extended/es/dev.tsv

QUESTION O 
TYPE: O 
GENETICS O 
AND O 
IMMUNOLOGY O 

CLINICAL O 
CASE: O 

Una B-Premise HighQuality
niña I-Premise HighQuality
de I-Premise HighQuality
8 I-Premise HighQuality
años I-Premise HighQuality
(caso I-Premise HighQuality
índice) I-Premise HighQuality
está I-Premise HighQuality
diagnosticada I-Premise HighQuality
clínicamente I-Premise HighQuality
como I-Premise HighQuality
afecta I-Premise HighQuality
de I-Premise HighQuality
neurofibromatosis I-Premise HighQuality
tipo I-Premise HighQuality
1 I-Premise HighQuality
(NF1) I-Premise HighQuality
o I-Premise HighQuality
enfermedad I-Premise HighQuality
de I-Premise HighQuality
Von I-Premise HighQuality
Recklinghausen I-Premise HighQuality
con I-Premise HighQuality
múltiples I-Premise HighQuality
neurofibromas, I-Premise HighQuality
manchas I-Premise HighQuality
café I-Premise HighQuality
con I-Premise HighQuality
leche I-Premise HighQuality
y I-Premise HighQuality
nódulos I-Premise HighQuality
de I-Premise HighQuality
Lisch. I-Premise HighQuality

Su B-Premise HighQuality
padre I-Premise HighQuality
(no I-Premise HighQuality
diagnosticado I-Premise HighQuality
de I-Premise HighQuality
NF1) I-Premise HighQuality
falleció I-Premise HighQuality
por I-Premise HighQuality
accidente I-Premise HighQuality
de I-Premise HighQuality
circulación I-Premise HighQuality
a I-Premise HighQuality
los I-Premise HighQuality
38 I-Premise HighQuality
años. I-Premise HighQuality

La B-Premise HighQuality
madre I-Premise HighQuality
presenta I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
dos I-Premise HighQuality
manchas I-Premise HighQuality
café I-Premise HighQuality
con I-Premise HighQuality
leche I-Premise HighQuality
y I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
consulta I-Premise HighQuality
de I-Premise HighQuality
consejo I-Premise HighQuality
genético I-Premise HighQuality
con I-Premise HighQuality
su I-Premise HighQuality
nueva I-Premise HighQuality
pareja I-Premise HighQuality
donde I-Premise HighQuality
se I-Premise HighQuality
plantea I-Premise HighQuality
un I-Premise HighQuality
diagnóstico I-Premise HighQuality
genético I-Premise HighQuality
pre I-Premise HighQuality
implantación I-Premise HighQuality
(DGP). I-Premise HighQuality

¿Está O 
indicado O 
en O 
este O 
caso O 
un O 
DGP? O 

1- O 
Sí, B-Claim HighQuality
al I-Claim HighQuality
tener I-Claim HighQuality
la I-Claim HighQuality
madre I-Claim HighQuality
2 I-Claim HighQuality
manchas I-Claim HighQuality
café I-Claim HighQuality
con I-Claim HighQuality
leche I-Claim HighQuality
es I-Claim HighQuality
portadora I-Claim HighQuality
y I-Claim HighQuality
el I-Claim HighQuality
DGP I-Claim HighQuality
está I-Claim HighQuality
indicado I-Claim HighQuality
con I-Claim HighQuality
estos I-Claim HighQuality
datos. I-Claim HighQuality

2- O 
Está B-Claim HighQuality
indicado I-Claim HighQuality
tras I-Claim HighQuality
detectar I-Claim HighQuality
la I-Claim HighQuality
mutación I-Claim HighQuality
causante I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
caso I-Claim HighQuality
índice I-Claim HighQuality
y I-Claim HighQuality
eventualmente I-Claim HighQuality
en I-Claim HighQuality
su I-Claim HighQuality
madre. I-Claim HighQuality

3- O 
No B-Claim HighQuality
está I-Claim HighQuality
indicado I-Claim HighQuality
pues I-Claim HighQuality
la I-Claim HighQuality
NF1 I-Claim HighQuality
responde I-Claim HighQuality
a I-Claim HighQuality
mutaciones I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
gen I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
neurofibromin I-Claim HighQuality
(17q11.2), I-Claim HighQuality
con I-Claim HighQuality
herencia I-Claim HighQuality
recesiva. I-Claim HighQuality

4- O 
No, B-Claim HighQuality
dos I-Claim HighQuality
manchas I-Claim HighQuality
café I-Claim HighQuality
con I-Claim HighQuality
leche I-Claim HighQuality
no I-Claim HighQuality
son I-Claim HighQuality
diagnósticas I-Claim HighQuality
y I-Claim HighQuality
su I-Claim HighQuality
nueva I-Claim HighQuality
pareja I-Claim HighQuality
es I-Claim HighQuality
muy I-Claim HighQuality
improbable I-Claim HighQuality
que I-Claim HighQuality
sea I-Claim HighQuality
portador I-Claim HighQuality
(la I-Claim HighQuality
NF1 I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
enfermedad I-Claim HighQuality
poco I-Claim HighQuality
frecuente). I-Claim HighQuality

5- O 
Está B-Claim HighQuality
indicado I-Claim HighQuality
con I-Claim HighQuality
estos I-Claim HighQuality
datos I-Claim HighQuality
un I-Claim HighQuality
DGP I-Claim HighQuality
consistente I-Claim HighQuality
en I-Claim HighQuality
seleccionar I-Claim HighQuality
embriones I-Claim HighQuality
in I-Claim HighQuality
vitro, I-Claim HighQuality
para I-Claim HighQuality
implantar I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
útero I-Claim HighQuality
materno I-Claim HighQuality
aquellos I-Claim HighQuality
sin I-Claim HighQuality
la I-Claim HighQuality
mutación. I-Claim HighQuality

CORRECT O 
ANSWER: O 
2 O 

Lo B-Claim HighQuality
primero I-Claim HighQuality
es I-Claim HighQuality
detectar I-Claim HighQuality
la I-Claim HighQuality
mutación I-Claim HighQuality
y I-Claim HighQuality
una I-Claim HighQuality
vez I-Claim HighQuality
detectada, I-Claim HighQuality
si I-Claim HighQuality
la I-Claim HighQuality
madre I-Claim HighQuality
es I-Claim HighQuality
portadora, I-Claim HighQuality
proseguir I-Claim HighQuality
con I-Claim HighQuality
el I-Claim HighQuality
DGP. I-Claim HighQuality

QUESTION O 
TYPE: O 
HEMATOLOGY O 

CLINICAL O 
CASE: O 

Una B-Premise HighQuality
mujer I-Premise HighQuality
de I-Premise HighQuality
43 I-Premise HighQuality
años I-Premise HighQuality
consulta I-Premise HighQuality
a I-Premise HighQuality
su I-Premise HighQuality
médico I-Premise HighQuality
de I-Premise HighQuality
Atención I-Premise HighQuality
Primaria I-Premise HighQuality
por I-Premise HighQuality
cansancio, I-Premise HighQuality
gingivorragia I-Premise HighQuality
y I-Premise HighQuality
petequias. I-Premise HighQuality

Se B-Premise HighQuality
realiza I-Premise HighQuality
analítica I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
que I-Premise HighQuality
destaca: I-Premise HighQuality
anemia I-Premise HighQuality
de I-Premise HighQuality
8 I-Premise HighQuality
gr/dl, I-Premise HighQuality
trombopenia I-Premise HighQuality
de I-Premise HighQuality
4000/microlitro I-Premise HighQuality
y I-Premise HighQuality
leucopenia I-Premise HighQuality
de I-Premise HighQuality
1200/microlitro I-Premise HighQuality
con I-Premise HighQuality
neutropenia I-Premise HighQuality
absoluta. I-Premise HighQuality

En B-Premise HighQuality
estudio I-Premise HighQuality
de I-Premise HighQuality
coagulación I-Premise HighQuality
se I-Premise HighQuality
observa I-Premise HighQuality
alargamiento I-Premise HighQuality
del I-Premise HighQuality
APTT I-Premise HighQuality
(43″), I-Premise HighQuality
actividad I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
protrombina I-Premise HighQuality
disminuida I-Premise HighQuality
(55%), I-Premise HighQuality
hipofibrinogenemia I-Premise HighQuality
(98 I-Premise HighQuality
mg/dl) I-Premise HighQuality
y I-Premise HighQuality
presencia I-Premise HighQuality
de I-Premise HighQuality
concentración I-Premise HighQuality
elevada I-Premise HighQuality
de I-Premise HighQuality
D-Dimero I-Premise HighQuality
y I-Premise HighQuality
monómeros I-Premise HighQuality
de I-Premise HighQuality
fibrina. I-Premise HighQuality

Se B-Premise HighQuality
remite I-Premise HighQuality
para I-Premise HighQuality
estudio I-Premise HighQuality
hematológico I-Premise HighQuality
urgente, I-Premise HighQuality
realizándose I-Premise HighQuality
un I-Premise HighQuality
aspirado I-Premise HighQuality
de I-Premise HighQuality
médula I-Premise HighQuality
ósea I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
que I-Premise HighQuality
se I-Premise HighQuality
observa I-Premise HighQuality
infiltración I-Premise HighQuality
masiva I-Premise HighQuality
por I-Premise HighQuality
elementos I-Premise HighQuality
inmaduros I-Premise HighQuality
de I-Premise HighQuality
núcleo I-Premise HighQuality
hendido I-Premise HighQuality
y I-Premise HighQuality
bastones I-Premise HighQuality
de I-Premise HighQuality
Auer I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
citoplasma. I-Premise HighQuality

¿Cuál O 
es O 
el O 
diagnóstico O 
más O 
probable O 
en O 
este O 
paciente? O 

1- O 
Leucemia B-Claim HighQuality
mieloide I-Claim HighQuality
crónica. I-Claim HighQuality

2- O 
Leucemia B-Claim HighQuality
aguda I-Claim HighQuality
promielocítica. I-Claim HighQuality

3- O 
Leucemia B-Claim HighQuality
aguda I-Claim HighQuality
monoblástica. I-Claim HighQuality

4- O 
Leucemia B-Claim HighQuality
linfoide I-Claim HighQuality
crónica. I-Claim HighQuality

5- O 
Leucemia B-Claim HighQuality
linfoide I-Claim HighQuality
aguda. I-Claim HighQuality

CORRECT O 
ANSWER: O 
2 O 

Tras O 
leer O 
el O 
enunciado O 
tan O 
largo, O 
quedarse O 
sin O 
aire, O 
repasarlo O 
y O 
agobiarnos, O 
llega O 
el O 
momento O 
de O 
echarle O 
cara O 
y O 
agarrarnos O 
a O 
algo O 
que O 
sea O 
muy O 
característico. O 

Una B-Premise HighQuality
mujer I-Premise HighQuality
con I-Premise HighQuality
pancitopenia. I-Premise HighQuality

Una B-Premise HighQuality
médula I-Premise HighQuality
ósea I-Premise HighQuality
que I-Premise HighQuality
muestra I-Premise HighQuality
infiltración I-Premise HighQuality
masiva I-Premise HighQuality
por I-Premise HighQuality
elementos I-Premise HighQuality
inmaduros I-Premise HighQuality
que I-Premise HighQuality
están I-Premise HighQuality
proliferando I-Premise HighQuality
sin I-Premise HighQuality
parar…¿con I-Premise HighQuality
bastones I-Premise HighQuality
de I-Premise HighQuality
Auer? I-Premise HighQuality

Leucemia B-Claim HighQuality
aguda I-Claim HighQuality
promielocítica. I-Claim HighQuality

Esos B-Claim HighQuality
bastones I-Claim HighQuality
son I-Claim HighQuality
la I-Claim HighQuality
fusión I-Claim HighQuality
de I-Claim HighQuality
gránulos I-Claim HighQuality
primarios I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
mielocitos I-Claim HighQuality
en I-Claim HighQuality
desarrollo. I-Claim HighQuality

Lo O 
dicen O 
Robin&Cotran O 
en O 
la O 
página O 
696 O 
de O 
su O 
libro O 
«Patología O 
general» O 
[1]. O 

También O 
lo O 
dicen O 
Carr O 
y O 
Rodak O 
en O 
su O 
libro O 
«Atlas O 
de O 
hematología O 
clínica» O 
en O 
la O 
página O 
157 O 
[2]. O 

QUESTION O 
TYPE: O 
MICROBIOLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
47 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
edad. I-Premise HighQuality

Natural B-Premise HighQuality
de I-Premise HighQuality
Cochabamba I-Premise HighQuality
(Bolivia), I-Premise HighQuality
reside I-Premise HighQuality
en I-Premise HighQuality
España I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
8 I-Premise HighQuality
años. I-Premise HighQuality

A B-Premise HighQuality
mediados I-Premise HighQuality
de I-Premise HighQuality
2009 I-Premise HighQuality
comienza I-Premise HighQuality
con I-Premise HighQuality
palpitaciones, I-Premise HighQuality
disnea I-Premise HighQuality
y I-Premise HighQuality
edemas I-Premise HighQuality
progresivos I-Premise HighQuality
en I-Premise HighQuality
extremidades I-Premise HighQuality
inferiores. I-Premise HighQuality

Es B-Premise HighQuality
diagnosticada I-Premise HighQuality
de I-Premise HighQuality
insuficiencia I-Premise HighQuality
cardiaca I-Premise HighQuality
secundaria I-Premise HighQuality
a I-Premise HighQuality
miocardiopatía I-Premise HighQuality
por I-Premise HighQuality
enfermedad I-Premise HighQuality
de I-Premise HighQuality
Chagas. I-Premise HighQuality

¿Cual O 
es O 
el O 
agente O 
etiológico O 
de O 
esta O 
enfermedad O 
endémica O 
en O 
varios O 
paises O 
de O 
Latinoamérica? O 

1- O 
Toxoplasma B-Claim HighQuality
gondii. I-Claim HighQuality

2- O 
Trypanosoma B-Claim HighQuality
brucei. I-Claim HighQuality

3- O 
Lehismania B-Claim HighQuality
donovani. I-Claim HighQuality

4- O 
Giardia B-Claim HighQuality
lamblia. I-Claim HighQuality

5- O 
Trypanosoma B-Claim HighQuality
cruzi. I-Claim HighQuality

CORRECT O 
ANSWER: O 
5 O 

La B-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
quinta. I-Claim HighQuality

La B-Claim HighQuality
causa I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
enfermedad I-Claim HighQuality
de I-Claim HighQuality
Chagas I-Claim HighQuality
es I-Claim HighQuality
Trypanosoma I-Claim HighQuality
cruzi. I-Claim HighQuality

QUESTION O 
TYPE: O 
SURGERY O 

CLINICAL O 
CASE: O 

Niño B-Premise HighQuality
de I-Premise HighQuality
de I-Premise HighQuality
año I-Premise HighQuality
y I-Premise HighQuality
medio I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
por I-Premise HighQuality
presentar I-Premise HighQuality
dolor I-Premise HighQuality
abdominal I-Premise HighQuality
e I-Premise HighQuality
ictericia. I-Premise HighQuality

En O 
la O 
exploración O 
se B-Premise HighQuality
palpa I-Premise HighQuality
una I-Premise HighQuality
masa I-Premise HighQuality
abdominal. I-Premise HighQuality

Al B-Premise HighQuality
realizar I-Premise HighQuality
una I-Premise HighQuality
ecografía I-Premise HighQuality
se I-Premise HighQuality
observa I-Premise HighQuality
la I-Premise HighQuality
presencia I-Premise HighQuality
de I-Premise HighQuality
un I-Premise HighQuality
quiste I-Premise HighQuality
de I-Premise HighQuality
colédoco. I-Premise HighQuality

¿Qué O 
actitud O 
terapéutica O 
adoptaremos? O 

1- O 
Se B-Claim HighQuality
realizara I-Claim HighQuality
una I-Claim HighQuality
punción I-Claim HighQuality
percutánea I-Claim HighQuality
para I-Claim HighQuality
lavado I-Claim HighQuality
peritoneal I-Claim HighQuality
para I-Claim HighQuality
comprobar I-Claim HighQuality
que I-Claim HighQuality
el I-Claim HighQuality
quiste I-Claim HighQuality
contiene I-Claim HighQuality
bilis I-Claim HighQuality
para I-Claim HighQuality
dejar I-Claim HighQuality
un I-Claim HighQuality
drenaje I-Claim HighQuality
que I-Claim HighQuality
mejore I-Claim HighQuality
el I-Claim HighQuality
dolor I-Claim HighQuality
abdominal. I-Claim HighQuality

2- O 
Se B-Claim HighQuality
indicará I-Claim HighQuality
una I-Claim HighQuality
resección I-Claim HighQuality
radical I-Claim HighQuality
de I-Claim HighQuality
toda I-Claim HighQuality
la I-Claim HighQuality
vía I-Claim HighQuality
bilair I-Claim HighQuality
para I-Claim HighQuality
sustiruirla I-Claim HighQuality
por I-Claim HighQuality
un I-Claim HighQuality
asa I-Claim HighQuality
de I-Claim HighQuality
intestino. I-Claim HighQuality

3- O 
Se B-Claim HighQuality
de I-Claim HighQuality
indicará I-Claim HighQuality
una I-Claim HighQuality
laparotomía I-Claim HighQuality
exploradora I-Claim HighQuality
y I-Claim HighQuality
un I-Claim HighQuality
drenaje I-Claim HighQuality
del I-Claim HighQuality
quiste I-Claim HighQuality
y I-Claim HighQuality
cuando I-Claim HighQuality
remita I-Claim HighQuality
la I-Claim HighQuality
dilatación I-Claim HighQuality
se I-Claim HighQuality
retirará I-Claim HighQuality
el I-Claim HighQuality
drenaje. I-Claim HighQuality

4- O 
Se B-Claim HighQuality
realizará I-Claim HighQuality
una I-Claim HighQuality
colangioresonancia I-Claim HighQuality
para I-Claim HighQuality
delimitar I-Claim HighQuality
el I-Claim HighQuality
quiste I-Claim HighQuality
y I-Claim HighQuality
se I-Claim HighQuality
indicará I-Claim HighQuality
una I-Claim HighQuality
laparotomía I-Claim HighQuality
para I-Claim HighQuality
la I-Claim HighQuality
resección I-Claim HighQuality
del I-Claim HighQuality
quiste I-Claim HighQuality
y I-Claim HighQuality
anastomsosis I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
vía I-Claim HighQuality
biliar. I-Claim HighQuality

5- O 
Es B-Claim HighQuality
necesaria I-Claim HighQuality
la I-Claim HighQuality
gammagrafía I-Claim HighQuality
con I-Claim HighQuality
HIDA I-Claim HighQuality
para I-Claim HighQuality
delimitar I-Claim HighQuality
el I-Claim HighQuality
quiste I-Claim HighQuality
y I-Claim HighQuality
poder I-Claim HighQuality
realizar I-Claim HighQuality
el I-Claim HighQuality
drenaje I-Claim HighQuality
percutáneo I-Claim HighQuality
con I-Claim HighQuality
seguridad. I-Claim HighQuality

CORRECT O 
ANSWER: O 
4 O 

Creo B-Claim HighQuality
que I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
4 I-Claim HighQuality
el B-Claim HighQuality
quiste I-Claim HighQuality
de I-Claim HighQuality
colédoco I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
patología I-Claim HighQuality
rara I-Claim HighQuality
pero O 
su B-Claim HighQuality
tratamiento I-Claim HighQuality
es I-Claim HighQuality
quirúrgico I-Claim HighQuality
y I-Claim HighQuality
consiste I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
resección I-Claim HighQuality
del I-Claim HighQuality
quiste I-Claim HighQuality
y I-Claim HighQuality
hepaticoyeyunosotmía. I-Claim HighQuality

La B-Claim HighQuality
colangioresonancia I-Claim HighQuality
es I-Claim HighQuality
necesaria I-Claim HighQuality
para I-Claim HighQuality
elegir I-Claim HighQuality
al I-Claim HighQuality
técnica I-Claim HighQuality
adecuada I-Claim HighQuality
para I-Claim HighQuality
las I-Claim HighQuality
cuatro I-Claim HighQuality
clases I-Claim HighQuality
de I-Claim HighQuality
quiste I-Claim HighQuality
de I-Claim HighQuality
colédoco I-Claim HighQuality
existentes I-Claim HighQuality
(clasificación I-Claim HighQuality
de I-Claim HighQuality
Todani). I-Claim HighQuality

QUESTION O 
TYPE: O 
PEDIATRICS O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
lactante I-Premise HighQuality
de I-Premise HighQuality
7 I-Premise HighQuality
meses I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
derivado I-Premise HighQuality
por I-Premise HighQuality
su I-Premise HighQuality
pediatra I-Premise HighQuality
de I-Premise HighQuality
zona I-Premise HighQuality
por I-Premise HighQuality
sospecha I-Premise HighQuality
de I-Premise HighQuality
enfermedad I-Premise HighQuality
de I-Premise HighQuality
Kawasaki. I-Premise HighQuality

