I don't even remember what I wrote about
Thursday, April 15, 2004 \ Time: 4:39 P.M. \ Mood: tired. \ Song: Toilet. \ Book: That Review book is crap!
Email from Mom. Saying she's gonna bring an old stethescope for me. Wants to bring me food, etc. If I do stay I won't be needing a stethescope. I'm passing ICM. I passed the oral. I don't need it.
Micro. Once again I know what disease they are asking for, just I don't know what characteristic it has. Lol. At the beginning of the test. They announced it's 150 Qs, 3 hours. The guy next to me made a noise in disgust. Nardell walks by and starts commenting as well. So I started my test laughing. Over all... Not so concerned.
Time: 9:22 P.M. \ Mood: frustrated. \ Song: BJD - Stop, Look, Listen. \ Book: Path handouts.
Mom called. Asked me how the test went. Asked me how the Qs were. A girl has a UTI. Therefore most common cause is E. coli. But the question is what enables the organism to colonize the urethra? Mom's like cause it's a shorter distance from the anus to the uethra in females. I'm like cause some E. coli has fimbriae.
Mom was saying she doesn't believe I'm doing as bad as I am and I'm just being hard on myself... Everything is on a curve and you stay there on the curve. If everything is on a curve and I stay there I'd be getting 50s and not 40s on pharm, or at least whatever I've been getting to be readjusted to a 70... So yeah, I'm not staying in my place on the curve at least for that class.
Time: 9:48 P.M. \ Mood: curious. \ Song: The little grey cells at "work". \ Book: ICM practice Qs.
Gonna try this... My answers bold, correct red, comments italicized.
1. An 11-year-old schoolboy suddenly stares off into space and will not respond to the teacher. This happens once too often and the parents are called to the Principal’s office. Which seizure disorder does he MOST LIKELY have?
a) simple partial
b) complex partial
c) generalized absence
d) myoclonic
e) tonic-clonic
After answer comment: OK... I seriously don't get that...
2. A 58-year-old Dominican is sent to the doctor by his wife. He has an unsightly redness of his eye, which appears to be extending over his pupil. A diagnosis of pterygium is made. This could MOST LIKELY be prevented by:
I have no freaking clue...
a) wrap around sunglasses
b) use of steroid eye drops
c) prompt use of antibiotics
d) use of saline eye drops
e) wearing prescription glasses
After answer comment: Ooh... It's caused by UV damage. I was actually thinking it was a fungi. No answer for that really.
3. A 23-year-old student presents to the health center following the 4th semester banquet, complaining of a headache and slight nausea. On examination, there is no neck-stiffness, photophobia, or fever. The MOST LIKELY diagnosis is:
a) meningococcal meningitis
b) temporal Arteritis
c) hang-over - have a feeling this may be the answer... but really... Did Winston write this? Certainly not Callender.
d) viral meningitis
e) influenza
4. A choirboy briefly loses consciousness near the end of a long concert. This has never happened before and there is no family history of syncopal attacks. He is not on medication and physical examination reveals a healthy 18-year-old male with no abnormalities. His ECG and blood glucose are both normal. The MOST LIKELY diagnosis is:
My God! Seriously! I've gone stupid!
a) orthostatic hypertension
b) carotid sinus syncope
c) vasovagal syncope
d) long-QT syndrome
e) transient ischaemic attack
5. A 22-year-old woman of fainting episodes on getting out of the bathtub. She likes to take hot baths after her shift as a waitress. She takes ibuprofen for menstrual cramps and is on oral contraceptives. Physical exam is normal. The MOST LIKELY diagnosis is:
a) orthostatic hypotension
b) carotid sinus syncope
c) vasovagal syncope
d) long-QT syndrome
e) transient ischaemic attack
6. A 71-year-old woman experiences sudden onset aphasia and confusion, which resolve within 24hrs. Carotid Doppler is performed and she is found to have carotid artery stenosis. Which of the following is the MOST LIKELY diagnosis?
a) transient ischaemic attack
b) infarction of the left m.c.a.
c) brainstem infarct
d) frontal lobe haemorrhage
e) left m.c.a. aneurism
7. If the patient in the previous question had presented with a personality change, which of the following would be the MOST LIKELY diagnosis?
a) transient ischaemic attack???
b) infarction of the left m.c.a.
c) brainstem infarct
d) frontal lobe haemorrhage
e) left m.c.a. aneurism
After answer comment: See, I was thinking, since he has corotid stenosis, it would still be likely TIA. I didn't get how a block would cause a hemorrhage. But yeah, now I get it. Aterosclerosis --> hypertension --> hemorrhage.
