USMLE-Rx Step 2 Qmax Challenge #21423

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 2 Qmax Challenge #21423A 32-year-old man is found to have a solitary, firm mass in the thyroid on routine physical examination. He has no complaints and the remainder of his physical examination is unremarkable. Family history is significant for an uncle who died of thyroid cancer at age 40 years. A biopsy of the thyroid stained with Congo red is shown in the image.

What further study should be done in this patient?

A. Barium swallow
B. Measurement of serum insulin-like growth factor-1
C. Measurement of urinary metanephrine levels
D. MRI of the brain
E. Renal biopsy

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

Start Early and Do Lots of Questions: Acing COMLEX and USMLE Prep

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By Ryan Nguyen

Many osteopathic medical students at the beginning of their second year struggle to come up with a game-plan to prepare for the COMLEX Level 1 and USMLE Step 1. With a disturbing number of resources and study plans to choose from, how can students determine what strategy will maximize their board scores?

Early in my second year, I scoured the depths of the internet pouring over the study schedules and tips of past test takers. I was looking for “the one,” a study schedule that would get me the scores of my dreams. The dirty secret to success? There was no one study plan that triumphs above all. While they all varied in their day-to-day plans, study plans from top scorers all echoed the same two principles: start preparation early and do lots and lots of practice questions.

This post is dedicated to when to start preparing and how many practice questions to do. (more…)

USMLE-Rx Step 1 Qmax Challenge #3421

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3421A 54-year-old woman complains about a persistent cough she has had for the past 3 months. The cough has been bothering her a lot and making her anxious. She thinks the anxiety is why she has lost some weight recently. She also blames the anxiety whenever she wakes up in the middle of the night and finds herself drenched in sweat. Further history reveals she has rheumatoid arthritis (RA), but her joint pains and swellings are well controlled by medications her rheumatologist has prescribed her. Following a physical examination, the physician orders an x-ray of the chest (see image). Based on the results, the physician immediately prescribes an antibiotic regimen and asks her to discontinue one of the drugs used to treat her RA.

Which of the following drugs increased her risk of developing the disease shown on the radiograph?

A. Etanercept
B. Methotrexate
C. Nonsteroidal anti-inflamatory drugs
D. Risedronate
E. Sulfasalazine

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

Mnemonic Monday: Inflammatory Bowel Disease – Crohn’s vs. Ulcerative Colitis

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By Haley Masterson

The two types of Inflammatory Bowel Disease are both idiopathic diseases of the immune system. However, they differ in several commonly tested ways that can be explained using a simple mnemonic: Only GALS can be Crones (Crohn’s).

Granulomas – While a lack of granulomas won’t rule out Crohn’s Disease, if a test question mentions them, you should be thinking about Crohn’s. Granulomas don’t appear in Ulcerative Colitis.

All Layers – Crohn’s affects all of the layers of the bowel– it’s a transmural disease, whereas Ulcerative Colitis is confined to the mucosa (with occasional submucosa inflammation). Only Crohn’s has muscularis and serosa involvement.

You can also think of “All Layers” as being “All levels” of the bowel – Crohn’s can affect anything from the ileum (the most commonly involved segment) to the sigmoid colon, whereas Ulcerative Colitis is generally limited to colonic lesions. This becomes easy to remember when you consider that Ulcerative Colitis has “colon” right in its name. (more…)

USMLE-Rx Step 2 Qmax Challenge #21296

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Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 2 Qmax Challenge #21296An 82-year-old man with hypertension, hypercholesterolemia, and chronic obstructive pulmonary disease presents to the emergency department with severe back pain. He also feels diaphoretic and nauseous. The patient states he is usually compliant with his medications but sometimes forgets to take them. He denies any alcohol use or illicit drug use. His temperature is 37.1°C (98.7°F), blood pressure is 165/104 mm Hg, pulse is 112/min, respiratory rate is 18/min, and oxygen saturation is 94%. On physical examination there is no jugular venous distension, and there are diminished but equal pulses bilaterally in the lower extremities. Cardiovascular examination reveals regular rate and rhythm without murmurs, rubs, or gallops. Because the patient has an allergy to CT contrast dye, an MRI of the chest is performed and is shown in the image below.

Which of the following is the most likely diagnosis?

A. Aortic dissection
B. Lumbar disc herniation
C. Pancreatic cancer
D. Perforated peptic ulcer
E. Ruptured aortic aneurysm

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

Military Medical School Made Simple

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By Tim Durso, 2D LT, USAF

Military Medical School Made SimpleI get a lot of questions about what exactly it means to be a medical student on military scholarship. There are plenty of official resources that you can find (just google Health Professions Scholarship Program), but I thought it might be a good idea to give a brief overview as a student currently in the process.

First of all, you might be wondering when and how to start the application process. I started early in my second semester of senior year of college by contacting a recruiter directly. This allowed me to gather the necessary paperwork and schedule training before medical school started. If I’ve learned anything from being a government employee so far, it never hurts to get a head start on a paperwork process. That’s not to say you can’t start later, or even after you’ve started medical school, because you definitely can. Remember, though, that a four-year HPSP scholarship carries with it a signing bonus that a shorter scholarship wouldn’t.

If you’re thinking about contacting a recruiter but don’t know what to expect, here’s a quick run-down of what you’re getting yourself into. The nuts and bolts: The military (in my case, the Air Force) pays for tuition, required books, and testing fees. In addition to the signing bonus for a four-year scholarship mentioned earlier, I receive a monthly stipend for living expenses. In return, after my residency, I will serve in the Air Force as a physician for four years of active duty and four years of reserve duty (with a whole bunch of caveats which are beyond the scope of a blog post). (more…)

USMLE-Rx Step 1 Qmax Challenge #3417

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3417A 58-year-old man presents to his physician with fatigue and cough. He has a history of chronic myelogenous leukemia and has been in remission for 3 years. His WBC count is 50,000/mm³, and immature cells are noted on peripheral blood smear. In the office he spikes a fever of 39.4°C (103°F). Lung tissue is obtained for biopsy and silver stained (results are shown in the image). Based on the results, appropriate antimicrobial therapy is initiated. In a few hours the patient develops blurred vision, and later the patient’s QTc interval is noted to be elongated on ECG.

What is the most likely antimicrobial agent this patient was prescribed?

A. Voriconazole
B. Amphotericin B
C. Caspofungin
D. Griseofulvin
E. Terbinafine

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

 

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