Usmle step 3 collection 1

ismailalmokyad's version from 2017-06-30 02:38


Question Answer
does depression put pt in risk for any other medical conditions?there is a bidirectional link between major depression and coronary artery disease, it also increase M&M in cardiovascular disease.
what is the earliest manifestation of CF?Meconium ileus(almost pathognomonic for disease), it is characterized by distal intestinal obstruction, where in the terminal ileum is dilated and filled with thick, tar like inspissated meconium. abdominal xray findings (dilated, gas filled loops of small bowel , absent air fluid levels, and a meconium mass with the right side of the abdomen)
what is the mood of inheritence in CF?autosomal recessive pattern.
what genetic disease is associated with duodenal atresia ?down's syndrome
when does most undescended testes(cryptorchidism) will descend spontaneously ?by age of 6 months.
when you preform orchiopexy for cryptorchidism ?if did not descended by age 6 months, to improve fertility and testicular growth. it also decrease the risk of testicular torsion.
does orchiopexy eliminate risk of testicular cancerIt decrease it but doesn't eliminate it. It is also make it easier to detect it as it is easier to palpate mass in scrotum than in abdomen.
what is the best way to diagnose cryptoorchidism?Ulta sound is diagnostic.
How active pulmonary tuberculosis should be treated in a pregnant women?with 3 drug therapy (isoniazid(INH), rifampin, and ethambutol for 2 months), followed by INH and rif for 7 additional months. All cross placenta but don't affect baby. but pyrazinamide is not used in pregnancy due to uncertain teratogenic properties. also pyridonine (B6) should be given to prevent INH neurotoxicity.
how you should follow active pulmonary TB pt while on treatment?counseling about meds S/E, monthly monitoring for disease response and drug associated hepatitis are required.
latent TB (+ve tuberculin skin test but no symptoms or cxray) treatment during pregnancy ?do not require treatment until after delivery.
Is latent TB infectious ?No
what is the treatment options for latent TBINH and rifapentine weekly for 3 months under direct observation(not recom for HIV, INH monotherapy for 6-9 months, or Rifampin for 4 months.
what is the risk to develop active TB in a latent TB patient ?very low 5-10%.but increase with immunosuppressed individuals and smokers.
when pt of active TB can be consider noninfectious ?when 3 consecutive acid fast bacilli sputum smears are negative(8-24 hours intercals and > 1 early morning samples)
Pear-shaped motile organisms on pap smear?this is trichomonas vaginalis infection. often pt has green frothy discharge, dysuria, dyspareunia, urinary frequency and/or vaginal pruritus. both partners should be treated with oral metronidazole.
what is the treatment of chlamydia?doxycycline

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