Posted by starting from IP 152.132.10.196 on March 25, 2008 at 13:49:40:
I found some questions from usmle123 are ridiculous, like:
A 70-year-old white woman is seen in the physician's office complaining that she "feels terrible." She is depressed, has no energy, and has great difficulty concentrating. She often feels lightheaded when rising to a standing position and has generalized abdominal pain and constipation. She also has had excessive thirst, fatigue and muscle weakness. She felt well before these symptoms began 2 weeks ago. Her past medical history is significant for hypertension for 20 years and diverticulosis. She underwent a left hemicolectomy 10 years ago for a perforated diverticulum. Her medications are a thiazide diuretic and a beta-blocker. She is a non-smoker and does not drink alcoholic beverages. Her family history is remarkable for lung cancer in her father and acute myocardial infarction in her mother. On examination, vital signs are: temperature of 37.3°C (99.2°F), sitting blood pressure of 115/70 mmHg (100/60 mmHg when standing), heart rate of 105 beats per minute, and a respiratory rate of 12 breaths per minute. The only finding on physical examination is diffuse abdominal tenderness. A digital rectal exam fails to show any occult blood.
Item 1 of 3
What would be the best initial step in the diagnostic workup on this patient?
Click on the circle next to your answer choice
A. Bone marrow biopsy
B. Complete blood count with differential
C. Peripheral blood smear
D. Serum electrolytes, calcium, phosphorus, parathyroid hormone (PTH)
E. Serum protein electrophoresis
The answer is D.
I do feel you need CBC first to rule out anemia.
What do you think?
And another question ask me if I know imiglucerase for Gaucher's disease, is it relevent? Do I need to know it?