USMLE Step 2: This month ’s question to beat

Getting ready for the United States Medical Licensing Examination ® (USMLE®) Step 2 is no easy feat, but we’re sharing expert insights to help give you a leg up. Take a look at the exclusive scoop on this month’s most-missed USMLE Step 2 test prep question. Think you have what it takes to rise above your peers? Test your USMLE knowledge, and view an expert v ideo explanation of the answer from Kaplan Medical. Once you ’ve got this question under your belt, be sure to test your knowledge with  other posts in this series . Ready. Set. Go. This month ’s question that stumped most students: A 14-year-old girl comes to the physician because of heavy menstrual bleeding that began with menarche two years ago. Her menstrual periods last eight to 10 days and occur approximately every 28 days. Her last menstrual period ended three days ago. Vital signs are temperature 37.0 ºC (98.6ºF), blood pressure 110/70 mm Hg, pulse 90/min and respirations 18/min. Physical examination shows a slender, calm girl who is in no distress but appears pale. The remainder of the examination is unremarkable. Laboratory studies show: WBC:   7,000/mm 3 Hb:   9 g/dL Hct:   27% Plt:   250,000/mm 3 Which of the following is the most appropriate next step in management? A. Begin a transfusion of packed red blood cells B. Order a pelvic ultrasound to rule out polycystic ovaries C. Order coagulation profile ...
Source: AMA Wire - Category: Journals (General) Authors: Source Type: news

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ConclusionsThe degree of aspirin effect immediately prior to cardiac surgery was weakly associated with the risks of postoperative bleeding and allogeneic blood product transfusion, suggesting that measuring aspirin-induced antiplatelet effect prior to cardiac surgery may be useful as an adjunct in optimizing patient blood management for patients who are at high-risk of bleeding and requiring allogeneic blood transfusion.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: Available online 24 June 2019Source: LWTAuthor(s): Yinxia Chen, Long Sheng, Mostafa Gouda, Meihu MaAbstractThe effects of ultrasonic treatment (180 W, 25 min) on the foaming and physicochemical properties of egg white from shell egg stored for seven periods (0, 15, 30, 45, 60, 75 and 90 d) were investigated in this study. The foaming ability significantly increased after ultrasound treatment and the highest foaming ability (99.13%) was achieved at 60 d compared to untreated egg white (29.75%). This improvement was ascribed to the increased free sulfhydryl content and surface hydrophobicity, indica...
Source: LWT Food Science and Technology - Category: Food Science Source Type: research
In this study, subcritical water extraction (SWE), SWE in aqueous citric acid (pH 5.0) (SWEC), and ultrasound-assisted SWEC (USWEC) were used to extract soluble dietary fiber (SDF) from wheat bran. Results showed that SWE-based methods significantly influenced the physicochemical, functional, and biological properties of the SDF. The fraction SDF-III attained via USWEC had higher SDF yield (46.30%) and carbohydrate content (82.91%), and lower weight-average molecular weight (65.2 kDa) and particle size (1.17 μm), and looser and more porous surface structure, compared with the SDF-I and SDF-II obtained by SWE and SWE...
Source: Food Chemistry - Category: Food Science Source Type: research
In this study, C57BL/6 J mice were parentally exposed to 100 ppb arsenic before conception. After weaning, both male and female offspring were maintained on 100 ppb arsenic and fed either a normal (LFD) or high fat diet (HFD). At 10 and 24 weeks of age, the offspring were sacrificed and kidneys collected. Exposure to arsenic led to an increase body-weight in LFD diet-fed female but not male mice. This response was not observed in HFD-fed female mice; however male mice showed significant increases in body weight in both As- and non-treated animals. Histological analysis shows that arsenic exposure significantly increa...
Source: Chemico Biological Interactions - Category: Biochemistry Source Type: research
Publication date: Available online 22 June 2019Source: Chemical Engineering and Processing - Process IntensificationAuthor(s): Rajeshree A. Khaire, Ashin A. Sunny, Parag R. GogateAbstractThe current work focuses on intensifying ultrafiltration applied for recovery of lactose from whey using ultrasound with detailed studies into effect of operating parameters such as power and frequency to maximize the degree of intensification. Ultrasonic probe (22 kHz frequency) at varying supplied powerfrom 50 W to 120 W and dual frequency ultrasonic reactor (22 kHz and 44 kHz operated individually and ...
Source: Chemical Engineering and Processing: Process Intensification - Category: Chemistry Source Type: research
The objective of this article is to describe the design, implementation and evaluation of an educational initiative conducted in a Mexican locality with the aim of promoting the consumption of fruits, vegetables (FVs) and simple water (SW) among preschoolers through the influence of their mothers and teachers. We used the Intervention Mapping methodology with qualitative and quantitative components. Mothers attended eight theoretical and practical sessions and two school meetings, while teachers were offered two workshops. Our results revealed positive changes among both groups: participants took greater interest in health...
Source: Evaluation and Program Planning - Category: International Medicine & Public Health Source Type: research
Abstract BACKGROUND: This large cohort study aimed to investigate the effect of acquired thrombocytopenia on the prognosis of patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). MATERIALS AND METHODS: Patients with stable coronary artery disease undergoing elective PCI were prospectively enrolled during 2013. All patients were followed for a median of 30 months (the 25th and 75th percentiles for follow-up time were 27 and 32 months). After excluding patients with baseline thrombocytopenia (
Source: The American Journal of the Medical Sciences - Category: General Medicine Authors: Tags: Am J Med Sci Source Type: research
DR JOHN SANTANIELLO (Oak Lawn, IL): The CRASH II and MATTERs trials established that tranexamic acid (TXA) benefits patients with hemorrhage in a select cohort, namely, those with fibrinolysis ≥3% on a rapid thrombelastography (TEG). Tranexamic acid did reduce mortality in CRASH II, but it was unclear whether it was due to prevention of clot lysis and improved coagulation with decreased bleeding, because there was no statistical difference in RBC transfusion in those groups. Because TXA inhibits plasmin, it has been speculated that improved survival may be caused by an attenuated inflammatory response by inhibiting its ...
Source: Journal of the American College of Surgeons - Category: Surgery Tags: Western surgical association article Source Type: research
Conditions:   MRI Guided Transurethral Ultrasound Ablation;   Localized Prostate Cancer;   Ablation Therapy Intervention:   Procedure: Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Tissue Sponsor:   University Hospital, Strasbourg, France Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Obstructive Sleep Apnea;   Morbid Obesity;   Epigenetic Disorder Interventions:   Device: CPAP;   Procedure: Bariatric Surgery Sponsor:   Aragon Institute of Health Sciences Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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