nbme 16 behavioural sciences doubts - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 08-26-2014
USMLE Forums Scout
 
Steps History: 1 + CS
Posts: 85
Threads: 36
Thanked 8 Times in 6 Posts
Reputation: 18
Default nbme 16 behavioural sciences doubts

1. A 23-year-old man comes to the emergency department because of a 2-week history of back pain refractory to treatment with over-the-counter medications. He demands a prescription for an opioid drug because "they're the only medications that decrease my pain." He becomes upset when he is told that over-the-counter medications should relieve his symptoms. His temperature is 37.1C (98.8F), pulse is 70/min, respirations are 18/min, and blood pressure is 120/70 mm Hg. Physical examination shows no abnormalities. Which of the following is the most appropriate action by the physician?
A.Determine which drugs have been prescribed for the patient in the past
B.Obtain serum toxicology screening on the patient
C.Order an MRI of the spine
D.Prescribe only a 2-week course of a narcotic medication for the patient
E.Refer the patient to a drug addiction program

2.A 79-year-old woman is admitted to the hospital after sustaining a fracture of the right hip when she fell down the stairs in her two-story home. She worked as a librarian for 40 years until she retired 14 years ago. Her hobbies include reading, knitting, and gardening. She also volunteers at the local hospital, reading to patients. She occasionally visits a local health club to participate in a swimming pool-based exercise class. She drinks one glass of wine daily with her evening meal. She is 155 cm (5 ft 1 in) tall and weighs 50 kg (110 lb); BMI is 21 kg/m2. Which of the following recommendations by the physician is most likely to decrease this patient's risk for additional fractures in the future?
A.Discontinue consumption of all alcoholic beverages
B.Discontinue gardening
C.Go for a long walk outside daily
D.Increase participation in swimming pool-based exercise classes to at least three times weekly
E.Lose weight

3.A previously healthy 18-year-old man is brought to the emergency department by his mother 45 minutes after she found him crouched in his closet, saying he had to hide from the intruders "from that other place." There were no intruders in the house. He has no history of alcohol or drug use. He appears afraid of the physician and sits far away from her. During the interview, he says he has heard two male voices in his head for the past 2 weeks. Physical examination and laboratory studies show no abnormalities. Which of the following is the most likely diagnosis?
A.Bipolar disorder
B.Brief psychotic disorder
C.Delusional disorder
D.Schizoaffective disorder
E.Schizophrenia


can anyone tell me the correct answer n explanation for these q. thanks in advance
Reply With Quote Quick reply to this message



  #2  
Old 08-27-2014
pranavmerchant's Avatar
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 350
Threads: 5
Thanked 237 Times in 123 Posts
Reputation: 247
Default

2. C
walking should help this woman.
I got this wrong so I know.

others im not sure.
Reply With Quote Quick reply to this message
  #3  
Old 08-27-2014
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 276
Threads: 21
Thanked 133 Times in 70 Posts
Reputation: 143
Post

Q#1 = single abnormal clue = back pain + sub-febrile temperature 37,1 C - I would suspect : Ankylosing spondylitis, but history is only two weeks then would order MRI of the spine = but logically you also gather an information about current medications he is on, so the most likely step - ask what medications he is taking currently. Answer: A

Q#2 DS=> Age related Osteoporosis = apply physical stress, Vit D + Ca2+

Q#3 DS=> Shizoaffective disorder, at least two weeks of stable mood + psychotic symptoms
Reply With Quote Quick reply to this message
 
  #4  
Old 08-27-2014
USMLE Forums Scout
 
Steps History: 1 + CS
Posts: 85
Threads: 36
Thanked 8 Times in 6 Posts
Reputation: 18
Default

pranav merchant- even i thought walking wud help but long walk can actually put stress on her bones..so i ve eliminated it but what google says is walking will strenghten bones

@citadel08- can u tell me how to differentiate between delusional disorder and schizoaffective disorder. i was confused between these two n selected wrong answer
Reply With Quote Quick reply to this message
  #5  
Old 08-27-2014
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 276
Threads: 21
Thanked 133 Times in 70 Posts
Reputation: 143
Default

In addition to the first question - just came to conclusion - the poor guy was probably taking an aspirin = at dose of 4000 mg/per day it uncouples oxidative phosphorylation = paradoxical aspirin induced hypertermia = that is why asking patients drug history is correct.

Delusional disorder = lasts more then month reference: FA 2013 ed. page 463
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
NBME 6 doubts drss90 USMLE Step 2 CK Forum 0 08-18-2013 12:21 PM
nbme 12 doubts!! help pls!!! sruthi USMLE Step 1 Forum 0 09-28-2012 07:51 AM
NBME form 3 doubts... wsams USMLE Step 1 Forum 4 03-13-2012 02:26 AM
NBME 7 doubts wsams USMLE Step 1 Forum 1 03-05-2012 06:09 PM
is kaplan enough for behavioural sciences?? mahwish USMLE Step 1 Forum 3 12-31-2010 12:25 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)