Refiere B-Premise HighQuality
fiebre I-Premise HighQuality
de I-Premise HighQuality
hasta I-Premise HighQuality
39,5ºC I-Premise HighQuality
de I-Premise HighQuality
5 I-Premise HighQuality
días I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
que I-Premise HighQuality
no I-Premise HighQuality
cede I-Premise HighQuality
a I-Premise HighQuality
pesar I-Premise HighQuality
del I-Premise HighQuality
tratamiento I-Premise HighQuality
con I-Premise HighQuality
amoxicilina I-Premise HighQuality
pautado I-Premise HighQuality
hace I-Premise HighQuality
72 I-Premise HighQuality
horas I-Premise HighQuality
por I-Premise HighQuality
sospecha I-Premise HighQuality
de I-Premise HighQuality
faringoamigdalitis I-Premise HighQuality
aguda. I-Premise HighQuality

Durante B-Premise HighQuality
las I-Premise HighQuality
últimas I-Premise HighQuality
24 I-Premise HighQuality
horas I-Premise HighQuality
asocia I-Premise HighQuality
exantema I-Premise HighQuality
eritematoso I-Premise HighQuality
ni I-Premise HighQuality
pruriginoso I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
cefalocaudal I-Premise HighQuality
y O 
durante B-Premise HighQuality
los I-Premise HighQuality
últimos I-Premise HighQuality
días I-Premise HighQuality
llama I-Premise HighQuality
la I-Premise HighQuality
atención I-Premise HighQuality
a I-Premise HighQuality
sus I-Premise HighQuality
padres I-Premise HighQuality
la I-Premise HighQuality
tos I-Premise HighQuality
y I-Premise HighQuality
una I-Premise HighQuality
intensa I-Premise HighQuality
conjuntivitis. I-Premise HighQuality

No B-Premise HighQuality
refieren I-Premise HighQuality
rinorrea. I-Premise HighQuality

A B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
clínica I-Premise HighQuality
presenta I-Premise HighQuality
subcrepitantes I-Premise HighQuality
en I-Premise HighQuality
ambas I-Premise HighQuality
bases I-Premise HighQuality
pulmonares I-Premise HighQuality
sin I-Premise HighQuality
taquipnea I-Premise HighQuality
ni I-Premise HighQuality
signos I-Premise HighQuality
de I-Premise HighQuality
dificultad I-Premise HighQuality
respiratoria. I-Premise HighQuality

A B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
orofaríngea I-Premise HighQuality
se I-Premise HighQuality
evidencian I-Premise HighQuality
manchas I-Premise HighQuality
blanquecinas I-Premise HighQuality
en I-Premise HighQuality
mucosa I-Premise HighQuality
yugal. I-Premise HighQuality

¿Cuál O 
es O 
el O 
diagnóstico O 
más O 
probable? O 

1- O 
Enfermedad B-Claim HighQuality
de I-Claim HighQuality
Kawasaki. I-Claim HighQuality

2- O 
Escarlatina. B-Claim HighQuality

3- O 
Reacción B-Claim HighQuality
alérgica I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
amoxicilina. I-Claim HighQuality

4- O 
Mononucleosis B-Claim HighQuality
infecciosa. I-Claim HighQuality

5- O 
Sarampión. B-Claim HighQuality

CORRECT O 
ANSWER: O 
5 O 

La B-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
5. I-Claim HighQuality

La B-Claim HighQuality
pista I-Claim HighQuality
está I-Claim HighQuality
en I-Claim HighQuality
las I-Claim HighQuality
lesiones I-Claim HighQuality
blanquecinas I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
mucosa I-Claim HighQuality
yugal I-Claim HighQuality
que I-Claim HighQuality
corresponden I-Claim HighQuality
a I-Claim HighQuality
las I-Claim HighQuality
manchas I-Claim HighQuality
de I-Claim HighQuality
Koplik, I-Claim HighQuality
que I-Claim HighQuality
son I-Claim HighQuality
patognomónicas I-Claim HighQuality
del I-Claim HighQuality
sarampión, I-Claim HighQuality
aunque I-Claim HighQuality
como I-Claim HighQuality
observación I-Claim HighQuality
diría I-Claim HighQuality
que I-Claim HighQuality
suelen I-Claim HighQuality
aparecer I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
fase I-Claim HighQuality
prodrómica I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
enfermedad I-Claim HighQuality
y I-Claim HighQuality
muchas I-Claim HighQuality
veces I-Claim HighQuality
ya I-Claim HighQuality
no I-Claim HighQuality
se I-Claim HighQuality
ven I-Claim HighQuality
cuando I-Claim HighQuality
aparece I-Claim HighQuality
el I-Claim HighQuality
exantema. I-Claim HighQuality

En B-Claim HighQuality
este I-Claim HighQuality
caso I-Claim HighQuality
está I-Claim HighQuality
describiendo I-Claim HighQuality
un I-Claim HighQuality
sarampión I-Claim HighQuality
complicado I-Claim HighQuality
con I-Claim HighQuality
una I-Claim HighQuality
neumonía. I-Claim HighQuality

Muy O 
oportuna O 
esta O 
pregunta O 
en O 
el O 
momento O 
actual. O 

QUESTION O 
TYPE: O 
UROLOGY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
paciente I-Premise HighQuality
varón I-Premise HighQuality
de I-Premise HighQuality
45 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
edad I-Premise HighQuality
con I-Premise HighQuality
antecedentes I-Premise HighQuality
de I-Premise HighQuality
litiasis I-Premise HighQuality
úrica I-Premise HighQuality
con I-Premise HighQuality
cólicos I-Premise HighQuality
nefríticos I-Premise HighQuality
expulsivos I-Premise HighQuality
de I-Premise HighQuality
repetición I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
25 I-Premise HighQuality
años, I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
Urgencias I-Premise HighQuality
refiriendo I-Premise HighQuality
palpitaciones I-Premise HighQuality
y I-Premise HighQuality
dolor I-Premise HighQuality
lumbar I-Premise HighQuality
derecho I-Premise HighQuality
intenso I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
2 I-Premise HighQuality
horas I-Premise HighQuality
antes. I-Premise HighQuality

El B-Premise HighQuality
análisis I-Premise HighQuality
de I-Premise HighQuality
orina I-Premise HighQuality
muestra I-Premise HighQuality
un I-Premise HighQuality
pH I-Premise HighQuality
de I-Premise HighQuality
5,5 I-Premise HighQuality
y I-Premise HighQuality
leucocituria I-Premise HighQuality
sin I-Premise HighQuality
proteinuria. I-Premise HighQuality

El B-Premise HighQuality
ECG I-Premise HighQuality
confirma I-Premise HighQuality
una I-Premise HighQuality
fibrilación I-Premise HighQuality
auricular I-Premise HighQuality
no I-Premise HighQuality
conocidad I-Premise HighQuality
previamente. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
bioquímica I-Premise HighQuality
sanguínea I-Premise HighQuality
destaca I-Premise HighQuality
una I-Premise HighQuality
creatinina I-Premise HighQuality
de I-Premise HighQuality
0.9mg/dl, I-Premise HighQuality
un I-Premise HighQuality
calcio I-Premise HighQuality
de I-Premise HighQuality
11mg/dl I-Premise HighQuality
y I-Premise HighQuality
una I-Premise HighQuality
LDH I-Premise HighQuality
de I-Premise HighQuality
950 I-Premise HighQuality
U/l. I-Premise HighQuality

¿Cual O 
es O 
la O 
maniobra O 
diagnóstica O 
mas O 
útil O 
a O 
realizar? O 

1- O 
Radiografía B-Claim HighQuality
simple I-Claim HighQuality
de I-Claim HighQuality
abdomen. I-Claim HighQuality

2- O 
UIV. B-Claim HighQuality

3- O 
TAC B-Claim HighQuality
con I-Claim HighQuality
contraste. I-Claim HighQuality

4- O 
ECOgrafía B-Claim HighQuality
abdominal. I-Claim HighQuality

5- O 
ECOCARDIOGRAFÍA B-Claim HighQuality
doppler. I-Claim HighQuality

CORRECT O 
ANSWER: O 
3 O 

En B-Claim HighQuality
esta I-Claim HighQuality
pregunta I-Claim HighQuality
tengo I-Claim HighQuality
mas I-Claim HighQuality
dudas I-Claim HighQuality
en I-Claim HighQuality
cuanto I-Claim HighQuality
a I-Claim HighQuality
cual I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
correcta, I-Claim HighQuality
pues I-Claim HighQuality
debemos I-Claim HighQuality
interpretar I-Claim HighQuality
cual I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
prueba I-Claim HighQuality
mas I-Claim HighQuality
útil, I-Claim HighQuality
con I-Claim HighQuality
cual I-Claim HighQuality
podemos I-Claim HighQuality
obtener I-Claim HighQuality
mas I-Claim HighQuality
rendimiento. I-Claim HighQuality

No B-Claim HighQuality
obstante I-Claim HighQuality
esta I-Claim HighQuality
situación I-Claim HighQuality
depende I-Claim HighQuality
así I-Claim HighQuality
mismo I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
servicios I-Claim HighQuality
de I-Claim HighQuality
radiología I-Claim HighQuality
de I-Claim HighQuality
cada I-Claim HighQuality
centro I-Claim HighQuality
y I-Claim HighQuality
de I-Claim HighQuality
sus I-Claim HighQuality
preferencias. I-Claim HighQuality

Me B-Claim HighQuality
centraré I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
parte I-Claim HighQuality
urológica, I-Claim HighQuality
dejando I-Claim HighQuality
de I-Claim HighQuality
lado I-Claim HighQuality
el I-Claim HighQuality
resto I-Claim HighQuality
de I-Claim HighQuality
sintomatología. I-Claim HighQuality

• O 
La B-Claim HighQuality
Rx I-Claim HighQuality
de I-Claim HighQuality
abdomen I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
primer I-Claim HighQuality
estudio I-Claim HighQuality
de I-Claim HighQuality
imagen I-Claim HighQuality
a I-Claim HighQuality
realizar I-Claim HighQuality
por I-Claim HighQuality
ser I-Claim HighQuality
rápido, I-Claim HighQuality
sencillo I-Claim HighQuality
y I-Claim HighQuality
prácticamente I-Claim HighQuality
inocuo I-Claim HighQuality
(salvo I-Claim HighQuality
en I-Claim HighQuality
niños I-Claim HighQuality
y I-Claim HighQuality
gestantes). I-Claim HighQuality

El B-Claim HighQuality
90% I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
cálculos I-Claim HighQuality
son I-Claim HighQuality
radiopacos I-Claim HighQuality
y I-Claim HighQuality
por I-Claim HighQuality
lo I-Claim HighQuality
tanto I-Claim HighQuality
visibles, I-Claim HighQuality
pero I-Claim HighQuality
la I-Claim HighQuality
sensibilidad I-Claim HighQuality
de I-Claim HighQuality
esta I-Claim HighQuality
prueba, I-Claim HighQuality
utilizada I-Claim HighQuality
de I-Claim HighQuality
manera I-Claim HighQuality
aislada, I-Claim HighQuality
disminuye I-Claim HighQuality
hasta I-Claim HighQuality
el I-Claim HighQuality
45-59%. I-Claim HighQuality

Es B-Claim HighQuality
una I-Claim HighQuality
prueba I-Claim HighQuality
obligatoria I-Claim HighQuality
en I-Claim HighQuality
toda I-Claim HighQuality
sospecha I-Claim HighQuality
de I-Claim HighQuality
dolor I-Claim HighQuality
cólico. I-Claim HighQuality

No B-Claim HighQuality
obstante I-Claim HighQuality
con I-Claim HighQuality
menor I-Claim HighQuality
rendimiento I-Claim HighQuality
que I-Claim HighQuality
las I-Claim HighQuality
otras. I-Claim HighQuality

Aunque B-Claim HighQuality
la I-Claim HighQuality
historia I-Claim HighQuality
urológica I-Claim HighQuality
hable I-Claim HighQuality
de I-Claim HighQuality
litiasis I-Claim HighQuality
úrica I-Claim HighQuality
(radiotrasparente), I-Claim HighQuality
con I-Claim HighQuality
un I-Claim HighQuality
ph I-Claim HighQuality
ácido I-Claim HighQuality
que I-Claim HighQuality
reafirma I-Claim HighQuality
el I-Claim HighQuality
diagnóstico I-Claim HighQuality
de I-Claim HighQuality
origen I-Claim HighQuality
úrico, I-Claim HighQuality
no I-Claim HighQuality
podemos I-Claim HighQuality
descartar I-Claim HighQuality
nunca I-Claim HighQuality
la I-Claim HighQuality
litiasis I-Claim HighQuality
de I-Claim HighQuality
oxalato I-Claim HighQuality
cálcico I-Claim HighQuality
que I-Claim HighQuality
puede I-Claim HighQuality
aparecer I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
sincrónica. I-Claim HighQuality

• O 
La B-Claim HighQuality
UIV I-Claim HighQuality
me I-Claim HighQuality
parece I-Claim HighQuality
una I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
opciones I-Claim HighQuality
con I-Claim HighQuality
mayor I-Claim HighQuality
rendimiento. I-Claim HighQuality

Nos B-Claim HighQuality
dará I-Claim HighQuality
claridad I-Claim HighQuality
diagnóstica I-Claim HighQuality
de I-Claim HighQuality
obstrucción, I-Claim HighQuality
de I-Claim HighQuality
su I-Claim HighQuality
magnitud I-Claim HighQuality
y I-Claim HighQuality
de I-Claim HighQuality
su I-Claim HighQuality
repercusión I-Claim HighQuality
renal. I-Claim HighQuality

Considerada B-Claim HighQuality
durante I-Claim HighQuality
mucho I-Claim HighQuality
tiempo I-Claim HighQuality
la I-Claim HighQuality
exploración I-Claim HighQuality
de I-Claim HighQuality
elección I-Claim HighQuality
para I-Claim HighQuality
el I-Claim HighQuality
estudio I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
pacientes I-Claim HighQuality
con I-Claim HighQuality
litiasis I-Claim HighQuality
renal. I-Claim HighQuality

Es B-Claim HighQuality
una I-Claim HighQuality
prueba I-Claim HighQuality
con I-Claim HighQuality
sensibilidad I-Claim HighQuality
y I-Claim HighQuality
especificidad I-Claim HighQuality
elevadas I-Claim HighQuality
(87-90% I-Claim HighQuality
y I-Claim HighQuality
94-100%, I-Claim HighQuality
respectivamente), I-Claim HighQuality
relativamente I-Claim HighQuality
inocua, I-Claim HighQuality
y I-Claim HighQuality
al I-Claim HighQuality
alcance I-Claim HighQuality
de I-Claim HighQuality
todos I-Claim HighQuality
los I-Claim HighQuality
hospitales. I-Claim HighQuality

Nos B-Claim HighQuality
informa I-Claim HighQuality
del I-Claim HighQuality
número, I-Claim HighQuality
tamaño, I-Claim HighQuality
forma I-Claim HighQuality
y I-Claim HighQuality
situación I-Claim HighQuality
del I-Claim HighQuality
cálculo, I-Claim HighQuality
así I-Claim HighQuality
como I-Claim HighQuality
del I-Claim HighQuality
estado I-Claim HighQuality
funcional I-Claim HighQuality
del I-Claim HighQuality
riñón I-Claim HighQuality
afecto. I-Claim HighQuality

• O 
El B-Claim HighQuality
TAC I-Claim HighQuality
con I-Claim HighQuality
contraste I-Claim HighQuality
me I-Claim HighQuality
parece I-Claim HighQuality
la I-Claim HighQuality
opción I-Claim HighQuality
con I-Claim HighQuality
mayor I-Claim HighQuality
rendimiento. I-Claim HighQuality

Sirve B-Claim HighQuality
para I-Claim HighQuality
descubrir I-Claim HighQuality
litiasis I-Claim HighQuality
que I-Claim HighQuality
otras I-Claim HighQuality
pruebas I-Claim HighQuality
no I-Claim HighQuality
logran I-Claim HighQuality
encontrar I-Claim HighQuality
y I-Claim HighQuality
nos I-Claim HighQuality
da I-Claim HighQuality
una I-Claim HighQuality
imagen I-Claim HighQuality
global I-Claim HighQuality
del I-Claim HighQuality
resto I-Claim HighQuality
de I-Claim HighQuality
estructuras. I-Claim HighQuality

Gran B-Claim HighQuality
rendimiento I-Claim HighQuality
pero I-Claim HighQuality
también I-Claim HighQuality
mas I-Claim HighQuality
cara, I-Claim HighQuality
mas I-Claim HighQuality
tiempo, I-Claim HighQuality
mas I-Claim HighQuality
radiación. I-Claim HighQuality

Se B-Claim HighQuality
ha I-Claim HighQuality
confirmado I-Claim HighQuality
como I-Claim HighQuality
una I-Claim HighQuality
exploración I-Claim HighQuality
de I-Claim HighQuality
gran I-Claim HighQuality
sensibilidad I-Claim HighQuality
y I-Claim HighQuality
especificidad, I-Claim HighQuality
superando I-Claim HighQuality
a I-Claim HighQuality
las I-Claim HighQuality
anteriores I-Claim HighQuality
pruebas I-Claim HighQuality
(94-100% I-Claim HighQuality
y I-Claim HighQuality
92-100%, I-Claim HighQuality
respectivamente, I-Claim HighQuality
para I-Claim HighQuality
la I-Claim HighQuality
detección I-Claim HighQuality
de I-Claim HighQuality
cálculo I-Claim HighQuality
ureteral) I-Claim HighQuality
y I-Claim HighQuality
con I-Claim HighQuality
sus I-Claim HighQuality
numerosas I-Claim HighQuality
ventajas I-Claim HighQuality
se I-Claim HighQuality
ha I-Claim HighQuality
convertido I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
examen I-Claim HighQuality
de I-Claim HighQuality
referencia I-Claim HighQuality
por I-Claim HighQuality
lo I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
espera I-Claim HighQuality
que I-Claim HighQuality
reemplazará I-Claim HighQuality
a I-Claim HighQuality
UIV I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
ecografía I-Claim HighQuality
en I-Claim HighQuality
todo I-Claim HighQuality
el I-Claim HighQuality
mundo. I-Claim HighQuality

Realiza B-Claim HighQuality
un I-Claim HighQuality
barrido I-Claim HighQuality
helicoidal I-Claim HighQuality
con I-Claim HighQuality
cortes I-Claim HighQuality
de I-Claim HighQuality
5 I-Claim HighQuality
mm I-Claim HighQuality
que I-Claim HighQuality
permite I-Claim HighQuality
la I-Claim HighQuality
detección I-Claim HighQuality
de I-Claim HighQuality
cálculos I-Claim HighQuality
de I-Claim HighQuality
hasta I-Claim HighQuality
2 I-Claim HighQuality
mm. I-Claim HighQuality

Con B-Claim HighQuality
la I-Claim HighQuality
administración I-Claim HighQuality
de I-Claim HighQuality
contraste, I-Claim HighQuality
permite I-Claim HighQuality
la I-Claim HighQuality
evaluación I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
función I-Claim HighQuality
renal. I-Claim HighQuality

• O 
La B-Claim HighQuality
Ecografía I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
prueba I-Claim HighQuality
rápida, I-Claim HighQuality
barata I-Claim HighQuality
e I-Claim HighQuality
inocua, I-Claim HighQuality
pero I-Claim HighQuality
muy I-Claim HighQuality
radiólog-dependiente. I-Claim HighQuality

Da B-Claim HighQuality
gran I-Claim HighQuality
información I-Claim HighQuality
renal I-Claim HighQuality
sobre I-Claim HighQuality
repercusión I-Claim HighQuality
obstructiva, I-Claim HighQuality
pero I-Claim HighQuality
menor I-Claim HighQuality
calidad I-Claim HighQuality
de I-Claim HighQuality
cara I-Claim HighQuality
a I-Claim HighQuality
encontrar I-Claim HighQuality
una I-Claim HighQuality
litiasis. I-Claim HighQuality

La B-Claim HighQuality
ecografía I-Claim HighQuality
sólo I-Claim HighQuality
detecta I-Claim HighQuality
cálculos I-Claim HighQuality
mayores I-Claim HighQuality
de I-Claim HighQuality
4 I-Claim HighQuality
mm, I-Claim HighQuality
situados I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
unión I-Claim HighQuality
pielo-ureteral I-Claim HighQuality
o I-Claim HighQuality
la I-Claim HighQuality
unión I-Claim HighQuality
urétero-vesical, I-Claim HighQuality
mientras I-Claim HighQuality
que I-Claim HighQuality
el I-Claim HighQuality
uréter I-Claim HighQuality
lumbar I-Claim HighQuality
y I-Claim HighQuality
pelviano I-Claim HighQuality
es I-Claim HighQuality
poco I-Claim HighQuality
accesible I-Claim HighQuality
debido I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
interposición I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
asas I-Claim HighQuality
intestinales. I-Claim HighQuality

Por B-Claim HighQuality
ello, I-Claim HighQuality
la I-Claim HighQuality
ecografía I-Claim HighQuality
realizada I-Claim HighQuality
de I-Claim HighQuality
manera I-Claim HighQuality
aislada I-Claim HighQuality
es I-Claim HighQuality
poco I-Claim HighQuality
sensible I-Claim HighQuality
(20-45%) I-Claim HighQuality
para I-Claim HighQuality
la I-Claim HighQuality
detección I-Claim HighQuality
de I-Claim HighQuality
cálculos, I-Claim HighQuality
pero I-Claim HighQuality
asociada I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
radiografía I-Claim HighQuality
simple I-Claim HighQuality
de I-Claim HighQuality
abdomen I-Claim HighQuality
aumenta I-Claim HighQuality
su I-Claim HighQuality
sensibilidad I-Claim HighQuality
y I-Claim HighQuality
especificidad. I-Claim HighQuality

