Updated: Aug 28, 2020. Updated: Aug 28, 2020. My two tcn:es olibdAmna rgrusye rof epdterrofa sigratc ecrul brobpyla trledues in oaemvoipyl,h edgainl ot easdreicn ASRA atvcytii dna rcnontoatic osi.akalsl isTh aslde ot aeop,kmalhiy hhiwc is a foract atht eposipsrsed ot oigixnd t.oxtiiyc PVCs aer neo fo hte omst omcmon onioeidsaitdcx-asg amhrsyrathi and rae otfen eht fsrti isgn fo … Study Schedule Step 2 CK. NBME Answers & Explanations — Updated daily need help with your account or subscription? Students have expressed a desire to receive explanations for correct and incorrect answers on NBME Self-Assessments.So far, answer explanations have been added to Medicine forms 3, 4, 5, and 6 and Surgery forms 3, 4, 5, and 6 of the Clinical Mastery Series. Editor: Jordan Abrams. If you are viewing this on the new Reddit layout, please take some time and look at our wiki (/r/step2/wiki) as it has a lot of valuable information regarding advice and approaches on taking Step 2 CK, along with analytical statistics of study resources. For NBME questions, I've found that whatever is told in the findings section of a stem should be taken as 100% true even if it's an incomplete description, super confusing, or misleading. Discussion in 'USMLE Step 2 CK' started by orthopod, May 24, 2015. Current M4 trying to help make NBME exams more useful by providing free, high-quality answer explanations specifically for Step 2 and shelf practice exams. Therefore will be helpful in devising a treatment strategy, • The other options listed are observational studies only, 1) No cleaving of C-terminal peptides on angiotensin I, • Angiotensin-converting enzyme (ACE) inhibitors decreased the conversion of Angiotensin I to Angiotensin II in the lung, • These will prevent ovulation; ↓ ovulation, → ↓ risk of ovarian cancer, • Painful vesicles on an erythematous base, • Poor baby is in a lot of pain, she just had a major surgery (thoracotomy), • Non-cardiogenic (PCWP <12) pulmonary edema in the setting of severe pancreatitis and suggestive CXR findings, • Burning substernal chest pain that is worse at night + a sour taste in mouth is consistent with GERD, • She is immunocompromised and therefore falls in the special category of people < 65 years old that should get the pneumococcal vaccine, • Nausea/vomiting + bulbar symptoms (blurry vision, diplopia, miosis), • Descending flaccid paralysis after ingestion of preformed botulinum toxin (likely from the home-canned foods), 10) Increased urinary excretion of calcium, • This patient’s high-normal calcium level is due to the secretion of calcium into the urine, 11) Hypertrophic obstructive cardiomyopathy, • Systolic murmur that increases with ↓ preload (eg, standing or valsalva) and ↓ afterload, 12) Fibrillation potentials in multiple muscles of multiple extremities, • Combined UMN (eg, Babinski) and LMN (eg, fasciculations) degeneration is consistent with Amyotrophic lateral sclerosis (ALS), • ALS shows fibrillations pattern representing acute denervation and large, long duration complexes representing chronic denervation, • Superficial wound dehiscence presents in the 1st postoperative week with leakage of serosanguinous fluid, • Obesity → ↑ risk in patients with abdominal incisions, • Emotional response to viewing his dead brother’s body, • Emotional distress → excessive vagal (PSNS) tone → cardioinhibitory response → hypotension and bradycardia, • Pulse of 45/min (bradycardia) during the event helps rule out hypoglycemia as the cause of syncope, 15) Supination of the forearm with the elbow in slight flexion, • This is nursemaid’s elbow (aka radial head subluxation), • Uterine atony is the most likely cause of postpartum hemorrhage in a patient with an enlarged uterus (uterus should be at the level of the umbilicus or lower after birth [this patients fundus is palpated 3cm above the umbilicus]), • The normal fundal height postpartum should be less than 2 cm, a fundal height of 3 cm indicates a boggy uterus (uterine atony), • Fetal weight >4000g → ↑ risk of uterine atony, • Placenta appears complete but torn (r/o retained placental tissue), • Uterine atony is the most common cause of postpartum hemorrhage, • Loss of parietal cells → loss of intrinsic factor → unable to absorb Vitamin B12 in the terminal ileum, • Correction of Schilling test with administration of oral intrinsic factor suggests that this patients megaloblastic anemia was due to lack of intrinsic factor, rather than