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Usmle กู อย่างละ 100ข้อ > USMLE 2 ชุด 9 > Flashcards

USMLE 2 ชุด 9 Flashcards

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USMLE® Step 1 flashcards
1
Q

endometriosis

A

infertility risk factor

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2
Q

7yo gild

taller than average

A

granulosa cell tumor
inc estradiol inc inhibin

if adult = breast tender, AUB, Post mens cell extner

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3
Q

sertoli + leydig presentation

IX?

A

amenorrhea deep voice
clitomegally oligomen unilat

IX surgery tumot staging _ rapid onset ?

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4
Q

daughter drug mum need to as daughter permission before tellin mum

A

ER STD MENTAL PRREGNANCT CONTRACEPTION

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5
Q

pelvic organ prolapse

A

multiparity post men hysterectomy obesisty

TX: passary

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6
Q

8wk AOG utz +yoke but no pole
in BHCG

no discharge bleed no FHB close cervix OS

A

missed abortion

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7
Q 
preeclampsia small for gestational age
low PLT 
\+ LDH
microangiopathic 
  caused from?
A

chronic uteroplacental insufficiency

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8
Q

hypoxic brain

A

abruptio placenta

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9
Q

42 yo breast swell pain BMI 46.6 no fever diffuse warm dimple
DX?

A

inflammatory breast

peado orange

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10
Q

fat necrosis

A

irregular boarder

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11
Q

fibroadenoma

A

regular boarder

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12
Q

infiltrate ductal lobular

A

yes dimple

no edema no red

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13
Q

ovarian ca

TX

A

explor lap

ถ้าสงใสทำ USก่อนแล้ว CA 125 แล้วค่อย SX

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14
Q

42 yo AUB irregular mens
no HA hot flush ok vagina
yes cool dry skin
dec FSH inc TSH inc Prolactin

A

hypothyroid

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15
Q

post opt DS CS T3g มี LQ pain serosang drainage

ขาไม่มีอะไร

A

septic thombophlebitis

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16
Q

post delivery anemic

tx?

A

IUD + levonogestrol ทำไห้ไม่มี mens

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17
Q

medroxy progesterone

A

wt gain

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18
Q

HIV pregnancy
TX?

viral load <1000- ART + vaginal
>1000- ART + zidovudin + CS

A

viral load
<1000- ART + vaginal
>1000- ART + zidovudin + CS

เด็ก zidovudin / multi ART ถ้า CS
check viral loac 4wk after , 3mo.6mo later

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19
Q

preg + HSV

A

acyclovir wk 36

even with no lesion

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20
Q

pap atypical glandular

IX?

A

endometrial biopsy at 35 yo

or AGE 45+ AUB
AGE -45 + obese no kid fail med lynch

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21
Q

ovarian cyst rupture

A

+ free fluid

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22
Q

post opt AUG irregular mens dec wt

normal TSH normal Prolactin inc FSH

A

accelerated ovarian follicule depletion
turner fragile X chemo

primary ovarian insufficientcy

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23
Q

stress incontinence

A

mid urethral sling
kegel excercise
hyper mobile urethra
urogenital mucosa atrophy weak pelvic floor

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24
Q

over flow incontinence

A

a blocker relax smooth muscle bladder neck

BPH,

cholinergic inc muscurinic inc bladder contraction

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25
Q

urgency incontinence

A

oxybutinin antimuscurinic urge to void immediate loss urine - neuro disorder

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26
Q

B1 thiamine wernicke encep

nystagmus - encep - ataxia

A

hyperemesis gravidarum hypo Cl
met alka
hypo K hypogly
inc LFT

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27
Q

B12

A

anemia

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28
Q

syphilis

A

constrict with accomodate but not to light

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29
Q

21 yo high fever hypotension(no in syphilis ) macular rash on body

A

staphylococcus aureaus ok at hand foot

TSS tampon
T1 exotoxin multiorgan failure

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30
Q

Abortion

A

provide list of ppt that can do ไม่ต้องถาม why

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31
Q

Growth restriction
chromosomeal lesion
uteroplacental

A

chromosomal lesion - global

uteroplacental - head sparring

Ix do biophysical profile UTZ doppler

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32
Q

pimple excercise CAH 21 hydroxylase

A

46XX no tit no egg but have pimple + big clit

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33
Q

PCOS

A

only pimple

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34
Q

sertoli leydig

A

1 egg, and clitomegally

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35
Q

34 wk AOG + hx eclampsia + FGR

s/p CS now with flank pain

A

schedule C?S at 37 AOG

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36
Q

37 wk cephalic version if not ?