• O 
La B-Claim HighQuality
ecocardiografía I-Claim HighQuality
doppler I-Claim HighQuality
no I-Claim HighQuality
tiene I-Claim HighQuality
uso I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
diagnóstico I-Claim HighQuality
urológico. I-Claim HighQuality

Mi B-Claim HighQuality
respuesta I-Claim HighQuality
sería I-Claim HighQuality
la I-Claim HighQuality
TAC I-Claim HighQuality
con I-Claim HighQuality
contraste I-Claim HighQuality
ev I-Claim HighQuality
y I-Claim HighQuality
fase I-Claim HighQuality
excretora I-Claim HighQuality
(respuesta I-Claim HighQuality
(c).), I-Claim HighQuality
en I-Claim HighQuality
cuanto I-Claim HighQuality
a I-Claim HighQuality
rendimiento, I-Claim HighQuality
sensibilidad I-Claim HighQuality
y I-Claim HighQuality
especificidad. I-Claim HighQuality

Hay B-Claim HighQuality
servicio I-Claim HighQuality
de I-Claim HighQuality
radiología I-Claim HighQuality
mas I-Claim HighQuality
hábiles I-Claim HighQuality
o I-Claim HighQuality
predispuestos I-Claim HighQuality
a I-Claim HighQuality
una I-Claim HighQuality
u I-Claim HighQuality
otra. I-Claim HighQuality

Sin B-Claim HighQuality
olvidar I-Claim HighQuality
que I-Claim HighQuality
la I-Claim HighQuality
Rx I-Claim HighQuality
de I-Claim HighQuality
abdomen I-Claim HighQuality
siempre I-Claim HighQuality
debe I-Claim HighQuality
hacerse I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
sospecha I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
cólico. I-Claim HighQuality

QUESTION O 
TYPE: O 
DERMATOLOGY O 

CLINICAL O 
CASE: O 

Hombre B-Premise HighQuality
de I-Premise HighQuality
62 I-Premise HighQuality
años I-Premise HighQuality
con I-Premise HighQuality
antecedentes I-Premise HighQuality
de I-Premise HighQuality
hábito I-Premise HighQuality
enólico I-Premise HighQuality
importante, I-Premise HighQuality
portador I-Premise HighQuality
de I-Premise HighQuality
virus I-Premise HighQuality
de I-Premise HighQuality
hepatitis I-Premise HighQuality
C, I-Premise HighQuality
sigue I-Premise HighQuality
tratamiento I-Premise HighQuality
con I-Premise HighQuality
Ibuprofeno I-Premise HighQuality
por I-Premise HighQuality
una I-Premise HighQuality
tendinitis I-Premise HighQuality
en I-Premise HighQuality
hombro I-Premise HighQuality
derecho, I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
su I-Premise HighQuality
dermatólogo I-Premise HighQuality
porque I-Premise HighQuality
despues I-Premise HighQuality
de I-Premise HighQuality
pasar I-Premise HighQuality
dos I-Premise HighQuality
semanas I-Premise HighQuality
de I-Premise HighQuality
vacaciones I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
playa I-Premise HighQuality
observa I-Premise HighQuality
la I-Premise HighQuality
aparición I-Premise HighQuality
de I-Premise HighQuality
ampollas I-Premise HighQuality
tensas I-Premise HighQuality
en I-Premise HighQuality
dorso I-Premise HighQuality
de I-Premise HighQuality
manos. I-Premise HighQuality

A B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
ademas I-Premise HighQuality
de I-Premise HighQuality
localización I-Premise HighQuality
y I-Premise HighQuality
ligera I-Premise HighQuality
hipertricosis I-Premise HighQuality
malar. I-Premise HighQuality

El O 
diagnóstico O 
más O 
probable O 
es: O 

1- O 
Epidermolisis B-Claim HighQuality
ampollosa I-Claim HighQuality
adquirida. I-Claim HighQuality

2- O 
Porfiria B-Claim HighQuality
cutánea I-Claim HighQuality
tarda. I-Claim HighQuality

3- O 
Reacción B-Claim HighQuality
fototóxica. I-Claim HighQuality

4- O 
Dermatitis B-Claim HighQuality
de I-Claim HighQuality
contácto. I-Claim HighQuality

5- O 
Porfiria B-Claim HighQuality
aguda I-Claim HighQuality
intermitente. I-Claim HighQuality

CORRECT O 
ANSWER: O 
2 O 

Porfiria B-Claim HighQuality
Cutánea I-Claim HighQuality
Tarda: I-Claim HighQuality
el B-Claim HighQuality
60% I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
pacientes I-Claim HighQuality
con I-Claim HighQuality
PCT, I-Claim HighQuality
son I-Claim HighQuality
varones, I-Claim HighQuality
muchos I-Claim HighQuality
de I-Claim HighQuality
ellos I-Claim HighQuality
ingieren I-Claim HighQuality
alcohol I-Claim HighQuality
en I-Claim HighQuality
exceso, I-Claim HighQuality
las I-Claim HighQuality
mujeres I-Claim HighQuality
que I-Claim HighQuality
la I-Claim HighQuality
desarrollan I-Claim HighQuality
suelen I-Claim HighQuality
estar I-Claim HighQuality
en I-Claim HighQuality
tratamiento I-Claim HighQuality
con I-Claim HighQuality
fármacos I-Claim HighQuality
que I-Claim HighQuality
contienen I-Claim HighQuality
Estrógenos. I-Claim HighQuality

La B-Claim HighQuality
mayoria I-Claim HighQuality
son I-Claim HighQuality
varones I-Claim HighQuality
con I-Claim HighQuality
indicios I-Claim HighQuality
de I-Claim HighQuality
sobrecarga I-Claim HighQuality
de I-Claim HighQuality
hierro, I-Claim HighQuality
esta I-Claim HighQuality
sobrecarga I-Claim HighQuality
reduce I-Claim HighQuality
la I-Claim HighQuality
actividad I-Claim HighQuality
del I-Claim HighQuality
enzima I-Claim HighQuality
uroporfirinógeno I-Claim HighQuality
descarboxilasa, I-Claim HighQuality
que I-Claim HighQuality
lleva I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
elevación I-Claim HighQuality
de I-Claim HighQuality
uroporfirinas. I-Claim HighQuality

Se B-Claim HighQuality
han I-Claim HighQuality
implicado I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
precipitación I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
PCT I-Claim HighQuality
adquirida I-Claim HighQuality
las I-Claim HighQuality
infecciones I-Claim HighQuality
por I-Claim HighQuality
VHC I-Claim HighQuality
y I-Claim HighQuality
VIH. I-Claim HighQuality

Existe B-Claim HighQuality
una I-Claim HighQuality
forma I-Claim HighQuality
hereditaria I-Claim HighQuality
con I-Claim HighQuality
patrón I-Claim HighQuality
AD. I-Claim HighQuality

Los B-Claim HighQuality
pacientes I-Claim HighQuality
con I-Claim HighQuality
PCT, I-Claim HighQuality
presentan I-Claim HighQuality
ampollas I-Claim HighQuality
en I-Claim HighQuality
piel I-Claim HighQuality
fotoexpuesta, I-Claim HighQuality
más I-Claim HighQuality
frecuente I-Claim HighQuality
en I-Claim HighQuality
dorso I-Claim HighQuality
de I-Claim HighQuality
manos I-Claim HighQuality
y I-Claim HighQuality
cuero I-Claim HighQuality
cabelludo. I-Claim HighQuality

Además B-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
fragilidad, I-Claim HighQuality
pueden I-Claim HighQuality
desarrollar I-Claim HighQuality
hipertricosis, I-Claim HighQuality
hiperpigmentación, I-Claim HighQuality
alopecia I-Claim HighQuality
cicatricial I-Claim HighQuality
e I-Claim HighQuality
induración I-Claim HighQuality
esclerodérmica. I-Claim HighQuality

QUESTION O 
TYPE: O 
CARDIOLOGY O 
AND O 
CARDIOVASCULAR O 
SURGERY O 

CLINICAL O 
CASE: O 

Paciente B-Premise HighQuality
varón I-Premise HighQuality
de I-Premise HighQuality
26 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
edad, I-Premise HighQuality
deportista I-Premise HighQuality
de I-Premise HighQuality
competición, I-Premise HighQuality
es I-Premise HighQuality
estudiado I-Premise HighQuality
porque I-Premise HighQuality
su I-Premise HighQuality
hermano I-Premise HighQuality
ha I-Premise HighQuality
tenido I-Premise HighQuality
una I-Premise HighQuality
muerte I-Premise HighQuality
súbita. I-Premise HighQuality

Las B-Premise HighQuality
pruebas I-Premise HighQuality
complementarias I-Premise HighQuality
detectan I-Premise HighQuality
la I-Premise HighQuality
existencia I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
miocardiopatía I-Premise HighQuality
hipertrófica I-Premise HighQuality
obstructiva. I-Premise HighQuality

Señale O 
la O 
opción O 
FALSA O 
respecto O 
a O 
dicha O 
patología: O 

1- O 
El B-Claim HighQuality
tratamiento I-Claim HighQuality
con I-Claim HighQuality
betabloqueantes I-Claim HighQuality
ayuda I-Claim HighQuality
a I-Claim HighQuality
reducir I-Claim HighQuality
los I-Claim HighQuality
síntomas. I-Claim HighQuality

2- O 
Se B-Claim HighQuality
debe I-Claim HighQuality
recomendar I-Claim HighQuality
el I-Claim HighQuality
abandono I-Claim HighQuality
del I-Claim HighQuality
deporte I-Claim HighQuality
de I-Claim HighQuality
competición. I-Claim HighQuality

3- O 
La B-Claim HighQuality
digoxina I-Claim HighQuality
es I-Claim HighQuality
útil I-Claim HighQuality
para I-Claim HighQuality
reducir I-Claim HighQuality
el I-Claim HighQuality
gradiente I-Claim HighQuality
subaórtico. I-Claim HighQuality

4- O 
Los B-Claim HighQuality
diuréticos I-Claim HighQuality
se I-Claim HighQuality
deben I-Claim HighQuality
evitar I-Claim HighQuality
o I-Claim HighQuality
utilizar I-Claim HighQuality
con I-Claim HighQuality
gran I-Claim HighQuality
cuidado. I-Claim HighQuality

5- O 
Dado B-Claim HighQuality
el I-Claim HighQuality
carácter I-Claim HighQuality
hereditario I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
patología I-Claim HighQuality
se I-Claim HighQuality
debe I-Claim HighQuality
realizar I-Claim HighQuality
estudio I-Claim HighQuality
de I-Claim HighQuality
despistaje I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
resto I-Claim HighQuality
de I-Claim HighQuality
familiares I-Claim HighQuality
directos. I-Claim HighQuality

CORRECT O 
ANSWER: O 
3 O 

Tenemos B-Claim HighQuality
un I-Claim HighQuality
miocardio I-Claim HighQuality
más I-Claim HighQuality
grueso I-Claim HighQuality
de I-Claim HighQuality
lo I-Claim HighQuality
debido, I-Claim HighQuality
con I-Claim HighQuality
predominio I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
septo, I-Claim HighQuality
y I-Claim HighQuality
que I-Claim HighQuality
además I-Claim HighQuality
está I-Claim HighQuality
tan I-Claim HighQuality
grueso I-Claim HighQuality
que I-Claim HighQuality
llega I-Claim HighQuality
a I-Claim HighQuality
obstruir I-Claim HighQuality
la I-Claim HighQuality
salida I-Claim HighQuality
del I-Claim HighQuality
VI, I-Claim HighQuality
produciendo I-Claim HighQuality
una I-Claim HighQuality
estenosis I-Claim HighQuality
“funcional” I-Claim HighQuality
con I-Claim HighQuality
gradiente I-Claim HighQuality
de I-Claim HighQuality
presiones. I-Claim HighQuality

Nuestro B-Claim HighQuality
objetivo I-Claim HighQuality
será, I-Claim HighQuality
en I-Claim HighQuality
primer I-Claim HighQuality
lugar, I-Claim HighQuality
“relajar” I-Claim HighQuality
el I-Claim HighQuality
miocardio: I-Claim HighQuality
para I-Claim HighQuality
ello I-Claim HighQuality
nos I-Claim HighQuality
conviene I-Claim HighQuality
un I-Claim HighQuality
betabloqueante, I-Claim HighQuality
mientras I-Claim HighQuality
que I-Claim HighQuality
la I-Claim HighQuality
digoxina, I-Claim HighQuality
como I-Claim HighQuality
buen I-Claim HighQuality
inotropo I-Claim HighQuality
positivo, I-Claim HighQuality
aumenta I-Claim HighQuality
el I-Claim HighQuality
gradiente I-Claim HighQuality
y I-Claim HighQuality
está I-Claim HighQuality
contraindicada. I-Claim HighQuality

El B-Claim HighQuality
deporte I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
muy I-Claim HighQuality
recomendable, I-Claim HighQuality
dado I-Claim HighQuality
el I-Claim HighQuality
riesgo I-Claim HighQuality
aumentado I-Claim HighQuality
de I-Claim HighQuality
muerte I-Claim HighQuality
súbita I-Claim HighQuality
que I-Claim HighQuality
tiene I-Claim HighQuality
esta I-Claim HighQuality
patología. I-Claim HighQuality

Y B-Claim HighQuality
si I-Claim HighQuality
tenemos I-Claim HighQuality
un I-Claim HighQuality
septo I-Claim HighQuality
gordo, I-Claim HighQuality
que I-Claim HighQuality
protruye I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
cavidad I-Claim HighQuality
del I-Claim HighQuality
VI, I-Claim HighQuality
no I-Claim HighQuality
nos I-Claim HighQuality
conviene I-Claim HighQuality
hacer I-Claim HighQuality
una I-Claim HighQuality
depleción I-Claim HighQuality
de I-Claim HighQuality
volumen, I-Claim HighQuality
pues I-Claim HighQuality
estaríamos I-Claim HighQuality
también I-Claim HighQuality
aumentando I-Claim HighQuality
el I-Claim HighQuality
gradiente. I-Claim HighQuality

En B-Claim HighQuality
cuanto I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
5, I-Claim HighQuality
es I-Claim HighQuality
cierta: I-Claim HighQuality
es I-Claim HighQuality
conveniente I-Claim HighQuality
realizar I-Claim HighQuality
una I-Claim HighQuality
exploración I-Claim HighQuality
cuidadosa I-Claim HighQuality
y I-Claim HighQuality
un I-Claim HighQuality
ECG I-Claim HighQuality
en I-Claim HighQuality
los I-Claim HighQuality
familiares I-Claim HighQuality
de I-Claim HighQuality
pacientes I-Claim HighQuality
con I-Claim HighQuality
hipertrófica. I-Claim HighQuality

QUESTION O 
TYPE: O 
PULMONOLOGY O 

CLINICAL O 
CASE: O 

Hombre B-Premise HighQuality
de I-Premise HighQuality
71 I-Premise HighQuality
años, I-Premise HighQuality
camarero I-Premise HighQuality
jubilado, I-Premise HighQuality
no I-Premise HighQuality
fumador, I-Premise HighQuality
que I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
ronquidos I-Premise HighQuality
nocturnos. I-Premise HighQuality

El B-Premise HighQuality
paciente I-Premise HighQuality
tiene I-Premise HighQuality
un I-Premise HighQuality
índice I-Premise HighQuality
de I-Premise HighQuality
masa I-Premise HighQuality
corporal I-Premise HighQuality
de I-Premise HighQuality
31,5 I-Premise HighQuality
Kg/m2 I-Premise HighQuality
y I-Premise HighQuality
refiere I-Premise HighQuality
ligera I-Premise HighQuality
somnolencia I-Premise HighQuality
diurna I-Premise HighQuality
postprandial I-Premise HighQuality
(Escala I-Premise HighQuality
de I-Premise HighQuality
Somnolencia I-Premise HighQuality
de I-Premise HighQuality
Epworth I-Premise HighQuality
de I-Premise HighQuality
3) I-Premise HighQuality
sin I-Premise HighQuality
otros I-Premise HighQuality
síntomas, I-Premise HighQuality
signos I-Premise HighQuality
o I-Premise HighQuality
antecedentes I-Premise HighQuality
clínicos I-Premise HighQuality
relevantes. I-Premise HighQuality

El B-Premise HighQuality
índice I-Premise HighQuality
de I-Premise HighQuality
apnea­-hipopnea I-Premise HighQuality
obtenido I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
polisomnografía I-Premise HighQuality
fue I-Premise HighQuality
de I-Premise HighQuality
18. I-Premise HighQuality

Con O 
estos O 
datos, O 
¿cuál O 
es O 
la O 
medida O 
a O 
adoptar O 
más O 
adecuada O 
en O 
este O 
paciente? O 

1- O 
Medidas B-Claim HighQuality
higiénico-dietéticas I-Claim HighQuality
y I-Claim HighQuality
control I-Claim HighQuality
evolutivo. I-Claim HighQuality

2- O 
Uvulopalatofaringoplastia. B-Claim HighQuality

3- O 
CPAP B-Claim HighQuality
(Presión I-Claim HighQuality
Positiva I-Claim HighQuality
Continua I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
Vía I-Claim HighQuality
Aérea) I-Claim HighQuality
nasal. I-Claim HighQuality

4- O 
Ventilación B-Claim HighQuality
mecánica I-Claim HighQuality
no I-Claim HighQuality
invasiva. I-Claim HighQuality

5- O 
Oxigenoterapia B-Claim HighQuality
nocturna. I-Claim HighQuality

CORRECT O 
ANSWER: O 
1 O 

Con B-Claim HighQuality
un I-Claim HighQuality
Indice I-Claim HighQuality
de I-Claim HighQuality
Apneas-Hipopneas I-Claim HighQuality
de I-Claim HighQuality
menos I-Claim HighQuality
de I-Claim HighQuality
30, I-Claim HighQuality
y I-Claim HighQuality
en I-Claim HighQuality
ausencia I-Claim HighQuality
de I-Claim HighQuality
síntomas I-Claim HighQuality
llamativos I-Claim HighQuality
de I-Claim HighQuality
SAOS I-Claim HighQuality
y I-Claim HighQuality
en I-Claim HighQuality
ausencia I-Claim HighQuality
de I-Claim HighQuality
profesiones I-Claim HighQuality
de I-Claim HighQuality
riesgo I-Claim HighQuality
como I-Claim HighQuality
podría I-Claim HighQuality
ser I-Claim HighQuality
conductor I-Claim HighQuality
profesional, I-Claim HighQuality
etc, I-Claim HighQuality
lo I-Claim HighQuality
correcto I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
control I-Claim HighQuality
de I-Claim HighQuality
peso I-Claim HighQuality
y I-Claim HighQuality
el I-Claim HighQuality
resto I-Claim HighQuality
de I-Claim HighQuality
medidas I-Claim HighQuality
higiénico-dietéticas, I-Claim HighQuality
con I-Claim HighQuality
seguimiento I-Claim HighQuality
periódico. I-Claim HighQuality

QUESTION O 
TYPE: O 
ENDOCRINOLOGY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
paciente I-Premise HighQuality
de I-Premise HighQuality
74 I-Premise HighQuality
años I-Premise HighQuality
con I-Premise HighQuality
resección I-Premise HighQuality
intestinal I-Premise HighQuality
tras I-Premise HighQuality
una I-Premise HighQuality
trombosis I-Premise HighQuality
mesentérica, I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
cansancio I-Premise HighQuality
y I-Premise HighQuality
dolor I-Premise HighQuality
óseo. I-Premise HighQuality

Había B-Premise HighQuality
sufrido I-Premise HighQuality
una I-Premise HighQuality
fractura I-Premise HighQuality
de I-Premise HighQuality
Colles I-Premise HighQuality
tres I-Premise HighQuality
meses I-Premise HighQuality
antes. I-Premise HighQuality

Los B-Premise HighQuality
estudios I-Premise HighQuality
analíticos I-Premise HighQuality
ponen I-Premise HighQuality
de I-Premise HighQuality
manifiesto I-Premise HighQuality
una I-Premise HighQuality
anemia I-Premise HighQuality
de I-Premise HighQuality
9.5 I-Premise HighQuality
g/dl, I-Premise HighQuality
microcítica, I-Premise HighQuality
albúmina I-Premise HighQuality
3.5 I-Premise HighQuality
g/di, I-Premise HighQuality
calcio I-Premise HighQuality
7.5 I-Premise HighQuality
mg/dl, I-Premise HighQuality
fosfato I-Premise HighQuality
2.0 I-Premise HighQuality
mg/dl I-Premise HighQuality
y I-Premise HighQuality
fosfatasa I-Premise HighQuality
alcalina I-Premise HighQuality
224 I-Premise HighQuality
UI I-Premise HighQuality
(normal I-Premise HighQuality
hasta I-Premise HighQuality
120 I-Premise HighQuality
UI). I-Premise HighQuality