a dietary deficiency, • Describes pain over the course of a year which is a pretty long time (osteonecrosis would present much more acutely), • Post-void dribbling associated with a tender, vaginal cystic mass, • Normal postvoid residual volume (< 150 mL for females) and urinalysis exclude other causes of incontinence, • Flash pulmonary edema (B/L crackles) secondary to HF (low cardiac index means that the blood is not being pumped forward → so it is backing up in the lungs → causing a high pulmonary artery pressure, • This is indicated if ≥ 70% stenosis of the carotid artery and the patient is symptomatic (or ≥ 80% stenosis if patient is asymptomatic), • Baby is <37 weeks gestational age = lungs are severely underdeveloped, • Formication = you feel like bugs are crawling on you, • Tooth decay and excoriations (from skin picking) are common signs of meth abuse, • Heavy alcohol use → purkinje cell (cerebellar vermis) damage → alcoholic cerebellar degeneration → truncal ataxia (eg, impaired tandem walking), • Given her ↑↑ BUN and Cr, you need to assess if there is hydronephrosis causing obstructive postrenal azotemia, • Viridans group streptococci (eg, Streptococcis sanguinis, mitis, oralis, mutans, sobrinus, and milleri) are associated with infective endocarditis after gingival manipulation (eg, going to the dentist), • Artificial valve → ↑ risk of endocarditis, • Temperature >104 with CNS dysfunction (eg, altered mental status, confusion), • Muscle tone would be increased if anticholinergic poisoning, • Withdrawn, poor sleep, daytime fatigue (lack of energy), academic performance has deteriorated (poor concentration), flat affect (psychomotor retardation) → meets the criteria for MDD, 29) Endoscopic retrograde cholangiopancreatography, • This patient with persistent abdominal pain after cholecystectomy likely has post-cholecystectomy syndrome, • ERCP should be used to directly visualize and find a causative factors, • Needed to reverse the organophosphate poisoning (will reverse all the symptoms except seizures), • However, organophosphate agent induced seizures should be treated with a benzodiazepine. NBME Answers & Explanations — Updated daily ... NBME 19 NBME 18 NBME 17 NBME 16 NBME 15 NBME 13 ⋅ Step 2 CK Free 120 Step 2 CK Form 6 Step 2 CK Form 7 Step 2 CK Form 8 home login register ⋅ contact ⋅ leaderboard links news ⋅ membership tags alerts tutors ⋅ scores score predictor. NBME OBGYN Form 6 - Answers & Explanations. Good luck to everyone! Community-acquired pneumonia. Step 2 CK CCSSA NBME Form 7. Step 2 CK CCSSA NBME Form 7. 2021 Bulletin Contribute just 1 download and receive 60% off Test Answer Explanations ... 60% off all Step 1 Practice Test Explanations. I feel you man, was guessing between the two answers as well. Here are the explanations for the updated 2014 (effectively 2014-15) official “USMLE Step 2 CK Sample Test Questions,” which can be found here. I felt horrible after taking 7 and dropping so much from UWSA1. By updated, I mean the webpage says “updated March 2019” and the “Content Description and General Information Booklet” was revised in some way. Not a good question, but a good review of details in the medication! A systolic murmur that radiates to the carotids = AS, • Fever, headache, and neck stiffness (nuchal rigidity) suggest meningitis, • If due to N. meningitidis, patient will also likely have myalgia and a petechial or purpuric rash, • ↓ C3, ⊕ ANA, arthralgias, rash over cheeks, UA highly suggestive of SLE (SLE is a clinical diagnosis need to have 4 of the 11 diagnostic criteria), 35) Allergic bronchopulmonary aspergillosis (ABPA), • Productive cough with occasional hemoptysis, ↑ eosinophils and serum IgE (asthmatics are more likely to develop ABPA), CXR findings of linear atelectasis (bronchiectasis) and cystic opacities (possible mucus plugging), • Chronic exposure to Aspergillus can result in ABPA, presenting with asthmatic symptoms or sinusitis, especially in patients with a history of asthma or cystic fibrosis. Authors: Susan Basharkhah. If you are interested in NBME answer explanations for Step 2CK and shelf practice exams, please click on specific menu items above. So placenta complete? While rotary nystagmus can be due to a number of etiologies (eg., MS, midbrain lesions, medulla involvement), 28) Repeated microfracture at the tendon insertion, • An active teenager has tenderness and swelling over the left tibial tubercle and the pain is worse with