A

myomectomy
C?S
previa
CC= abruoture placenta

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37
Q

rupture ectopic - hypotension adnexal mass tender
cervical motion tenderness
miss abortion vaginal bleed
diffuse pain

A

rupture torsion unilateral

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38
Q

vaginal delivery

A

copmlete breech frank breech

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39
Q

PCOS
GNRH
ESTROGEN
FSH

A

inc GNRH
inc ESTROGEN
normal FSH

40
Q

primary ovarian insuff
GNRH
ESTROGEN
FSH

A

inc GNRH
DEC ESTROGEN
inc FSH

turner fragile

41
Q

34 yo infertile feel warm at night hypothyroid take levothyroxin

TSH??

A

normal TSH

42
Q

OCP not cause wt gain

MCC SE?

A

break thought bleeding , cervic CA

ลด endometrial CA

43
Q

45yo diff sleeping dec wt edema fat
uterus enlarge

IX

A

BHCG = r/o preg first

44
Q

43yo 39wk AOG seizure cyanotic RR30 O2 75% on face mask

DX
TX?

A

amniotic embolism

TX? intubation

45
Q

inc AFP

A

abdominal wall defect
spinal bifida
anenceph
miltiple gestation

46
Q

dec AFP

A

18,21

47
Q

PAP +

CC

A

cervical stenosis

48
Q

vulvular lichen sclerosis
painful puritus
defecation alopecia areation hot flush thin white labia minor major

IX
TX?

A

biopsy

stroid

49
Q

UTZ
sac
crown rump
BPD

A

sac - 4.5-6w
crown rump 7-14w
BPD 14-30wk

50
Q

20yo มี RLQ pain bleeding - BHCG 1000

IX?

A

repeat BHCG 2 วันหลัง dec BHCG ไม่ r/o

51
Q

physiologic pregnancy change

renal
CBC
pulmonary

A

renal- inc CO inc renal flow inc GFR dec BUNCR, in Na excrete - nocturia frequency, inc ADH threshld mild hyponat

CBC - inc plasma dilutional anemia, fibrogen coag hyper coag, dec protein S

pulmonary - progesterone stimulate central inc tidal centilation> chronic respi alkalosis

52
Q

pregnancy +VDRL TX

A

Penicillin

if allergic = do desensitized @@@ dont change

53
Q

pregnancy
+conization ดู ?

TX?

A

cervical length TVUZ

  • 2.5 progesterone maintain pregnency
  • 2cm + cerclage
54
Q

ovarian torsion

A

laparoscopy with detorsion

55
Q

RH -

A

Anti D globulin at 28-32 then 3 days after delivery

56
Q

46XY blind pouch no terus ovary cervix + milk no hair + egg

A

androgen insensitivity syndrome AIS

57
Q

16 yo recurrent lowe abdo pain 1 day before normal

A

primary dysmenorrhea inc prostagladin endometrial produce in contraction NV

TX NSAID

58
Q

hyper MG

A

renal insuff = secrete by kidney

59
Q

28yo disconfort urination + pain passing stool suprapubic pain nodularity posterir culdesac

DX TX

A

exmeteriosis

TX LAP

60
Q

8wk AOG routine visit
BMI 23
do what ?>

A

influenza vaccine

no FBS ต้อง morbid obese+25))) macrosomic infant

61
Q

44yo night sweat irregualr mass HT

IX?

A

TSH FSH

r/o thyroid ก่อน reassure ptx

62
Q

25 wk AOG

hepatitis vaccine

A

ไหเ hep B + A vaccine ได้
hep C = GD< cholestasis preterm

CS not protective
yes milk breast feeding

63
Q

UTZ heterogenous mass + cystic structure
=hydatidiform mole
Presentation

TX

A

hyperthyroid
hyper emesis
preeclampsia
suction curretage then contracep 6 mo and BHCG

64
Q

26yo anxiety when breastfeed irritable ocnstipation wt gain

IX

A

thyroid test

hypothyroid

65
Q

twin mcc cc

A

preterm labor

66
Q

IUFD

A

20-23wk - dilate evacation
24wk - vaginal delivery

but delay until patient is ready

67
Q

19yo
muscular excercise
amenorrhea ?

