50 years of age, • Can be asymptomatic or cause lumbar pain on exertion, gait problems, radiculopathic pain, or urinary incontinence, • EKG shows ST segment elevation in leads V2-V6, • EKG shows 2 wide QRS complexes in a row with a rate of > 120, • The bright yellow plaque seen on funduscopic examination is likely a thrombotic atherosclerootic plaque that has dislodged from the ICA, • Of the arteries listed, only the ICA branches into vessels that feed the brain and eye (ie, retinal artery), leading to transient blindness, • Acute onset pleuritic chest pain (increases with inspiration), SOB, fever, and an inspiratory rub all suggest acute pericarditis, Found a mistake or have a suggestion? Score: 253 USMLE Step 1 Practice Tests: CBSE, 2 months out, 165 NBME 17, 4 weeks out, 219 NBME 16, 3 weeks out, 225 UWSA1, 1.5 weeks out, 255 UWSA2, 1 week out, 249 NBME 18, 2 days out, 244 Dedicated Time: 7 weeks. At the end of each exam, you will also get a raw CBSSA score and a raw to three-digit score conversion table. If there is no artery (CRAO) then there is no blood flow → therefore NO hemorrhages. Whether you’re preparing for the United States Medical Licensing Exam® (USMLE®), an NBME Subject Examination, or the International Foundations of Medicine® (IFOM®) exam, we have a Self-Assessment designed to help. To play, press and hold the enter key. They secrete mucus and can become obstructed leading to a cyst or abscess that causes pain, tenderness and dyspareunia, • Physical exam:edema and inflammation of the area with a deep fluctuant mass, • Sxs of schizophrenia (for this patient that includes auditory hallucinations and disorganized thinking) but sxs must last less than 1 month and patient returns to baseline functioning after the episodes, • A fixed, non-tender mass in the cul-de-sac causing ascites (positive fluid wave) is likely to be ovarian cancer, • Diagnosis and treatment depend on removal via laparotomy, • Meigs syndrome is associated with a triad of: ascites, pleural effusion, and ovarian tumor; surgical removal of the tumor leads to a resolution of sxs, 18) Measurement of serum amylase activity, • Epigastric pain that radiates to the back is characteristic of acute pancreatitis, • HTN and proteinuria in a pregnant woman > 20 weeks gestation who also presents with epigastric pain and headache is concerning for HELLP syndrome → check platelet count (in this case you would expect the platelet count to be low), • Primary lactase deficiency (age-dependent decline after childhood) is common in people of African, Asian or Native American decent, • Celiac disease is more common in Northern Europeans, • The pain began after physical exertion (moving heavy furniture), is pleuritic (worse with inspiration) and is reproducible (tenderness to palpation lateral to the sternum), • Pt is 3 days post op → perfect timing for a possible DVT (tightness and tenderness to palpation of the left calf), • Prolactinomas should be managed conservatively with dopaminergic agents (eg, bromocriptine) before surgery is considered (eg, transphenoidal resection), • Subconjunctival hemorrhage will spontaneously resolve, • Given that she has perfect visual acuity and no eye pain best no treatment is indicated, • She is in active labor and has a history of GBS UTI → intrapartum prophylaxis with penicillin is indicated, 27) Brisk rotatory nystagmus on left lateral gaze, • Decreased upward gaze is a common finding in the elderly. Below you will find a handy chart that will allow you to make a conversion between your NBME to USMLE score. Background The methods for assigning final grades in clerkships for MS3students in 2020-2021 academic year will utilize a pass/fail system requiring students to meet minimum passing scores on major grading components (Clinical Assessment, NBME Subject Exam and OSCE). The conversion table is unique to each exam and can change through the years even for the same exam, as NBME adds more test-takers to its statistical analyses. Like everything, however, take these scores with a grain of salt. Free 120 NBME 24 NBME 23 NBME 22 NBME 21 NBME 20 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 i felt like i Failed, time managemnt was problem missed 7-8 question on exam, Nbme 7 do not take it few days before exam it under estimates n shatters confidence Guide & help each other , Thank you a friend ''True -passion'' from this Fourm for Guiding me _____ Vaccine doses should not be reduced for preterm or low-birth-weight infants (with the exception of Hep B vaccine which cannot be administered to premature infants if they weigh less than 2000g, 8) Destruction and dilation of the distal airways, • Bronchiectasis - patient with productive cough and recurrent pneumonia; on CXR will see multiple cysts and bronchial crowding (however these findings are nonspecific), • GAS pharyngitis → acute rheumatic fever → holosystolic murmur in the 4th ICS at the MCL (murmur of mitral regurgitation), • This is the treatment of choice for neuroprophylaxis if delivery occurs before 32 weeks of gestation, • Postviral inflammation → Subacute thyroiditis (de Quervain thyroiditis), • Tender goiter, fever, hyperthyroid symptoms, 12) Surreptitious administration of thyroxine, • Decreased radioiodine uptake suggests either Thyroiditis or exogenous thyroid hormone, • Duration of hyperthyroid symptoms and non-palpable thyroid