Las B-Premise HighQuality
radiografías I-Premise HighQuality
del I-Premise HighQuality
fémur I-Premise HighQuality
muestran I-Premise HighQuality
unas I-Premise HighQuality
bandas I-Premise HighQuality
radiolúcidas I-Premise HighQuality
perpendiculares I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
cortical I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
lado I-Premise HighQuality
interno I-Premise HighQuality
de I-Premise HighQuality
su I-Premise HighQuality
parte I-Premise HighQuality
superior. I-Premise HighQuality

¿Cuál O 
es O 
el O 
diagnóstico O 
más O 
probable?: O 

1- O 
Osteoporosis. B-Claim HighQuality

2- O 
Enfermedad B-Claim HighQuality
de I-Claim HighQuality
Paget. I-Claim HighQuality

3- O 
Osteitis B-Claim HighQuality
fibrosa. I-Claim HighQuality

4- O 
Metástasis B-Claim HighQuality
de I-Claim HighQuality
cáncer I-Claim HighQuality
de I-Claim HighQuality
próstata. I-Claim HighQuality

5- O 
Osteomalacia. B-Claim HighQuality

CORRECT O 
ANSWER: O 
5 O 

Aunque O 
esta O 
no O 
me O 
la O 
habían O 
asignado, O 
la O 
respondo O 
también O 
ya O 
que O 
trata O 
un O 
tema O 
de O 
endocrinología: O 
la O 
vitamina O 
D. O 

En B-Claim HighQuality
este I-Claim HighQuality
caso I-Claim HighQuality
hay I-Claim HighQuality
datos I-Claim HighQuality
importantes I-Claim HighQuality
como I-Claim HighQuality
el I-Claim HighQuality
antecedente I-Claim HighQuality
de I-Claim HighQuality
resección I-Claim HighQuality
intestinal, I-Claim HighQuality
la I-Claim HighQuality
hipocalcemia I-Claim HighQuality
y I-Claim HighQuality
ha I-Claim HighQuality
hipofosforemoia; I-Claim HighQuality
esto I-Claim HighQuality
nos I-Claim HighQuality
debe I-Claim HighQuality
hacer I-Claim HighQuality
pensar I-Claim HighQuality
en I-Claim HighQuality
un I-Claim HighQuality
déficit I-Claim HighQuality
de I-Claim HighQuality
vitamina I-Claim HighQuality
D I-Claim HighQuality
por I-Claim HighQuality
malabsorción I-Claim HighQuality
y I-Claim HighQuality
por I-Claim HighQuality
tanto, I-Claim HighQuality
en I-Claim HighQuality
una I-Claim HighQuality
osteomalacia. I-Claim HighQuality

El B-Claim HighQuality
resto I-Claim HighQuality
de I-Claim HighQuality
datos: I-Claim HighQuality
fractura I-Claim HighQuality
previa, I-Claim HighQuality
dolores I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
radiografía I-Claim HighQuality
apoyan I-Claim HighQuality
el I-Claim HighQuality
diagnóstico. I-Claim HighQuality

QUESTION O 
TYPE: O 
PEDIATRICS O 

CLINICAL O 
CASE: O 

Lactante B-Premise HighQuality
de I-Premise HighQuality
1 I-Premise HighQuality
mes I-Premise HighQuality
de I-Premise HighQuality
vida I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
del I-Premise HighQuality
hospital I-Premise HighQuality
remitido I-Premise HighQuality
por I-Premise HighQuality
su I-Premise HighQuality
pediatra I-Premise HighQuality
por I-Premise HighQuality
ictericia. I-Premise HighQuality

Refiere B-Premise HighQuality
ésta I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
10 I-Premise HighQuality
días I-Premise HighQuality
y I-Premise HighQuality
ha I-Premise HighQuality
ido I-Premise HighQuality
en I-Premise HighQuality
aumento. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
analítica I-Premise HighQuality
de I-Premise HighQuality
sangre I-Premise HighQuality
destaca I-Premise HighQuality
una I-Premise HighQuality
bilirrubina I-Premise HighQuality
total I-Premise HighQuality
de I-Premise HighQuality
7mg/dl I-Premise HighQuality
siendo I-Premise HighQuality
la I-Premise HighQuality
bilirrubina I-Premise HighQuality
indirecta I-Premise HighQuality
de I-Premise HighQuality
1,5mg/dl. I-Premise HighQuality

La O 
causa O 
más O 
probable, O 
de O 
entre O 
las O 
siguientes, O 
de O 
esta O 
ictericia O 
es: O 

1- O 
Atresia B-Claim HighQuality
de I-Claim HighQuality
vías I-Claim HighQuality
biliares. I-Claim HighQuality

2- O 
Ictericia B-Claim HighQuality
por I-Claim HighQuality
lactancia I-Claim HighQuality
materna. I-Claim HighQuality

3- O 
Isoinmunización B-Claim HighQuality
0-A I-Claim HighQuality
de I-Claim HighQuality
aparición I-Claim HighQuality
tardía. I-Claim HighQuality

4- O 
Enfermedad B-Claim HighQuality
de I-Claim HighQuality
Gilbert. I-Claim HighQuality

5- O 
Esferocitosis B-Claim HighQuality
hereditaria. I-Claim HighQuality

CORRECT O 
ANSWER: O 
1 O 

El B-Claim HighQuality
aumento I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
bilirrubina I-Claim HighQuality
directa I-Claim HighQuality
nos I-Claim HighQuality
descarta I-Claim HighQuality
de I-Claim HighQuality
inmediato I-Claim HighQuality
el I-Claim HighQuality
resto I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
opciones I-Claim HighQuality
donde O 
el B-Claim HighQuality
aumento I-Claim HighQuality
de I-Claim HighQuality
bilirrubina I-Claim HighQuality
total I-Claim HighQuality
sería I-Claim HighQuality
a I-Claim HighQuality
expensas I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
bilirrubina I-Claim HighQuality
indirecta. I-Claim HighQuality

La B-Claim HighQuality
atresia I-Claim HighQuality
de I-Claim HighQuality
vías I-Claim HighQuality
biliares I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
principal I-Claim HighQuality
indicación I-Claim HighQuality
de I-Claim HighQuality
trasplante I-Claim HighQuality
hepático I-Claim HighQuality
infantil. I-Claim HighQuality

QUESTION O 
TYPE: O 
HEMATOLOGY O 

CLINICAL O 
CASE: O 

En B-Premise HighQuality
una I-Premise HighQuality
mujer I-Premise HighQuality
de I-Premise HighQuality
29 I-Premise HighQuality
años I-Premise HighQuality
se I-Premise HighQuality
hallan I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
curso I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
analítica I-Premise HighQuality
rutinaria I-Premise HighQuality
los I-Premise HighQuality
siguientes I-Premise HighQuality
parámetros: I-Premise HighQuality
Hb I-Premise HighQuality
11 I-Premise HighQuality
.5 I-Premise HighQuality
g/dL, I-Premise HighQuality
VCM I-Premise HighQuality
70 I-Premise HighQuality
fl, I-Premise HighQuality
HCM I-Premise HighQuality
28 I-Premise HighQuality
pg, I-Premise HighQuality
Ferritina I-Premise HighQuality
10 I-Premise HighQuality
ng/mL, I-Premise HighQuality
leucocitos I-Premise HighQuality
5.200/mm3, I-Premise HighQuality
plaquetas I-Premise HighQuality
335.000/mm3. I-Premise HighQuality

La B-Premise HighQuality
exploración I-Premise HighQuality
física I-Premise HighQuality
es I-Premise HighQuality
normal. I-Premise HighQuality

La O 
exploración O 
mas O 
indicada O 
en O 
esta O 
situación O 
es: O 

1- O 
Exploración B-Claim HighQuality
ginecológica. I-Claim HighQuality

2- O 
Estudio B-Claim HighQuality
de I-Claim HighQuality
sangre I-Claim HighQuality
oculta I-Claim HighQuality
en I-Claim HighQuality
heces. I-Claim HighQuality

3- O 
Estudio B-Claim HighQuality
radiológico I-Claim HighQuality
del I-Claim HighQuality
aparato I-Claim HighQuality
digestivo. I-Claim HighQuality

4- O 
Electroforesis B-Claim HighQuality
de I-Claim HighQuality
hemoglobinas. I-Claim HighQuality

5- O 
Test B-Claim HighQuality
de I-Claim HighQuality
Cooms. I-Claim HighQuality

CORRECT O 
ANSWER: O 
1 O 

La B-Claim HighQuality
causa I-Claim HighQuality
más I-Claim HighQuality
frecuente I-Claim HighQuality
en I-Claim HighQuality
mujer I-Claim HighQuality
joven I-Claim HighQuality
de I-Claim HighQuality
anemia I-Claim HighQuality
ferropénica I-Claim HighQuality
microcítica I-Claim HighQuality
es I-Claim HighQuality
por I-Claim HighQuality
pérdidas I-Claim HighQuality
ginecológicas I-Claim HighQuality
crónicas. I-Claim HighQuality

QUESTION O 
TYPE: O 
HEMATOLOGY O 

CLINICAL O 
CASE: O 

Hombre B-Premise HighQuality
de I-Premise HighQuality
71 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
edad I-Premise HighQuality
que I-Premise HighQuality
presenta I-Premise HighQuality
analítica I-Premise HighQuality
con I-Premise HighQuality
pancitopenia I-Premise HighQuality
severa I-Premise HighQuality
sin I-Premise HighQuality
presencia I-Premise HighQuality
de I-Premise HighQuality
células I-Premise HighQuality
inmaduras I-Premise HighQuality
y I-Premise HighQuality
con I-Premise HighQuality
estudio I-Premise HighQuality
medular I-Premise HighQuality
sugestivo I-Premise HighQuality
de I-Premise HighQuality
anemia I-Premise HighQuality
aplásica I-Premise HighQuality
grave. I-Premise HighQuality

¿Cuál O 
sería O 
el O 
abordaje O 
terapéutico O 
fundamental? O 

1- O 
Tratamiento B-Claim HighQuality
con I-Claim HighQuality
metilprednisolona I-Claim HighQuality
a I-Claim HighQuality
dosis I-Claim HighQuality
de I-Claim HighQuality
1 I-Claim HighQuality
g/Kg/día I-Claim HighQuality
durante I-Claim HighQuality
5 I-Claim HighQuality
días. I-Claim HighQuality

2- O 
Estudio B-Claim HighQuality
de I-Claim HighQuality
hermanos I-Claim HighQuality
y I-Claim HighQuality
si I-Claim HighQuality
alguno I-Claim HighQuality
es I-Claim HighQuality
HLA I-Claim HighQuality
compatible, I-Claim HighQuality
trasplante I-Claim HighQuality
alogénico I-Claim HighQuality
de I-Claim HighQuality
progenitores I-Claim HighQuality
hematopoyéticos. I-Claim HighQuality

3- O 
Terapia B-Claim HighQuality
inmunosupresora I-Claim HighQuality
con I-Claim HighQuality
ciclosporina I-Claim HighQuality
e I-Claim HighQuality
inmunoglobulina I-Claim HighQuality
antitimocítica. I-Claim HighQuality

4- O 
Soporte B-Claim HighQuality
hemoterápico. I-Claim HighQuality

5- O 
Quimioterapia B-Claim HighQuality
y I-Claim HighQuality
si I-Claim HighQuality
respuesta I-Claim HighQuality
trasplante I-Claim HighQuality
autólogo I-Claim HighQuality
de I-Claim HighQuality
progenitores I-Claim HighQuality
hematopoyéticos. I-Claim HighQuality

CORRECT O 
ANSWER: O 
3 O 

Anemia B-Claim HighQuality
aplásica I-Claim HighQuality
grave I-Claim HighQuality
y I-Claim HighQuality
no I-Claim HighQuality
candidato I-Claim HighQuality
a I-Claim HighQuality
transplante I-Claim HighQuality
alogénico I-Claim HighQuality
por I-Claim HighQuality
su I-Claim HighQuality
edad. I-Claim HighQuality

Antisupresores B-Claim HighQuality
parece I-Claim HighQuality
lo I-Claim HighQuality
más I-Claim HighQuality
idóneo. I-Claim HighQuality

QUESTION O 
TYPE: O 
NEUROLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
29 I-Premise HighQuality
años, I-Premise HighQuality
obesa, I-Premise HighQuality
sin I-Premise HighQuality
antecedentes I-Premise HighQuality
de I-Premise HighQuality
interés, I-Premise HighQuality
que I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
cefalea I-Premise HighQuality
pulsátil, I-Premise HighQuality
bilateral, I-Premise HighQuality
intensa, I-Premise HighQuality
de I-Premise HighQuality
un I-Premise HighQuality
mes I-Premise HighQuality
de I-Premise HighQuality
evolución, I-Premise HighQuality
acompañada I-Premise HighQuality
de I-Premise HighQuality
diplopia I-Premise HighQuality
horizontal I-Premise HighQuality
y I-Premise HighQuality
episodios I-Premise HighQuality
de I-Premise HighQuality
amaurosis I-Premise HighQuality
monocular I-Premise HighQuality
de I-Premise HighQuality
segundos I-Premise HighQuality
de I-Premise HighQuality
duración. I-Premise HighQuality

La B-Premise HighQuality
exploración I-Premise HighQuality
es I-Premise HighQuality
normal, I-Premise HighQuality
salvo I-Premise HighQuality
por I-Premise HighQuality
la I-Premise HighQuality
presencia I-Premise HighQuality
de I-Premise HighQuality
papiledema I-Premise HighQuality
bilateral. I-Premise HighQuality

¿Cuál O 
de O 
estas O 
pruebas O 
cree O 
que O 
le O 
va O 
a O 
permitir O 
confirmar O 
plenamente O 
su O 
diagnóstico? O 

1- O 
Ecografía B-Claim HighQuality
de I-Claim HighQuality
troncos I-Claim HighQuality
supraaórticos. I-Claim HighQuality

2- O 
Resonancia B-Claim HighQuality
magnética I-Claim HighQuality
de I-Claim HighQuality
cráneo. I-Claim HighQuality

3- O 
Electroencefalograma. B-Claim HighQuality

4- O 
Punción B-Claim HighQuality
lumbar. I-Claim HighQuality

5- O 
Potenciales B-Claim HighQuality
evocados I-Claim HighQuality
visuales. I-Claim HighQuality

CORRECT O 
ANSWER: O 
4 O 

Nuevamente O 
nos O 
presentan O 
un O 
caso O 
para O 
realizar O 
un O 
diagnóstico O 
y O 
luego, O 
en O 
este O 
caso, O 
realizar O 
una O 
prueba O 
confirmatoria. O 

Ahora B-Claim HighQuality
el I-Claim HighQuality
síntoma I-Claim HighQuality
guía I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
papiledema I-Claim HighQuality
bilateral I-Claim HighQuality
que I-Claim HighQuality
es I-Claim HighQuality
indicativa I-Claim HighQuality
de I-Claim HighQuality
hipertensión I-Claim HighQuality
intracraneal. I-Claim HighQuality

Aunque B-Premise HighQuality
no I-Premise HighQuality
comenta I-Premise HighQuality
se I-Premise HighQuality
haya I-Premise HighQuality
descartado I-Premise HighQuality
una I-Premise HighQuality
lesión I-Premise HighQuality
ocupante I-Premise HighQuality
de I-Premise HighQuality
espacio, I-Premise HighQuality
dado I-Premise HighQuality
que I-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
neurológica I-Premise HighQuality
normal I-Premise HighQuality
y I-Premise HighQuality
con I-Premise HighQuality
el I-Premise HighQuality
resto I-Premise HighQuality
de I-Premise HighQuality
síntomas I-Premise HighQuality
se B-Claim HighQuality
deduce I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
trata I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
hipertensión I-Claim HighQuality
intracraneal I-Claim HighQuality
idiopática I-Claim HighQuality
o I-Claim HighQuality
pseudotumor I-Claim HighQuality
cerebri. I-Claim HighQuality

Entre B-Premise HighQuality
los I-Premise HighQuality
otros I-Premise HighQuality
datos I-Premise HighQuality
sugestivos I-Premise HighQuality
de I-Premise HighQuality
esta I-Premise HighQuality
entidad I-Premise HighQuality
están: I-Premise HighQuality
mujer I-Premise HighQuality
en I-Premise HighQuality
edad I-Premise HighQuality
reproductiva, I-Premise HighQuality
obesidad, I-Premise HighQuality
y I-Premise HighQuality
diplopia I-Premise HighQuality
(por I-Premise HighQuality
afectación I-Premise HighQuality
de I-Premise HighQuality
VI I-Premise HighQuality
par I-Premise HighQuality
craneal). I-Premise HighQuality

Es B-Claim HighQuality
característica I-Claim HighQuality
que I-Claim HighQuality
la I-Claim HighQuality
cefalea I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
borrosidad I-Claim HighQuality
visual I-Claim HighQuality
se I-Claim HighQuality
agraven I-Claim HighQuality
súbitamente I-Claim HighQuality
por I-Claim HighQuality
las I-Claim HighQuality
mañanas I-Claim HighQuality
al I-Claim HighQuality
levantarse I-Claim HighQuality
o I-Claim HighQuality
al I-Claim HighQuality
cambiar I-Claim HighQuality
de I-Claim HighQuality
postura I-Claim HighQuality
produciendocegueras I-Claim HighQuality
transitorias I-Claim HighQuality
(Neurología, I-Claim HighQuality
Zarranz). I-Claim HighQuality

La B-Claim HighQuality
punción I-Claim HighQuality
lumbar I-Claim HighQuality
presenta, I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
invariable, I-Claim HighQuality
un I-Claim HighQuality
incremento I-Claim HighQuality
de I-Claim HighQuality
presión I-Claim HighQuality
de I-Claim HighQuality
líquido I-Claim HighQuality
cefalorraquídeo, I-Claim HighQuality
por I-Claim HighQuality
lo I-Claim HighQuality
cual I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
4. I-Claim HighQuality

QUESTION O 
TYPE: O 
DIGESTIVE O 
TRACT O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
chico I-Premise HighQuality
de I-Premise HighQuality
17 I-Premise HighQuality
años, I-Premise HighQuality
deportista I-Premise HighQuality
y I-Premise HighQuality
sin I-Premise HighQuality
antecedentes I-Premise HighQuality
de I-Premise HighQuality
interés, I-Premise HighQuality
acude I-Premise HighQuality
al I-Premise HighQuality
médico I-Premise HighQuality
por I-Premise HighQuality
presentar I-Premise HighQuality
ictericia I-Premise HighQuality
conjuntival I-Premise HighQuality
ocasionalmente. I-Premise HighQuality

Niega B-Premise HighQuality
ingesta I-Premise HighQuality
de I-Premise HighQuality
fármacos I-Premise HighQuality
y I-Premise HighQuality
dolor I-Premise HighQuality
abdominal. I-Premise HighQuality

En B-Premise HighQuality
los I-Premise HighQuality
análisis I-Premise HighQuality
realizados I-Premise HighQuality
se I-Premise HighQuality
observan I-Premise HighQuality
cifras I-Premise HighQuality
de I-Premise HighQuality
ALT, I-Premise HighQuality
AST, I-Premise HighQuality
GGT I-Premise HighQuality
y I-Premise HighQuality
FA I-Premise HighQuality
normales, I-Premise HighQuality
con I-Premise HighQuality
bilirrubina I-Premise HighQuality
total I-Premise HighQuality
de I-Premise HighQuality
3,2 I-Premise HighQuality
mg/dl I-Premise HighQuality
y I-Premise HighQuality
bilirrubina I-Premise HighQuality
directa I-Premise HighQuality
de I-Premise HighQuality
0,4 I-Premise HighQuality
mg/dl. I-Premise HighQuality

No B-Premise HighQuality
tiene I-Premise HighQuality
anemia I-Premise HighQuality
y I-Premise HighQuality
el I-Premise HighQuality
hígado I-Premise HighQuality
es I-Premise HighQuality
ecográficamente I-Premise HighQuality
normal. I-Premise HighQuality

¿Cuál O 
es O 
su O 
diagnóstico? O 

1- O 
Síndrome B-Claim HighQuality
de I-Claim HighQuality
Rotor. I-Claim HighQuality

2- O 
Coledocolitiasis. B-Claim HighQuality

3- O 
Síndrome B-Claim HighQuality
de I-Claim HighQuality
Dubin-Johnson. I-Claim HighQuality

4- O 
Hepatitis B-Claim HighQuality
aguda. I-Claim HighQuality

5- O 
Síndrome B-Claim HighQuality
de I-Claim HighQuality
Gilbert. I-Claim HighQuality

CORRECT O 
ANSWER: O 
5 O 

Un B-Claim HighQuality
aumento I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
bilirrubina I-Claim HighQuality
indirecta I-Claim HighQuality
menor I-Claim HighQuality
de I-Claim HighQuality
5 I-Claim HighQuality
(de I-Claim HighQuality
manera I-Claim HighQuality
intermitente, I-Claim HighQuality
bajo I-Claim HighQuality
situaciones I-Claim HighQuality
de I-Claim HighQuality
estrés) I-Claim HighQuality
en I-Claim HighQuality
un I-Claim HighQuality
chico I-Claim HighQuality
joven I-Claim HighQuality
sano I-Claim HighQuality
nos I-Claim HighQuality
debe I-Claim HighQuality
hacer I-Claim HighQuality
pensar I-Claim HighQuality
en I-Claim HighQuality
un I-Claim HighQuality
síndrome I-Claim HighQuality
de I-Claim HighQuality
Gilbert. I-Claim HighQuality

