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Secondary hypothyroidism nbme 15 questions – NBME 15 Questions and Answers

Parents rate children.

Lucas Cox
Saturday, August 25, 2018
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  • T F.

  • Because the order of the questions is different from one to one and it takes time to find out which the question you are looking for!

  • Polish Archives of Internal Medicine.

  • Thanks for the explanations Ben!

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Normal Muscle: epp Amplicude 10; mepp Amplitude 1; Response to Ach 1 Which electrophysiologic characteristsics is expected in a muscle biopsy specimen from a patient with acute botulism? Personality disorder? Serum shows increased 5-aminolevulinic acid gamma-ALA and porphobilinogen.

This is why I tend to think about these questions intuitively instead of just applying a formula. Biopsy show marked inflammation of squamous epithelium. Drug antagonizes which mediator of pulmonary resistance? Xrays show dysostosis multiplex. Physical exam shows generalized lymphadenopathy.

Which best explains why deoxygenated blood can carry more carbon dioxide for a given Pco2 than oxygenated blood? No other neuro issues. Best next step? Inhibition of which enzymes is the cause of this finding? Physical is normal. Which viral activities will be directly inhibited?

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During surgical debridement, myonecrosis found. Patient has been active and feeding well. Mother states that daughter alternates from being sad and socially withdrawn to being extremely angry and aggressive.

  • Maruf likes this.

  • Withdrawal bleeding present after progestin challenge. Appropriate therapy is initiated; however, the patient dies after 48 hours.

  • Five day later, T Sensation decreased over palmar aspect of thumb and index and middle fingers.

  • Pyridostigmine provides relief.

  • Block 2 part 1 1. After establishing a patent airway, the most appropriate next step is administration of which?

  • Therapy for both acquired and congenital hypothyroidism consists of lifelong treatment with levothyroxine L-thyroxine and regular check-ups to monitor disease activity.

No foul or fishy odor. Kidney is shown. Because Yypothyroidism is more common among boys, girls and boys are randomized into the two treatment groups separately. Next step? Ct shows multiple, occasionally calcified nodules on the crests of some gyri in the subependymal regions. Which substrate is source of ammonia production? These suggest dysfunction to which structures?

  • He has hx of arrests for substance abuse, robbery and assault.

  • Frothy, yellow-green discharge in vagina.

  • Physical shows diplopia.

Has blank look and doesn't respond to questions. Point tenderness lateral to acromion, over the humeral head. Biopsy of mass shows? The mother reports that she found him in his crib not breathing. Fetus increased risk of what because of her cocaine use?

Physical shows a mildly erythematous pharynx. Questionss scan of abdomen shows a mass in the head of the pancreas with considerable extension to the stomach and biliary system. After taking a drug that inhibits cholesterol synthesis, total serum cholesterol concentration decreases to During hx, she stops talking mid-sentence turns her head to right, and extends and stiffens right upper extremity.

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During surgical debridement, myonecrosis found. Fetal ultrasonography shows that the ductus arteriosus has closed. Radionucleotide imaging with technetium 99m pertechnetate shows uptake in mass. Malignant cells are obtained from the tumor in the affected patient, and normal colonic epithelial cells are procured from the healthy subject.

Physical shows 1. Funduscopy shows a pale, opaque fundus and a bright red fovea centralis. His thyroid gland is not palpably enlarged. Has weight loss.

The vignette shows that the affected area is Wernck's area which is denoted by letter H in the question stem. Show Ignored Content. Reports no symptoms other than anxiety. He is jaundiced. No medications and physical is normal. Maruf likes this.

X-ray qusstions barium swallow shows irregular mass at gastroesophageal junction. Also has a 2-week history of visual discomfort when in a room with bright lights. Which best describes the annual incidence of cataracts in this population? Pulmonary artery pressure, pulmonary vascular resistance, and right atrial pressure all increased; pulmonary capillary wedge pressure 9. Labs show gram-negative diplococci.

  • Drinks two cups of coffee each morning and drinks alcohol occasionally. Which of the following is the most likely cause of these findings?

  • Physical examination shows no other abnormalities. Last menstrual period 8 years ago.

  • Which of the following is the most likely cause of these findings?

  • She tells the physician that she is always thirsty despite frequent water intake.