8. A 71-year-old man has sudden onset right-sided weakness. Which of the following is the MOST LIKELY diagnosis?
OMG! What the hell is this crap!?!
a) transient ischaemic attack
b) infarction of the left m.c.a.
c) brainstem infarct
d) frontal lobe haemorrhage
e) left m.c.a. aneurism
After answer comment: OK, that was a stupid mistake. Must have saw the left thing and jumped at that answer, but I actually remember it being me wanting that 1. HTML is confusing! Anyway, I was thinking any sort of bleed would kill him... But then again an aneurism would only kill you if it burst...
9. A 56-year-old janitor suddenly loses sight in his left eye. When questioned in the ER he complains of a headache and says that he had to stop wearing his favorite cap as it had begun to hurt his temples. Physical examination revealed lumpy temporal arteries. Which of the following is the BEST course of action?
Ooh... I don't know. I know it's Temporal arteritis. But what's the treatment... I know you're at risk for going blind in the other eye.
a) prescribe acetaminophen for the headache
b) perform ophthalmoscopy for the headache
c) perform CT for possible occipital c.v.a.
d) give high dose corticosteroids
e) perform urgent irridotomy
10. A 62-year-old man complains of headaches and breathlessness. The family doctor confirms a diagnosis of hypertension. When he performs fundoscopy which would be the MOST LIKELY finding?
a) copper wiring
b) no red reflex
c) new vessel formation
d) irregular pupils
e) irridotomy scar
After answer comment: I don't even know what copper wiring is. Plus I can't find it in Winston's handout.
11. A 62-year-old man gives a history of increased urinary frequency and excessive thirst for several years. The doctor confirms a diagnosis of Diabetes Mellitus which has gone untreated. When he performs fundoscopy which is the MOST LIKELY finding?
a) copper wiring
b) papilloedema
c) new vessel formation
d) irregular pupils
e) irridotomy scar
12. A 62-year-old man is found to have a space-occupying lesion. Which of the following would MOST LIKELY be found on ophthalmoscopy?
a) copper wiring
b) papilloedema
c) new vessel formation
d) irregular pupils
e) irridotomy scar
13. During your internal medicine rotation you see a 35year old White female with SLE. She has been on prednisone 60mg daily for 6 months. During the review of systems, which symptom is MOST LIKELY related to steroid use?
A. Decreased frequency of urination
B. Emotional stability
C. Dyspepsia - I'm totally guessing plus I don't see any logic behind my answer
D. Regular menstrual cycle
E. Rapid resolution of infection
After answer comment: Good guess... And I still don't know why.
14. In the above patient which examination finding is not a feature of iatrogenic Cushing’s syndrome?
A. Buffalo hump
B. Moon facies
C. Moustache or beard (hirsuitism)
D. Truncal obesity
E. Striae gravidarum
After answer comment: Haha! You get stretch marks, but not pregnancy stretch marks!
15. You order lab investigations on the above patient. Which abnormality is MOST LIKELY due to Cushing’s?
A. Hypotension
B. Hypoglycemia
C. Hyperkalemia
D. Loss of sensation
E. Wasting of proximal muscles
16. A 55-year-old black female presents C/O pain in her joints for several years. Which is MOST LIKELY to be present in osteoarthritis?