En B-Claim HighQuality
el I-Claim HighQuality
síndrome I-Claim HighQuality
de I-Claim HighQuality
Rotor, I-Claim HighQuality
Dubin-Johnson I-Claim HighQuality
y I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
coledocolitiasis I-Claim HighQuality
hay I-Claim HighQuality
aumento I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
bilirrubina I-Claim HighQuality
directa. I-Claim HighQuality

De B-Claim HighQuality
tratarse I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
hepatitis I-Claim HighQuality
aguda I-Claim HighQuality
debería I-Claim HighQuality
haber I-Claim HighQuality
una I-Claim HighQuality
elevación I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
transaminasas. I-Claim HighQuality

QUESTION O 
TYPE: O 
PNEUMOLOGY O 

CLINICAL O 
CASE: O 

En B-Premise HighQuality
un I-Premise HighQuality
paciente I-Premise HighQuality
con I-Premise HighQuality
enfermedad I-Premise HighQuality
pulmonar I-Premise HighQuality
obstructiva I-Premise HighQuality
crónica I-Premise HighQuality
(EPOC) I-Premise HighQuality
leve I-Premise HighQuality
en I-Premise HighQuality
fase I-Premise HighQuality
estable I-Premise HighQuality
se I-Premise HighQuality
evidencia I-Premise HighQuality
poliglobulia I-Premise HighQuality
e I-Premise HighQuality
insuficiencia I-Premise HighQuality
respiratoria. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
radiografía I-Premise HighQuality
de I-Premise HighQuality
tórax I-Premise HighQuality
no I-Premise HighQuality
se I-Premise HighQuality
aprecian I-Premise HighQuality
alteraciones I-Premise HighQuality
reseñables. I-Premise HighQuality

¿Cuál O 
de O 
los O 
siguientes O 
procedimientos O 
consideraría O 
realizar O 
en O 
primer O 
lugar O 
para O 
descartar O 
la O 
coexistencia O 
de O 
otras O 
enfermedades O 
que O 
puedan O 
justificar O 
los O 
hallazgos O 
descritos?: O 

1- O 
Poligrafía B-Claim HighQuality
respiratoria. I-Claim HighQuality

2- O 
Ecocardiograma. B-Claim HighQuality

3- O 
Tomografía B-Claim HighQuality
computarizada I-Claim HighQuality
torácica. I-Claim HighQuality

4- O 
Gammagrafía B-Claim HighQuality
pulmonar. I-Claim HighQuality

5- O 
Punción B-Claim HighQuality
de I-Claim HighQuality
médula I-Claim HighQuality
ósea. I-Claim HighQuality

CORRECT O 
ANSWER: O 
1 O 

El O 
planteamiento O 
es O 
dudoso O 
por O 
falta O 
de O 
datos O 
suficientes. O 

Por B-Claim HighQuality
frecuencia, I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
podria I-Claim HighQuality
ser I-Claim HighQuality
la I-Claim HighQuality
la I-Claim HighQuality
Poligrafia I-Claim HighQuality
respiratoria, I-Claim HighQuality
sobre I-Claim HighQuality
todo I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
caso I-Claim HighQuality
de I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
trate I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
paciente I-Claim HighQuality
obeso, I-Claim HighQuality
dato I-Claim HighQuality
que I-Claim HighQuality
desconocemos, I-Claim HighQuality
pero O 
podria B-Claim HighQuality
ser I-Claim HighQuality
correcta I-Claim HighQuality
tambien I-Claim HighQuality
la I-Claim HighQuality
2 I-Claim HighQuality
(Ecocardiograma) I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
caso I-Claim HighQuality
de I-Claim HighQuality
sospecha I-Claim HighQuality
de I-Claim HighQuality
cardiopatia I-Claim HighQuality
asociada, I-Claim HighQuality
menos I-Claim HighQuality
frecuente I-Claim HighQuality
pero I-Claim HighQuality
tambien I-Claim HighQuality
posible. I-Claim HighQuality

La O 
asociacion O 
de O 
EPOC O 
con O 
SAOS O 
es O 
una O 
causa O 
frecuente O 
de O 
deterioro O 
de O 
la O 
EPOC, O 
mayor O 
del O 
que O 
le O 
corresponderia O 
por O 
afectacion O 
funcional. O 

QUESTION O 
TYPE: O 
DIGESTIVE O 
SYSTEM O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
hombre I-Premise HighQuality
de I-Premise HighQuality
52 I-Premise HighQuality
años I-Premise HighQuality
sin I-Premise HighQuality
enfermedades I-Premise HighQuality
concomitantes, I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
por I-Premise HighQuality
melenas I-Premise HighQuality
de I-Premise HighQuality
24 I-Premise HighQuality
horas I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
sin I-Premise HighQuality
repercusión I-Premise HighQuality
hemodinámica. I-Premise HighQuality

Niega B-Premise HighQuality
consumo I-Premise HighQuality
de I-Premise HighQuality
antiinflamatorios I-Premise HighQuality
no I-Premise HighQuality
esteroideos. I-Premise HighQuality

El B-Premise HighQuality
hematocrito I-Premise HighQuality
es I-Premise HighQuality
de I-Premise HighQuality
33% I-Premise HighQuality
y I-Premise HighQuality
el I-Premise HighQuality
resto I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
analítica I-Premise HighQuality
es I-Premise HighQuality
normal. I-Premise HighQuality

La B-Premise HighQuality
endoscopia I-Premise HighQuality
digestiva I-Premise HighQuality
alta I-Premise HighQuality
realizada I-Premise HighQuality
de I-Premise HighQuality
forma I-Premise HighQuality
urgente I-Premise HighQuality
a I-Premise HighQuality
las I-Premise HighQuality
6 I-Premise HighQuality
horas I-Premise HighQuality
del I-Premise HighQuality
ingreso I-Premise HighQuality
muestra I-Premise HighQuality
un I-Premise HighQuality
estómago I-Premise HighQuality
normal, I-Premise HighQuality
sin I-Premise HighQuality
sangre I-Premise HighQuality
ni I-Premise HighQuality
restos I-Premise HighQuality
hemáticos I-Premise HighQuality
y I-Premise HighQuality
una I-Premise HighQuality
úlcera I-Premise HighQuality
excavada I-Premise HighQuality
de I-Premise HighQuality
8 I-Premise HighQuality
mm I-Premise HighQuality
de I-Premise HighQuality
diámetro I-Premise HighQuality
en I-Premise HighQuality
cara I-Premise HighQuality
anterior I-Premise HighQuality
del I-Premise HighQuality
bulbo I-Premise HighQuality
duodenal I-Premise HighQuality
con I-Premise HighQuality
«vaso I-Premise HighQuality
visible» I-Premise HighQuality
en I-Premise HighQuality
su I-Premise HighQuality
base I-Premise HighQuality
y I-Premise HighQuality
sin I-Premise HighQuality
sangrado I-Premise HighQuality
activo. I-Premise HighQuality

¿Cuál O 
de O 
las O 
siguientes O 
afirmaciones O 
es O 
cierta? O 

1- O 
En B-Claim HighQuality
la I-Claim HighQuality
endoscopia I-Claim HighQuality
inicial I-Claim HighQuality
está I-Claim HighQuality
indicado I-Claim HighQuality
aplicar I-Claim HighQuality
una I-Claim HighQuality
terapéutica I-Claim HighQuality
endoscópica I-Claim HighQuality
y I-Claim HighQuality
posteriormente I-Claim HighQuality
instaurar I-Claim HighQuality
tratamiento I-Claim HighQuality
endovenoso I-Claim HighQuality
con I-Claim HighQuality
dosis I-Claim HighQuality
altas I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
inhibidor I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
bomba I-Claim HighQuality
de I-Claim HighQuality
protones. I-Claim HighQuality
Esta I-Claim HighQuality
estrategia I-Claim HighQuality
ha I-Claim HighQuality
demostrado I-Claim HighQuality
reducir I-Claim HighQuality
el I-Claim HighQuality
riesgo I-Claim HighQuality
de I-Claim HighQuality
recidiva I-Claim HighQuality
hemorrágica I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
mortalidad. I-Claim HighQuality

2- O 
En B-Claim HighQuality
la I-Claim HighQuality
endoscopia I-Claim HighQuality
inicial, I-Claim HighQuality
dada I-Claim HighQuality
la I-Claim HighQuality
ausencia I-Claim HighQuality
de I-Claim HighQuality
sangrado I-Claim HighQuality
activo, I-Claim HighQuality
no I-Claim HighQuality
está I-Claim HighQuality
indicado I-Claim HighQuality
aplicar I-Claim HighQuality
una I-Claim HighQuality
terapéutica I-Claim HighQuality
endoscópica. I-Claim HighQuality
Posteriormente, I-Claim HighQuality
para I-Claim HighQuality
reducir I-Claim HighQuality
el I-Claim HighQuality
riesgo I-Claim HighQuality
de I-Claim HighQuality
recidiva I-Claim HighQuality
hemorrágica, I-Claim HighQuality
se I-Claim HighQuality
deberá I-Claim HighQuality
instaurar I-Claim HighQuality
tratamiento I-Claim HighQuality
endovenoso I-Claim HighQuality
con I-Claim HighQuality
dosis I-Claim HighQuality
altas I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
inhibidor I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
bomba I-Claim HighQuality
de I-Claim HighQuality
protones. I-Claim HighQuality

3- O 
n B-Claim HighQuality
la I-Claim HighQuality
endoscopia I-Claim HighQuality
inicial I-Claim HighQuality
está I-Claim HighQuality
indicado I-Claim HighQuality
aplicar I-Claim HighQuality
una I-Claim HighQuality
terapéutica I-Claim HighQuality
endoscópica. I-Claim HighQuality
No I-Claim HighQuality
se I-Claim HighQuality
ha I-Claim HighQuality
podido I-Claim HighQuality
demostrar I-Claim HighQuality
que I-Claim HighQuality
instaurar I-Claim HighQuality
posteriormente I-Claim HighQuality
tratamiento I-Claim HighQuality
con I-Claim HighQuality
dosis I-Claim HighQuality
altas I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
inhibidor I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
bomba I-Claim HighQuality
de I-Claim HighQuality
protones I-Claim HighQuality
aporte I-Claim HighQuality
beneficio I-Claim HighQuality
adicional I-Claim HighQuality
alguno. I-Claim HighQuality

4- O 
Dado B-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
trata I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
úlcera I-Claim HighQuality
complicada I-Claim HighQuality
(hemorragia) I-Claim HighQuality
la I-Claim HighQuality
mejor I-Claim HighQuality
opción I-Claim HighQuality
terapéutica, I-Claim HighQuality
una I-Claim HighQuality
vez I-Claim HighQuality
resuelto I-Claim HighQuality
el I-Claim HighQuality
episodio I-Claim HighQuality
hemorrágico, I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
vagotomía I-Claim HighQuality
y I-Claim HighQuality
piloroplastia. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
1 O 

Se B-Claim HighQuality
trata I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
úlcera I-Claim HighQuality
de I-Claim HighQuality
grado I-Claim HighQuality
IIa I-Claim HighQuality
(clasificación I-Claim HighQuality
de I-Claim HighQuality
Forrest), I-Claim HighQuality
con I-Claim HighQuality
alto I-Claim HighQuality
riesgo I-Claim HighQuality
de I-Claim HighQuality
recidiva. I-Claim HighQuality

Por B-Claim HighQuality
eso, I-Claim HighQuality
se I-Claim HighQuality
indica I-Claim HighQuality
claramente I-Claim HighQuality
el I-Claim HighQuality
tratamiento I-Claim HighQuality
endoscópico I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
hospitalización I-Claim HighQuality
con I-Claim HighQuality
tratamiento I-Claim HighQuality
endovenoso I-Claim HighQuality
con I-Claim HighQuality
IBPs I-Claim HighQuality
(en I-Claim HighQuality
nuestro I-Claim HighQuality
medio I-Claim HighQuality
es I-Claim HighQuality
habitualmente I-Claim HighQuality
el I-Claim HighQuality
omeprazol) I-Claim HighQuality
durante I-Claim HighQuality
al I-Claim HighQuality
menos I-Claim HighQuality
72 I-Claim HighQuality
horas. I-Claim HighQuality

La B-Claim HighQuality
cirugía I-Claim HighQuality
está I-Claim HighQuality
indicada I-Claim HighQuality
en I-Claim HighQuality
hemorragias I-Claim HighQuality
masivas I-Claim HighQuality
o I-Claim HighQuality
refractarias I-Claim HighQuality
al I-Claim HighQuality
tratamiento I-Claim HighQuality
médico. I-Claim HighQuality

QUESTION O 
TYPE: O 
INFECTIOUS O 
DISEASES O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
hombre I-Premise HighQuality
de I-Premise HighQuality
47 I-Premise HighQuality
años, I-Premise HighQuality
fumador I-Premise HighQuality
activo, I-Premise HighQuality
con I-Premise HighQuality
historia I-Premise HighQuality
de I-Premise HighQuality
abuso I-Premise HighQuality
de I-Premise HighQuality
drogas I-Premise HighQuality
por I-Premise HighQuality
vía I-Premise HighQuality
parenteral I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
Urgencias I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
cuadro I-Premise HighQuality
de I-Premise HighQuality
2 I-Premise HighQuality
horas I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
de I-Premise HighQuality
dolor I-Premise HighQuality
costal I-Premise HighQuality
izquierdo I-Premise HighQuality
pleurítico I-Premise HighQuality
de I-Premise HighQuality
inicio I-Premise HighQuality
agudo I-Premise HighQuality
y I-Premise HighQuality
disnea I-Premise HighQuality
progresiva I-Premise HighQuality
hasta I-Premise HighQuality
hacerse I-Premise HighQuality
de I-Premise HighQuality
reposo. I-Premise HighQuality

En B-Premise HighQuality
las I-Premise HighQuality
2 I-Premise HighQuality
semanas I-Premise HighQuality
previas I-Premise HighQuality
había I-Premise HighQuality
presentado I-Premise HighQuality
febrícula, I-Premise HighQuality
malestar I-Premise HighQuality
general I-Premise HighQuality
y I-Premise HighQuality
tos I-Premise HighQuality
seca. I-Premise HighQuality

A B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
el I-Premise HighQuality
paciente I-Premise HighQuality
impresiona I-Premise HighQuality
de I-Premise HighQuality
gravedad, I-Premise HighQuality
está I-Premise HighQuality
taquipneico I-Premise HighQuality
a I-Premise HighQuality
36 I-Premise HighQuality
rpm, I-Premise HighQuality
con I-Premise HighQuality
tiraje I-Premise HighQuality
supraclavicular, I-Premise HighQuality
saturación I-Premise HighQuality
de I-Premise HighQuality
oxígeno I-Premise HighQuality
por I-Premise HighQuality
pulsioximetría I-Premise HighQuality
de I-Premise HighQuality
81%, I-Premise HighQuality
cianosis, I-Premise HighQuality
sudoración, I-Premise HighQuality
taquicardia I-Premise HighQuality
a I-Premise HighQuality
135 I-Premise HighQuality
latidos I-Premise HighQuality
por I-Premise HighQuality
minuto I-Premise HighQuality
y I-Premise HighQuality
PA I-Premise HighQuality
de I-Premise HighQuality
75/47 I-Premise HighQuality
mm I-Premise HighQuality
Hg. I-Premise HighQuality

La B-Premise HighQuality
tráquea I-Premise HighQuality
está I-Premise HighQuality
desviada I-Premise HighQuality
hacia I-Premise HighQuality
el I-Premise HighQuality
lado I-Premise HighQuality
derecho I-Premise HighQuality
y I-Premise HighQuality
la I-Premise HighQuality
auscultación I-Premise HighQuality
demuestra I-Premise HighQuality
ausencia I-Premise HighQuality
completa I-Premise HighQuality
de I-Premise HighQuality
murmullo I-Premise HighQuality
vesicular I-Premise HighQuality
en I-Premise HighQuality
hemitórax I-Premise HighQuality
izquierdo. I-Premise HighQuality

Se B-Premise HighQuality
realiza I-Premise HighQuality
una I-Premise HighQuality
serología I-Premise HighQuality
VIH I-Premise HighQuality
que I-Premise HighQuality
resulta I-Premise HighQuality
positiva I-Premise HighQuality
y I-Premise HighQuality
presenta I-Premise HighQuality
un I-Premise HighQuality
recuento I-Premise HighQuality
de I-Premise HighQuality
linfocitos I-Premise HighQuality
CDA I-Premise HighQuality
de I-Premise HighQuality
176 I-Premise HighQuality
células/ml. I-Premise HighQuality

¿Cuál O 
es O 
el O 
diagnóstico O 
más O 
probable? O 

1- O 
Rotura B-Claim HighQuality
de I-Claim HighQuality
bulla I-Claim HighQuality
enfisematosa I-Claim HighQuality
subpleural. I-Claim HighQuality

2- O 
FNeumonía B-Claim HighQuality
bacteriana I-Claim HighQuality
necrotizante I-Claim HighQuality
adquirida I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
comunidad. I-Claim HighQuality

3- O 
Tuberculosis B-Claim HighQuality
pulmonar. I-Claim HighQuality

4- O 
Neumonía B-Claim HighQuality
por I-Claim HighQuality
Pneumocystis I-Claim HighQuality
jiroveci. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
4 O 

Paciente B-Premise HighQuality
con I-Premise HighQuality
factor I-Premise HighQuality
de I-Premise HighQuality
riesgo I-Premise HighQuality
para I-Premise HighQuality
adquisición I-Premise HighQuality
de I-Premise HighQuality
VIH, I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
cuadro I-Premise HighQuality
de I-Premise HighQuality
inicio I-Premise HighQuality
subagudo I-Premise HighQuality
de I-Premise HighQuality
2 I-Premise HighQuality
semanas I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
(febrícula, I-Premise HighQuality
malestar I-Premise HighQuality
general I-Premise HighQuality
y I-Premise HighQuality
tos I-Premise HighQuality
seca) I-Premise HighQuality
que I-Premise HighQuality
se I-Premise HighQuality
agrava I-Premise HighQuality
de I-Premise HighQuality
forma I-Premise HighQuality
brusca I-Premise HighQuality
(dolor I-Premise HighQuality
pleurítico) I-Premise HighQuality
y I-Premise HighQuality
progresiva I-Premise HighQuality
(disnea). I-Premise HighQuality

El B-Claim HighQuality
examen I-Claim HighQuality
físico I-Claim HighQuality
sugiere I-Claim HighQuality
un I-Claim HighQuality
neumotórax I-Claim HighQuality
(taquipnea, B-Premise HighQuality
tiraje, I-Premise HighQuality
baja I-Premise HighQuality
saturación, I-Premise HighQuality
cianosis, I-Premise HighQuality
diaforesis, I-Premise HighQuality
taquicardia, I-Premise HighQuality
tráquea I-Premise HighQuality
desviada I-Premise HighQuality
y I-Premise HighQuality
ausencia I-Premise HighQuality
de I-Premise HighQuality
murmullo I-Premise HighQuality
vesicular). I-Premise HighQuality

Tiene B-Premise HighQuality
una I-Premise HighQuality
serología I-Premise HighQuality
de I-Premise HighQuality
para I-Premise HighQuality
VIH I-Premise HighQuality
positiva I-Premise HighQuality
y I-Premise HighQuality
un I-Premise HighQuality
CD4 I-Premise HighQuality
menos I-Premise HighQuality
de I-Premise HighQuality
200 I-Premise HighQuality
cel./mL. I-Premise HighQuality

La B-Premise HighQuality
radiografía I-Premise HighQuality
muestra I-Premise HighQuality
hiperclaridad I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
campo I-Premise HighQuality
pulmonar I-Premise HighQuality
izquierdo I-Premise HighQuality
con I-Premise HighQuality
ausencia I-Premise HighQuality
de I-Premise HighQuality
vasos I-Premise HighQuality
entre I-Premise HighQuality
el I-Premise HighQuality
límite I-Premise HighQuality
del I-Premise HighQuality
pulmón I-Premise HighQuality
y I-Premise HighQuality
la I-Premise HighQuality
pared I-Premise HighQuality
torácica I-Premise HighQuality
del I-Premise HighQuality
lado I-Premise HighQuality
izquierdo, I-Premise HighQuality
desplazamiento I-Premise HighQuality
del I-Premise HighQuality
mediastino I-Premise HighQuality
y I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
tráquea I-Premise HighQuality
al I-Premise HighQuality
lado I-Premise HighQuality
derecho, I-Premise HighQuality
además I-Premise HighQuality
se I-Premise HighQuality
observa I-Premise HighQuality
un I-Premise HighQuality
muñón I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
hilio I-Premise HighQuality
pulmonar I-Premise HighQuality
izquierdo I-Premise HighQuality
que I-Premise HighQuality
correspondería I-Premise HighQuality
al I-Premise HighQuality
pulmón I-Premise HighQuality
colapsado. I-Premise HighQuality