jumping = Osgood-Schlatter Disease (aka tibial tubercle apophysitis), 29) Esophageal peristalsis ↓, Lower esophageal sphincter tone ↑, • On Manometry, achalasia presents with ↑ LES resting pressure, incomplete LES relaxation, and ↓ peristalsis of distal esophagus (due to atrophy of smooth muscle in the lower esophagus), 30) Increased sensitivity, decreased specificity, • Lowering the cutoff point means → catch more of the true positives → ↑ sensitivity at the expense of having more false positives (which causes the specificity to ↓), • Young obese patient with severe pain in the knee and hip, • Since there are no signs of inflammation, his pain is likely due to slipped femoral capital epiphysis SCFE (hip pain can present as referred hip and/or knee pain), • Diminished carotid upstrokes = LV is pumping out a ↓ cardiac output (since the stenotic aortic valve requires a lot of pressure to overcome and open) b. Forums Medical USMLE Step 2 CK. Register for Free. Suppurative arthritis does even more, if you’re likely to remember that. ihTs is a grtae lxaepme of a oyplro tternwi o.estniqu Is hte nitfna lsitl dedetsa ormf the yeusrgr ro elea?indttv Wath is vnee pahnpeign to the cugrilas e?its Wyh is sagnceali atypher ont edaryla robdnao- sotp ureysr?g hyW is isht hartou uhcs a abgd-u?eoch, entaPla"c asappre tcepmelo btu tr"no - if is't tnor dan oyln psarape omp,cteel trahre tahn bneig iomdrcfne as ocetpeml, owh nac uyo rleu uot aeirtned aecllpatn seitsu? Please note: The HY Medicine is in no way affiliated with the Federation of State, Medical Boards (FSMB) or the National Board of Medical Examiners® (NBME®), • Goal of family therapy is to ↓ conflict, help family members understand each other’s needs and to help the family cope with the internally destructive forces, • Spherocytes + ↑ mean corpuscular hemoglobin concentration (MCHC) = hereditary spherocytosis → sxs improve with splenectomy, 4) Surgical exploration of the mediastinum, • Widened mediastinum on CXR after CABG is consistent with aortic dissection, • Pain relieved with vomiting (relieves some intra-abdominal pressure), • SBO initially has high pitched bowel sounds but a complete obstruction has ↓ or absent bowel sounds, • Acute gout attack (swelling, erythema, tenderness of great toe), • Celecoxib (COX-2 inhibitor) can help with gout but a non-selective COX inhibitor (Indomethacin) would be better because COX-1 inhibitor also prevents hemostasis (no build up of uric acid at a single site), • 2nd line for acute gout attack = colchicine, • Bruising and tenderness over sternum = blunt thoracic injury, • Isthmus of thoracic aorta is most vulnerable location to deceleration injuries → thoracic aortic aneurysm (widened mediastinum), • Pancytopenia → perform bone marrow aspiration to see if this is aplastic anemia or cancer, • Indigestion while walking briskly or uphill that is relieved by rest is consistent with angina (especially given that her sxs are not related to eating and aren’t relieved by antacids), • Pretest probability of CAD is intermediate in women with typical aging age 30-50 or atypical angina ≥ age 50, • Zenker diverticulum presents with dysphagia, regurgitation, and halitosis, • Dx: barium esophagram or esophageal manometry, • No current genital herpes outbreak → can safely deliver vaginally, • Have to rupture the still intact membranes (amniotomy), • Pregnant women with a history of genital HSV infection should receive prophylactic acyclovir or valacyclovir beginning at 36 weeks of pregnancy, • High levels of progesterone during pregnancy → relaxation of ureters and bladder → urinary stasis, • Crusted, papular, honey colored lesions with clear discharge is consistent with impetigo, • Manic episode (marked impairment) + depressive episode = Bipolar I, • Painful vulvar blisters (vesicles, pustules, or ulcers) + systemic symptoms (malaise, myalgia) = HSV, • Genital herpes can be diagnosed with viral culture or PCR, 18) Central retinal vein occlusion (CRVO), • CRVO = acute or subacute U/L vision loss that is usually noted upon waking in the morning, • CRVO is associated with a “blood and thunder” appearance (diffuse hemorrhage) and cotton wool spots (patches of white exudate), • The key difference between CRAO and CRVO is the presence of hemorrhages. If you join a smooth curve along the posterior border of the lumbar vertebral bodies and the posterior border of the sacrum, L5 is clearly slipped anteriorly and doesn't sit on