suggests surreptitious thyroxine (eg., weight loss pills that contain bovine thyroxine), • Esophageal mucosal irritation secondary to oral medications, • 1 year history of auditory hallucinations and bizarre behaviors, 15) Transfusion of group O, Rh-negative packed red blood cells, • Patient still unstable after infusion of 3L crystalloid, • Acute hemolytic transfusion reaction - after blood transfusion the patient remains tachycardic and hypotensive (remember that group O blood will have anti-A and anti-B antibodies), • Radiation is indicated for cancers that have metastasized to the spine, • Atypical antipsychotics are the treatment of choice for schizophreniform, • The mothers all have a history of chickenpox prior to pregnancy → therefore they will all have immunity to varicella virus and protective IgG antibodies will be transferred to the babies via the placenta, • If pap smears shows high grade squamous intraepithelial lesion the next step depends on the patient’s age, • If 21-24 yrs → colposcopy → if CIN II or CIN III → excisional or ablative treatment, • If > 24 yrs → colposcopy or loop electrosurgical excision (LEEP) is indicated, 20) No pharmacotherapy is indicated at this time, • The rash described is that of Erythema Infectiosum (aka 5th’s disease due to parvovirus B19), • Mixed cryoglobulinemia is associated with HCV infection, 22) Fibrosis of the sternomastoid muscles, • Contracted SCM muscle → head tilted toward affected muscle, chin points away from contracted muscle, • Treatment involves early physiotherapy and passive positioning, • Skin is cool and clammy, iindicates that SVR is high in an effort to divert blood flow away from the extremities to maintain perfusion to vital organs, • Extensive vomiting a common cause of hypovolemia, • Painful third trimester vaginal bleeding, • RLQ tenderness with rebound, fever, and leukocytosis with no adnexal masses on U/S (which rules out ovarian torsion), • Firm rubbery LN is likely a lymphoma, ↑ cell turnover → ↑ serum LDH, • Subclavian catheter is in good position,so there is no need to adjust or remove it, • Pneumothorax (PTX) is a common complication of placing a subclavian catheter, but this patient's PTX is small and she is not presenting with signs of respiratory distress, • A small PTX (<20% in size) with no signs of respiratory or circulatory collapse will resolve spontaneously; 100% O2 will accelerate resorption of ai, 28) Add lisinopril to the medication regimen, • ACEi are renal protective for patients with DM, • The ulcer has healed so there is no medical treatment indicated at this time, • Sliding hiatal hernias (type 1) are treated medically (unless refractory), • Paraesophageal hernias (type 2) treated surgically because of the risk of strangulation, • This is likely hypertrophic osteoarthropathy (a paraneoplastic syndrome secondary to to lung cancer), • Presents with clubbing of fingers/toes and swelling/pain in joints/long bones, • X-linked disorder that presents with recurrent infections, eczema and thrombocytopenia, ↓ IgM, • Patient has CKD so his BUN/Cr ratio is showing an intrinsic kidney problem, • Patient then has furosemide added changing the ratio from 8.3 to 10.4 - this increase in ratio could suggest CKD with superimposed prerenal azotemia, • Glomerulonephritis would show RBC casts, • Interstitial nephritis would show WBC casts & eosinophils, • Tubular Necrosis would show granular casts, • She is presenting with signs and sxs of hyperthyroidism (fatigue, palpitations anxiety, weight loss, heat intolerance, increased bowel movements), • Confirmed by ↓ TSH and ↑ T4 as well as ↑ uptake on thyroid scan, • If a patient is suspected of having myoglobinuria or rhabdomyolysis they should immediately be started on IV hydration, • Creatine Kinase (CK) level > 5000 = an absolute indication for hospital admission and aggressive IV hydration → vigorous IV hydration prevents precipitation of myoglobin in the urine → therefore brik diuresis will prevent ATN 2/2 nephrotoxic, • Malformations in the dorsum of the embryo, such as neural tube defects, • Zinc deficiency classically presents with acral or periorificial dermatitis, alopecia and diarrhea, • Zinc deficiency also causes impaired wound healing, hypogonadism, and an altered sense of taste and smell, • Venous ulcers (caused by chronic venous insufficiency) classically develop superior to the medial ankle and are often associated with skin changes (eg, hyperpigmentation) and unilateral edema, • Prisoners (along with children, eldery, and pregnant) are considered vulnerable populations. 