La B-Claim HighQuality
sospecha I-Claim HighQuality
de I-Claim HighQuality
VIH I-Claim HighQuality
es I-Claim HighQuality
alta I-Claim HighQuality
y O 
aunque B-Claim HighQuality
está I-Claim HighQuality
pendiente I-Claim HighQuality
de I-Claim HighQuality
confirmación, I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
urgencia I-Claim HighQuality
es I-Claim HighQuality
válido I-Claim HighQuality
asumir I-Claim HighQuality
esta I-Claim HighQuality
opción. I-Claim HighQuality

Dicho B-Claim HighQuality
esto, I-Claim HighQuality
busco I-Claim HighQuality
patologías I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
asocien I-Claim HighQuality
a I-Claim HighQuality
este I-Claim HighQuality
cuadro, I-Claim HighQuality
la B-Claim HighQuality
rotura I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
bulla I-Claim HighQuality
si I-Claim HighQuality
bien I-Claim HighQuality
se I-Claim HighQuality
relaciona I-Claim HighQuality
con I-Claim HighQuality
la I-Claim HighQuality
aparición I-Claim HighQuality
de I-Claim HighQuality
síntomas I-Claim HighQuality
bruscos I-Claim HighQuality
no I-Claim HighQuality
va I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
mano I-Claim HighQuality
con I-Claim HighQuality
los I-Claim HighQuality
otros I-Claim HighQuality
síntomas I-Claim HighQuality
(hay B-Claim HighQuality
que I-Claim HighQuality
buscar I-Claim HighQuality
algo I-Claim HighQuality
que I-Claim HighQuality
explique I-Claim HighQuality
todo I-Claim HighQuality
o I-Claim HighQuality
casi I-Claim HighQuality
todo), I-Claim HighQuality
la B-Claim HighQuality
neumonía I-Claim HighQuality
si I-Claim HighQuality
bien I-Claim HighQuality
es I-Claim HighQuality
cierto I-Claim HighQuality
puede I-Claim HighQuality
estar I-Claim HighQuality
relacionada I-Claim HighQuality
con I-Claim HighQuality
buena I-Claim HighQuality
parte I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
síntomas I-Claim HighQuality
no I-Claim HighQuality
se I-Claim HighQuality
correlaciona I-Claim HighQuality
con I-Claim HighQuality
la I-Claim HighQuality
imagen, I-Claim HighQuality
la B-Claim HighQuality
TB I-Claim HighQuality
pulmonar I-Claim HighQuality
podría I-Claim HighQuality
estar I-Claim HighQuality
manifestarse I-Claim HighQuality
con I-Claim HighQuality
todo I-Claim HighQuality
lo I-Claim HighQuality
antes I-Claim HighQuality
dicho I-Claim HighQuality
y I-Claim HighQuality
provocar I-Claim HighQuality
un I-Claim HighQuality
neumotórax, I-Claim HighQuality
pero O 
aquí O 
ante O 
un B-Premise HighQuality
cuadro I-Premise HighQuality
respiratorio I-Premise HighQuality
con I-Premise HighQuality
más I-Premise HighQuality
de I-Premise HighQuality
7 I-Premise HighQuality
días I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
que I-Premise HighQuality
se I-Premise HighQuality
complica I-Premise HighQuality
de I-Premise HighQuality
forma I-Premise HighQuality
brusca, I-Premise HighQuality
en O 
un B-Premise HighQuality
paciente I-Premise HighQuality
con I-Premise HighQuality
una I-Premise HighQuality
alta I-Premise HighQuality
sospecha I-Premise HighQuality
de I-Premise HighQuality
infección I-Premise HighQuality
por I-Premise HighQuality
VIH I-Premise HighQuality
la B-Claim HighQuality
opción I-Claim HighQuality
más I-Claim HighQuality
clara I-Claim HighQuality
va I-Claim HighQuality
por I-Claim HighQuality
la I-Claim HighQuality
neumonía I-Claim HighQuality
por I-Claim HighQuality
P. I-Claim HighQuality
jirovecii. I-Claim HighQuality

En B-Claim HighQuality
los I-Claim HighQuality
pacientes I-Claim HighQuality
con I-Claim HighQuality
Pneumocystis, I-Claim HighQuality
el I-Claim HighQuality
10 I-Claim HighQuality
%, I-Claim HighQuality
aparecen I-Claim HighQuality
neumatoceles I-Claim HighQuality
que I-Claim HighQuality
en I-Claim HighQuality
ocasiones I-Claim HighQuality
pueden I-Claim HighQuality
abrirse I-Claim HighQuality
al I-Claim HighQuality
espacio I-Claim HighQuality
pleural I-Claim HighQuality
produciendo I-Claim HighQuality
un I-Claim HighQuality
neumotórax I-Claim HighQuality
espontáneo. I-Claim HighQuality

Recordando, B-Claim HighQuality
los I-Claim HighQuality
gérmenes I-Claim HighQuality
más I-Claim HighQuality
frecuentes I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
afectación I-Claim HighQuality
pulmonar I-Claim HighQuality
en I-Claim HighQuality
pacientes I-Claim HighQuality
con I-Claim HighQuality
infección I-Claim HighQuality
por I-Claim HighQuality
VIH/SIDA I-Claim HighQuality
son I-Claim HighQuality
P. I-Claim HighQuality
jiroveci I-Claim HighQuality
(solo I-Claim HighQuality
o I-Claim HighQuality
asociado I-Claim HighQuality
a I-Claim HighQuality
tuberculosis I-Claim HighQuality
u I-Claim HighQuality
otras I-Claim HighQuality
micobacterias), I-Claim HighQuality
S. I-Claim HighQuality
pneumoniae, I-Claim HighQuality
H. I-Claim HighQuality
influenzae, I-Claim HighQuality
S. I-Claim HighQuality
aureus, I-Claim HighQuality
citomegalovirus, I-Claim HighQuality
Legionella, I-Claim HighQuality
estafilococos I-Claim HighQuality
y I-Claim HighQuality
bacilos I-Claim HighQuality
gramnegativos I-Claim HighQuality
(Pseudomonas). I-Claim HighQuality

Los B-Claim HighQuality
pacientes I-Claim HighQuality
con I-Claim HighQuality
neumonía I-Claim HighQuality
por I-Claim HighQuality
P. I-Claim HighQuality
jirovecii I-Claim HighQuality
presentan, I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
90% I-Claim HighQuality
de I-Claim HighQuality
casos, I-Claim HighQuality
un I-Claim HighQuality
recuento I-Claim HighQuality
de I-Claim HighQuality
CD4< I-Claim HighQuality
250 I-Claim HighQuality
cel./mL. I-Claim HighQuality

Otros O 
agentes O 
que O 
pueden O 
provocar O 
afección O 
pulmonar O 
con O 
menor O 
frecuencia O 
son O 
Rhodococcus O 
equi, O 
Nocardia, O 
Aspergillus, O 
Cryptococcus, O 
Toxoplasma O 
yLeishmania. O 

Aunque O 
la O 
frecuencia O 
de O 
las O 
diferentes O 
infecciones O 
oportunistas O 
ha O 
variado O 
como O 
consecuencia O 
de O 
la O 
administración O 
de O 
los O 
tratamientos O 
antirretrovirales O 
de O 
alta O 
eficacia, O 
nuestro O 
paciente O 
estaría O 
en O 
un O 
escenario O 
donde O 
aún O 
no O 
recibió O 
TARGA. O 

QUESTION O 
TYPE: O 
INFECTIOUS O 
DISEASES O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
hombre I-Premise HighQuality
de I-Premise HighQuality
58 I-Premise HighQuality
años I-Premise HighQuality
refería I-Premise HighQuality
una I-Premise HighQuality
historia I-Premise HighQuality
de I-Premise HighQuality
semanas I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
con I-Premise HighQuality
lesiones I-Premise HighQuality
cutáneas I-Premise HighQuality
progresivas, I-Premise HighQuality
medianamente I-Premise HighQuality
dolorosas, I-Premise HighQuality
en I-Premise HighQuality
su I-Premise HighQuality
brazo I-Premise HighQuality
izquierdo. I-Premise HighQuality

Había B-Premise HighQuality
empezado I-Premise HighQuality
como I-Premise HighQuality
una I-Premise HighQuality
lesión I-Premise HighQuality
eritematosa I-Premise HighQuality
en I-Premise HighQuality
su I-Premise HighQuality
pulgar I-Premise HighQuality
izquierdo. I-Premise HighQuality

Tenía B-Premise HighQuality
unas I-Premise HighQuality
estrías I-Premise HighQuality
rojizas I-Premise HighQuality
visibles I-Premise HighQuality
como I-Premise HighQuality
líneas I-Premise HighQuality
de I-Premise HighQuality
conexión I-Premise HighQuality
entre I-Premise HighQuality
las I-Premise HighQuality
lesiones. I-Premise HighQuality

El B-Premise HighQuality
paciente I-Premise HighQuality
no I-Premise HighQuality
presentaba I-Premise HighQuality
fiebre I-Premise HighQuality
ni I-Premise HighQuality
otros I-Premise HighQuality
síntomas I-Premise HighQuality
generales. I-Premise HighQuality

Había B-Premise HighQuality
estado I-Premise HighQuality
trabajando I-Premise HighQuality
en I-Premise HighQuality
su I-Premise HighQuality
jardín I-Premise HighQuality
pero I-Premise HighQuality
no I-Premise HighQuality
recordaba I-Premise HighQuality
haberse I-Premise HighQuality
hecho I-Premise HighQuality
ninguna I-Premise HighQuality
herida. I-Premise HighQuality

El B-Premise HighQuality
diagnóstico I-Premise HighQuality
etiológico I-Premise HighQuality
se I-Premise HighQuality
realizó I-Premise HighQuality
por I-Premise HighQuality
cultivo I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
biopsia I-Premise HighQuality
cutánea. I-Premise HighQuality

¿Cuál O 
es O 
el O 
agente O 
causal O 
más O 
probable O 
de O 
este O 
proceso? O 

1- O 
Dermatofitosis B-Claim HighQuality
por I-Claim HighQuality
Microsporum I-Claim HighQuality
gypseum. I-Claim HighQuality

2- O 
Infección B-Claim HighQuality
cutánea I-Claim HighQuality
por I-Claim HighQuality
Staphylococcus I-Claim HighQuality
aureus. I-Claim HighQuality

3- O 
Esporotricosis. B-Claim HighQuality

4- O 
Infección B-Claim HighQuality
cutánea I-Claim HighQuality
por I-Claim HighQuality
Mycobacterium I-Claim HighQuality
marinum. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

El B-Premise HighQuality
paciente I-Premise HighQuality
desarrolla I-Premise HighQuality
una I-Premise HighQuality
actividad I-Premise HighQuality
en I-Premise HighQuality
contacto I-Premise HighQuality
con I-Premise HighQuality
tierra I-Premise HighQuality
y I-Premise HighQuality
plantas I-Premise HighQuality
(que I-Premise HighQuality
nos I-Premise HighQuality
la I-Premise HighQuality
proporcionan I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
forma I-Premise HighQuality
no I-Premise HighQuality
gratuita). I-Premise HighQuality

Los B-Premise HighQuality
síntomas I-Premise HighQuality
son I-Premise HighQuality
crónicos, I-Premise HighQuality
que I-Premise HighQuality
empezaron I-Premise HighQuality
de I-Premise HighQuality
forma I-Premise HighQuality
distal I-Premise HighQuality
(pulgar I-Premise HighQuality
izquierdo) I-Premise HighQuality
y I-Premise HighQuality
van I-Premise HighQuality
afectando I-Premise HighQuality
al I-Premise HighQuality
brazo I-Premise HighQuality
ipsilateral I-Premise HighQuality
(estrías I-Premise HighQuality
rojizas). I-Premise HighQuality

No B-Premise HighQuality
había I-Premise HighQuality
síntomas I-Premise HighQuality
sistémicos. I-Premise HighQuality

Comentan B-Premise HighQuality
además I-Premise HighQuality
que I-Premise HighQuality
el I-Premise HighQuality
diagnóstico I-Premise HighQuality
fue I-Premise HighQuality
hecho I-Premise HighQuality
a I-Premise HighQuality
partir I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
biopsia I-Premise HighQuality
cutánea. I-Premise HighQuality

De B-Claim HighQuality
los I-Claim HighQuality
microorganismos I-Claim HighQuality
comentados, I-Claim HighQuality
el I-Claim HighQuality
Microsporum I-Claim HighQuality
gypseum I-Claim HighQuality
no I-Claim HighQuality
suele I-Claim HighQuality
manifestar I-Claim HighQuality
la I-Claim HighQuality
diseminación I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
infección I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
aspecto I-Claim HighQuality
linfangítico, I-Claim HighQuality
en B-Claim HighQuality
general I-Claim HighQuality
los I-Claim HighQuality
hongos I-Claim HighQuality
queratinófilos I-Claim HighQuality
(dermatofitos)no I-Claim HighQuality
tienen I-Claim HighQuality
ninguna I-Claim HighQuality
capacidad I-Claim HighQuality
de I-Claim HighQuality
invadir I-Claim HighQuality
tejidos I-Claim HighQuality
profundos, I-Claim HighQuality
así O 
que O 
descartamos B-Claim HighQuality
esta I-Claim HighQuality
opción. I-Claim HighQuality

La B-Claim HighQuality
infección I-Claim HighQuality
por I-Claim HighQuality
Staphylococcus I-Claim HighQuality
aureus I-Claim HighQuality
puede I-Claim HighQuality
afectar I-Claim HighQuality
capas I-Claim HighQuality
superficiales I-Claim HighQuality
y I-Claim HighQuality
profundas I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
tejidos, I-Claim HighQuality
se I-Claim HighQuality
pueden I-Claim HighQuality
diseminar I-Claim HighQuality
siguiendo I-Claim HighQuality
un I-Claim HighQuality
trayecto I-Claim HighQuality
linfangítico, I-Claim HighQuality
pero I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
usual I-Claim HighQuality
una I-Claim HighQuality
evolución I-Claim HighQuality
tan I-Claim HighQuality
larga, I-Claim HighQuality
suele I-Claim HighQuality
ser I-Claim HighQuality
aguda I-Claim HighQuality
(días) I-Claim HighQuality
y I-Claim HighQuality
acompañada I-Claim HighQuality
de I-Claim HighQuality
síntomas I-Claim HighQuality
sistémicos I-Claim HighQuality
por I-Claim HighQuality
lo I-Claim HighQuality
general, I-Claim HighQuality
por O 
eso O 
descartamos B-Claim HighQuality
esta I-Claim HighQuality
opción. I-Claim HighQuality

El B-Claim HighQuality
Mycobacterium I-Claim HighQuality
marinum I-Claim HighQuality
(y I-Claim HighQuality
no I-Claim HighQuality
Mycobacterum I-Claim HighQuality
marinum) I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
micobacteria I-Claim HighQuality
no I-Claim HighQuality
tuberculosa I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
caracteriza I-Claim HighQuality
por I-Claim HighQuality
ser I-Claim HighQuality
ambiental, I-Claim HighQuality
oportunista I-Claim HighQuality
y I-Claim HighQuality
fotocromógena. I-Claim HighQuality

Tiene B-Claim HighQuality
un I-Claim HighQuality
crecimiento I-Claim HighQuality
lento, I-Claim HighQuality
de I-Claim HighQuality
2 I-Claim HighQuality
a I-Claim HighQuality
8 I-Claim HighQuality
semanas, I-Claim HighQuality
a I-Claim HighQuality
una I-Claim HighQuality
temperatura I-Claim HighQuality
que I-Claim HighQuality
oscila I-Claim HighQuality
entre I-Claim HighQuality
los I-Claim HighQuality
30 I-Claim HighQuality
a I-Claim HighQuality
37 I-Claim HighQuality
°C. I-Claim HighQuality

Afecta B-Claim HighQuality
a I-Claim HighQuality
diferentes I-Claim HighQuality
especies I-Claim HighQuality
de I-Claim HighQuality
peces I-Claim HighQuality
tanto I-Claim HighQuality
de I-Claim HighQuality
aguas I-Claim HighQuality
frías, I-Claim HighQuality
cálidas, I-Claim HighQuality
dulces I-Claim HighQuality
o I-Claim HighQuality
saladas, I-Claim HighQuality
especialmente I-Claim HighQuality
aguas I-Claim HighQuality
estancadas I-Claim HighQuality
de I-Claim HighQuality
peceras I-Claim HighQuality
y I-Claim HighQuality
piscinas I-Claim HighQuality
sin I-Claim HighQuality
cloro. I-Claim HighQuality

La B-Claim HighQuality
infección I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
humano I-Claim HighQuality
se I-Claim HighQuality
produce I-Claim HighQuality
por I-Claim HighQuality
el I-Claim HighQuality
contacto I-Claim HighQuality
directo I-Claim HighQuality
con I-Claim HighQuality
peces I-Claim HighQuality
o I-Claim HighQuality
con I-Claim HighQuality
aguas I-Claim HighQuality
contaminadas I-Claim HighQuality
en I-Claim HighQuality
presencia I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
pérdida I-Claim HighQuality
de I-Claim HighQuality
continuidad I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
piel I-Claim HighQuality
del I-Claim HighQuality
huésped. I-Claim HighQuality

Nuestro B-Premise HighQuality
paciente I-Premise HighQuality
no I-Premise HighQuality
tiene I-Premise HighQuality
antecedente I-Premise HighQuality
de I-Premise HighQuality
exposición I-Premise HighQuality
a I-Premise HighQuality
peces I-Premise HighQuality
o I-Premise HighQuality
agua I-Premise HighQuality
(no I-Premise HighQuality
lo I-Premise HighQuality
dicen), I-Premise HighQuality
así O 
que O 
teniendo B-Claim HighQuality
en I-Claim HighQuality
cuenta I-Claim HighQuality
que I-Claim HighQuality
por I-Claim HighQuality
lo I-Claim HighQuality
general I-Claim HighQuality
el I-Claim HighQuality
diagnóstico I-Claim HighQuality
se I-Claim HighQuality
basa I-Claim HighQuality
en I-Claim HighQuality
un I-Claim HighQuality
alto I-Claim HighQuality
índice I-Claim HighQuality
de I-Claim HighQuality
sospecha I-Claim HighQuality
y I-Claim HighQuality
preguntando I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
específica I-Claim HighQuality
este I-Claim HighQuality
antecedente, I-Claim HighQuality
nuestro I-Claim HighQuality
caso I-Claim HighQuality
se I-Claim HighQuality
aleja I-Claim HighQuality
de I-Claim HighQuality
esta I-Claim HighQuality
posibilidad. I-Claim HighQuality

El B-Claim HighQuality
complejo I-Claim HighQuality
Sporothrix I-Claim HighQuality
schenckii I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
agente I-Claim HighQuality
causal I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
Esporotricosis, I-Claim HighQuality
este I-Claim HighQuality
hongo I-Claim HighQuality
dimórfico I-Claim HighQuality
se I-Claim HighQuality
ubica I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
suelo, I-Claim HighQuality
el I-Claim HighQuality
complejo I-Claim HighQuality
está I-Claim HighQuality
formado I-Claim HighQuality
por I-Claim HighQuality
5 I-Claim HighQuality
especies, I-Claim HighQuality
S. I-Claim HighQuality
schenckii I-Claim HighQuality
sensu I-Claim HighQuality
strictu, I-Claim HighQuality
S. I-Claim HighQuality
brasiliensis I-Claim HighQuality
y I-Claim HighQuality
S. I-Claim HighQuality
globosa, I-Claim HighQuality
capaces I-Claim HighQuality
de I-Claim HighQuality
causar I-Claim HighQuality
enfermedad I-Claim HighQuality
humana I-Claim HighQuality
y I-Claim HighQuality
animal; I-Claim HighQuality
las I-Claim HighQuality
otras I-Claim HighQuality
dos I-Claim HighQuality
son I-Claim HighQuality
S. I-Claim HighQuality
mexicana I-Claim HighQuality
y I-Claim HighQuality
S. I-Claim HighQuality
albicana I-Claim HighQuality
no I-Claim HighQuality
asociadas I-Claim HighQuality
con I-Claim HighQuality
ninguna I-Claim HighQuality
enfermedad. I-Claim HighQuality

Los B-Claim HighQuality
pacientes I-Claim HighQuality
se I-Claim HighQuality
suelen I-Claim HighQuality
contagiar I-Claim HighQuality
por I-Claim HighQuality
la I-Claim HighQuality
exposición I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
tierra I-Claim HighQuality
mediante I-Claim HighQuality
un I-Claim HighQuality
objeto I-Claim HighQuality
punzante I-Claim HighQuality
(espinas, I-Claim HighQuality
tallos, I-Claim HighQuality
garras I-Claim HighQuality
de I-Claim HighQuality
animales, I-Claim HighQuality
etc) I-Claim HighQuality
y I-Claim HighQuality
presentan I-Claim HighQuality
una I-Claim HighQuality
evolución I-Claim HighQuality
lenta, I-Claim HighQuality
afecta I-Claim HighQuality
tejidos I-Claim HighQuality
profundos I-Claim HighQuality
y I-Claim HighQuality
su I-Claim HighQuality
diseminación I-Claim HighQuality
típicamente I-Claim HighQuality
suele I-Claim HighQuality
seguir I-Claim HighQuality
un I-Claim HighQuality
trayecto I-Claim HighQuality
como I-Claim HighQuality
el I-Claim HighQuality
descrito I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
pregunta. I-Claim HighQuality