the curve. I’m a recent grad. Indomethacin is typically the DOC, better than celecoxib. → uterine atony, Indomethacin is typically the first choice NSAID for acute gout flares. If it was a CF patient = pseudomonas. Step 2 CK Score – 260, the exam was in mid-March. :roll_eyes: ;), entaPti geninesrpt whti snispsgommyst/ gcnncoenir orf. Block 1 _ 1-5 EABEA 6-10 BDABE 11-15 ABADG 16-20 AADBB 21-25 FDCED 26-30 FEDEA 31-35 GCBCA 36-40 BCBCA 41-45 FECAE 46-50 FIFY, f**king millenials. That'll be RAZR phone and Windows 98. By contributing just 1 download today to help us grow, earn 60% off all Step 1 Practice Test Explanations. Uptodate for reference. Overall, there are only three new questions when compared with last year’s set (#90, 95, and 104), which I’ve marked with asterisks below. The multiple choice test is complemented by the subjective Step 2 CS exam. Preparation time – 4.5 months with 2 weeks gap so 4m effectively. May include psychogenic polydipsia secondary to psychosis or other mental disorders or non-psychogenic varieties, • This is the most common cause of community acquired pneumonia (PNA), • This is the treatment of choice to acutely terminate sxs of anxiety (tachycardia, tachypnea), 6) Blood 1+, Protein 1+, RBC 0-5, WBC 0-5, Pigmented granular Casts + renal tubular epithelial cells, • Findings are consistent with Acute Tubular Necrosis, • This helps to prevent aspiration pneumonia, • Recurrent late decelerations indicate fetal distress, • Medical conditions must be excluded prior to diagnosing a psychiatric condition, • This patient's bradycardia and hyporeflexia suggest hypothyroidism, • This is an indicated treatment for lead poisoning, • Patient has a history of alcoholism and presents with ataxia & nystagmus, • Perivascular changes secondary to recurrent small PE → ↑ pulmonary vascular resistance → ↑ pressure in the pulmonary circuit → ↑ RV afterload → dilatation and/or hypertrophy of the right heart, • Will present as pure right sided HF (JVD, dyspnea, ascites, LE pitting edema, cardiomegaly but NO pulmonary edema (pulmonary edema is associated with left sided HF), • Pt presents with aortic dissection (tearing sensation in midchest that radiates to his back and HTN), • Tx: IV beta blockers (eg, labetalol) → ↓ heart rate, ↓ BP, and ↓ LV contractility, • RUQ abdominal pain after eating + nausea, • U/S shows cholelithiasis (she has a h/o of sickle cell disease so these are likely to be pigment gallstones 2/2 hemolysis) + pericholecystic fluid (a sign of inflammation), • Bartholin glands are located on the lateral sides of the vulva. Here’s the complete overview of NBME STEP 2 CK Form 1, 2, 3, 4 Offline With Answers: The NBME offers three web-based self-assessments to medical students and graduates evaluating their readiness to take USMLE exam. CMS step 2 CK all forms except family med. Submit errata here, • Treatment for cardiac tamponade (JVD, distant heart sounds, hypotension +. I also chose Dexamethasone, but uptodate says the glucocorticoid choice is prednisone not dexamethasone. NBME Answers & Explanations — Updated daily. Celecoxib has anti-inflammatory efficacy hence the categorization as a NSAID. Lungs are clear and he is well perfused, • ⊕ PPD but ⊖ CXR → isoniazid + pyridoxine (B6) for 9 months, • Phencyclidine (PCP) intoxication: agitation, psychosis, disorientation, and nystagmus, • Agitation and aggression can be managed with a benzo, • Myasthenia gravis (weakness, lethargy, diplopia) is associated with myasthenia gravis, • Myasthenia gravis: autoantibodies to postsynaptic ACh receptors at the NMJ → destruction and internalization of ACh receptors, • Diplopia and ptosis that are worse at the end of the day, • ↓ release of Ach from motor nerve terminals → flaccid paralysis seen in Botulism, • Guillain-Barre syndrome → inflammation and demyelination of peripheral nerves and motor fibers, • Presents with ascending weakness and diminished/absent DTRs following a recent respiratory or GI infection, 40) Increase the frequency of dose to every 3 hours, • She says it’s moderately effective but loses its effectiveness 3 hours after each dose → so make this the dosing regimen, 41) Inadequate refrigeration of the implicated food, • Nausea and vomiting 3-4 hours after ingestion of egg salad so it is likely due to enterotoxins (if it were due to the bacteria itself then the inoculation time would be longer), • Erythema nodosum (tender, red nodules on the anterior shins) + B/L