![]() Here are some pieces of advice to keep in mind: What can help is understanding that it is not “just” about remembering content: Taking an organized approach and having your strategy in place early on can help tremendously. Studying for the USMLE Step 1 exam can seem like a daunting task due to the breadth of content covered. Students: Educators’ Pro Tips for Tough Topics.Maternity Nursing and Care of the Childbearing Family.Diversity, Equity, Inclusion, and Belonging.Given the patient’s risk factors, plans were made for early coronary angiography. Since admission, she required 2 doses of sublingual nitric oxide for recurrent angina, and repeat troponin levels continued to rise. Upon diagnosis, management with inhaled oxygen therapy, beta-blockers and aspirin, and low-molecular-weight heparin therapy were initiated, and the patient was placed on bed rest with continuous electrocardiographic monitoring. ECG findings noted ST depressions and T wave inversions on anterolateral leads, accompanied by elevated cardiac enzymes. Which of the following is the most likely diagnosis?Ī. Membranoproliferative glomerulonephritisĪ 71-year-old woman with a past medical history of type 2 diabetes, hypercholesterolemia, and hypertension was admitted to the hospital 8 hours ago with substernal chest pain for management of acute non-ST-elevated myocardial infarction. Urinalysis results are as follows: pHĪ renal biopsy is sent which shows normal glomeruli on light microscopy. On examination, there is pitting edema of the upper and lower extremities bilaterally. The vital signs include: blood pressure 100/62 mm Hg, pulse 110/min, temperature 36.7☌ (98.0☏), and respiratory rate 16/min. His birth history is uneventful and all his vaccinations are up to date. His mother does not provide any history of similar symptoms in the past. The puffiness first started in his eyes and then spread to the face. What is the most likely reticulocyte range for this patient?Ī 5-year-old boy is brought to the office by his mother with complaints of facial puffiness and ‘frothy’ urine for 4 days. The following laboratory values are obtained: Hematocrit Heart examination reveals a 2/6 systolic murmur at the right upper sternal border. Lung and abdominal examinations are within normal limits. HEENT examination demonstrates mild conjunctival pallor. On physical examination, she has a blood pressure of 128/72 mm Hg, a pulse of 87/min, and an oxygen saturation of 94% on room air. She states that she has been very healthy previously, and managed her own health without a physician for the past 20 years. Her diet consists of a Mediterranean diet that includes fruits, vegetables, and fish. The patient is a retired accountant and denies smoking history, but she does admit to 1 small glass of red wine daily for the past 5 years. ![]() She takes oral omeprazole as needed and a daily baby aspirin. Her past medical history includes mild osteoporosis and occasional gastric reflux disease. She denies difficulty breathing while sitting comfortably, but she has increased dyspnea upon walking or other mildly strenuous activity. She denies chest pain, syncope, lower extremity edema, or a cough. She noticed that she is feeling increasingly short of breath after walking the same distance from the bus stop to her home. If the findings suggest a possible pituitary gland disorder, which of the following laboratory abnormalities is most likely in this patient?Ī. Before test: ACTH high, after test: aldosterone suppressionī. Before test: ACTH low, after test: cortisol elevationĬ. Before test: ACTH high, after test: cortisol suppressionĭ. Before test: ACTH low, after test: aldosterone normalizesĮ. Before test: ACTH high, after test: cortisol elevationĪ 67-year-old woman presents to the clinic complaining of progressive fatigue over the past 4 months. ![]() A high-dose dexamethasone suppression test is also conducted to measure ACTH. You order a low dose dexamethasone suppression test, which is positive. On visual field examination, he is found to have a loss of vision in the lateral visual fields bilaterally. He has a round face, centripetal obesity, and striae on the skin with atrophy over the abdomen and thighs. ![]() During the physical examination, his blood pressure is 148/80 mm Hg, the heart rate is 65/min, the temperature is 36.8☌ (98.2☏), and the respirations are 14/min. The patient’s blood pressure normalizes before the emergency department physician can evaluate him. He currently does not take any medication. Past medical history is insignificant and both of his parents are healthy.
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