Bacterial vacinosis- get_a wet ‘ besore giving met prevalence ratio. IF extrapolated to generalized population, only then SD, SE. ___and other measures willbe used. .a-€ iC, crusted plaque w/ areas of ulceration on forehead- SCC Actinie-keratosis-has_a-oritty-text Cume in thigh post trauma, paintess, Slowly Growing, Soft tissue mass. MRT Shows Soft tissue mass- core needle biopsy uSe incontinence brie¢s instead of catheter to avoid UTI Hand washing erior to Central Venous catheter 10 t cnt Cc ( agter transfusion- Pick Fluid overload even i¢ elevated JVP not mentioned Timetine of cerebral ingarction- when last aspiri . - itis MRL of sei not blood cultures ~ Suspected osteosarcoma- MRI First then biopsy ~ Type 2 OM For 20 years- Hypertension even — though creatinine iS normal Urine 4 protein cauSe of HTN iS renal parenchymal disease by OM CKD — GIR w/Virat URT & 1/0 asthma - 02 Saturation Suddenty dropsS_bronchospasm —OSA-Increased-putmonary HTN can be seen on echo Paintess gross hematuria -Atways transitional cell carinoma-2 om mass in the bladder stittbirth acter 2 Ks Ky Nst in 3red-timester starting at 32 ks Also do 2 or 3 ultrasound across gestation to detect anamoties z 5 Siin-an-otel man wit { Stage pancreatic cancer- Don't treat it Civer transplant man walks on beach & gets Severe pain that radiates in his him- Reassure becauSe Stranger’s anxiety confusion + Fever + jaundice + tow platetets” = TTO- plasmapharesis SMA type-I Cingantite)- death isi {ue to resvirat fistress_Atso + di¢ficulty Feeding and in mobility SMA type IT (Dubowitz): never walk or stand without assista —SMA type TIT (Kugelberg-Welander—__ sundi }: imat-muSet “ness i arms & tegs, Skeletal abnormatities . Trace — OTRTI waddving gait. High CK Ketorolac 08 Reetaminophen? oni Bt ay 5 Lonsittitis-Peritonsittar abscess- Needle aSpiration & antibiotic therapy ha oH hitia A9- Test ¢t ‘ blood for Factor & after delivery oF boy minimal hair & intellectual development diSorder- Ktinefetter even if height is Short CauStic alkali ingested - esophagoScopy emergently performed the test veSicles on inside of mouth & posterior oropharyn OCR oF an open vesicle Vitamin 812 deficiency Scenario but MRI Shows mitd cortical atroot ' vertictes& muttipte-s sor Tot intensities: Ignore the MRI Returned From South West Asia 2 months —ago, two pimples on nose that enlarged ____ —to- forma -Singte-open Sore, eventuatty——_— fevetoving ascat 5¢- Leishmaniasis Gonococeal Arthritis - even if No gram Stain and no culture - Continue antibiotics Overhead work in 60 year old man Sening Shoulder pain 4_day tat pak Linabitity-rais higt Rotator cuts tear Sudden patpitations trigued by caffeine, atcohol- SVTCAVNRD Asymptomatic & smatt pleural errusions from a known cause Like pneumonia require no K Lithogenie bite-cal : . MR 2 ( + ( (3 - echo not angiography Do angio after ECG & cardiac biomarkers Suggest Severe dizziness & Spinning SenSation when head moved . Brie¢ episode of double isi {pain i k- Vertebral art stenosis and Sudd a wis fissection—CTangio stat Cirrhosis = Na tow-K ee due to prostaglandin & ADH Light periods ¢rom 6 months - on oce ____Reassure Tick removed before 24-36 hours- Reassure ___and_¢ollow_upin2 weeks = Share_Shooting butt pain i bient ; trotted-t rods-ancd acetaminophen - add TCH or snRI 1St Line in neuropathic Pain Paroxysmal cyanosis in a 3 month old baby- Tetralogy of Falot 11 ' fi sitive in-31-year-otd Prevalence iS 1%- So PPV will explain Paediatric H Lension--Renat_USG.