f****i
发帖数: 129 | 1 34.
A 57-year-old woman is brought to the emergency
department because of
abdominal pain for 12 hours. Over the past 3 hours,
the pain has become
severe and generalized. Over the past month, she has
had mild upper
abdominal discomfort that is relieved by eating. She
has a history of
recurrent migraines treated with sumatriptan as
needed. Her temperature
is 38.2 C (100.8 F), blood pressure is 170/95 mm Hg,
and pulse is
110/min. Abdominal examination shows mild distention;
there is marked
rigidity with diffuse tenderness. Bowel sounds are
absent. Rectal
examination shows no abnormalities; test of the stool
for occult blood is
negative. Laboratory studies show:
Hematocrit 36%
Leukocyte count 16,500/mm3
Serum
Na+ 145 mEq/L
Cl– 106 mEq/L
K+ 3.8 mEq/L
HCO3– 19 mEq/L
Urea nitrogen (BUN) 32 mg/dL
Which of the following is the most appropriate next
step in diagnosis?
A
) X-ray films of the abdomen while supine and
standing
B
) Abdominal ultrasonography
C
) Upper gastrointestinal series with contrast
D
) HIDA scan
E
) Fiberoptic endoscopy of the upper
gastrointestinal tract
36. An asymptomatic 62-year-old man comes for a
follow-up visit.
One month ago, he had acute cystitis treated with
ciprofloxacin. At his
initial visit, a urine culture grew Klebsiella
pneumoniae. He has a
2-year history of chronic prostatitis and has had four
episodes of
cystitis over the past year. His temperature is 36.9
C (98.4 F).
Examination, including prostate examination, shows no
abnormalities. Which of
the following is the most appropriate measure to
prevent recurrent
episodes of cystitis in this patient?
A
) Trimethoprim-sulfamethoxazole prophylaxis
B
) Insertion of a Foley catheter
C
) Total prostatectomy
D
) Transurethral prostatectomy
E
) No treatment is available
37. A 32-year-old woman comes for a routine health
maintenance
examination. Examination shows a bloody discharge
from the nipple of her
left breast. There is no palpable mass. On
questioning, she says that
she never noted the discharge and does not perform
breast
self-examinations. Which of the following is the most
likely diagnosis?
A
) Breast abscess
B
) Breast cyst
C
) Breast hematoma
D
) Fibroadenoma
E
) Fibrocystic changes of the breast
F
) Intraductal adenoma
34. A or B?
36. A or D?
37. F, intraductal adenoma=intraductal papilloma???
Please explain. Thanks! | D*********t
发帖数: 140 | | x*******8
发帖数: 68 | | S******9
发帖数: 2837 | | w***0
发帖数: 222 | 5 Q1: A, if you suspect "perforation".
Q2: A if you choose from A or D, since PE reveals "normal prostate", I might
choose E rather A though. | f****i
发帖数: 129 | 6 for 34. I chosed A too, but on MTB it says to test perforation chest X ray
should be used.
for 36, I chosed D too, but why not A???
for 37, is the intraductal adenoma the same as intraductal papilloma?
because the presentation in the stem looks just like intraductal papilloma.
Anyone? please!
【在 x*******8 的大作中提到】
: a,d,f
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