hilar lymphadenopathy (fullness) on CXR = sarcoidosis, • Sarcoidosis → ↑ 1α-hydroxylase vitamin D activation in macrophages of non-caseating granulomas → ↑ calcium, • Incarcerated inguinal hernia = medical emergency (don’t waste time getting the doppler u/s), • Most children walk their first steps independently by 12 months, • However, children <15 months that do not yet walk is normal (children >15 months that do not walk should be evaluated), • Randomized controlled clinical trials study the effect of a medication compared to a placebo or an existing standard of care medication. An answer form for recording answers for this practice is provided on page 53. You must review and become familiar with the Bulletin before completing your application for USMLE Step 1, Step 2 CK, or Step 3. UWSA2 (4 days out): 258. Official Step 2 CK Practice Exam - Answers & Explanations . Step 1 score – 262, gave in mid-September last year. 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Feel free to check out my answer explanations for Step 2 CCSSA practice exam Form 6 at the link below. NBME Answers & Explanations — Updated daily need help with your account or subscription? need help with your account or subscription? In the actual examination, answers will be selected on the screen; no answer form will be provided. 38.82 KB; 1 file(s) May 5, 2018; Become a Contributor Today . STEP 2 CK real deal: 259. = H. influenzae. If there is no vein (CRVO) then there is still blood coming in via the artery but the path out is obstructed → hemorrhages, • In CRAO on fundoscopic examination you will see diffuse ischemic retinal whitening, pale optic disc, cherry red fovea, and boxcar segmentation of blood in retinal veins, • Blockage and/or inflammation of pilosebaceous units → Acne vulgaris, • Bilateral retinal hemorrhages and neurological abnormalities (eg, poor feeding, sleeping more than usual) suggest shaken baby syndrome, • Has had normal BP before most recent measurement, • HTN diagnosis requires two separate elevated BP measurements, • Alcoholic with low serum magnesium will also have low serum calcium, • Hypomagnesemia → PTH resistance and ↓ PTH secretion with subsequent hypocalcemia, • Contrast-induced nephropathy could have possibly been prevented with IVF, • Had the creatinine bump been purely from hypovolemia (volume depletion/poor intake), then it would have been apparent on admission, • Tortuous dilation of the pampiniform plexus, • Triad: respiratory distress, neurologic dysfunction, petechial rash, • Common after fracture of a long bone (contains marrow [eg, femur]) or orthopedic surgery, • Presence of petechiae helps to differentiate fat embolism from ARDS, • In fat embolism syndrome will see respiratory alkalosis vs. metabolic acidosis in ARDS, • Anorexia → ↓ GnRH → ↓ LH, FSH → ↓ estrogen → amenorrhea and bone loss (→ ↑ risk of osteoporosis), • ‘Bamboo spine’ = fusion of vertebral bodies with ossification of intervertebral discs, • Presents with limited spinal mobility (eg, ↓ flexion at the waist), morning stiffness that improves with activity, and tenderness of sacroiliac joint, • Prolonged corticosteroid use (eg, prednisone) → osteoporosis → ↑ risk of vertebral compression fracture, • Treatment for cardiac tamponade (JVD, distant heart sounds, hypotension + electrical alternans) = pericardiocentesis, • Meningitis → have to rule out increased intracranial pressure since the patient’s optic fundi can’t be visualized, • Focal neurological findings (eg, nystagmus, right upper extremity weakness) suggests ↑ intracranial pressure (ICP), • Head CT should be performed prior to lumbar puncture to rule out causes of ↑ ICP (eg, hemorrhages, masses), • “FAILS” mnemonic for when to get CT before LP (would give empiric abx before going to CT), • L = space occupying Lesion (will have papilledema), • Removal of brain tumor likely caused central DI → lack of ADH → hypovolemic hypernatremic and does not respond to fluids (high urine output), • PDD = a Type IV Hypersensitivity Reaction (requires T cells to be functional for these tests to be reactive), • Non-reactive PPD in the presence of Mycobacterium tuberculosis infection suggests inadequate delayed type hypersensitivity reaction and T-cell dysfunction, • Statin-induced myopathy with associated proximal muscle weakness, • Decreased coenzyme Q10 synthesis (involved in muscle cell energy production), • Split S2 is heard during inspiration (which is physiologic) and