QUESTION O 
TYPE: O 
INFECTIOUS O 
DISEASES O 

CLINICAL O 
CASE: O 

Hombre B-Premise HighQuality
de I-Premise HighQuality
46 I-Premise HighQuality
años I-Premise HighQuality
usuario I-Premise HighQuality
de I-Premise HighQuality
drogas I-Premise HighQuality
por I-Premise HighQuality
vía I-Premise HighQuality
parenteral I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
presentando I-Premise HighQuality
fiebre I-Premise HighQuality
con I-Premise HighQuality
escalofríos, I-Premise HighQuality
confusión I-Premise HighQuality
mental, I-Premise HighQuality
mialgias I-Premise HighQuality
difusas I-Premise HighQuality
y I-Premise HighQuality
dolor I-Premise HighQuality
intenso I-Premise HighQuality
en I-Premise HighQuality
mano I-Premise HighQuality
izquierda I-Premise HighQuality
de I-Premise HighQuality
24 I-Premise HighQuality
horas I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
sin I-Premise HighQuality
claros I-Premise HighQuality
signos I-Premise HighQuality
flogóticos I-Premise HighQuality
locales. I-Premise HighQuality

No B-Premise HighQuality
refiere I-Premise HighQuality
ningún I-Premise HighQuality
antecedente I-Premise HighQuality
traumático. I-Premise HighQuality

A B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
destaca: I-Premise HighQuality
temperatura I-Premise HighQuality
38,9“C, I-Premise HighQuality
120 I-Premise HighQuality
latidos I-Premise HighQuality
por I-Premise HighQuality
minuto, I-Premise HighQuality
frecuencia I-Premise HighQuality
respiratoria I-Premise HighQuality
30/min, I-Premise HighQuality
presión I-Premise HighQuality
arterial I-Premise HighQuality
90/54 I-Premise HighQuality
mm I-Premise HighQuality
Hg. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
analítica I-Premise HighQuality
destaca I-Premise HighQuality
una I-Premise HighQuality
leucocitosis I-Premise HighQuality
con I-Premise HighQuality
desviación I-Premise HighQuality
izquierda I-Premise HighQuality
(25.000 I-Premise HighQuality
leucocitos/mm3, I-Premise HighQuality
80% I-Premise HighQuality
neutrófilos); I-Premise HighQuality
aumento I-Premise HighQuality
de I-Premise HighQuality
las I-Premise HighQuality
cifras I-Premise HighQuality
de I-Premise HighQuality
creatinina I-Premise HighQuality
(1,6 I-Premise HighQuality
mg/dL) I-Premise HighQuality
y I-Premise HighQuality
de I-Premise HighQuality
CK I-Premise HighQuality
(138 I-Premise HighQuality
U/L). I-Premise HighQuality

De O 
entre O 
los O 
siguientes, O 
¿cuál O 
es O 
el O 
diagnóstico O 
más O 
probable?: O 

1- O 
Fascitis B-Claim HighQuality
necrotizante I-Claim HighQuality
estreptocócica. I-Claim HighQuality

2- O 
Gangrena B-Claim HighQuality
por I-Claim HighQuality
Clostridium I-Claim HighQuality
spp. I-Claim HighQuality

3- O 
Celulitis B-Claim HighQuality
por I-Claim HighQuality
micobacterias. I-Claim HighQuality

4- O 
Erisipela. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
1 O 

Tengo B-Claim HighQuality
mis I-Claim HighQuality
dudas I-Claim HighQuality
entre I-Claim HighQuality
la I-Claim HighQuality
1 I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
2; I-Claim HighQuality
excepcionalmente B-Claim HighQuality
C. I-Claim HighQuality
botulinum I-Claim HighQuality
puede I-Claim HighQuality
infectar I-Claim HighQuality
heridas I-Claim HighQuality
traumáticas I-Claim HighQuality
o I-Claim HighQuality
por I-Claim HighQuality
punción I-Claim HighQuality
en I-Claim HighQuality
UDVP I-Claim HighQuality
que I-Claim HighQuality
utilizan I-Claim HighQuality
heroína I-Claim HighQuality
marrón I-Claim HighQuality
o I-Claim HighQuality
causar I-Claim HighQuality
sinusitis I-Claim HighQuality
en I-Claim HighQuality
cocainómanos. I-Claim HighQuality

Por B-Claim HighQuality
otra I-Claim HighQuality
parte, I-Claim HighQuality
el I-Claim HighQuality
caso I-Claim HighQuality
se I-Claim HighQuality
puede I-Claim HighQuality
referir I-Claim HighQuality
a I-Claim HighQuality
una I-Claim HighQuality
sepsis I-Claim HighQuality
grave I-Claim HighQuality
con I-Claim HighQuality
pobre I-Claim HighQuality
manifestación I-Claim HighQuality
inicial I-Claim HighQuality
a I-Claim HighQuality
primera I-Claim HighQuality
vista, I-Claim HighQuality
con I-Claim HighQuality
rabdomiolisis I-Claim HighQuality
incipiente I-Claim HighQuality
y I-Claim HighQuality
dolor I-Claim HighQuality
muscular, I-Claim HighQuality
en B-Claim HighQuality
este I-Claim HighQuality
caso I-Claim HighQuality
puede I-Claim HighQuality
tratarse I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
fascitis I-Claim HighQuality
necrotizante, I-Claim HighQuality
donde I-Claim HighQuality
el I-Claim HighQuality
germen I-Claim HighQuality
más I-Claim HighQuality
frecuentemente I-Claim HighQuality
implicado I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
S. I-Claim HighQuality
pyogenes. I-Claim HighQuality

QUESTION O 
TYPE: O 
RHEUMATOLOGY O 

CLINICAL O 
CASE: O 

Hombre B-Premise HighQuality
de I-Premise HighQuality
40 I-Premise HighQuality
años, I-Premise HighQuality
sin I-Premise HighQuality
antecedentes I-Premise HighQuality
de I-Premise HighQuality
interés,que I-Premise HighQuality
presenta I-Premise HighQuality
artritis I-Premise HighQuality
aguda I-Premise HighQuality
de I-Premise HighQuality
rodilla I-Premise HighQuality
derecha I-Premise HighQuality
de I-Premise HighQuality
5 I-Premise HighQuality
días I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
así I-Premise HighQuality
como I-Premise HighQuality
febrícula I-Premise HighQuality
de I-Premise HighQuality
hasta I-Premise HighQuality
37,7°C. I-Premise HighQuality

No B-Premise HighQuality
refiere I-Premise HighQuality
antecedente I-Premise HighQuality
traumático. I-Premise HighQuality

Presenta B-Premise HighQuality
derrame I-Premise HighQuality
articular, I-Premise HighQuality
calor I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
palpación I-Premise HighQuality
y I-Premise HighQuality
limitación I-Premise HighQuality
funcional I-Premise HighQuality
por I-Premise HighQuality
el I-Premise HighQuality
dolor. I-Premise HighQuality

Se B-Premise HighQuality
practica I-Premise HighQuality
artrocentesis I-Premise HighQuality
diagnóstica I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
que I-Premise HighQuality
se I-Premise HighQuality
evidencian I-Premise HighQuality
30000 I-Premise HighQuality
cels/mícroL I-Premise HighQuality
con I-Premise HighQuality
predominio I-Premise HighQuality
de I-Premise HighQuality
neutrófilos. I-Premise HighQuality

En B-Premise HighQuality
el I-Premise HighQuality
examen I-Premise HighQuality
con I-Premise HighQuality
luz I-Premise HighQuality
polarizada I-Premise HighQuality
se I-Premise HighQuality
descubren I-Premise HighQuality
cristales I-Premise HighQuality
romboidales I-Premise HighQuality
y I-Premise HighQuality
cilíndricos I-Premise HighQuality
con I-Premise HighQuality
birrefringencia I-Premise HighQuality
débilmente I-Premise HighQuality
positiva. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
radiografía I-Premise HighQuality
simple I-Premise HighQuality
de I-Premise HighQuality
rodillas I-Premise HighQuality
se I-Premise HighQuality
descubren I-Premise HighQuality
depósitos I-Premise HighQuality
radiodensos I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
menisco I-Premise HighQuality
externo I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
rodilla. I-Premise HighQuality

Señale O 
la O 
respuesta O 
FALSA: O 

1- O 
El B-Claim HighQuality
tratamiento I-Claim HighQuality
inicial I-Claim HighQuality
consistirá I-Claim HighQuality
en I-Claim HighQuality
antiinflamatorios I-Claim HighQuality
no I-Claim HighQuality
esteroideos, I-Claim HighQuality
así I-Claim HighQuality
como I-Claim HighQuality
la I-Claim HighQuality
aspiración I-Claim HighQuality
del I-Claim HighQuality
líquido I-Claim HighQuality
sinovial. I-Claim HighQuality

2- O 
Es B-Claim HighQuality
conveniente I-Claim HighQuality
la I-Claim HighQuality
realización I-Claim HighQuality
de I-Claim HighQuality
cultivo I-Claim HighQuality
del I-Claim HighQuality
líquido I-Claim HighQuality
sinovial I-Claim HighQuality
para I-Claim HighQuality
descartar I-Claim HighQuality
sinovitis I-Claim HighQuality
infecciosa. I-Claim HighQuality

3- O 
Una B-Claim HighQuality
vez I-Claim HighQuality
pasado I-Claim HighQuality
el I-Claim HighQuality
brote I-Claim HighQuality
agudo I-Claim HighQuality
habrá I-Claim HighQuality
que I-Claim HighQuality
instaurar I-Claim HighQuality
tratamiento I-Claim HighQuality
con I-Claim HighQuality
alopurinol I-Claim HighQuality
para I-Claim HighQuality
disminuir I-Claim HighQuality
la I-Claim HighQuality
incidencia I-Claim HighQuality
de I-Claim HighQuality
nuevos I-Claim HighQuality
brotes I-Claim HighQuality
de I-Claim HighQuality
artritis I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
futuro. I-Claim HighQuality

4- O 
El B-Claim HighQuality
diagnóstico I-Claim HighQuality
más I-Claim HighQuality
probable I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
artritis I-Claim HighQuality
aguda I-Claim HighQuality
por I-Claim HighQuality
depósito I-Claim HighQuality
de I-Claim HighQuality
cristales I-Claim HighQuality
de I-Claim HighQuality
pirofosfato I-Claim HighQuality
cálcico I-Claim HighQuality
(pseudogota). I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Es B-Claim HighQuality
una I-Claim HighQuality
condrocalcinosis. I-Claim HighQuality

No B-Claim HighQuality
existe I-Claim HighQuality
tratamiento I-Claim HighQuality
para I-Claim HighQuality
esta I-Claim HighQuality
enfermedad, I-Claim HighQuality
únicamente I-Claim HighQuality
tratamiento I-Claim HighQuality
para I-Claim HighQuality
los I-Claim HighQuality
brotes I-Claim HighQuality
(colchicina, I-Claim HighQuality
AINEs I-Claim HighQuality
o I-Claim HighQuality
corticoides) I-Claim HighQuality
aunque B-Claim HighQuality
en I-Claim HighQuality
ocasiones I-Claim HighQuality
si I-Claim HighQuality
los I-Claim HighQuality
brotes I-Claim HighQuality
son I-Claim HighQuality
habituales I-Claim HighQuality
se I-Claim HighQuality
deja I-Claim HighQuality
la I-Claim HighQuality
colchicina I-Claim HighQuality
mantenida. I-Claim HighQuality

El B-Claim HighQuality
alopurinol I-Claim HighQuality
no I-Claim HighQuality
ha I-Claim HighQuality
demostrado I-Claim HighQuality
ninguna I-Claim HighQuality
eficacia I-Claim HighQuality
en I-Claim HighQuality
esta I-Claim HighQuality
artropatía I-Claim HighQuality
por I-Claim HighQuality
microcristales, I-Claim HighQuality
sí I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
gota. I-Claim HighQuality

QUESTION O 
TYPE: O 
CRITICAL, O 
PALLIATIVE O 
AND O 
EMERGENCY O 
CARE O 

CLINICAL O 
CASE: O 

Hombre B-Premise HighQuality
de I-Premise HighQuality
35 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
edad I-Premise HighQuality
sufre I-Premise HighQuality
una I-Premise HighQuality
quemadura I-Premise HighQuality
eléctrica I-Premise HighQuality
de I-Premise HighQuality
alto I-Premise HighQuality
voltaje I-Premise HighQuality
(3000 I-Premise HighQuality
voltios) I-Premise HighQuality
por I-Premise HighQuality
contacto I-Premise HighQuality
directo I-Premise HighQuality
con I-Premise HighQuality
cable I-Premise HighQuality
con I-Premise HighQuality
su I-Premise HighQuality
mano I-Premise HighQuality
izquierda. I-Premise HighQuality

Al B-Premise HighQuality
ingreso I-Premise HighQuality
presenta I-Premise HighQuality
contractura I-Premise HighQuality
en I-Premise HighQuality
flexión I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
mano, I-Premise HighQuality
palidez I-Premise HighQuality
de I-Premise HighQuality
los I-Premise HighQuality
dedos I-Premise HighQuality
y I-Premise HighQuality
ausencia I-Premise HighQuality
de I-Premise HighQuality
pulso I-Premise HighQuality
radial I-Premise HighQuality
y I-Premise HighQuality
cubital I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
palpación I-Premise HighQuality
¿Cuál O 
es O 
la O 
medida O 
invasiva O 
de O 
urgencia O 
a O 
realizar? O 

1- O 
Bloqueo B-Claim HighQuality
axilar I-Claim HighQuality
con I-Claim HighQuality
catéter. I-Claim HighQuality

2- O 
Escarotomía B-Claim HighQuality
descompresiva. I-Claim HighQuality

3- O 
Monitorización B-Claim HighQuality
de I-Claim HighQuality
presión I-Claim HighQuality
intracompartimental. I-Claim HighQuality

4- O 
Escarectomía. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

La O 
3. O 

Ante B-Claim HighQuality
la I-Claim HighQuality
sospecha I-Claim HighQuality
de I-Claim HighQuality
síndrome I-Claim HighQuality
compartimental I-Claim HighQuality
la I-Claim HighQuality
medida I-Claim HighQuality
invasiva I-Claim HighQuality
de I-Claim HighQuality
urgencia I-Claim HighQuality
a I-Claim HighQuality
realizar I-Claim HighQuality
sería I-Claim HighQuality
medir I-Claim HighQuality
la I-Claim HighQuality
presión I-Claim HighQuality
intracompartimental I-Claim HighQuality
y, I-Claim HighQuality
según I-Claim HighQuality
el I-Claim HighQuality
resultado, I-Claim HighQuality
proceder I-Claim HighQuality
al I-Claim HighQuality
tratamiento. I-Claim HighQuality

QUESTION O 
TYPE: O 
ENDOCRINOLOGY O 

CLINICAL O 
CASE: O 

Una B-Premise HighQuality
mujer I-Premise HighQuality
de I-Premise HighQuality
35 I-Premise HighQuality
años I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
nódulo I-Premise HighQuality
tiroideo I-Premise HighQuality
derecho I-Premise HighQuality
detectado I-Premise HighQuality
incidentalmente I-Premise HighQuality
una I-Premise HighQuality
mañana I-Premise HighQuality
al I-Premise HighQuality
observarse I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
espejo I-Premise HighQuality
un I-Premise HighQuality
bulto I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
cara I-Premise HighQuality
anterior I-Premise HighQuality
del I-Premise HighQuality
cuello. I-Premise HighQuality

Tras B-Premise HighQuality
los I-Premise HighQuality
estudios I-Premise HighQuality
pertinentes I-Premise HighQuality
se I-Premise HighQuality
decide I-Premise HighQuality
intervenir I-Premise HighQuality
quirúrgicamente I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
paciente I-Premise HighQuality
realizándose I-Premise HighQuality
una I-Premise HighQuality
tiroidectomia I-Premise HighQuality
total I-Premise HighQuality
con I-Premise HighQuality
vaciamiento I-Premise HighQuality
del I-Premise HighQuality
componente I-Premise HighQuality
ganglionar I-Premise HighQuality
central. I-Premise HighQuality

Siendo O 
el O 
informe O 
del O 
patólogo O 
de B-Premise HighQuality
nódulo I-Premise HighQuality
tiroideo I-Premise HighQuality
de I-Premise HighQuality
2,3 I-Premise HighQuality
cm I-Premise HighQuality
ocupado I-Premise HighQuality
en I-Premise HighQuality
su I-Premise HighQuality
totalidad I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
carcinoma I-Premise HighQuality
papilar I-Premise HighQuality
de I-Premise HighQuality
tiroides, I-Premise HighQuality
variante I-Premise HighQuality
células I-Premise HighQuality
altas, I-Premise HighQuality
sin I-Premise HighQuality
infiltración I-Premise HighQuality
vascular I-Premise HighQuality
pero I-Premise HighQuality
sí I-Premise HighQuality
capsular. I-Premise HighQuality

Las B-Premise HighQuality
concentraciones I-Premise HighQuality
de I-Premise HighQuality
tiroglobulina I-Premise HighQuality
24 I-Premise HighQuality
h I-Premise HighQuality
después I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
tiroidectomia I-Premise HighQuality
son I-Premise HighQuality
de I-Premise HighQuality
14 I-Premise HighQuality
ng/mL. I-Premise HighQuality

¿Cuál O 
sería O 
el O 
siguiente O 
paso O 
que O 
usted O 
daría O 
en O 
esta O 
paciente? O 

1- O 
Remitir B-Claim HighQuality
de I-Claim HighQuality
nuevo I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
paciente I-Claim HighQuality
al I-Claim HighQuality
cirujano I-Claim HighQuality
para I-Claim HighQuality
que I-Claim HighQuality
realice I-Claim HighQuality
un I-Claim HighQuality
vaciamiento I-Claim HighQuality
ganglionar I-Claim HighQuality
laterocervical I-Claim HighQuality
derecho. I-Claim HighQuality

2- O 
Iniciar B-Claim HighQuality
tratamiento I-Claim HighQuality
con I-Claim HighQuality
una I-Claim HighQuality
dosis I-Claim HighQuality
de I-Claim HighQuality
levotiroxina I-Claim HighQuality
supresora I-Claim HighQuality
de I-Claim HighQuality
TSH I-Claim HighQuality
y I-Claim HighQuality
citarla I-Claim HighQuality
a I-Claim HighQuality
revisión I-Claim HighQuality
6 I-Claim HighQuality
meses I-Claim HighQuality
después I-Claim HighQuality
con I-Claim HighQuality
una I-Claim HighQuality
nueva I-Claim HighQuality
determinación I-Claim HighQuality
analítica I-Claim HighQuality
de I-Claim HighQuality
tiroglobulina I-Claim HighQuality
y I-Claim HighQuality
una I-Claim HighQuality
ecografía I-Claim HighQuality
cervical. I-Claim HighQuality

3- O 
Solicitar B-Claim HighQuality
un I-Claim HighQuality
PET-TAC I-Claim HighQuality
para I-Claim HighQuality
ver I-Claim HighQuality
si I-Claim HighQuality
hay I-Claim HighQuality
afectación I-Claim HighQuality
ganglionar. I-Claim HighQuality

4- O 
Demorar B-Claim HighQuality
el I-Claim HighQuality
inicio I-Claim HighQuality
del I-Claim HighQuality
tratamiento I-Claim HighQuality
sustitutivo-supresor I-Claim HighQuality
de I-Claim HighQuality
TSH I-Claim HighQuality
con I-Claim HighQuality
levotiroxina I-Claim HighQuality
y I-Claim HighQuality
remitir I-Claim HighQuality
la I-Claim HighQuality
paciente I-Claim HighQuality
al I-Claim HighQuality
servicio I-Claim HighQuality
de I-Claim HighQuality
Medicina I-Claim HighQuality
Nuclear I-Claim HighQuality
para I-Claim HighQuality
la I-Claim HighQuality
administración I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
dosis I-Claim HighQuality
ablativa I-Claim HighQuality
de I-Claim HighQuality
100 I-Claim HighQuality
mCi I-Claim HighQuality
de I-Claim HighQuality
I131. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
4 O 

La O 
comprobación O 
de O 
la O 
presencia O 
de O 
tiroglobulina O 
en O 
sangre O 
y O 
el O 
desarrollo O 
de O 
técnicas O 
mediante O 
las O 
cuales O 
es O 
posible O 
determinarla, O 
han O 
permitido O 
contar O 
con O 
un O 
nuevo O 
procedimiento O 
para O 
el O 
control O 
de O 
pacientes O 
con O 
carcinoma O 
papilar O 
o O 
folicular O 
del O 
tiroides. O 