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50 years of age, • Can be asymptomatic or cause lumbar pain on exertion, gait problems, radiculopathic pain, or urinary incontinence, • EKG shows ST segment elevation in leads V2-V6, • EKG shows 2 wide QRS complexes in a row with a rate of > 120, • The bright yellow plaque seen on funduscopic examination is likely a thrombotic atherosclerootic plaque that has dislodged from the ICA, • Of the arteries listed, only the ICA branches into vessels that feed the brain and eye (ie, retinal artery), leading to transient blindness, • Acute onset pleuritic chest pain (increases with inspiration), SOB, fever, and an inspiratory rub all suggest acute pericarditis, Found a mistake or have a suggestion? Score: 253 USMLE Step 1 Practice Tests: CBSE, 2 months out, 165 NBME 17, 4 weeks out, 219 NBME 16, 3 weeks out, 225 UWSA1, 1.5 weeks out, 255 UWSA2, 1 week out, 249 NBME 18, 2 days out, 244 Dedicated Time: 7 weeks. At the end of each exam, you will also get a raw CBSSA score and a raw to three-digit score conversion table. If there is no artery (CRAO) then there is no blood flow → therefore NO hemorrhages. Whether you’re preparing for the United States Medical Licensing Exam® (USMLE®), an NBME Subject Examination, or the International Foundations of Medicine® (IFOM®) exam, we have a Self-Assessment designed to help. To play, press and hold the enter key. They secrete mucus and can become obstructed leading to a cyst or abscess that causes pain, tenderness and dyspareunia, • Physical exam:edema and inflammation of the area with a deep fluctuant mass, • Sxs of schizophrenia (for this patient that includes auditory hallucinations and disorganized thinking) but sxs must last less than 1 month and patient returns to baseline functioning after the episodes, • A fixed, non-tender mass in the cul-de-sac causing ascites (positive fluid wave) is likely to be ovarian cancer, • Diagnosis and treatment depend on removal via laparotomy, • Meigs syndrome is associated with a triad of: ascites, pleural effusion, and ovarian tumor; surgical removal of the tumor leads to a resolution of sxs, 18) Measurement of serum amylase activity, • Epigastric pain that radiates to the back is characteristic of acute pancreatitis, • HTN and proteinuria in a pregnant woman > 20 weeks gestation who also presents with epigastric pain and headache is concerning for HELLP syndrome → check platelet count (in this case you would expect the platelet count to be low), • Primary lactase deficiency (age-dependent decline after childhood) is common in people of African, Asian or Native American decent, • Celiac disease is more common in Northern Europeans, • The pain began after physical exertion (moving heavy furniture), is pleuritic (worse with inspiration) and is reproducible (tenderness to palpation lateral to the sternum), • Pt is 3 days post op → perfect timing for a possible DVT (tightness and tenderness to palpation of the left calf), • Prolactinomas should be managed conservatively with dopaminergic agents (eg, bromocriptine) before surgery is considered (eg, transphenoidal resection), • Subconjunctival hemorrhage will spontaneously resolve, • Given that she has perfect visual acuity and no eye pain best no treatment is indicated, • She is in active labor and has a history of GBS UTI → intrapartum prophylaxis with penicillin is indicated, 27) Brisk rotatory nystagmus on left lateral gaze, • Decreased upward gaze is a common finding in the elderly. Below you will find a handy chart that will allow you to make a conversion between your NBME to USMLE score. Background The methods for assigning final grades in clerkships for MS3students in 2020-2021 academic year will utilize a pass/fail system requiring students to meet minimum passing scores on major grading components (Clinical Assessment, NBME Subject Exam and OSCE). The conversion table is unique to each exam and can change through the years even for the same exam, as NBME adds more test-takers to its statistical analyses. Like everything, however, take these scores with a grain of salt. Free 120 NBME 24 NBME 23 NBME 22 NBME 21 NBME 20 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 i felt like i Failed, time managemnt was problem missed 7-8 question on exam, Nbme 7 do not take it few days before exam it under estimates n shatters confidence Guide & help each other , Thank you a friend ''True -passion'' from this Fourm for Guiding me _____ Vaccine doses should not be reduced for preterm or low-birth-weight infants (with the exception of Hep B vaccine which cannot be administered to premature infants if they weigh less than 2000g, 8) Destruction and dilation of the distal airways, • Bronchiectasis - patient with productive cough and recurrent pneumonia; on CXR will see multiple cysts and bronchial crowding (however these findings are nonspecific), • GAS pharyngitis → acute rheumatic fever → holosystolic murmur in the 4th ICS at the MCL (murmur of mitral regurgitation), • This is the treatment of choice for neuroprophylaxis if delivery occurs before 32 weeks of gestation, • Postviral inflammation → Subacute thyroiditis (de Quervain thyroiditis), • Tender goiter, fever, hyperthyroid symptoms, 12) Surreptitious administration of thyroxine, • Decreased radioiodine uptake suggests either Thyroiditis or exogenous thyroid hormone, • Duration of hyperthyroid symptoms and non-palpable thyroid suggests surreptitious thyroxine (eg., weight loss pills that contain bovine thyroxine), • Esophageal mucosal irritation secondary to oral medications, • 1 year history of auditory hallucinations and bizarre behaviors, 15) Transfusion of group O, Rh-negative packed red blood cells, • Patient still unstable after infusion of 3L crystalloid, • Acute hemolytic transfusion reaction - after blood transfusion the patient remains tachycardic and hypotensive (remember that group O blood will have anti-A and anti-B antibodies), • Radiation is indicated for cancers that have metastasized to the spine, • Atypical antipsychotics are the treatment of choice for schizophreniform, • The mothers all have a history of chickenpox prior to pregnancy → therefore they will all have immunity to varicella virus and protective IgG antibodies will be transferred to the babies via the placenta, • If pap smears shows high grade squamous intraepithelial lesion the next step depends on the patient’s age, • If 21-24 yrs → colposcopy → if CIN II or CIN III → excisional or ablative treatment, • If > 24 yrs → colposcopy or loop electrosurgical excision (LEEP) is indicated, 20) No pharmacotherapy is indicated at this time, • The rash described is that of Erythema Infectiosum (aka 5th’s disease due to parvovirus B19), • Mixed cryoglobulinemia is associated with HCV infection, 22) Fibrosis of the sternomastoid muscles, • Contracted SCM muscle → head tilted toward affected muscle, chin points away from contracted muscle, • Treatment involves early physiotherapy and passive positioning, • Skin is cool and clammy, iindicates that SVR is high in an effort to divert blood flow away from the extremities to maintain perfusion to vital organs, • Extensive vomiting a common cause of hypovolemia, • Painful third trimester vaginal bleeding, • RLQ tenderness with rebound, fever, and leukocytosis with no adnexal masses on U/S (which rules out ovarian torsion), • Firm rubbery LN is likely a lymphoma, ↑ cell turnover → ↑ serum LDH, • Subclavian catheter is in good position,so there is no need to adjust or remove it, • Pneumothorax (PTX) is a common complication of placing a subclavian catheter, but this patient's PTX is small and she is not presenting with signs of respiratory distress, • A small PTX (<20% in size) with no signs of respiratory or circulatory collapse will resolve spontaneously; 100% O2 will accelerate resorption of ai, 28) Add lisinopril to the medication regimen, • ACEi are renal protective for patients with DM, • The ulcer has healed so there is no medical treatment indicated at this time, • Sliding hiatal hernias (type 1) are treated medically (unless refractory), • Paraesophageal hernias (type 2) treated surgically because of the risk of strangulation, • This is likely hypertrophic osteoarthropathy (a paraneoplastic syndrome secondary to to lung cancer), • Presents with clubbing of fingers/toes and swelling/pain in joints/long bones, • X-linked disorder that presents with recurrent infections, eczema and thrombocytopenia, ↓ IgM, • Patient has CKD so his BUN/Cr ratio is showing an intrinsic kidney problem, • Patient then has furosemide added changing the ratio from 8.3 to 10.4 - this increase in ratio could suggest CKD with superimposed prerenal azotemia, • Glomerulonephritis would show RBC casts, • Interstitial nephritis would show WBC casts & eosinophils, • Tubular Necrosis would show granular casts, • She is presenting with signs and sxs of hyperthyroidism (fatigue, palpitations anxiety, weight loss, heat intolerance, increased bowel movements), • Confirmed by ↓ TSH and ↑ T4 as well as ↑ uptake on thyroid scan, • If a patient is suspected of having myoglobinuria or rhabdomyolysis they should immediately be started on IV hydration, • Creatine Kinase (CK) level > 5000 = an absolute indication for hospital admission and aggressive IV hydration → vigorous IV hydration prevents precipitation of myoglobin in the urine → therefore brik diuresis will prevent ATN 2/2 nephrotoxic, • Malformations in the dorsum of the embryo, such as neural tube defects, • Zinc deficiency classically presents with acral or periorificial dermatitis, alopecia and diarrhea, • Zinc deficiency also causes impaired wound healing, hypogonadism, and an altered sense of taste and smell, • Venous ulcers (caused by chronic venous insufficiency) classically develop superior to the medial ankle and are often associated with skin changes (eg, hyperpigmentation) and unilateral edema, • Prisoners (along with children, eldery, and pregnant) are considered vulnerable populations. 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50 years of age, • Can be asymptomatic or cause lumbar pain on exertion, gait problems, radiculopathic pain, or urinary incontinence, • EKG shows ST segment elevation in leads V2-V6, • EKG shows 2 wide QRS complexes in a row with a rate of > 120, • The bright yellow plaque seen on funduscopic examination is likely a thrombotic atherosclerootic plaque that has dislodged from the ICA, • Of the arteries listed, only the ICA branches into vessels that feed the brain and eye (ie, retinal artery), leading to transient blindness, • Acute onset pleuritic chest pain (increases with inspiration), SOB, fever, and an inspiratory rub all suggest acute pericarditis, Found a mistake or have a suggestion? Score: 253 USMLE Step 1 Practice Tests: CBSE, 2 months out, 165 NBME 17, 4 weeks out, 219 NBME 16, 3 weeks out, 225 UWSA1, 1.5 weeks out, 255 UWSA2, 1 week out, 249 NBME 18, 2 days out, 244 Dedicated Time: 7 weeks. At the end of each exam, you will also get a raw CBSSA score and a raw to three-digit score conversion table. If there is no artery (CRAO) then there is no blood flow → therefore NO hemorrhages. Whether you’re preparing for the United States Medical Licensing Exam® (USMLE®), an NBME Subject Examination, or the International Foundations of Medicine® (IFOM®) exam, we have a Self-Assessment designed to help. To play, press and hold the enter key. They secrete mucus and can become obstructed leading to a cyst or abscess that causes pain, tenderness and dyspareunia, • Physical