S3 (which is physiologic in children). click here to email us (or see the contact page ... NBME 19 NBME 18 NBME 17 NBME 16 NBME 15 NBME 13 ⋅ Step 2 CK Free 120 Step 2 CK Form 6 Step 2 CK Form 7 Step 2 CK Form 8 home … INTRODUCTION TO USMLE STEP 2 CK SAMPLE TEST QUESTIONS 1) Provide free, high-quality answer explanations to NBME practice exams. In a 25-year smoker (COPD?) It is activated by acetylCoA( from beta- oxidation. It's between the sacrum and L5. I think torn but complete means the whole placenta is there, but in pieces? Product Manager Jennifer Wise, … NBME Answers & Explanations — Updated daily ... NBME 19 NBME 18 NBME 17 NBME 16 NBME 15 NBME 13 ⋅ Step 2 CK Free 120 Step 2 CK Form 6 Step 2 CK Form 7 Step 2 CK Form 8 home login register ⋅ contact ⋅ leaderboard links news ⋅ membership tags alerts tutors ⋅ scores score predictor. From the 2014 official “Step 2 CK content description and general information” booklet (official link is dead, that’s the Archive.org cache version), I’ve listed each question and its answer with a succinct (grossly simplified) take-home message: The newest set of official questions (2014-2015) has been released. need help with your account or subscription? Prophylactic diazepam has been shown to decrease neurocognitive dysfunction after organophosphate poisoning, • Haemophilus influenzae is a gram ⊖ coccobacilli, • Pseudomonas aeruginosa is a gram ⊖ bacilli associated with ventilator acquired pneumonia, • Neisseria meningitidis = gram ⊖ diplococci, • Escherichia coli = gram ⊖ bacilli (doesn’t cause pneumonia), • Treatment of choice to induce ovulation in a patient with PCOS that is trying to get pregnant, • Caused by recipient anti-IgA antibodies, • Rapid onset of shock, urticaria and respiratory distress (eg, swelling of tongue and throat) in the setting of IgA deficiency, • Anaphylaxis is an acute condition involving the skin/mucosa and either respiratory or cardiovascular, • Multiple infections with encapsulated organisms, in the setting of appropriate immunization suggests B-lymphocyte dysfunction, • ↓ Ig → ↓ complement activation → ↓ opsonization → ↑ susceptibility to encapsulated organisms, • Abscess growing catalase positive bacteria = NADPH oxidase deficiency, • Gurgling sounds when she breathes means she’s about to lose her airway → intubation needed, however she has facial fractures, • Best choice of those listed for acute lyme disease (tetracyclines can also be used unless patient is pregnant or a child ≤ 8 years old), • IV ceftriaxone is TOC for disseminated lyme disease, • Fever, anemia, thrombocytopenia, renal involvement (eg, ↑ creatinine concentration), neurologic dysfunction (eg, waxing and waning consciousness), • Digoxin toxicity → new cardiac arrhythmias (eg, premature ventricular contractions), • ↓ potassium → ↑ risk of digoxin toxicity, • Bone metastasis (eg, breast cancer) → hypercalcemia of malignancy, • Severe hypercalcemia (>12) → confusion and delirium, • If you get a needle stick while drawing blood from someone that tests positive for the HepB surface antigen, you do not need any treatment if YOU have adequate concentrations of anti-HepB antibodies (because this indicates you have immunity to Hep B), • Patient with known Hep B immunity who is exposed to the disease → give reassurance, • Patient with unknown immunity who is exposed to the disease → give HBIG and HepB vaccine, • She has traveler’s diarrhea aka non-inflammatory, watery diarrhea, • ETEC (Enterotoxic Escherichia coli) is the most common cause of water diarrhea, • Yersinia and Shigella both cause dysentery (bloody diarrhea), • Pickwickian syndrome (obesity hypoventilation syndrome), • Obesity → hypoventilation → ↑ PaCO2 during daytime, 45) Determine if the patient wants to discuss his decision with anyone else, • Respect the patient’s wishes and his autonomy and figure out his motive’s while trying to understand where he is coming from, 46) Education about puberty for the child and parents, • His (acute onset) symptoms suggest cord compression (secondary to a hematoma) likely due to his anticoagulation therapy with enoxaparin, • Toxicity causes an initial respiratory alkalosis followed by a metabolic acidosis, • He has an appropriate urine sodium and osmolality which indicates that his kidney function is intact, • Excessive oral intake of fluid in the absence of physiologic stimulus to drink. * Re:NBME 7 block 1 q 1 to 50 #2392040 : god99 - 05/09/11 10:25 : 7.