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Board question of the day 4

Funmi Adesina — Mon, 20 Mar 2017 17:34:24 +0000

4. A 62-year-old woman with a ten-year history of rheumatoid arthritis presents with painful swelling at the back of the knee that is visible on physical examination only when the knee is extended. Which of the following is the most likely diagnosis?

A) Anserine bursitis
B) Baker’s cyst
C) Deep venous thrombosis
D) Prepatellar bursitis
E) Infrapatellar bursitis

Explanation

Correct Answer B. Baker’s Cyst
A Baker’s cyst occurs in the midline of the popliteal fossa and is often a complication of rheumatoid arthritis. The cyst represents a diverticulum of the synovial sac that protrudes through the joint capsule of the knee. The knee is composed of 12 different bursae.

Educational Objectives
A Baker’s cyst, also called a popliteal cyst, is usually the result of a problem with your knee joint, such as arthritis or a cartilage tear. Both conditions can cause your knee to produce too much fluid, which can lead to a Baker’s cyst.

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Question of the day 6

Funmi Adesina — Sun, 05 Mar 2017 07:33:24 +0000

6. A 32-year-old farmer consults with symptoms of night sweats, low-grade fever, cough, and fatigue. He does not smoke. He has a history of asthma. The chest x-ray required for immigration was normal 5 mo ago. He received the BCG vaccine as a child. The skin test for tuberculosis is positive at 15 mm. The most likely diagnosis is

A) Influenza
B) Brucellosis
C) Aspergillosis
D) Mycobacterium bovis
E) M. tuberculosis

Explanation

Correct Answer D. Mycobacterium bovis
Most people are at very low risk for being infected with M. bovis. People at higher risk include individuals who work with cattle, bison, or cervids (e.g., deer or elk), or products from these animals such as hides, milk, or meat. Examples of occupations or hobbies that might put people at increased risk include ranching, dairy farming, working in a slaughterhouse or as a butcher, and hunting.

Educational Objectives
Not all M. bovis infections progress to TB disease, so there might be no symptoms at all. In people, symptoms of TB disease caused by M. bovis are similar to the symptoms of TB caused by M. tuberculosis; this can include fever, night sweats, and weight loss. Other symptoms might occur depending on the part of the body affected by the disease.

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Board review question of day 5

Funmi Adesina — Sun, 05 Mar 2017 07:04:58 +0000

A 16-year-old boy is referred to your practice for leg claudication. Blood pressure in his right arm is 150/110 mm Hg, while blood pressure in his left leg is 80/60 mm Hg. On auscultation, a systolic murmur best heard over the middle of the upper back is detected. You also find that the patient’s femoral pulses are diminished when compared to his brachial pulses. Which of the following is the most likely diagnosis?

A) Patent ductus arteriosus
B) Ventricular septal defect
C) Coarctation of the aorta
D) Atrial septal defect
E) Tetralogy of Fallot

Explanation

Correct Answer C. Coarctation of the aorta
Coarctation of the aorta is narrowing of the aorta usually just distal to the origin of the ductus arteriosus and subclavian artery. Patients may complain of epistaxis, head-ache, cold peripheral extremities, and claudication. Absent, delayed, or markedly diminished femoral pulses may also be found. The low arterial pressure in the legs in the face of hypertension in the arm is also a clue to the diagnosis. Chest radiograph in coarctation shows rib notching secondary to the dilated collateral arteries.

Educational Objectives
Coarctation of the aorta (CoA) is a relatively common defect that accounts for 5-8% of all congenital heart defects. Coarctation of the aorta may occur as an isolated defect or in association with various other lesions, most commonly bicuspid aortic valve and ventricular septal defect (VSD).

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SMASHUSMLE App

Funmi Adesina — Thu, 07 Apr 2016 15:58:05 +0000

We just launched our SmashUSMLE test prep app on April 4th, 2016. We are very excited to bring this app to students preparing for the USMLE step 1 and USMLE Step 2 CK. Our app has tons of exciting features which include:

USMLE review videos with speed up and HD functionality
USMLE practice question banks
Performance analytics
USMLE prep audio book
USMLE study guides
USMLE lecture notes

This is the only app to allow students to learn on the go with complete USMLE review inside one app. Please feel free to download the app from the app store.

SmashUSMLE app for Iphone and Android

Download from the app store

iphone/ipad app download – https://itunes.apple.com/us/app/smash…

Google play store – https://play.google.com/store/apps/de…

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