$ iu ure ri lack thyroid features? Do not do TFTS ~ Qualitative studies-study Sociat or other phenomenon as to how people think about the disease, Stigma etc No erecautions for EBV transmission Nodut DRE-Bioesy indicated: i ~ who has tife expectancy of greater than 10 years fever& high COH-mataria Na, Cow K - Increased aldosterone, Cow Renin vaccinia i$ vaccine For Small POK € Polydipsia & polyuria - Psychogenic polydipsia- DI would be constant Nuchat rigidity-Virat Cs¢ Findings - Aseptic ingitis not viral hatitis CAP (mitd-moderate) even in Sickle cell trait- oral Azithro, doxy or amoxicillin Patients with co-morbidities A icittin-ct be & Levorl . plow height consistently in Same percentile Since many years v G constitutionat Growth detay- detay in ° berty too-Don't pick thyroid thing —_—unless Symptoms_are mentioned — Exertional dySpnea & exercise intolerance in a lady with Of that can't climb one Flight £ Stairs- Adenosi lear Stress test aft sting Ecg not ise stress test ~ Paintess bony masses near knees & anktes- osteochondroma- Sessile or pedunculated tumor whose cortex iS continuous with _cortex of underlying bone 3 cm non tender, ¢luctuant mass invoking the lect eosteri fertuing +t ing- ( a Vestibular gland cySt are adjeacent to urethra 7 [2 -P 49 ern Nqoronken Y knf ae J, oa aaelle shectih Cthw Avr pen As dySuria, increased urinary Frequency & blood tinged urine ina S2 ld ' ‘ t hyst ‘ ‘ triosis t-end triosis 10 years BRCHA: Q 1 year Ss tid Excision-N {or MRT 17 year old gir Losing weight and dieting - Advice not to-to$ ight & tt ue Ingtiximab & azathioprine in Crohn's patient Follow-up test : CBC to check anemia or pancytopenia Betat is.02 fi bet groups iS-found: Type TE error Power = 1- Beta Decease Beta chest and abd to check For mets Iat tum: during detivery HSV2 ~ Women at 16 weeks are given cerclage or bed rest if cervix <25 mm and then followed -cohort ine-teat vite tresiduat volume 500 mi: Overflow incontinence eit < 22/23 whe 12 Pre-mature, non viable baby(¢used eyelids, NO nipples or Lanugo)- Discontinue suscitative errorts authorities like State medical board or Medicat director NOTCLINIC AOMIN vey, x : x bi thium, con tinue it Da ta iS Scarce For patients making end of Life decisions, __a capacity assessment Should be performed. Extore aSoning & understanding ie ( ( Symetoms& quality oF life, reduce hospital readmissions and durations of Stay Schizophrenic patient agrees to treatment but Says he won't adhere- change oral medicine to injectible f it 0 Facilit ‘ainst welt High SuSpicion inden for PE in Syncope tients Specially those who tak —eontraceptives— ——-—-—@-— Febrile non hemolytic transfusion reaction __Acetaminophen overflow incontinence due to OM- neurogenic bladder Syoptomabe & Sdem Femoral aneurysm cauSes thrombosis oF third toe- Aneurysm treated First Surgically and thrombosis treated later iy puis Patient wants doctor to Falsigya / disability Form So She can get education- Tett her other means i.e. work options No treatment for Igh deficiency- identicy Ion degici by Looking at tg Levels Attergic rhinitis—2nd-¢ i-histamines ‘intranasal Steroids Macutar deg tion-ditated_sundoscori exam e isk OF morealityr . =, ; ( 1'0.5+1'0.5 X0.5) X 0.2 Wernicke -Korsakof¢- Dumb to Sealy, red patches an ams, legs & body Pityriasis rosacea 32 you old man with HIV- pneumococcal A iate vaccines riven 7 years ag ~ when Dx was made- PCV 13 then PP SV 23 & weeks later and then ePSu 23 5 years later and then at 65 yeas ofS