exam:edema and inflammation of the area with a deep fluctuant mass, • Sxs of schizophrenia (for this patient that includes auditory hallucinations and disorganized thinking) but sxs must last less than 1 month and patient returns to baseline functioning after the episodes, • A fixed, non-tender mass in the cul-de-sac causing ascites (positive fluid wave) is likely to be ovarian cancer, • Diagnosis and treatment depend on removal via laparotomy, • Meigs syndrome is associated with a triad of: ascites, pleural effusion, and ovarian tumor; surgical removal of the tumor leads to a resolution of sxs, 18) Measurement of serum amylase activity, • Epigastric pain that radiates to the back is characteristic of acute pancreatitis, • HTN and proteinuria in a pregnant woman > 20 weeks gestation who also presents with epigastric pain and headache is concerning for HELLP syndrome → check platelet count (in this case you would expect the platelet count to be low), • Primary lactase deficiency (age-dependent decline after childhood) is common in people of African, Asian or Native American decent, • Celiac disease is more common in Northern Europeans, • The pain began after physical exertion (moving heavy furniture), is pleuritic (worse with inspiration) and is reproducible (tenderness to palpation lateral to the sternum), • Pt is 3 days post op → perfect timing for a possible DVT (tightness and tenderness to palpation of the left calf), • Prolactinomas should be managed conservatively with dopaminergic agents (eg, bromocriptine) before surgery is considered (eg, transphenoidal resection), • Subconjunctival hemorrhage will spontaneously resolve, • Given that she has perfect visual acuity and no eye pain best no treatment is indicated, • She is in active labor and has a history of GBS UTI → intrapartum prophylaxis with penicillin is indicated, 27) Brisk rotatory nystagmus on left lateral gaze, • Decreased upward gaze is a common finding in the elderly. Below you will find a handy chart that will allow you to make a conversion between your NBME to USMLE score. Background The methods for assigning final grades in clerkships for MS3students in 2020-2021 academic year will utilize a pass/fail system requiring students to meet minimum passing scores on major grading components (Clinical Assessment, NBME Subject Exam and OSCE). The conversion table is unique to each exam and can change through the years even for the same exam, as NBME adds more test-takers to its statistical analyses. Like everything, however, take these scores with a grain of salt. Free 120 NBME 24 NBME 23 NBME 22 NBME 21 NBME 20 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 i felt like i Failed, time managemnt was problem missed 7-8 question on exam, Nbme 7 do not take it few days before exam it under estimates n shatters confidence Guide & help each other , Thank you a friend ''True -passion'' from this Fourm for Guiding me _____ Vaccine doses should not be reduced for preterm or low-birth-weight infants (with the exception of Hep B vaccine which cannot be administered to premature infants if they weigh less than 2000g, 8) Destruction and dilation of the distal airways, • Bronchiectasis - patient with productive cough and recurrent pneumonia; on CXR will see multiple cysts and bronchial crowding (however these findings are nonspecific), • GAS pharyngitis → acute rheumatic fever → holosystolic murmur in the 4th ICS at the MCL (murmur of mitral regurgitation), • This is the treatment of choice for neuroprophylaxis if delivery occurs before 32 weeks of gestation, • Postviral inflammation → Subacute thyroiditis (de Quervain thyroiditis), • Tender goiter, fever, hyperthyroid symptoms, 12) Surreptitious administration of thyroxine, • Decreased radioiodine uptake suggests either Thyroiditis or exogenous thyroid hormone, • Duration of hyperthyroid symptoms and non-palpable thyroid suggests surreptitious thyroxine (eg., weight loss pills that contain bovine thyroxine), • Esophageal mucosal irritation secondary to oral medications, • 1 year history of auditory hallucinations and bizarre behaviors, 15) Transfusion of group O, Rh-negative packed red blood cells, • Patient still unstable after infusion of 3L crystalloid, • Acute hemolytic transfusion reaction - after blood transfusion the patient remains tachycardic and hypotensive (remember that group O blood will have anti-A and anti-B antibodies), • Radiation is indicated for cancers that have metastasized to the spine, • Atypical antipsychotics are the treatment of choice for schizophreniform, • The mothers all have a history of chickenpox prior to pregnancy → therefore they will all have immunity to varicella virus and protective IgG antibodies will be transferred to the babies via the placenta, • If pap smears shows high grade squamous intraepithelial lesion the next step depends on the patient’s age, • If 21-24 yrs → colposcopy → if CIN II or CIN III → excisional or ablative treatment, • If > 24 yrs → colposcopy or loop electrosurgical excision (LEEP) is indicated, 20) No pharmacotherapy is indicated at this time, • The rash described is that of Erythema Infectiosum (aka 5th’s disease due to parvovirus B19), • Mixed cryoglobulinemia is associated with HCV infection, 22) Fibrosis of the sternomastoid muscles, • Contracted SCM muscle → head tilted toward affected muscle, chin points