Questions

DIRECTIONS Each of the numbered items or incomplete statements in this section is followed by answers or by completion of the statements. Select the one lettered answer or completion that is best in each case. 106. A 59-year-old woman presents complaining of a cough productive of sputum for nearly 10 years. Her cough occurs during the day and she produces sputum daily. The woman states that as a child, she had several episodes of pneumonia requiring hospital admissions and antibiotics. Several...

Answers

The answer is a. (Fauci, 14 e, pp 712-715.) Multiple myeloma (MM) is a neoplasm characterized by proliferation of plasma cells (fried-egg-appearing cells) seen typically in patients over the age of 50. The disorder may lead to bone pain, pathologic fracture, anemia, susceptibility to infections, renal failure, and hypercalcemia. The bone pain of MM worsens with movement (the pain of metastatic bone disease is typically worse at night). Patients have an increased serum globulin and a...

A score of 07 is mild BPH 819 is moderate BPH and 2035 is severe BPH

The answer is b. (Fauci, 14 e, p 1544.) IgA nephropathy (Berger's) is the most commonly encountered form of focal glomerulonephritis worldwide, and patients will often have microhematuria. It may follow an upper respiratory tract infection or physical exertion. Bladder cancer is a common cause of asymptomatic microhematuria but is usually found in patients over the age of 50. Risk factors for bladder neoplasia include aniline, rubber, other organic solvents, industrial dyes, and tobacco...

Syndrome Associated With Hypospadia

The answer is b. (Seidel, 4 e, pp 665-668. Tierney, 39 e, pp 1141-1142.) Germ cell tumors are the most common tumors in men between 20 and 35 years of age. A man who presents with a testicular mass and an elevated serum a-fetoprotein (AFP) level most likely has non-seminomatous testicular cancer. The elevated AFP implies yolk sac or nonseminomatous elements. Patients with seminomas (more common than nonseminomas) often have elevations in human chorionic gonadotropin (hCG). All germ cell...

Terms of

A 21-year-old man presents to your office for a preemployment physical examination. He is 6 ft 3 in. tall and weighs 70 kg. Heart examination is remarkable for a midsystolic click and a grade 2 systolic murmur that increases with Valsalva maneuver. The patient has an arm span that exceeds his height and has long, slender fingers. The thumb sign (Steinberg sign) is positive. Which of the following is the most likely diagnosis 6. A nursing home patient is transferred to the hospital for possible...

Obstetrics and Gynecology

DIRECTIONS Each of the numbered items or incomplete statements in this section is followed by answers or by completion of the statements. Select the one lettered answer or completion that is best in each case. 452. A 23-year-old woman presents with fever and bilateral lower quadrant abdominal pain for two days. She complains of the onset of a mucopurulent vaginal discharge with her menses, which she states is yellowish in color. She has a new sexual partner and uses a nonbar-rier method of...

Pediatrics and Neonatology

The answer is b. (Behrman, 16 e, pp 1385-1399. Hay, 14 e, pp 496-497.) The five congenital heart disorders listed in the answer (the five T's) cause right-to-left shunts and subsequent cyanosis. Tetralogy of Fallot is the most common type of cyanotic heart lesion and consists of Pulmonary stenosis, RVH, an Overriding aorta, and VSD (PROV). Children present with dyspnea, cyanosis after the neonatal period, irritability, easy fati-gability, and retarded growth and development. Physical...

Terms of Use

A 17-year-old patient presents with severe pruritus that is worse at night. Upon examination of the skin, areas of excoriated papules are observed in the interdigital area. Family members report similar symptoms. Which of the following is the most likely diagnosis 51. A 35-year-old woman who had been camping in Wisconsin 2 wk ago develops an erythematous rash on her inner thigh. The macular lesion is 10 cm in diameter and had a distinct red border with central clearing. Two days ago, a...

The answer is c Seidel 4e pp 532533 Normal liver span is 612 cm in the MCL and 48 cm in the midsternal line MSL Micro

Nodular cirrhosis is typically uniform throughout the liver and the nodules are < 3 mm in size. It is due to a metabolic insult such as alcohol use. The nodules of macronodular cirrhosis, which are less uniform, are > 3 mm in size and are due to drugs or infection. 204. The answer is c. (Fauci, 14 e, pp 1626-1629. Sapira, p 273.) Diabetic patients, especially those with poor control, may develop delayed gastric emptying (autonomic dysfunction). Often patients will have a succussion splash...

Infectious Diseases

DIRECTIONS Each of the numbered items or incomplete statements in this section is followed by answers or by completion of the statements. Select the one lettered answer or completion that is best in each case. 426. A 25-year-old heterosexual man develops a urethral discharge and dysuria 5 days after having unprotected sexual intercourse with a new partner. Physical examination reveals meatal erythema. There are no penile lesions and no inguinal lymphadenopathy. A purulent ure-thral discharge is...

The answer is a Fauci 14e pp 14511455 Massive lifethreatening hemoptysis is 100 cc of blood in 24 h The most common

Cause for nonmassive hemoptysis (< 30 cc day) in smokers and nonsmoking patients with a normal chest radiograph is bronchitis. Chronic bronchitis is characterized by excessive secretions manifested by a productive cough, often purulent or bloody, for 3 mo or more for 2 consecutive years in the absence of any other disease to explain the symptoms. Patients are often obese and cyanotic (blue bloater). The mnemonic is BBB Bronchitis Blue Bloater. 117. The answer is a. (Fauci, 14 e, pp...

The answer is d Fauci 14e pp 21162118 Gynecomastia is

Seen in 50-60 of adolescent boys and usually occurs during Tanner stages 2 or 3. It is usually painful and may be unilateral or bilateral. It gradually appears and gradually disappears within 1 year of onset. Pubertal changes that occur during Tanner stages 2 and 3 include growth spurt, growth of testes and penis, spermarche, acne, axillary perspiration, and appearance of pubic hair. The boy in this case should be reassured and followed monthly. If the gynecomastia does not resolve, it will be...

Hematology and Oncology

Purpuric rash abdominal pain glomerulonephritis in a child young patient HENOCH-SCHONLEIN PURPURA HSP Purpura livedo reticularis after a coronary angiogram think CHOLESTEROL ATHEROEMBOLIC DISEASE Purpura livedo reticularis hepatitis B abdominal pain after meals footdrop HTN think POLYARTERITIS NODOSA THROMBOTIC THROMBOCYTOPENIC PURPURA TTP mnemonic FAT RN 2. Anemia, microangiopathic hemolytic schistocytes 5. Neurologic abnormalities confusion, aphasia, headache, coma, seizures HEMOLYTIC UREMIC...

Causes of Hematuria mnemonic Switch Gps

Stones, Sickle cell disease, Scleroderma, SLE, Sulfonamides Wegener's granulomatosis Infections, Instrumentation, Iatrogenic, Interstitial nephritis Trauma, TB, Tumor, TTP, Tubulointerstitial disease Cryoglobulinemia, Cyclophosphamide Hemolytic uremic syndrome, Henoch-Schonlein purpura, Hemophilia Papillary necrosis, Polycystic kidney disease, Polyarteritis nodosa Schistosomiasis, Sponge disease medullary Most common organisms responsible for URINARY TRACT INFECTIONS UTIs mnemonic SEEK PP...