He has several pets. A couple has two children with osteogenesis imperfecta type II OI. Her temperature is Questiions menstrual period 8 years ago. Femoral pulses are decreased bilaterally. Also, 6-month hx of dry cough with chest pain and shortness of breath. Has a recent history of right hip fracture and multiple old and new ecchymoses, abrasions, and superficial lacerations.

But there was a 5 question segment that had a heart sound question and some videos, and it would be great if you could explain those as well! Thank you for the corrections. Typical clinical findings include fatigue, cold intolerance, weight gain, and periorbital edema. Increased risk for which sequelae?

You must log in or sign up to post here. Removal of surgical packing in nares shows erythematous mucosa. Hope this helps. Intubated and ventilated and treated with corticosteroids. Chest Xray: coarse reticular pattern. Lesion is where in the following drawing?

Secondary hypothyroidism nbme 15 questions his diet, decreased his coffee and citrus intake, and has raised the head of his bead. In rare cases, hormone production may be sufficient, but thyroid hormones may have insufficient peripheral effects. Below 3rd percentile for height and 10th percentile for weight. Have you hear anything similar or might this be one of the more fictional rumors? Gram stain of sputum shows gram-negative rods.

  • Labs: hemoglobin

  • Physical exam shows generalized lymphadenopathy.

  • Which explains the appearance of the fat?

  • Fifteen minutes after arrival, he has visual disturbances. European endocrinology.

Mechanisms related to the pathophysiology and management of central hypothyroidism. European endocrinology. Mode of inheritance? Micro exam shows motile organisms secondary hypothyroidism nbme 15 questions flagella. But notice that this histology slice actually has the sides labeled explicitly in the upper corners left on the left, right on the right. But, you think they are like the real exam questions? Mass moves upward with swallowing and protrusion of tongue.

Newborn undergoes surgical repair of esophageal atresia. Urine pregnancy test positive. He is a medical student, and says hypothyroisism he has noticed that the symptom occurs during studying for final exams and other periods of stress. Hypothyroidism: an update. Autoimmun Rev. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association.

  • Point tenderness to palpation of the radial aspect of the wrist between the abductor pollicis longus and extensor pollicis brevis tendons.

  • Urine culture grows an organism that is lactose fermenting and spot-indole test positive.

  • Strength is normal and symmetric in the distal and proximal upper and lower extremities.

Next step? Otherwise, it can confuse others in the TestPirates community. Returns to normal state in 4 to 5 minutes. Has blank look and doesn't respond to questions. Type of seizure? Vision screening is performed on people who are older than 65 years. No cervical or perineal lacerations.

Increased risk for which sequelae? Sx started 24 hours after he ate at a wedding reception and other people have similar sx. Pale and lethargic. During surgical debridement, myonecrosis found. T F and muscle rigidity is present.

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Reason for exon skipping in this patient's affected gene? Daughter appears extremely worried and exhausted and is intermittently tearful during the visit. Thyroxine T4 and thyroid-stimulating hormone concentrations are decreased. Mean of 10 patients?

Labs: hb Patient's urine microscopically shows? Cause of symptoms? Can you please explain Block 2 part 2 Q34? On examination, the right pupil is larger than the left, it also seems like the right eye is looking somewhat down and to the right. Which lifestyle change will decrease recurrence of symptoms?

Appropriate therapy is questions however, the patient dies after 48 hours. Super high hematocrits are indicative. Removal of surgical packing in nares shows erythematous mucosa. The set has no new questions a few have actually been removedso this is still current. Hx of delayed development. Malignant cell from site will drain to which lymph nodes first? However, in hyperthyroidism FT3 and FT4 would be increased.

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The bone marrow biopsy results demonstrate that the body has appropriately increased platelet production, meaning that this is not a platelet production issue. Which of the secondary hypothyroidism nbme 15 questions embryonic germ layers is the origin of the cells that fill the lumen? Tumor-like growth, upper urinary tract infection, and this is key lipid-laden foamy macrophages make this neither acute pyelo nor cancer. It should stay the same because renal compensation doesnt happen that early but that was not an option so at the end I was stuck between the timeline and the ABGs.

Bleeding stopped with pressure. Labs show increased prothrombin time and increased serum AST activity. Site of the malformations? He appears drunk and says that he began feeling ill after ingesting a homemade alcoholic beverage provided by a friend. Eur J Endocrinol.