away from contracted muscle, • Treatment involves early physiotherapy and passive positioning, • Skin is cool and clammy, iindicates that SVR is high in an effort to divert blood flow away from the extremities to maintain perfusion to vital organs, • Extensive vomiting a common cause of hypovolemia, • Painful third trimester vaginal bleeding, • RLQ tenderness with rebound, fever, and leukocytosis with no adnexal masses on U/S (which rules out ovarian torsion), • Firm rubbery LN is likely a lymphoma, ↑ cell turnover → ↑ serum LDH, • Subclavian catheter is in good position,so there is no need to adjust or remove it, • Pneumothorax (PTX) is a common complication of placing a subclavian catheter, but this patient's PTX is small and she is not presenting with signs of respiratory distress, • A small PTX (<20% in size) with no signs of respiratory or circulatory collapse will resolve spontaneously; 100% O2 will accelerate resorption of ai, 28) Add lisinopril to the medication regimen, • ACEi are renal protective for patients with DM, • The ulcer has healed so there is no medical treatment indicated at this time, • Sliding hiatal hernias (type 1) are treated medically (unless refractory), • Paraesophageal hernias (type 2) treated surgically because of the risk of strangulation, • This is likely hypertrophic osteoarthropathy (a paraneoplastic syndrome secondary to to lung cancer), • Presents with clubbing of fingers/toes and swelling/pain in joints/long bones, • X-linked disorder that presents with recurrent infections, eczema and thrombocytopenia, ↓ IgM, • Patient has CKD so his BUN/Cr ratio is showing an intrinsic kidney problem, • Patient then has furosemide added changing the ratio from 8.3 to 10.4 - this increase in ratio could suggest CKD with superimposed prerenal azotemia, • Glomerulonephritis would show RBC casts, • Interstitial nephritis would show WBC casts & eosinophils, • Tubular Necrosis would show granular casts, • She is presenting with signs and sxs of hyperthyroidism (fatigue, palpitations anxiety, weight loss, heat intolerance, increased bowel movements), • Confirmed by ↓ TSH and ↑ T4 as well as ↑ uptake on thyroid scan, • If a patient is suspected of having myoglobinuria or rhabdomyolysis they should immediately be started on IV hydration, • Creatine Kinase (CK) level > 5000 = an absolute indication for hospital admission and aggressive IV hydration → vigorous IV hydration prevents precipitation of myoglobin in the urine → therefore brik diuresis will prevent ATN 2/2 nephrotoxic, • Malformations in the dorsum of the embryo, such as neural tube defects, • Zinc deficiency classically presents with acral or periorificial dermatitis, alopecia and diarrhea, • Zinc deficiency also causes impaired wound healing, hypogonadism, and an altered sense of taste and smell, • Venous ulcers (caused by chronic venous insufficiency) classically develop superior to the medial ankle and are often associated with skin changes (eg, hyperpigmentation) and unilateral edema, • Prisoners (along with children, eldery, and pregnant) are considered vulnerable populations. 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nbme 7 score conversion
Posted By: February 11, 2021
Plus we use data contributed from students like you! Elite Medical Prep can help with personalized 1-on-1 tutoring. NBME 7 : NBME 7 is a slightly older exam and hence NBME 7 predictive value is a bit lower than the predictive value of newer tests and also NBME 7 difficulty level is a bit easier. Assessment Score: 248 The chart below represents the distribuon of scores for recent examinees from US and Canadian medical schools taking Step 1 for the first me. We have an NBME-to-USMLE conversion chart on our website you can check it out HERE. I made an excel sheet to help students calculate their 3-digit score from their percent correct on NBMEs. National Board of Medical Examiners 7/7 440 215 40 132 430 213 30 130 420 211 20 128 410 209 10 < 128 The material presented on the NBME self-assessments is owned and copyrighted by the National Board of Medical Examiners and provided for educational purposes only. Because of average predictive value of NBME 6 when comparing NBME 6 vs real exam score, NBME 6 tends to be averagely predictive of your USMLE Step 1 score. Below you will find a handy chart that will allow you to make a conversion between your NBME to USMLE score. Block 1 _ 1-5 EABEA 6-10 BDABE 11-15 ABADG 16-20 AADBB 21-25 FDCED 26-30 … NBME 3 score# of mistakes NBME 4 score # of mistakeNBME 6 score. Reactions: 1 users Reply. We provide a best guess and a confidence interval. #3235638 : cancer_84 - 08/17/15 18:40 : Im trying to post a link from other forum and it won't let me do it, ppl have posted their assesment exam scores and real exam scores, google this: " NBME, UWSA, Qbanks Averages, Correlation with Real Step 2 CK Exam Score " and click on first link that comes up in search. * Re:Nbme 7 killed me !! Not important, but I thought I'd post the email so people know how the data is reported. Need a little help preparing for your shelf exam? While there is no formal conversion between the COMLEX Level 1 and USMLE Step 1 Score there is published that COMLEX Level 1 scores and USMLE Step 1 scores are highly correlated (Figure 1.) Use this chart to give yourself an approximation of what your actual USMLE score might look like compared