Property:AnswerEExp
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'''Incorrect'''-The transhiatal approach would probably be avoided in this situation where an unknown amount of mediastinal contamination has taken place. +
'''Incorrect'''-Metformin inhibits liver glucose production and is effective in treating Dawn phenomenon. This will be the next step if including longer acting insulin to the evening dose did not help. +
'''Incorrect'''-Mixed hearing loss can occur secondary to fractures of the temporal bone when both the middle and the inner ear are traumatized. +
'''Correct'''-Penetrating injury to the intraperitoneal or extraperitoneal rectum should be diagnosed by immediate sigmoidoscopy. When sigmoidoscopy is inconclusive, contrast studies of the rectum using a watersoluble radiopaque medium such as gastrografin can be done. +
'''Incorrect'''-Ethanol, methanol, and anti retrovirals are other drugs that cause type B lactic acidosis. +
'''Correct'''-The patient is presenting with asymptomatic primary hyperparathyroidism. The laboratory diagnosis of hypercalcemia, hypophosphatemia and elevated serum PTH hormones, suggest primary hyperparathyroidism. Asymptomatic primary hyperparathyroidism is a common disorder particularly in females above 60 years of age who are usually diagnosed during a routine chemistry screening. While patients with symptomatic primary hyperparathyroidism require surgical intervention, not all patients with asymptomatic primary hyperparathyroidism except those with at least one of the following features would require a surgical intervention.<br>
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1.Age less than 50 years<br>
2.Serum calcium at least 1 mg/dL above the upper limit of normal<br>
3.Bone mineral density (BMD) lower than T-2.5 at lumbar spine, femoral neck, total hip, or 33% (one third) radius<br>
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This patient has two of the above features i.e. serum calcium 1 mg/dL above the upper limit of normal and DEXA scan showing BMD lower than T-2.5 at lumbar spine and femoral neck. Thus surgical intervention is indicated in this patient. +
Vasopressin is not a steroid hormone. There are 5 main classes of steroid hormones: androgens, estrogens, progestins, mineralocorticoids, and glucocorticoids. Aldosterone is an example of a mineralocorticoid steroid hormone. +
By inhibiting leukocyte adhesion, glucocorticoids causes an increase in circulating neutrophils leading to neutrophilia rather than neutropenia. +
Intracellular accumulation of glycogen results in abnormal glycogen metabolism and glycogen storage diseases. +
Non-maleficence is a principle of medical ethics that refers to a physician's obligation to do no harm. +
Denial is an immature defense mechanism characterized by blocking an aspect of reality from conscious awareness. For example, a man who has been recently diagnosed with terminal cancer denies that he has cancer or he might die from his condition. +
Fibrillin protein defects cause Marfan syndrome and Weill-Marchesani syndrome. Chediak-Higashi syndrome is not associated with fibrillin protein defects. +
Edema factor is an exotoxin of ''B. anthracis'', the bacteria responsible for anthrax. Edema factor has calmodulin (CaM)-activated adenylyl cyclase activity that increases the concentration of cyclic AMP (cAMP) to supraphysiological levels. +
Diabetic nephropathy is a common microvascular complication in advanced diabetes mellitus. Renal biopsy under light microscopy would reveal characteristic eosinophilic nodules in the glomerular tuft called “Kimmelsteil-Wilson” lesion. +
MERRF syndrome (Myoclonic Epilepsy with Ragged Red Fibers) and MELAS (Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) are 2 examples of diseases with mitochondrial inheritance. +
Type X collagen may be present in cartilage. Examples of type X collagen are not high yield for USMLE Step 1. +
Pain is due to the effect of bradykinin and other pain mediators on nerve endings that have been sensitized by PGE2. +