p******9
发帖数: 114 | 1 1. A 5-year-old boy is brought to the physician 1 hour after urinating
bright red blood. He has been taking ibuprofen since injuring his right
flank while wrestling with friends yesterday; he also has been taking
penicillin for 3 days for streptococcal pharyngitis. His temperature is 36.7
C (98 F), blood pressure is 90/48mm Hg, pulse is 108/min, and respirations
are 18/min. Examination shows purple ecchymoses over the shins and right
flank; there is tenderness of the right costovertebral area. The abdomen is
nontender. Genital examination shows no abnormalities. There is no edema.
Urinalysis shows gross blood; microscopic examination shows 5–10 leukocytes
/hpf and erythrocytes that are too numerous to count. Which of the following
is the most likely explanation for this patient's hematuria?
A) Acute pyelonephritis
B) Ibuprofen-induced acute papillary necrosis
C) Post-streptococcal glomerulonephritis
D) Rhabdomyolysis
E) Traumatic injury to the kidney
2. Two days after admission to the hospital because of a 3-day history of
slurred speech, double vision, and dysphagia, a 24-year-old woman becomes
quadriplegic and requires intubation and mechanical ventilation. Her medical
history is unremarkable. One week ago, she attended a family picnic;
several of her family members have had abdominal cramps and diarrhea since
the picnic. Her temperature is 37 C (98.6 F), blood pressure is 120/80 mm Hg
, and pulse is 120/min. Examination shows dry mucous membranes, large
unreactive pupils,
ophthalmoplegia, and profound facial weakness. There is areflexia,
quadriplegia, and no movement of the palate and tongue. Sensation is normal.
Babinski's sign is absent. Which of the following is the most appropriate
pharmacotherapy?
A) Antitoxin B) Azathioprine C) Interferon D) Pyridostigmine E) Riluzole
3.A 1-week-old newborn has had poor feeding, vomiting, and progressive
lethargy over the past 4 days. She was born at term; pregnancy, labor, and
delivery were uncomplicated, and she had no congenital anomalies. She is
being breast-fed. She has a healthy 2-year-old brother; a sister died at 10
days of age after a full-term birth. Examination shows decreased muscle tone
and poor responsiveness; reflexes are normal. Serum bicarbonate level is 8
mEq/L, pH is 7.15, and plasma ammonia level is 10 times the upper limit of
normal. Which of the following is the
most likely cause?
A) Mitochondrial disorder
B) Mucopolysaccharidoses disorder
C) Organic acid metabolism disorder
D) Renal tubular acidosis
E) X-linked leukodystrophy
4.A 40-year-old man has the sudden onset of excruciating head and neck pain
while carrying books from the basement to the attic. His temperature is 37 C
(98.6 F), blood pressure is 130/90 mm Hg, and pulse is 90/min. He has
photophobia and develops eye pain with lateral eye movements. His neck is
markedly stiff and cannot be passively flexed. He has diffuse hyperreflexia
in all extremities with normal strength and sensation. Plantar reflexes are
flexor bilaterally. Which of the following is the most likely diagnosis?
A) Cervical osteoarthritis
B) Meningitis
C) Ruptured cervical disc
D) Subarachnoid hemorrhage
E) Syringomyelia
5.An 82-year-old man comes to the physician because of a 3-day history of
low back pain that radiates to the right leg. He also has had a lesion over
the right shin and weakness of the right
foot. He began taking prednisone 2 weeks ago for acute bronchitis. He has
chronic obstructive pulmonary disease, benign prostatic hypertrophy, and
glaucoma. Examination shows numerous papular and vesicular lesions over the
right anterior and posterior shin. There is weakness of right knee flexion,
ankle dorsiflexion, plantar flexion, eversion, and inversion; the right
ankle reflex is absent. Sensation to pinprick and cold is decreased over the
right lower extremity. Which of the following is the most likely causal
organism?
A) Borrelia burgdorferi
B) Epstein-Barr virus
C) Herpes simplex virus 1
D) Poliovirus
E) Treponema pallidum
F) Varicella-zoster virus | S**********e
发帖数: 1325 | 2 I took a quick look and I thought it's E,?,?,D,D.
Waiting for the right answers from Niu people. | p******9
发帖数: 114 | 3 我这里有一份别人的答案，E，A, C, D, F
For me,
1，think B is also possible。Since if E is the right answer, pt should have
gross hematouria from the beginning.
2,3,5, I have no idea either。
4, think C is better than D. |
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