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Old 11-03-2010
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Question NBME Form 6 Questions that I got wrong

Q1-A 54 year old male hs acute pain several hours after rubber band ligation of prolapsing hemorrhoid. which of da following z most likely explanation of pain???
A-A ligation involving mucous linning of anal canal
B-Ligation stopped blood supply to hemorrhoids
C-ligation wz done at da level of anal column
D-ligation wz done inferior to pectinate line
E-Ligation wz done on internal hemorrhoids


I answered B bt it wz wrong. wat shld b right answer??

Q2-A 16 year old boy comes to physician for physical examination required for a lifeguard job at a local pool. Physical exam hs no abnormalities. which of following advice by physician is most appropriate???
A-Advise him to wear a wide brimmed hat,sunglasses n sunscreen
B-suggest him yo wear goggles when swimming in pool
C-tell him he cld make more money mowing lawns
D-tell him dat he z fine n to enjoy himself at pool this summer
E-warn him to wait about one hour after eating before going swimming

I answered D bt it was wrong....................So tell me what should b answer
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Old 11-05-2010
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Q1 - I think answer is D-ligation wz done inferior to pectinate line, because hemorrhoids below the pectinate line (external) are painful, unlike hemorrhoids above this line (internal). I think hemorrhoids + pain = external hemorrhoids.

Q2 - Hmm.. D is definitely wrong, because simply he's not going there to have fun, but to work. I think it's either B or E. Not sure.
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Old 11-05-2010
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Q2: Why not A. I would say that if he is going to work whole summer in the sun shine, it should be mentioned that it could be beneficial to protect as much sun shining as possible due to UV radiation. So I'd go for A.
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Old 11-05-2010
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I think
Q1: D
Q2:A
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Old 11-05-2010
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#1: D, below pectinate line: somatic nerves carried by inferior pudendal: pain

#2: A wear sunscreen
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Old 11-05-2010
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Quote:
Originally Posted by fin-84 View Post
Q2: Why not A. I would say that if he is going to work whole summer in the sun shine, it should be mentioned that it could be beneficial to protect as much sun shining as possible due to UV radiation. So I'd go for A.
Won't the hat and glasses interfere with his job when he jumps into the pool to save someone? Also, the sunscreen would get washed away after the first dip!
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Old 11-05-2010
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First one is D because the somatic nerve is involved and thus the pain. If it's above the pectinate line it's visceral and there should be little to no pain (or blunt).

Second one I would go for A - to tell the boy to wear a hat/sunglasses/sunscreen because of the risk of exposure to UV light which increases the incidence of skin malignancies.
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Quote:
Originally Posted by Haisook View Post
Won't the hat and glasses interfere with his job when he jumps into the pool to save someone? Also, the sunscreen would get washed away after the first dip!
Yeah I guess it could be unconvinient, but hey I would rather feel little unconvinient than UV exposure (little experience of sunburns). but still i think the A is the thing
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Old 11-05-2010
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Q1.I think its D
Q2.A
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