Mass is from which region labeled in picture? Vitals normal. Using "think" in your responses makes me wary of how certain you are. Immediately develops severe oliguria.

Baby born at term to healthy woman goitrogens and hypothyroidism blood group is O, Rh-positive. No foul or fishy odor. CXR shows hilar adenopathy and right nbbme node enlargement. Stagnaro-Green A. Hi Ben, I just took a practice session at my center today. Hope I do well on the actual beast too. F — While staph aureus is the most common cause of hematogenous osteomyelitis in children, Salmonella is the most frequent cause for patients with sickle cell anemia a test favorite.

Acquired hypothyroidism

Hashimoto thyroiditis: Clinical and diagnostic criteria. Feels faint, light-headed, and dizze when he gets out of bed. Because the order of the questions is different from one to one and it takes time to find out which the question you are looking for!

Three hypothyroiddism erosions are noted. I missed this question in the exam because according to UW 3 hrs is the borderline of both or so I remembered so I went with pure respiratory alkalosis. The ratios of growth of reassortant viruses in the presence and absence of AC are shown in table. Pale and lethargic. Physical shows large fontanels, midface hypoplasia, hepatomegaly and cryptorchidism. So a genetically male patient with complete androgen insensitivity is externally phenotypically female. Can Klebsiella colonize the stomach?

Physical shows swelling and tenderness of left side of face. Ultrasound shows no abnormalities. Which type of shock? I think was ferrochelatase. Which describes the changes? Struck him on the lateral side of his leg. Her temperature is

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So a genetically male patient with complete androgen insensitivity is externally phenotypically female. Mean of 10 patients? He began to breath again after she picked him up.

Physical exam is within normal limits. Lungs clear to auscultation and percussion. During an experiment of muscle contraction, nbme calcium is decreased after a substance is administered to a muscle preparation obtained from an experiment animal. Speech is fluent but has many grammatical errors, word substitutions, and neologisms. Labs show mild normochromic anemia and ESR The protein forms part of the ubiquitin-ligase complex E3 that targets hypoxia-inducible factor

This patient has likely defective function or expression of which of the following protein? PPD skin test is positive, but culture of the sputum shows only normal flora after 2 days. Autopsy of organs will show? Significant improvement in cough scores for patients receiving dextromethorphan. The bone marrow biopsy results demonstrate that the body has appropriately increased platelet production, meaning that this is not a platelet production issue. Dot on monogram indicates relationship between her serum calcium and parathyroid hormone concentrations.

Before periods were regular until 25yo. Has not had suprapubic pain. Photomicrograph shows the mesenteric fat as seen at autopsy. One-half hour after an uncomplicated vaginal delivery, a year-old woman delivers the placenta but has continued heavy blood loss from the vagina.

  • Which is cause of findings?

  • Difficult to arouse.

  • Point tenderness lateral to acromion, over the humeral head.

  • Which neurotransmitter? Physical shows ptosis of left eyelid, eye fixed in the out position and pupil is dilated.

Also has a 2-week history of visual discomfort when in a room with bright lights. Sensation to pinprick and vibration is decreased from just above the ankles distally. The discomfort is more severe in bed at night and is relieved by taking a hot bath. Which of the following is the most likely cause of these findings?

Point tenderness nbme palpation of the radial aspect hypothyrodiism the wrist between the abductor pollicis longus and extensor pollicis brevis tendons. Remember, low folate leads to macrocytic anemia and hypersegmented neutrophils. There where almost the same questions you explained, thanks for that. Expiratory wheezing is heard bilaterally. The initial step is to determine TSH levelswhich may be followed by measurement of FT4 levels to confirm or rule out the suspected diagnosis. Reason for exon skipping in this patient's affected gene? Which protein is necessary for leukocyte count to increase?

Sx resolve after 36 hours but persist in milder form for several days. This may lead to acute renal failure if allowed to continue but this diagnosis requires a change in creatinine of 0. The history of tonsillectomy is often a subtle tip-off of multiple prior episodes of strep throat or tonsillitis. Lead concentration is

Mild tenderness over the suprapubic region. Physical shows a mildly erythematous pharynx. Cataracts are found in Urine culture grows an organism that is lactose fermenting and spot-indole test positive.

  • After establishing a patent airway, the most appropriate next step is administration of which? Thank you so much!

  • She is often angry and occasionally misses dialysis appointments.

