Kenhub step 1 videos and questions bank 2021


Kanal geosi va tili: Hindiston, Inglizcha
Toifa: Ta’lim



Kanal geosi va tili
Hindiston, Inglizcha
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Educational objective: Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy, and REM sleep-related phenomena (ie, hypnagogic/hypnopompic hallucinations, sleep paralysis).


Which of the following is the most likely diagnosis in this patient?
So‘rovnoma
  •   A. Brief psychotic disorder
  •   B. Delayed sleep-wake phase disorder
  •   C. Idiopathic hypersomnia
  •   D. Insufficient sleep
  •   E. Narcolepsy
  •   F. Obstructive sleep apnea
  •   G.REM sleep behavior disorder
30 ta ovoz


A 23-year-old man comes to the physician at his girlfriend's insistence. She says that the patient's frequent snoring keeps her up at night and that in the last 4 months he has twice fallen asleep while they were talking. In this same period, the patient says that he has regularly fallen asleep in the afternoon while reading or watching television but typically feels refreshed after a brief nap. When asked whether he experiences any other symptoms, the patient hesitantly reveals that he sometimes hears a voice call his name prior to falling asleep. He also reports uncharacteristic episodes of clumsiness in which he has suddenly dropped objects or fallen to his knees. Examination shows no abnormalities.


Educational objective: Injury to the radial nerve at the supinator muscle may occur due to repetitive pronation/supination of the forearm, direct trauma, or subluxation of the radius. Patients typically have weakness during finger and thumb extension (ie, finger-drop) without wrist drop or sensory deficits.Educational objective: Injury to the radial nerve at the supinator muscle may occur due to repetitive pronation/supination of the forearm, direct trauma, or subluxation of the radius. Patients typically have weakness during finger and thumb extension (ie, finger-drop) without wrist drop or sensory deficits.


The nerve affected in this patient was most likely injured at which of the following locations?
So‘rovnoma
  •   A.Axilla
  •   B. Carpal tunnel
  •   C. Coracobrachialis
  •   D.Hook of hamate
  •   E. Midshaft of the humerus
  •   F. Supinator muscle
35 ta ovoz


A 35-year-old, right-handed mechanic comes to the clinic due to progressive right hand weakness. The patient frequently uses a screwdriver at work. Neurologic examination shows preserved sensation in the upper limbs. There is weakness on extension of the fingers and thumb in the right hand. Strength is otherwise intact. Triceps reflexes are 2+ and bilaterally symmetric.


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Educational objective: West Nile virus is a single-strand flavivirus transmitted by mosquitoes, most commonly in the summer. Most infections are asymptomatic or may present with a flu-like illness (West Nile fever), often with a maculopapular or morbilliform rash. Neuroinvasive disease manifests as meningitis, encephalitis, or asymmetric flaccid paralysis; patients may have parkinsonian features.


The agent infecting this patient most likely uses which of the following modes of transmission?
So‘rovnoma
  •   A. Blood transfusion
  •   B. Fecal-oral
  •   C. Insect bite
  •   D. Respiratory
  •   E.Sexual
22 ta ovoz


A 68-year-old woman is brought to the emergency department due to confusion and lower extremity weakness. The symptoms began 2 days ago along with fever, headache, malaise, and myalgias. Today, the patient was noted to be confused and had difficulty ambulating due to left lower extremity weakness. The patient has a history of lymphoma in remission, hypertension, and type 2 diabetes mellitus. She drinks alcohol socially but does not use tobacco or illicit drugs. She is visiting her family in Texas for the summer and has never traveled outside the United States. Temperature is 38.3 C (101 F), blood pressure is 130170 mm Hg, and pulse is 96/min. The patient is oriented to place and person only and has a coarse hand tremor. There is flaccid paralysis of the left lower extremity with preserved sensation. CT scan of the head shows no abnormalities. Lumbar puncture is performed, and cerebrospinal fluid analysis shows lymphocytic pleocytosis and elevated protein. Cerebrospinal fluid polymerase chain reaction testing yields viral RNA.


Educational objective: Bacterial meningitis causes an increase in cerebrospinal fluid (CSF) neutrophil count and protein concentration as well as a decrease in CSF glucose. Streptococcus pneumoniae is a leading cause of community-acquired pneumonia, otitis media, and meningitis in adults. S pneumoniae appears on Gram stain as lancet-shaped, Gram-positive cocci in pairs.


Gram stain of the CSF would most likely reveal which of the following?
So‘rovnoma
  •   A. Bean-shaped, Gram-negative cocci in pairs
  •   B. Lancet-shaped, Gram-positive cocci in pairs
  •   C.Gram-positive cocci in clusters
  •   D. Non-motile Gram-negative coccobacilli
  •   E. Motile Gram-positive rods
23 ta ovoz






Educational Objective: Vitamin A overuse can result in intracranial hypertension, skin changes and hepatosplenomegaly.

20 ta oxirgi post ko‘rsatilgan.

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