ort HD ia imailiaus on erased Man on vent for 4 days due to pneumonia € \ abso Prpothuapy & . Lovesicat-sistuta in-a-77 year otd-ma t (Cc ¢ IBD in young Symptomatic patients Sciatica due to Lumbar herniation - _no further testing needed ~ CAD patient with BP 145/78 - HCTZ Cool 140/90 fo eu 130/80 ‘hn DM 8 CCD So Smoking cessation and home oxygen therapy — for cor pulmonate colonoScopy annually iS recommended for patients with more than 10 adenomas Baby Fed with only cow's milk will be deficient in iron RAS in kids angioplasty or Calcium channet blockers New drug for COPD tested in hospital patients only admitted during a Fixed time Sampting bias and ¢ lizabitity-Biggest Limitati _NauSea_and-general_-mataise_are-because-o¢ — tow Sodi ie Lassiuen Seen. ‘Discontinue diuretic Dying patient with Loud heath & Secretions __Glycopyrrotate and Scopolamine = Stitt ha bo See the kids Sickling - urgent Surgical washout if high ICP not controtied ( a ( t] ability to re-abSorb 7 ise TTT —EMG and- NCS 6 hours af¢ter transfusion- fever, cyanosis, hypoxemia and hypotension- TRALT _Putmonary contusion 24-48 hours later Tmmunochemical test is not ELISA 0&®P to congirm Giardia WOW syndrome -cardiac electrophySiologic Study- Procainamide if¢ arrhythmia How the Positive resut affects the probabibility that the person consumes atcohot- Likelihood Rati Pericardiat-e¢susion-Dumb Dumb-Dumb-Dumt Dumb Dumb-Betlieve the pictures fre inabilty to evacuate bladder / incontinence and mass protuding from vagina -cyStocele be Medical emergency and the alert person changes her mind Suddenty From the advance directive -Do what the patient Says Normat CTG- Normat Labor deceleration 80 digrerential between armS-Subclavian artery Stenosis __Coarctation causes dig¢erence between upper-&towertimbs Unstable patient with epiglottitis - endotracheal intubation under direct __laryngoscopyinOT Y month old girl, Meningitis -[Link]- Blue, diplococcus on CSF Neonate iS tilt 1 month Coperamide can increase the risk oF toxic mega colon Recognize tonic MC Extent oF post bite injury may take hours to days to fully assess Urinalysis iS necessary in the diagnosis oF urge incontinence transverse tract e-distat-t at ~ metaphysis with posterior displacemat oF distal fragment- Decreased radial pulse Brachial artery injury — Lo t my oe M _ \ ft Roo al \ (YS 7 \\ 1 \\ 7 \\ tT \ for CTScan no need to rule out with ultrasound 22 year old woman- widetysptit A2, 0 pulmonic murmur- Biggest riSk in 10 years Pulmonary hypertension Don't pick things nothing is tioned of Unilateral gynecomastia can occur in puberty 47 year old woman, back pain worsens with Sitting to Standing, Sitting For a Long time I¢ a result does not cause a Significant fice in clinical ti t clinicalt Signicicant SB0s toms-hist partial intussusception RLS - chee! iti Sudden chest and back pain in Marfgan- Aortic dissection-CT Scan oF chest even iF hemodynamically unstable Hereditary angioedema discontinue Lisinopril I N@ME-Schizophrenia-S io-but ( tl . (| pick Schizophrenia ( ( Cul ( 4 hour dose Should Switch to Sustained retease or transdermal patches oF tong king opiods tit hi Mes matron Wertott sv Aeeendicities, unstable or clear Signs- OT 5 day history oF itchy raSh and hiStory oF allergy - Urticarial raSh -Diephenhydramine ilostazot for clavdicati Two epiSodes of viSion loss& headaches ESR high- prednisone Vis abo thaounds— stimesg 7 ib. Met wrod te lopnenre AL bLhardlr0

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