Internal Medicine NBME 3

E

B: cardiogenic shock leads to decreased perfusion of tissues. Decreased perfusion leads decreased oxygen delivery to tissues which leads to anaerobic glycolosis and increased lactic acid production.

H

C

E

E

C

D

D

D

C

B

D -> pe

D

E -> pul edema

C

C

B

C

Factor 8 inhibitor is abs formed against transfused factor 8 that may cause patient to *experience new breakthrough bleeding *not have spontaneous resolution of bleeding as expected based on prior experience •SO>>>the inhibitor should be suspected when any bleeding episodes of hemophilia is refractory to usual therapy •Dx and screened by Bethesda assay that can confirm inhibitor presence and quantify ab titre

C

A

H

B

E

E

C

D

B

D

A

E

D

E

B

B

E

A

E

A

C

41. A

E

E

E

H

B

A

A - step pneumo

J

F

25. E