USMLE Forum Archives - USMLE Step 3 - IM- Respi 2
IM- Respi 2
harry206 - 06-03-09 02:47
A 54-year-old African American woman comes to the office because of fatigue, anorexia, weight loss,
and fever. The patient reports that over the past few months, these symptoms, which were new, have
progressively worsened. She has a past medical history significant only for temporal arteritis for which
she takes low-dose prednisone daily. Her physical examination is remarkable for a temperature of 37
C (98.6 F), blood pressure is 130/85 mm Hg, pulse is 80/min, and respirations are 20/min. Her lungs
are clear, there are no murmurs and no cyanosis or clubbing of the digits. A chest radiograph discloses
bilateral hilar lymphadenopathy. After obtaining a thorough occupational, environmental, and
medication-use history, the most appropriate diagnostic step is to
harry206 - 06-03-09 02:47
A 54-year-old African American woman comes to the office because of fatigue, anorexia, weight loss,
and fever. The patient reports that over the past few months, these symptoms, which were new, have
progressively worsened. She has a past medical history significant only for temporal arteritis for which
she takes low-dose prednisone daily. Her physical examination is remarkable for a temperature of 37
C (98.6 F), blood pressure is 130/85 mm Hg, pulse is 80/min, and respirations are 20/min. Her lungs
are clear, there are no murmurs and no cyanosis or clubbing of the digits. A chest radiograph discloses
bilateral hilar lymphadenopathy. After obtaining a thorough occupational, environmental, and
medication-use history, the most appropriate diagnostic step is to
The correct answer and explanation will be available after you answer.
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#13
Re: IM- Respi 2 conym5 - 04-11-10 08:38 In most centers, skin and transbronchial lung biopsies have supplanted biopsy of mediastinal lymph nodes and the liver because of their high yield, greater specificity, and low morbidity...
#17
Re: IM- Respi 2 babbu5508 - 08-31-10 00:52 My answer is: d.
schedule a mediastinal lymph node biopsy to obtain evidence of noncaseating granulomas....sarcoidosis...???
#20
Re: IM- Respi 2 babbu5508 - 09-30-10 07:14 Differential diagnosis of sarcoidosis includes metastatic disease, lymphoma, septic emboli, rheumatoid nodules, Wegener's granulomatosis, varicella infection, and atypical infections such as mycobacterium avium complex, cytomegalovirus, and cryptococcus
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