First all what the hell is C/O
A. Heberden’s nodes
B. Swan neck deformity
C. Boutonniere deformity
D. Subluxation of the metatarso-phalangeal joints
E. Nodules on extensor surfaces of forearms
17. In the above patient which finding is MOST LIKELY to be present in rheumatoid arthritis?
A. Bouchard’s nodes
B. Crepitus in the knees
C. Varus deformity of the knees
D. Heberden’s nodes
E. Boutonniere deformity
18. In the above patient which findings would support the diagnosis of rheumatoid arthritis:
A. Osteophytes on x-ray
B. Morning stiffness for < 30minutes
C. Redness of the eyes
D. Diffuse interstitial infiltrates on chest x-ray
E. Bony erosions and decalcification on x-ray of hands
19. A 55-year-old patient with multiple myeloma is started on chemotherapy. As a result her uric acid levels become significantly elevated and she becomes dehydrated. On evaluation what findings are MOST LIKELY to be present?
I'm sorry, this has nothing to do with the Q. But Callender... I can tell it's her Q. First of all she taught this. Then the format changed... There are single spaces after periods. Then after the letter for the answer it's indented. Frankly it's annoying. Then, I have to say... I love a man who puts 2 spaces after a period. Hm... is he a comma after an and person? Lol. Wait... So what was the Q?
A. Osteophytes on x-ray
B. Bony erosions on x-ray
C. Crepitus of both knees
D. Erythema and tenderness of knee and surrounding tissues
E. Nodules in the eye
12/19... Not bad. Using previous tests minimum passing. That would be an... 83. A B. I was getting worried that maybe I should be studying for my ICM shelf tomorrow. I think I'll do OK. But then again it could be like previous shelves. Yeah, I know what they are talking about what is the answer...
Oh yeah, another comment on Winston. Noticed he spelled "generalized" correctly. So sexy!
Friday, April 16, 2004 \ Time: 12:51 A.M. \ Mood: irritated. \ Song: Hard Headed Woman. \ Book: Path pover points.
More into how Winston's a dream come true. I mean, he's British. He punctuates correctly. Spell "correctly." But then again it could be an autocorrection thing. But if I were British and it kept correcting my spelling, I'd change it back. I did notice he spelled hematocrit like that and not haematocrit. Neither is autocorrected nor thought correct by Word. Oh yeah, so he's British. Spells right *and* at least that I've seen, doesn't have British are better attitude. I've personally found the spelling differences distracting, especially when I'm trying to study.
Email from Mom. Saying she's gonna bring an old stethescope for me. Wants to bring me food, etc. If I do stay I won't be needing a stethescope. I'm passing ICM. I passed the oral. I don't need it.
Micro. Once again I know what disease they are asking for, just I don't know what characteristic it has. Lol. At the beginning of the test. They announced it's 150 Qs, 3 hours. The guy next to me made a noise in disgust. Nardell walks by and starts commenting as well. So I started my test laughing. Over all... Not so concerned.
Time: 9:22 P.M. \ Mood: frustrated. \ Song: BJD - Stop, Look, Listen. \ Book: Path handouts.
Mom called. Asked me how the test went. Asked me how the Qs were. A girl has a UTI. Therefore most common cause is E. coli. But the question is what enables the organism to colonize the urethra? Mom's like cause it's a shorter distance from the anus to the uethra in females. I'm like cause some E. coli has fimbriae.
Mom was saying she doesn't believe I'm doing as bad as I am and I'm just being hard on myself... Everything is on a curve and you stay there on the curve. If everything is on a curve and I stay there I'd be getting 50s and not 40s on pharm, or at least whatever I've been getting to be readjusted to a 70... So yeah, I'm not staying in my place on the curve at least for that class.
Time: 9:48 P.M. \ Mood: curious. \ Song: The little grey cells at "work". \ Book: ICM practice Qs.
Gonna try this... My answers bold, correct red, comments italicized.
1. An 11-year-old schoolboy suddenly stares off into space and will not respond to the teacher. This happens once too often and the parents are called to the Principal’s office. Which seizure disorder does he MOST LIKELY have?
a) simple partial
b) complex partial
c) generalized absence
d) myoclonic
e) tonic-clonic
After answer comment: OK... I seriously don't get that...