  • Physical shows ptosis of left eyelid, eye fixed in the out position and pupil is dilated. Mass moves upward with swallowing and protrusion of tongue.

  • Note that C is wrong no matter what.

Activity of which enzymes has most likely increased in this patient's hepatocytes? Mohammad Taha Questions can't send you the actual form. BMI Previous evaluations showed mild coarctation of the thoracic aorta with dilation of ascending aorta, mild aortic regurgitation but no heart failure. CXR shows hilar adenopathy and right paratracheal node enlargement. She has had urinary frequency and dysuria for 2 days.

Organisms are most likely present in which cells? Male newborn has multiple congenital anomalies resulting from failure of migration of neural crest cells during embryonic development. Expiratory wheezing is heard bilaterally. Share This Page Tweet. Which is present? Labs show increased prothrombin time and increased serum AST activity.

Next step? Which additional hematologic findings is most likely abnormal? These explanations have been great! B — Thiazides typically used as antihypertensives also increase calcium resorption in the distal tubule and are therefore useful in preventing calcium oxalate stone formation in patients with hypercalciuria the mechanism is not really worth learning.

Blood and urine cultures are negative. Mechanism of causal organism? Temp 36 C Which of the following is the most likely mechanism of the termination of the tachycardia in this patient? Lesion is where in the following drawing?

Her blood group is Hypothyroidiwm, Rh-positive. A bacteriostatic drug that acts by inhibiting the secondary hypothyroidism nbme 15 questions of aminoacyl-tRNA to the 30S subunit of bacterial ribosomes is prescribed. Physical shows diaphoresis. A year-old man comes to the physician with 2-month history of pain in his feet. Labs show mild normochromic anemia and ESR Hypertrophy of calf muscles on physical. Angiodysplasia typically causes painless GI bleeding like that seen in diverticulosis.

Would you say the medfriends predictor is accurate or overshoots the actual score? Underwent sinus operation for removal of nasal polyps 2 days ago. Last menstrual period was 4 months ago. No medications and does not smoke cigarettes or drink alcohol. The more anaerobic metabolism you use and lactate build-up you have, the more hyperemia you need to clear out the waste products.

Parents say son has recently become more stubborn and has begun to have temper tantrums. No allergies. Withdrawal bleeding present after progestin challenge. Requests parents not be told about appointment. Malar rash that does not involve the nasolabial folds.

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I just answered this but its not correct. Assuming the necessary reagents are available, which of the following methods would be the secndary effective in screening the archives for the variant protein? Began weight-training program 6 weeks ago. Bilateral crackles heard. Also, 6-month hx of dry cough with chest pain and shortness of breath. Proximal muscle weakness and tenderness over the surface of both shins. Patient's oligomenorrhea is due to increased production of which hormone?

His sister died of leukemia 4 months ago. Lungs clear. Physical: halitosis. I have selected choice D thinking the same principle. Ross DS. I'm pretty sure Block 2 should be 0.

Physical shows diffuse rash with erythroderma and hyperemic oral mucous membranes. Physical is normal. Last menstrual period 8 years ago. Physical: uterus consistent with week gestation.

Next step? No allergies. Struck him on the lateral side of his leg. Adverse effect most likely?

Eventually, we nypothyroidism have a nice list here of all of the questions and answers that you can refer to. Birth weight was 8 lb 0 oz. Breath sounds decreased bilaterally. Parents say son has recently become more stubborn and has begun to have temper tantrums. A CT scan of the chest is shown.

Type of seizure? A — All the vesicles contain the same viral infection, so all should have the same appearance on gel. Muscle Nerve. Thanks for replying! Constricted pupils and stupor.

  • Physical is normal.

  • Your name or email address: Do you already have an account?

  • Study to evaluate effectiveness of cough medication in children. A CT scan of the chest is shown.

Clinical features of adrenal insufficiency in patients with acquired immunodeficiency syndrome. B — Post-streptococcal glomerulonephritis is caused by the deposition of circulating immune complexes a type III hypersensitivity and a test-favorite. No major medical illness. Associated fun fact: the most common cause of secondary amenorrhea is pregnancy. Photo shown of biopsy of specimen from esophagogastroduodenoscopy. Underlying cause of findings?

The explanation for 74 is incorrect. He is muscular with no obesity. Drug antagonizes which mediator of pulmonary resistance? Best statement?

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