to the NBME exam you just took. As of August 2019, the reults are reported as a Step 1 estimated equivalent score. NBME 7 =231 march 2015 (what!!!) In this example, prisoners are coerced/persuaded to participate in exchange for early parole, • Patient has a ⊕ culture showing gram-positive cocci in clusters (likely S. aureus) and he has a subclavian catheter → most appropriate antibiotic is one that has gram-positive coverage as well as MRSA coverage, • Eye pain and ↓ vision suggest optic neuritis, • Optic neuritis + relative afferent pupillary defect suggest multiple sclerosis (MS), • A condition in which a vertebral body slips forward in relation to the vertebra beneath, • Most commonly involves L5 slipping over S1, • Most commonly affects children, adolescents, and in individuals > 50 years of age, • Can be asymptomatic or cause lumbar pain on exertion, gait problems, radiculopathic pain, or urinary incontinence, • EKG shows ST segment elevation in leads V2-V6, • EKG shows 2 wide QRS complexes in a row with a rate of > 120, • The bright yellow plaque seen on funduscopic examination is likely a thrombotic atherosclerootic plaque that has dislodged from the ICA, • Of the arteries listed, only the ICA branches into vessels that feed the brain and eye (ie, retinal artery), leading to transient blindness, • Acute onset pleuritic chest pain (increases with inspiration), SOB, fever, and an inspiratory rub all suggest acute pericarditis, Found a mistake or have a suggestion? Score: 253 USMLE Step 1 Practice Tests: CBSE, 2 months out, 165 NBME 17, 4 weeks out, 219 NBME 16, 3 weeks out, 225 UWSA1, 1.5 weeks out, 255 UWSA2, 1 week out, 249 NBME 18, 2 days out, 244 Dedicated Time: 7 weeks. At the end of each exam, you will also get a raw CBSSA score and a raw to three-digit score conversion table. If there is no artery (CRAO) then there is no blood flow → therefore NO hemorrhages. Whether you’re preparing for the United States Medical Licensing Exam® (USMLE®), an NBME Subject Examination, or the International Foundations of Medicine® (IFOM®) exam, we have a Self-Assessment designed to help. To play, press and hold the enter key. They secrete mucus and can become obstructed leading to a cyst or abscess that causes pain, tenderness and dyspareunia, • Physical exam:edema and inflammation of the area with a deep fluctuant mass, • Sxs of schizophrenia (for this patient that includes auditory hallucinations and disorganized thinking) but sxs must last less than 1 month and patient returns to baseline functioning after the episodes, • A fixed, non-tender mass in the cul-de-sac causing ascites (positive fluid wave) is likely to be ovarian cancer, • Diagnosis and treatment depend on removal via laparotomy, • Meigs syndrome is associated with a triad of: ascites, pleural effusion, and ovarian tumor; surgical removal of the tumor leads to a resolution of sxs, 18) Measurement of serum amylase activity, • Epigastric pain that radiates to the back is characteristic of acute pancreatitis, • HTN and proteinuria in a pregnant woman > 20 weeks gestation who also presents with epigastric pain and headache is concerning for HELLP syndrome → check platelet count (in this case you would expect the platelet count to be low), • Primary lactase deficiency (age-dependent decline after childhood) is common in people of African, Asian or Native American decent, • Celiac disease is more common in Northern Europeans, • The pain began after physical exertion (moving heavy furniture), is pleuritic (worse with inspiration) and is reproducible (tenderness to palpation lateral to the sternum), • Pt is 3 days post op → perfect timing for a possible DVT (tightness and tenderness to palpation of the left calf), • Prolactinomas should be managed conservatively with dopaminergic agents (eg, bromocriptine) before surgery is considered (eg, transphenoidal resection), • Subconjunctival hemorrhage will spontaneously resolve, • Given that she has perfect visual acuity and no eye pain best no treatment is indicated, • She is in active labor and has a history of GBS UTI → intrapartum prophylaxis with penicillin is indicated, 27) Brisk rotatory nystagmus on left lateral gaze, • Decreased upward gaze is a common finding in the elderly. Below you will find a handy chart that will allow you to make a conversion between your NBME to USMLE score. Background The methods for assigning final grades in clerkships for MS3students in 2020-2021 academic year will utilize a pass/fail system requiring students to meet minimum passing scores on major grading components (Clinical Assessment, NBME Subject Exam and OSCE). The conversion table is unique to each exam and can change through the years even for the same exam, as NBME adds more test-takers to its statistical analyses. Like everything, however, take these scores with a grain of salt. Free 120 NBME 24 NBME 23 NBME 22 NBME 21 NBME 20 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 i felt like i Failed, time managemnt was problem missed 7-8 question on exam, Nbme 7 do not take it few days before exam it under estimates n shatters confidence Guide & help each other , Thank you a friend ''True -passion'' from this Fourm for Guiding me _____ Vaccine doses should not be reduced for preterm or low-birth-weight infants (with the exception of Hep B vaccine which cannot be administered to premature infants if