Questions need help - 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 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 07-18-2014
USMLE Forums Scout
 
Steps History: Not yet
Posts: 21
Threads: 8
Thanked 1 Time in 1 Post
Reputation: 11
Default Questions need help

1. A 2 y/o girl brought to ER 20 mins after her mom found her ill and breathing rapidly. She found an open bottle of aspirin in the child’s play area but does not know how many tablets r missing. On arrival, the pt appears mildly lethargic. Her temp is 38C, pulse 130/min, RR= 46/min, and BP is 100/70. There is adequate perfusion. The remainder of the exam shows no abnormalities. Measurement of serum aspirin concentration is ordered. Arterial blood gas analysis on room air is most likely to show which of the following?
A) metabolic acidosis
B) metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
E) Mixed metabolic acidosis & Respiratory alkalosis


So is it suppose to be D) just respiratory alkalosis since only 20mins?





2. A 5lb 5 oz newborn is delivered at 37 weeks gestation to a 32 year old women, gravida 1 para 1, following an uncomplicated delivery. The mom has history of IV drug use and received no prenatal care. She did not take any med during pregnancy. Rapid HIV testing of the mother after delivery is positive. Exam of newborn shows no abnormalities. Which of the following is the best next step to manage the newborn?
A) A 6-week course of oral AZT beginning at the 2 week exam
B) A 6-week course of oral AZT only if CD4 count decreases to less than 200/mm
C) A 6-week course of oral AZT within 12 hours after delivery
D) A 6-week course of triple antiretroviral therapy beginning at the 2 week exam
E) A 6-week course of triple antiretroviral therapy if the CD4 T count decrease to less than 200/mm
F) A 6-week course of triple antiretroviral therapy within 24 hours after delivery


For this question it seems like its baby of HIV positive mom who had not taken any antiretral virals during pregnancy. So is the any F) triple drugs for baby within 24 hours? I remember that if the mom is on AZT during pregnancy, then its 6 week of only AZT within 12 hours (C). but since the mom did not take AZT, so the infant has to be on triple therapy right?

P.S. someone plz tell me if (all moms r HIV positive):
1) the mom is on AZT throughout pregnancy + C-section then what u
do with baby? Tx or test first like PCR and stuff
2) the mom is on AZT throughout pregnancy, but vaginal delivery
3) mom did not take meds during pregnancy, but C-section
4) mom didn't take meds and vaginal delivery (I think thats the same
as the question stem)

Sry for asking so many questions



3.A 1 y/o AA girl with Sickle cell diseased is brought to the ER b/c of the sudden onset of high fever, irritability and tachypnea 6 hours ago. Her diet consists of iron fortified formula and pureed fruits and vegetables. Her mom states that she only misses an occasional dose of penicillin prophylaxis. She appears ill. Her tem is 39, pulse is 180/min and respirations r 48/min. Exam shows conjunctival pallor. A grade 2/6 murmur is heard best at the left sternal border. Lab studies show a hematocrit of 23%, leukocyte count of 23,000 and platelet count of 250,000. The best next step is to give?
A) Oral penicillin
B) IV cefotaxime
C) IV corticosteroids
D) IVIG
E) IV naficillin
F) IV penicillin


I know the is probably SC pt developing pneumonia, so it's usually strep pneumo right? What do we tx it with? IV penicillin or like naficillin
Reply With Quote Quick reply to this message



  #2  
Old 07-18-2014
USMLE Forums Scout
 
Steps History: 1 + CK
Posts: 15
Threads: 6
Thanked 0 Times in 0 Posts
Reputation: 10
Default

1. If the mother was not on ART then neonate should be given zidovudine for 6 weeks and nevirapine 3 doses(i.e at birth,48hrs n 96 hrs) ,intiating treatment within 6-12 hrs..but this is not in option!
Reply With Quote Quick reply to this message
  #3  
Old 07-19-2014
USMLE Forums Scout
 
Steps History: Not yet
Posts: 21
Threads: 8
Thanked 1 Time in 1 Post
Reputation: 11
Default

Quote:
Originally Posted by IM22 View Post
1. If the mother was not on ART then neonate should be given zidovudine for 6 weeks and nevirapine 3 doses(i.e at birth,48hrs n 96 hrs) ,intiating treatment within 6-12 hrs..but this is not in option!

i know, you have to choose from the choices given....sigh, what if the mother were on meds?
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


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)