Step 2 CK NBME Form 4Edited Block 1 1. D (recurrent candidal infections >> impaired cell mediated immunity)2. A (reassuring pattern)3.
E (normal pressure hydrocephalus >> impairment of the higher mental control of the bladder which basically inhibits the voiding reflex)4. A (post-streptococcal acute glomerulonephritis)5. D (hostility towards authority without gross moral violations)6. Pico2000 software. B (high BP plus papilledema)7. E (Multiple sclerosis)8. C (the patient is psychotic so her demand for an abortion cannot be allowed. Haloperidol can be used in pregnancy if the benefit to the mother clearly outweighs the potential fetal risk9.
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Signalizaciya yaguar tez b s avtozapuskom instrukciya po primeneniyu code. D (Crohn's disease predisposes to fibrotic strictures)10. D (Slipped capital femoral epiphysis)11. E (RSV infection)12. A (facial edema + linked with history of food intake)13.
E (hint: irregular mobile mass in the right upper quadrant)14. B (blood cultures to confirm endocarditis. Blood cultures should always be collected before antibiotic treatment begins.)15. D (chronic pancreatitis. Amylase and lipase may or may not be elevated. Pancreatic enzyme replacement therapy to relieve steatorrhea.)16. B (increased intracranial pressure plus growth retardation plus visual difficulty >> craniopharyngioma fits)17.
F (joint aspiration >> first step in management of a swollen, tender joint)18. D NSAIDS (Osgood Schlatter Disease: Osteochondrosis of the tibial tubercle Tx: Kaplan notes say immobilization of the knee in an extension (or ) Cylinder cast for 4 6 weeks.
Books also mention NSAIDs as part of treatment. Apparently the correct answer on online NBME, informed by a commenter, is D - NSAIDs)19. A (pulmonary embolism, Spiral CT scan preferred over pulmonary angiography)20. E (restrictive pattern on PFTs)21.
B (Intussception >> contrast enema is diagnostic and therapeutic)22. D (oral-esophageal candidiasis in HIV >> Fluconazole)23. G (Diabetes mellitus)24.
B (Febrile neutropenia)25. A (only 40% of original participants remain)27. F (patient was well-controlled on Paroxetine >> best option is to resume it)28. G (hint: masses vary in size with her menstrual cycle)29. A ( diastolic decrescendo murmur ) A31. B (Systolic murmur radiating to carotids is classic for aortic stenosis.)32.
D (Metronidazole for pseudomembranous colitis)33. A (L to R shunt >> increased pulmonary blood flow)35.
A (subarachnoid haemorrhage can lead to diabetes insipidus)36. F (vitamin D supplementation is recommended for all breastfed infants)37. D (patient fulfills criteria of Major Depression. Note the marked anhedonia >> no longer enjoys the taste of food)38. A (von Willibrand disease)39. A (specific trigger, doesn't fulfill criteria of Major Depression)40.
A (Urge incontinence)41. D (N0 M0 indicates that the tumor removal was most likely complete, therefore metastatic diseases is unlikely. Plus patient's smoking history also is risk factor for primary lung cancer.)42. A (Hemochromatosis)43. C (alzeimers Dementia)45. B (Postal worker >> high risk for bioterrorism.
Cutaneous anthrax eschar is characteristic)46. E (ankle edema >> well known side effect of Nifedipine) Block 2 1. E (positive ANA and dsDNA)2. C (ST elevation on ECG at lead 2 3 AvF)3. G (Tension pneumothorax)4.
B handwashing practices. C (Naproxen >> nephrotoxicity)6. C (looks like alcohol withdrawal)8. D (Hydatidiform mole)9. B (obesity, papilledema, bifrontal headaches)10. B (hyperkalemia with ECG changes >> Ca Gluconate)11.
D (GI obstruction, first step NG decompression)12. B (depression history + mania episode now) B13. A (2 year h/o productive cough >> Chronic Bronchitis. O2 sat: 90% >> Blue Bloater)15. A (smoking is a contraindication for OCPs)16. C (Foreign body ingestion >> bronchoscopy)17. M low TSH high blood pressure M18.
C (Isoniazid neurotoxicity preventable by administration of B6)19. B (hyperglycemia can cause hyponatremia)20. E (elderly patient, hematocrit too low, transfuse RBC. We don't use 5% Dextrose water or 0.45% saline for resuscitation, we use 0.9% Saline, which isn't given among options)21. A (oral & genital ulcers plus erythema nodosum)22. C (Erysipelas)23.
D (MRI shows a mass obstructing CSF outflow from the ventricles. Choice E is wrong. Choroid plexus papilloma most commonly occurs in Children, and even Choroid plexus papilloma itself can cause obstruction to CSF flow depending on its location)24.