NBME Clinical Science Mastery Series: Medicine - Form 4

Question 1

Pain with abduction of the shoulder against resistance represents an injury to which structure?

Answer 1

The supraspinatus muscle (empty beer can test)

Question 2

Recurrence of taenia after successful topical treatment most often results from ______________.

Answer 2

autoinfection from an untreated lesion

Think of this if the question tells you that a cruris was cured but returned with pedis.

Question 3

Per the NBME, what is a stronger indication for anticoagulation, adenocarcinoma or prosthetic valve?

Answer 3

Prosthetic valve

You only anticoagulate those with malignancy if they have had a clot.

Question 4

In a person with recurrent pneumonia and lymphocytosis, ___________ is most likely to yield a diagnosis.

Answer 4

serum protein electrophoresis

I actually don’t know what the disease is and was not able to find out by a five-minute search, but this is a question on the NBME. Sounds like maybe multiple myeloma but I don’t think it causes lymphocytosis. IG deficiency?

Question 5

The proper HAART regimen is _____________.

Answer 5

triple therapy

Question 6

Which PNA vaccine is given every five years?

Answer 6

23 valent

Question 7

In which populations is the meningitis vaccine indicated/

Answer 7

• Children 11 - 12 with a booster at 16
• Young adults going to college or the military
• Those without spleens

Question 8

The best initial therapy for PCOS is ______________.

Answer 8

oral contraceptives

Medroxyprogesterone is used for the differentiation of PCOS from anatomic problems.

• If the woman bleeds after withdrawal of medroxyprogesterone (Provera), then she has a high estrogen state with no anatomic obstruction (i.e., PCOS).
• If the woman does not bleed after withdrawal of Provera, then she has either low estrogen (which would cause lack of endometrial proliferation) or an outflow tract obstruction.

Question 9

Pressure ulcers with eschars should be treated with ________________.

Answer 9

debridement

Question 10

How can you prevent anemia in CKD?

Answer 10

Give EPO.

Question 11

What is the best way to prevent lacunar infarctions?

Answer 11

BP control.

Although the pathology is described as lipohyalinosis –which might make you think it is related to cholesterol deposition –it results from HTN. Keep them from developing HTN!

Question 12

Slow adduction of the eye with contralateral gaze results from disruption of the ____________ MLF.

Answer 12

ipsilateral

So if the left eye cannot adduct when looking right, then it is the LEFT MLF that is malfunctioning.

Question 13

Essential HTN with age results from _____________.

Answer 13

decreased vascular compliance

Question 14

Which hyperthyroidism drug can cause agranulocytosis?

Answer 14

PTU

Question 15

True or false: Hodgkin’s can cause lymphocytosis.

Answer 15

True

Question 16

True or false: a fixed split S2 with a systolic murmur is likely VSD.

Answer 16

False

This is ASD. The systolic murmur results from increased flow over the pulmonic valve.

Question 17

Patchy infiltrates with increased interstitial markings in a person with an 8-day history of illness likely represents pneumonia from what etiology?

Answer 17

Mycoplasma

The radiographic description with the long illness course point you in this direction.

Question 18

Does lactose intolerance affect villi morphology?

Answer 18

No

Villi blunting is a sign of celiac.