2. A 58-year-old Dominican is sent to the doctor by his wife. He has an unsightly redness of his eye, which appears to be extending over his pupil. A diagnosis of pterygium is made. This could MOST LIKELY be prevented by:
I have no freaking clue...
a) wrap around sunglasses
b) use of steroid eye drops
c) prompt use of antibiotics
d) use of saline eye drops
e) wearing prescription glasses
After answer comment: Ooh... It's caused by UV damage. I was actually thinking it was a fungi. No answer for that really.
3. A 23-year-old student presents to the health center following the 4th semester banquet, complaining of a headache and slight nausea. On examination, there is no neck-stiffness, photophobia, or fever. The MOST LIKELY diagnosis is:
a) meningococcal meningitis
b) temporal Arteritis
c) hang-over - have a feeling this may be the answer... but really... Did Winston write this? Certainly not Callender.
d) viral meningitis
e) influenza
4. A choirboy briefly loses consciousness near the end of a long concert. This has never happened before and there is no family history of syncopal attacks. He is not on medication and physical examination reveals a healthy 18-year-old male with no abnormalities. His ECG and blood glucose are both normal. The MOST LIKELY diagnosis is:
My God! Seriously! I've gone stupid!
a) orthostatic hypertension
b) carotid sinus syncope
c) vasovagal syncope
d) long-QT syndrome
e) transient ischaemic attack
5. A 22-year-old woman of fainting episodes on getting out of the bathtub. She likes to take hot baths after her shift as a waitress. She takes ibuprofen for menstrual cramps and is on oral contraceptives. Physical exam is normal. The MOST LIKELY diagnosis is:
a) orthostatic hypotension
b) carotid sinus syncope
c) vasovagal syncope
d) long-QT syndrome
e) transient ischaemic attack
6. A 71-year-old woman experiences sudden onset aphasia and confusion, which resolve within 24hrs. Carotid Doppler is performed and she is found to have carotid artery stenosis. Which of the following is the MOST LIKELY diagnosis?
a) transient ischaemic attack
b) infarction of the left m.c.a.
c) brainstem infarct
d) frontal lobe haemorrhage
e) left m.c.a. aneurism
7. If the patient in the previous question had presented with a personality change, which of the following would be the MOST LIKELY diagnosis?
a) transient ischaemic attack???
b) infarction of the left m.c.a.
c) brainstem infarct
d) frontal lobe haemorrhage
e) left m.c.a. aneurism
After answer comment: See, I was thinking, since he has corotid stenosis, it would still be likely TIA. I didn't get how a block would cause a hemorrhage. But yeah, now I get it. Aterosclerosis --> hypertension --> hemorrhage.
8. A 71-year-old man has sudden onset right-sided weakness. Which of the following is the MOST LIKELY diagnosis?
OMG! What the hell is this crap!?!
a) transient ischaemic attack
b) infarction of the left m.c.a.
c) brainstem infarct
d) frontal lobe haemorrhage
e) left m.c.a. aneurism
After answer comment: OK, that was a stupid mistake. Must have saw the left thing and jumped at that answer, but I actually remember it being me wanting that 1. HTML is confusing! Anyway, I was thinking any sort of bleed would kill him... But then again an aneurism would only kill you if it burst...
9. A 56-year-old janitor suddenly loses sight in his left eye. When questioned in the ER he complains of a headache and says that he had to stop wearing his favorite cap as it had begun to hurt his temples. Physical examination revealed lumpy temporal arteries. Which of the following is the BEST course of action?
Ooh... I don't know. I know it's Temporal arteritis. But what's the treatment... I know you're at risk for going blind in the other eye.
a) prescribe acetaminophen for the headache
b) perform ophthalmoscopy for the headache
c) perform CT for possible occipital c.v.a.
d) give high dose corticosteroids
e) perform urgent irridotomy
10. A 62-year-old man complains of headaches and breathlessness. The family doctor confirms a diagnosis of hypertension. When he performs fundoscopy which would be the MOST LIKELY finding?
a) copper wiring
b) no red reflex
c) new vessel formation
d) irregular pupils
e) irridotomy scar
After answer comment: I don't even know what copper wiring is. Plus I can't find it in Winston's handout.