they weigh less than 2000g, 8) Destruction and dilation of the distal airways, • Bronchiectasis - patient with productive cough and recurrent pneumonia; on CXR will see multiple cysts and bronchial crowding (however these findings are nonspecific), • GAS pharyngitis → acute rheumatic fever → holosystolic murmur in the 4th ICS at the MCL (murmur of mitral regurgitation), • This is the treatment of choice for neuroprophylaxis if delivery occurs before 32 weeks of gestation, • Postviral inflammation → Subacute thyroiditis (de Quervain thyroiditis), • Tender goiter, fever, hyperthyroid symptoms, 12) Surreptitious administration of thyroxine, • Decreased radioiodine uptake suggests either Thyroiditis or exogenous thyroid hormone, • Duration of hyperthyroid symptoms and non-palpable thyroid suggests surreptitious thyroxine (eg., weight loss pills that contain bovine thyroxine), • Esophageal mucosal irritation secondary to oral medications, • 1 year history of auditory hallucinations and bizarre behaviors, 15) Transfusion of group O, Rh-negative packed red blood cells, • Patient still unstable after infusion of 3L crystalloid, • Acute hemolytic transfusion reaction - after blood transfusion the patient remains tachycardic and hypotensive (remember that group O blood will have anti-A and anti-B antibodies), • Radiation is indicated for cancers that have metastasized to the spine, • Atypical antipsychotics are the treatment of choice for schizophreniform, • The mothers all have a history of chickenpox prior to pregnancy → therefore they will all have immunity to varicella virus and protective IgG antibodies will be transferred to the babies via the placenta, • If pap smears shows high grade squamous intraepithelial lesion the next step depends on the patient’s age, • If 21-24 yrs → colposcopy → if CIN II or CIN III → excisional or ablative treatment, • If > 24 yrs → colposcopy or loop electrosurgical excision (LEEP) is indicated, 20) No pharmacotherapy is indicated at this time, • The rash described is that of Erythema Infectiosum (aka 5th’s disease due to parvovirus B19), • Mixed cryoglobulinemia is associated with HCV infection, 22) Fibrosis of the sternomastoid muscles, • Contracted SCM muscle → head tilted toward affected muscle, chin points away from contracted muscle, • Treatment involves early physiotherapy and passive positioning, • Skin is cool and clammy, iindicates that SVR is high in an effort to divert blood flow away from the extremities to maintain perfusion to vital organs, • Extensive vomiting a common cause of hypovolemia, • Painful third trimester vaginal bleeding, • RLQ tenderness with rebound, fever, and leukocytosis with no adnexal masses on U/S (which rules out ovarian torsion), • Firm rubbery LN is likely a lymphoma, ↑ cell turnover → ↑ serum LDH, • Subclavian catheter is in good position,so there is no need to adjust or remove it, • Pneumothorax (PTX) is a common complication of placing a subclavian catheter, but this patient's PTX is small and she is not presenting with signs of respiratory distress, • A small PTX (<20% in size) with no signs of respiratory or circulatory collapse will resolve spontaneously; 100% O2 will accelerate resorption of ai, 28) Add lisinopril to the medication regimen, • ACEi are renal protective for patients with DM, • The ulcer has healed so there is no medical treatment indicated at this time, • Sliding hiatal hernias (type 1) are treated medically (unless refractory), • Paraesophageal hernias (type 2) treated surgically because of the risk of strangulation, • This is likely hypertrophic osteoarthropathy (a paraneoplastic syndrome secondary to to lung cancer), • Presents with clubbing of fingers/toes and swelling/pain in joints/long bones, • X-linked disorder that presents with recurrent infections, eczema and thrombocytopenia, ↓ IgM, • Patient has CKD so his BUN/Cr ratio is showing an intrinsic kidney problem, • Patient then has furosemide added changing the ratio from 8.3 to 10.4 - this increase in ratio could suggest CKD with superimposed prerenal azotemia, • Glomerulonephritis would show RBC casts, • Interstitial nephritis would show WBC casts & eosinophils, • Tubular Necrosis would show granular casts, • She is presenting with signs and sxs of hyperthyroidism (fatigue, palpitations anxiety, weight loss, heat intolerance, increased bowel movements), • Confirmed by ↓ TSH and ↑ T4 as well as ↑ uptake on thyroid scan, • If a patient is suspected of having myoglobinuria or rhabdomyolysis they should immediately be started on IV hydration, • Creatine Kinase (CK) level > 5000 = an absolute indication for hospital admission and aggressive IV hydration → vigorous IV hydration prevents precipitation of myoglobin in the urine → therefore brik diuresis will prevent ATN 2/2 nephrotoxic, • Malformations in the dorsum of the embryo, such as neural tube defects, • Zinc deficiency classically presents with acral or periorificial dermatitis, alopecia and diarrhea, • Zinc deficiency also causes impaired wound healing, hypogonadism, and an altered sense of taste and smell, • Venous ulcers (caused by chronic venous insufficiency) classically develop superior to the medial ankle and are often associated with skin changes (eg, hyperpigmentation) and unilateral edema, • Prisoners (along with children, eldery, and pregnant) are considered vulnerable populations.
