She tells you that her husband of 30 years left her 6 months ago. Medications include etanercept, methotrexate, prednisone, and tramadol. Medical history is otherwise unremarkable. She has difficulty bathing and dressing, but she is able to stand and walk independently. Rheumatoid arthritis was diagnosed at age 35 years, and the patient has been unable to work for the past 10 years. Which of the following cell types is most affected by this patient's condition?Ī 54-year-old woman with severe rheumatoid arthritis comes to the office for a routine follow-up examination. Sensation to pain and temperature is decreased at the lower costal margin and below, most pronounced on the right. Proprioception and sensation to vibration are absent over the left lower extremity and decreased over the right lower extremity to the level of the hip. Deep tendon reflexes are normal in the upper extremities but hyperactive in the lower extremities, especially on the left. Examination shows spastic lower extremities and moderate weakness of the left lower extremity, more prominently in the flexor than in the extensor muscles. His temperature is 37☌ (98.6☏), pulse is 55/min, respirations are 10/min, and blood pressure is 110/70 mm Hg. He is 157 cm (5 ft 2 in) tall and weighs 55 kg (121 lb) BMI is 22 kg/m 2. He had an episode of optic neuritis in the right eye 3 years ago. He began to notice some problems with his balance 2 days ago, and his walking has become progressively worse since then. ![]() To further support medical students and graduates, NBME will also make the new answer key enhancement available for the Clinical Science Mastery Series and the International Foundations of Medicine® (IFOM®) Clinical Science Self-Assessment beginning in October 2018.A 27-year-old man is brought to the emergency department by his roommates because of an inability to walk. This enhancement is part of the NBME’s commitment to continuous improvement. ![]() Prices for the NBME Self-Assessments will remain the same and longitudinal feedback, which allows you to track your progress over time, will continue to be provided at no cost to you when you complete multiple assessments. However, if you purchase and/or start it but do not complete it until after July 2nd, you will be able to see the answers for both your correctly and incorrectly answered questions. If you purchase the self-assessment and complete it before July 2nd, you will only be able to see the answers for your incorrectly answered questions. You will have the opportunity to review every question with its corresponding correct answer after you complete your test. With correct answers available, you will not need to spend time researching the correct answers. Comprehensive Clinical Medicine Self-Assessment (CCMSA) for those who are preparing for the multiple-choice questions in Step 3 of the USMLE.Comprehensive Clinical Science Self-Assessment (CCSSA) for those who are preparing for Step 2 CK of the USMLE.Comprehensive Basic Science Self-Assessment (CBSSA) for those who are preparing for Step 1 of the USMLE.This answer key enhancement will be available for the following self-assessments: Together, it offers you a great opportunity to fully understand the broad array of concepts required.īeginning July 2, 2018, after you complete an NBME self-assessment you will see the correct answers for all of the exam questions. If you are preparing for a United States Medical Licensing Examination® (USMLE®) Step, learning from your mistakes, or going over those questions you guessed at during practice tests can be just as important as reviewing content. And later you may not remember the question or the answer you chose. ![]() No matter how much you prepare, sometimes the correct answer may not be apparent to you. Learning Resources: Unlocking Assessment.Health & Wellness Coach Certifying Exam.United States Medical Licensing Exam® (USMLE®).International Foundation of Medicine® (IFOM®).
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