Patient who is immunosuppressed and presents with a painful, vesicular rash involving the V1 dermatome, most consistent with herpes zoster.A 56-year-old man has had the painful weeping rash shown for 2 days. Key idea: Elevated alkaline phosphatase with normal GGT more concerning for bone disorders/diseaseĢ.Key idea: If a patient has an elevated alkaline phosphatase, then the next step is to measure gamma glutamyl transferase (GGT) to determine whether the elevated alkaline phosphatase is hepatobiliary in origin.Key idea: Alcohol use disorder often presents with sleep disturbances because alcohol leads to poor quality of sleep.Middle-aged woman who is alone at home most of the day who presents with sleep disturbances and is found to have MCV at the upper limit of normal, mildly elevated LFTs with AST > ALT, and an increased alkaline phosphatase with increased gamma glutamyl transferase, most consistent with alcohol usage.Good luck with your exams!ġ: A 42-year-old woman comes to the physician for an annual pelvic examination and Pap smear… Lastly, please check out my Youtube channel ( ) and the “Biostatistics Curriculum” option above for free videos and practice questions reviewing all the essential biostatistics topics covered on NBME exams. I also offer reasonably priced tutoring, so please reach out using the Tutoring menu option listed above if you would like personalized support.įurthermore, I offer personal statement and application review services for residency applicants, so please reach out using the “Residency Advising and Application Preparation” menu option above if interested. However, given multiple email requests, I will post my Venmo if you want to send a few dollars to show your support for the website. These answer explanations are and always will be free.
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