A

hypothalamic anemirrhea

dec gnrh dec LH dec FSH dec estrogen

68
Q

18yo vaginal puritus yellow discharge vercix bleed

TX

A

azithro + ceftri

cervicitis - chlamydia + gonorrhea +- fitzhuge curtis

metro - green frothy

69
Q

CMV

A

periventricular intracranial calcification

70
Q

aspirate breast cyst then fu

A

2-4 mo after

71
Q

G5P0A4 baby not move
FHR 130 mod vaiability
IX?

A

biophysical profile

NST 20-40min = +2 contract
BIO- UTZ amniotic breath movement tone == equivocal 6

less = placental dysfunction

72
Q

ureteral diverticulum presentation

A

recurrent UTI with post void dripping + anterior vaginal wall mass bloody ytrthral discharge

73
Q

late decel tx

A

C?S ถึงจะon going active phase

74
Q

UTZ multiple thin echogenic band ?

A

cystic teratoma = hair

75
Q

postcoital bleed - yellow cervical discharge + friable cervix bleed

gold standard IX?

A

no organism = goldstandard NAAT

chamydia intracellular > light microscope

76
Q

prenatal ANC + initial VDRL BsAG Anti HiV cbc chlamydia PCR UC U prot

A

24-28 CBC +50g glucose 1 hr tolerent test

35+ GB strep

77
Q

tamoxigen

A

antagonist breast

agonist uterus

78
Q

PPROM

A

risk for preterm @@

79
Q

sinusoidal

A

fetal blood loss from vasa previa

need CS

80
Q

28 wk AOG anenceph
rupture
breech

TX?

A

allow spontanous delivery

81
Q

48 yo pale vaginal mucosa
scarred cervix

think irritate narrow vaginal introitus

dyspareunia

A

atrophic vaginitis
+- bleeding UTI dec elastic
fissure petechiae

82
Q

thick peri anal$

white excproation from minora to anal

A

lichen sclerosis

83
Q

HTN 140/90 x 2 times
if OCP
TX?

A

stop OCP choose another route

84
Q

Post partum DI
now suprapubic pain radiate down
bipedal edema
+4 kg shoulder dystochia

DX?

A

pubic symphysis diastasos

TX NSAO Dconservative PT
pelvic suppore

85
Q

Bilat ovarian cyst

UTZ multilocular areola

A

adenocacinoma

PAGET disease

86
Q

8yo pelvic exam มี flesh papules at vulva+ anus + bleeding

A

sexual abuse genital warts

ACUMINATA

87
Q

stress incontinence

TX

A

1 pelvic floow muscle excercise
2 wt loss
3 pessary sling procedure

88
Q

shallow ulcer genital + painful + surrounding erythema

A

HSV

Ducreyi = 1-2 ulcer well dermarcated

89
Q

pseudo cyesis

A

clinical pregnent แต่ไม่ preg จริง

90
Q

42 yo PMS PMDD return to work 2 mo withsymptom daily 2 cycle in luteal phase

TX?

A

give SSRI

91
Q

look like orange peal at the axillar

A

hydradenitis suppurative
hair follicle inflammation
ABSCESS

92
Q

20 y PTA + sex

what vaccine

A

HPV

93
Q

LAte decel

A

uterine rupture

dec oxytocin

94
Q

1 yo swing arm then cry hold arm pronate against chest

extend + pronate

TX?

A

gently pronate right forearm
supinate foarm flex elbow

DX radial head subluxation
nurse maid elbow

95
Q

stat = ถ้า confident interval มี 1 หรือ ตกอยู่ใน 1

A

null value not stat significant

p value >0.05

96
Q

10 y
post trauma with hallucination
2wk work ได้ take risperidone

DX ?

A

schizaaffective
มี MDS + schizo + Manic

แต่มี delusion hallo +2 wk ตอนไม่มี MDS, Manic

Usmle กู อย่างละ 100ข้อ (10 decks)

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