11. A 62-year-old man gives a history of increased urinary frequency and excessive thirst for several years. The doctor confirms a diagnosis of Diabetes Mellitus which has gone untreated. When he performs fundoscopy which is the MOST LIKELY finding?
a) copper wiring
b) papilloedema
c) new vessel formation
d) irregular pupils
e) irridotomy scar
12. A 62-year-old man is found to have a space-occupying lesion. Which of the following would MOST LIKELY be found on ophthalmoscopy?
a) copper wiring
b) papilloedema
c) new vessel formation
d) irregular pupils
e) irridotomy scar
13. During your internal medicine rotation you see a 35year old White female with SLE. She has been on prednisone 60mg daily for 6 months. During the review of systems, which symptom is MOST LIKELY related to steroid use?
A. Decreased frequency of urination
B. Emotional stability
C. Dyspepsia - I'm totally guessing plus I don't see any logic behind my answer
D. Regular menstrual cycle
E. Rapid resolution of infection
After answer comment: Good guess... And I still don't know why.
14. In the above patient which examination finding is not a feature of iatrogenic Cushing’s syndrome?
A. Buffalo hump
B. Moon facies
C. Moustache or beard (hirsuitism)
D. Truncal obesity
E. Striae gravidarum
After answer comment: Haha! You get stretch marks, but not pregnancy stretch marks!
15. You order lab investigations on the above patient. Which abnormality is MOST LIKELY due to Cushing’s?
A. Hypotension
B. Hypoglycemia
C. Hyperkalemia
D. Loss of sensation
E. Wasting of proximal muscles
16. A 55-year-old black female presents C/O pain in her joints for several years. Which is MOST LIKELY to be present in osteoarthritis?
First all what the hell is C/O
A. Heberden’s nodes
B. Swan neck deformity
C. Boutonniere deformity
D. Subluxation of the metatarso-phalangeal joints
E. Nodules on extensor surfaces of forearms
17. In the above patient which finding is MOST LIKELY to be present in rheumatoid arthritis?
A. Bouchard’s nodes
B. Crepitus in the knees
C. Varus deformity of the knees
D. Heberden’s nodes
E. Boutonniere deformity
18. In the above patient which findings would support the diagnosis of rheumatoid arthritis:
A. Osteophytes on x-ray
B. Morning stiffness for < 30minutes
C. Redness of the eyes
D. Diffuse interstitial infiltrates on chest x-ray
E. Bony erosions and decalcification on x-ray of hands
19. A 55-year-old patient with multiple myeloma is started on chemotherapy. As a result her uric acid levels become significantly elevated and she becomes dehydrated. On evaluation what findings are MOST LIKELY to be present?
I'm sorry, this has nothing to do with the Q. But Callender... I can tell it's her Q. First of all she taught this. Then the format changed... There are single spaces after periods. Then after the letter for the answer it's indented. Frankly it's annoying. Then, I have to say... I love a man who puts 2 spaces after a period. Hm... is he a comma after an and person? Lol. Wait... So what was the Q?
A. Osteophytes on x-ray
B. Bony erosions on x-ray
C. Crepitus of both knees
D. Erythema and tenderness of knee and surrounding tissues
E. Nodules in the eye
12/19... Not bad. Using previous tests minimum passing. That would be an... 83. A B. I was getting worried that maybe I should be studying for my ICM shelf tomorrow. I think I'll do OK. But then again it could be like previous shelves. Yeah, I know what they are talking about what is the answer...
Oh yeah, another comment on Winston. Noticed he spelled "generalized" correctly. So sexy!
Friday, April 16, 2004 \ Time: 12:51 A.M. \ Mood: irritated. \ Song: Hard Headed Woman. \ Book: Path pover points.
More into how Winston's a dream come true. I mean, he's British. He punctuates correctly. Spell "correctly." But then again it could be an autocorrection thing. But if I were British and it kept correcting my spelling, I'd change it back. I did notice he spelled hematocrit like that and not haematocrit. Neither is autocorrected nor thought correct by Word. Oh yeah, so he's British. Spells right *and* at least that I've seen, doesn't have British are better attitude. I've personally found the spelling differences distracting, especially when I'm trying to study.