La B-Claim HighQuality
tiroglobulina I-Claim HighQuality
es I-Claim HighQuality
sintetizada I-Claim HighQuality
en I-Claim HighQuality
las I-Claim HighQuality
células I-Claim HighQuality
foliculares I-Claim HighQuality
y I-Claim HighQuality
luego I-Claim HighQuality
secretada I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
circulación, I-Claim HighQuality
por B-Claim HighQuality
lo I-Claim HighQuality
tanto, I-Claim HighQuality
después I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
tiroidectomía I-Claim HighQuality
total I-Claim HighQuality
debe I-Claim HighQuality
desaparecer, I-Claim HighQuality
si B-Claim HighQuality
eso I-Claim HighQuality
no I-Claim HighQuality
ocurre I-Claim HighQuality
hay I-Claim HighQuality
que I-Claim HighQuality
pensar I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
existencia I-Claim HighQuality
de I-Claim HighQuality
restos I-Claim HighQuality
de I-Claim HighQuality
tejido I-Claim HighQuality
de I-Claim HighQuality
metástasis. I-Claim HighQuality

QUESTION O 
TYPE: O 
GYNECOLOGY O 
AND O 
OBSTETRICS O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
20 I-Premise HighQuality
años I-Premise HighQuality
con I-Premise HighQuality
tumoración I-Premise HighQuality
ovárica I-Premise HighQuality
de I-Premise HighQuality
15 I-Premise HighQuality
cm, I-Premise HighQuality
sólido-quística, I-Premise HighQuality
detectada I-Premise HighQuality
por I-Premise HighQuality
ecografía I-Premise HighQuality
tras I-Premise HighQuality
presentar I-Premise HighQuality
síntomas I-Premise HighQuality
abdominales I-Premise HighQuality
inespectíficos. I-Premise HighQuality

En B-Premise HighQuality
el I-Premise HighQuality
estudio I-Premise HighQuality
histopatológico I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
pieza I-Premise HighQuality
correspondiente I-Premise HighQuality
se I-Premise HighQuality
encuentran I-Premise HighQuality
dientes, I-Premise HighQuality
pelos, I-Premise HighQuality
zonas I-Premise HighQuality
de I-Premise HighQuality
epitelio I-Premise HighQuality
intestinal, I-Premise HighQuality
áreas I-Premise HighQuality
de I-Premise HighQuality
epitelio I-Premise HighQuality
escamoso I-Premise HighQuality
(15%) I-Premise HighQuality
y I-Premise HighQuality
bronquial, I-Premise HighQuality
así I-Premise HighQuality
como I-Premise HighQuality
elementos I-Premise HighQuality
neuroectodérmicos I-Premise HighQuality
y I-Premise HighQuality
embrionarios I-Premise HighQuality
en I-Premise HighQuality
varias I-Premise HighQuality
de I-Premise HighQuality
las I-Premise HighQuality
preparaciones I-Premise HighQuality
histológicas. I-Premise HighQuality

En O 
referencia O 
a O 
este O 
caso, O 
señale O 
el O 
diagnóstico O 
correcto: O 

1- O 
Teratocarcinoma. B-Claim HighQuality

2- O 
Teratoma B-Claim HighQuality
inmaduro. I-Claim HighQuality

3- O 
Teratoma B-Claim HighQuality
quístico I-Claim HighQuality
maduro. I-Claim HighQuality

4- O 
Disgerminoma. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

La B-Claim HighQuality
respuesta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
3, I-Claim HighQuality
teratoma I-Claim HighQuality
quístico I-Claim HighQuality
maduro. I-Claim HighQuality

Esto B-Claim HighQuality
es I-Claim HighQuality
así I-Claim HighQuality
por I-Claim HighQuality
las I-Claim HighQuality
características I-Claim HighQuality
propias I-Claim HighQuality
del I-Claim HighQuality
tumor:los I-Claim HighQuality
teratomas I-Claim HighQuality
maduros I-Claim HighQuality
se I-Claim HighQuality
hallan I-Claim HighQuality
constituidos I-Claim HighQuality
por I-Claim HighQuality
tejidos I-Claim HighQuality
adultos, I-Claim HighQuality
procedentes I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
tres I-Claim HighQuality
hojas I-Claim HighQuality
embrionarias, I-Claim HighQuality
con I-Claim HighQuality
neto I-Claim HighQuality
predominio I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
elementos I-Claim HighQuality
ectodérmicos I-Claim HighQuality
(epidermis, I-Claim HighQuality
estructuras I-Claim HighQuality
pilosebáceas I-Claim HighQuality
y I-Claim HighQuality
tejido I-Claim HighQuality
neural). I-Claim HighQuality

El B-Claim HighQuality
teratoma I-Claim HighQuality
maduro I-Claim HighQuality
es I-Claim HighQuality
un I-Claim HighQuality
tumor I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
células I-Claim HighQuality
germinales I-Claim HighQuality
ováricas. I-Claim HighQuality

QUESTION O 
TYPE: O 
GYNECOLOGY O 
AND O 
OBSTETRICS O 

CLINICAL O 
CASE: O 

Una B-Premise HighQuality
embarazada I-Premise HighQuality
de I-Premise HighQuality
10 I-Premise HighQuality
semanas I-Premise HighQuality
de I-Premise HighQuality
gestación, I-Premise HighQuality
acude I-Premise HighQuality
urgencias I-Premise HighQuality
hospitalarias I-Premise HighQuality
por I-Premise HighQuality
presentar I-Premise HighQuality
una I-Premise HighQuality
presión I-Premise HighQuality
arterial I-Premise HighQuality
de I-Premise HighQuality
160/105 I-Premise HighQuality
mmHg. I-Premise HighQuality

Buen B-Premise HighQuality
estado I-Premise HighQuality
general, I-Premise HighQuality
sólo I-Premise HighQuality
leve I-Premise HighQuality
cefalea, I-Premise HighQuality
motivo I-Premise HighQuality
por I-Premise HighQuality
el I-Premise HighQuality
que I-Premise HighQuality
se I-Premise HighQuality
tomó I-Premise HighQuality
la I-Premise HighQuality
presión I-Premise HighQuality
arterial. I-Premise HighQuality

Tras B-Premise HighQuality
4 I-Premise HighQuality
horas I-Premise HighQuality
de I-Premise HighQuality
reposo I-Premise HighQuality
presenta I-Premise HighQuality
cifras I-Premise HighQuality
de I-Premise HighQuality
150/95mmHg. I-Premise HighQuality

Se B-Premise HighQuality
le I-Premise HighQuality
realiza I-Premise HighQuality
un I-Premise HighQuality
hemograma I-Premise HighQuality
que I-Premise HighQuality
es I-Premise HighQuality
normal I-Premise HighQuality
y I-Premise HighQuality
una I-Premise HighQuality
proteinuria I-Premise HighQuality
que I-Premise HighQuality
es I-Premise HighQuality
negativa. I-Premise HighQuality

¿Qué O 
tipo O 
de O 
hipertensión O 
presenta? O 

1- O 
Preeclampsia B-Claim HighQuality
moderada. I-Claim HighQuality

2- O 
Hipertensión B-Claim HighQuality
inducida I-Claim HighQuality
por I-Claim HighQuality
el I-Claim HighQuality
embarazo. I-Claim HighQuality

3- O 
Hipertensión B-Claim HighQuality
crónica. I-Claim HighQuality

4- O 
Eclampsia. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

La B-Claim HighQuality
hipertensión I-Claim HighQuality
crónica I-Claim HighQuality
se I-Claim HighQuality
define I-Claim HighQuality
como I-Claim HighQuality
aquella I-Claim HighQuality
que I-Claim HighQuality
está I-Claim HighQuality
presente I-Claim HighQuality
antes I-Claim HighQuality
del I-Claim HighQuality
embarazo I-Claim HighQuality
o I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
diagnostica I-Claim HighQuality
antes I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
semana I-Claim HighQuality
20 I-Claim HighQuality
de I-Claim HighQuality
gestación. I-Claim HighQuality

En B-Premise HighQuality
este I-Premise HighQuality
caso, I-Premise HighQuality
la I-Premise HighQuality
paciente I-Premise HighQuality
está I-Premise HighQuality
embarazada I-Premise HighQuality
de I-Premise HighQuality
10 I-Premise HighQuality
semanas I-Premise HighQuality
por O 
lo O 
que O 
la B-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
3. I-Claim HighQuality

QUESTION O 
TYPE: O 
PNEUMOLOGY O 
AND O 
THORACIC O 
SURGERY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
38 I-Premise HighQuality
años, I-Premise HighQuality
no I-Premise HighQuality
fumadora, I-Premise HighQuality
diagnosticada I-Premise HighQuality
previamente I-Premise HighQuality
de I-Premise HighQuality
rinitis I-Premise HighQuality
atópica I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
por I-Premise HighQuality
cuadro I-Premise HighQuality
de I-Premise HighQuality
dos I-Premise HighQuality
meses I-Premise HighQuality
consistente I-Premise HighQuality
en I-Premise HighQuality
tos I-Premise HighQuality
y I-Premise HighQuality
sibilantes I-Premise HighQuality
intermitentes I-Premise HighQuality
de I-Premise HighQuality
predominio I-Premise HighQuality
nocturno. I-Premise HighQuality

Rx B-Premise HighQuality
de I-Premise HighQuality
tórax I-Premise HighQuality
normal. I-Premise HighQuality

Espirometría B-Premise HighQuality
dentro I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
normalidad I-Premise HighQuality
con I-Premise HighQuality
prueba I-Premise HighQuality
broncodilatadora I-Premise HighQuality
negativa. I-Premise HighQuality

¿Cuál O 
de O 
las O 
siguientes O 
pruebas O 
solicitaría O 
a O 
continuación? O 

1- O 
Rx B-Claim HighQuality
de I-Claim HighQuality
senos I-Claim HighQuality
paranasales. I-Claim HighQuality

2- O 
TAC B-Claim HighQuality
torácico. I-Claim HighQuality

3- O 
Test B-Claim HighQuality
de I-Claim HighQuality
metacolina. I-Claim HighQuality

4- O 
Prick-test. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Una B-Premise HighQuality
espirometria I-Premise HighQuality
normal I-Premise HighQuality
y I-Premise HighQuality
un I-Premise HighQuality
test I-Premise HighQuality
broncodilatador I-Premise HighQuality
negativo I-Premise HighQuality
puntualmente I-Premise HighQuality
no I-Premise HighQuality
excluye I-Premise HighQuality
asma, I-Premise HighQuality
y O 
la B-Premise HighQuality
clínica I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
paciente I-Premise HighQuality
es I-Premise HighQuality
altamente I-Premise HighQuality
sugestiva I-Premise HighQuality
de I-Premise HighQuality
asma, I-Premise HighQuality
por O 
lo O 
que O 
un B-Claim HighQuality
test I-Claim HighQuality
de I-Claim HighQuality
metacolina I-Claim HighQuality
permitiría I-Claim HighQuality
confirmar I-Claim HighQuality
el I-Claim HighQuality
diagnostico, I-Claim HighQuality
al I-Claim HighQuality
menos I-Claim HighQuality
de I-Claim HighQuality
hiperreactividad I-Claim HighQuality
bronquial. I-Claim HighQuality

QUESTION O 
TYPE: O 
PSYCHIATRY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
hombre I-Premise HighQuality
de I-Premise HighQuality
80 I-Premise HighQuality
años I-Premise HighQuality
es I-Premise HighQuality
llevado I-Premise HighQuality
a I-Premise HighQuality
Urgencias I-Premise HighQuality
por I-Premise HighQuality
la I-Premise HighQuality
policía I-Premise HighQuality
a I-Premise HighQuality
encontrarle I-Premise HighQuality
por I-Premise HighQuality
la I-Premise HighQuality
noche, I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
calle, I-Premise HighQuality
a I-Premise HighQuality
varios I-Premise HighQuality
bloques I-Premise HighQuality
de I-Premise HighQuality
su I-Premise HighQuality
domicilio, I-Premise HighQuality
algo I-Premise HighQuality
perdido. I-Premise HighQuality

Dice B-Premise HighQuality
al I-Premise HighQuality
médico I-Premise HighQuality
de I-Premise HighQuality
Urgencias I-Premise HighQuality
«me I-Premise HighQuality
encuentro I-Premise HighQuality
bien, I-Premise HighQuality
estaba I-Premise HighQuality
paseando I-Premise HighQuality
y I-Premise HighQuality
me I-Premise HighQuality
he I-Premise HighQuality
perdido». I-Premise HighQuality

La O 
revisión, O 
por O 
sistemas, O 
es O 
anodina. O 

Al B-Premise HighQuality
preguntarle I-Premise HighQuality
por I-Premise HighQuality
su I-Premise HighQuality
medicación, I-Premise HighQuality
no I-Premise HighQuality
recuerda. I-Premise HighQuality

En B-Premise HighQuality
su I-Premise HighQuality
historial I-Premise HighQuality
constan I-Premise HighQuality
glipizida, I-Premise HighQuality
atenolol I-Premise HighQuality
y I-Premise HighQuality
acenocumarol. I-Premise HighQuality

Ha B-Premise HighQuality
estado I-Premise HighQuality
en I-Premise HighQuality
Urgencias I-Premise HighQuality
3 I-Premise HighQuality
veces I-Premise HighQuality
en I-Premise HighQuality
los I-Premise HighQuality
últimos I-Premise HighQuality
tres I-Premise HighQuality
meses I-Premise HighQuality
por I-Premise HighQuality
«mareo», I-Premise HighQuality
dolor I-Premise HighQuality
lumbar I-Premise HighQuality
y I-Premise HighQuality
un I-Premise HighQuality
INR I-Premise HighQuality
de I-Premise HighQuality
5. I-Premise HighQuality

Refiere B-Premise HighQuality
independencia I-Premise HighQuality
en I-Premise HighQuality
actividades I-Premise HighQuality
básicas I-Premise HighQuality
e I-Premise HighQuality
instrumentales I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
vida I-Premise HighQuality
diaria. I-Premise HighQuality

No O 
hay O 
evidencia O 
de O 
familiares O 
o O 
amigos O 
cercanos. O 

Varias O 
referencias O 
del O 
trabajo O 
social O 
del O 
área O 
indican O 
que O 
rechaza O 
ayudas O 
o O 
visitas O 
médicas O 
o O 
de O 
enfermería. O 

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
física, I-Premise HighQuality
únicamente I-Premise HighQuality
destaca I-Premise HighQuality
temperatura I-Premise HighQuality
de I-Premise HighQuality
37.7, I-Premise HighQuality
IMC I-Premise HighQuality
de I-Premise HighQuality
16, I-Premise HighQuality
PA I-Premise HighQuality
de I-Premise HighQuality
160/90, I-Premise HighQuality
FC I-Premise HighQuality
de I-Premise HighQuality
90 I-Premise HighQuality
y I-Premise HighQuality
SO2 I-Premise HighQuality
de I-Premise HighQuality
99%. I-Premise HighQuality

Tiene B-Premise HighQuality
pérdida I-Premise HighQuality
global I-Premise HighQuality
de I-Premise HighQuality
masa I-Premise HighQuality
muscular. I-Premise HighQuality

Está B-Premise HighQuality
vestido I-Premise HighQuality
con I-Premise HighQuality
la I-Premise HighQuality
bata I-Premise HighQuality
de I-Premise HighQuality
casa I-Premise HighQuality
y I-Premise HighQuality
huele I-Premise HighQuality
a I-Premise HighQuality
orina. I-Premise HighQuality

Rechaza B-Premise HighQuality
contestar I-Premise HighQuality
a I-Premise HighQuality
las I-Premise HighQuality
preguntas I-Premise HighQuality
del I-Premise HighQuality
Minimental. I-Premise HighQuality

En B-Premise HighQuality
las I-Premise HighQuality
pruebas I-Premise HighQuality
de I-Premise HighQuality
laboratorio I-Premise HighQuality
destacan I-Premise HighQuality
13.000 I-Premise HighQuality
leucos, I-Premise HighQuality
Glucemia I-Premise HighQuality
300, I-Premise HighQuality
hemoglobina I-Premise HighQuality
glicosilada I-Premise HighQuality
11%, I-Premise HighQuality
INR I-Premise HighQuality
0.9, I-Premise HighQuality
en I-Premise HighQuality
orina I-Premise HighQuality
más I-Premise HighQuality
de I-Premise HighQuality
50 I-Premise HighQuality
leucocitos/campo, I-Premise HighQuality
nitritos+ I-Premise HighQuality
y I-Premise HighQuality
urocultivo I-Premise HighQuality
> I-Premise HighQuality
100.000 I-Premise HighQuality
bacilos I-Premise HighQuality
Gram I-Premise HighQuality
negativos. I-Premise HighQuality

Es B-Premise HighQuality
ingresado I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
hospital, I-Premise HighQuality
recibe I-Premise HighQuality
antibióticos, I-Premise HighQuality
insulina I-Premise HighQuality
y I-Premise HighQuality
se I-Premise HighQuality
reinicia I-Premise HighQuality
acenocumarol I-Premise HighQuality
con I-Premise HighQuality
buena I-Premise HighQuality
evolución. I-Premise HighQuality

Está B-Premise HighQuality
estable I-Premise HighQuality
y I-Premise HighQuality
quiere I-Premise HighQuality
irse I-Premise HighQuality
a I-Premise HighQuality
su I-Premise HighQuality
domicilio. I-Premise HighQuality

La B-Premise HighQuality
enfermera I-Premise HighQuality
de I-Premise HighQuality
planta I-Premise HighQuality
dice I-Premise HighQuality
que I-Premise HighQuality
es I-Premise HighQuality
incapaz I-Premise HighQuality
de I-Premise HighQuality
autoadministrarse I-Premise HighQuality
la I-Premise HighQuality
insulina. I-Premise HighQuality

¿Cuál O 
de O 
los O 
siguientes O 
es O 
el O 
próximo O 
paso O 
para O 
determinar O 
la O 
seguridad O 
del O 
paciente O 
en O 
su O 
domicilio? O 

1- O 
Referir B-Claim HighQuality
a I-Claim HighQuality
Atención I-Claim HighQuality
Primaria I-Claim HighQuality
y I-Claim HighQuality
trabajo I-Claim HighQuality
social I-Claim HighQuality
del I-Claim HighQuality
área I-Claim HighQuality
para I-Claim HighQuality
determinar I-Claim HighQuality
la I-Claim HighQuality
seguridad I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
domicilio. I-Claim HighQuality

2- O 
Evaluación B-Claim HighQuality
formal I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
capacidad I-Claim HighQuality
para I-Claim HighQuality
tomar I-Claim HighQuality
decisiones I-Claim HighQuality
concernientes I-Claim HighQuality
a I-Claim HighQuality
su I-Claim HighQuality
salud. I-Claim HighQuality

3- O 
Evaluación B-Claim HighQuality
para I-Claim HighQuality
descartar I-Claim HighQuality
demencia. I-Claim HighQuality

4- O 
Evaluación B-Claim HighQuality
para I-Claim HighQuality
descartar I-Claim HighQuality
depresión. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
2 O 

Evaluar B-Claim HighQuality
la I-Claim HighQuality
capacidad I-Claim HighQuality
no I-Claim HighQuality
tiene I-Claim HighQuality
que I-Claim HighQuality
ver I-Claim HighQuality
con I-Claim HighQuality
quitar I-Claim HighQuality
la I-Claim HighQuality
autonomía I-Claim HighQuality
al I-Claim HighQuality
paciente, I-Claim HighQuality
sino I-Claim HighQuality
asegurarnos I-Claim HighQuality
de I-Claim HighQuality
que I-Claim HighQuality
el I-Claim HighQuality
paciente I-Claim HighQuality
comprende I-Claim HighQuality
y I-Claim HighQuality
es I-Claim HighQuality
consciente I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
consecuencias I-Claim HighQuality
de I-Claim HighQuality
sus I-Claim HighQuality
decisiones. I-Claim HighQuality

De B-Claim HighQuality
hecho I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
medida I-Claim HighQuality
de I-Claim HighQuality
protección I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
pacientes I-Claim HighQuality
más I-Claim HighQuality
frágiles I-Claim HighQuality
para I-Claim HighQuality
asegurar I-Claim HighQuality
los I-Claim HighQuality
mejores I-Claim HighQuality
cuidados. I-Claim HighQuality

Esto B-Claim HighQuality
no I-Claim HighQuality
lo I-Claim HighQuality
hace I-Claim HighQuality
un I-Claim HighQuality
psiquiatra, I-Claim HighQuality
sino I-Claim HighQuality
el I-Claim HighQuality
médico I-Claim HighQuality
a I-Claim HighQuality
cargo. I-Claim HighQuality

Hay B-Claim HighQuality
varios I-Claim HighQuality
tests I-Claim HighQuality
o I-Claim HighQuality
entrevistas I-Claim HighQuality
semiestructuradas I-Claim HighQuality
para I-Claim HighQuality
valorar I-Claim HighQuality
la I-Claim HighQuality
capacidad I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
pacientes, I-Claim HighQuality
y I-Claim HighQuality
todos I-Claim HighQuality
los I-Claim HighQuality
médicos I-Claim HighQuality
deberían I-Claim HighQuality
conocer I-Claim HighQuality
estos I-Claim HighQuality
instrumentos. I-Claim HighQuality

Es O 
importante O 
que O 
sea O 
el O 
médico O 
a O 
cargo O 
el O 
que O 
realiza O 
esta O 
valoración, O 
porque O 
es O 
el O 
que O 
previamente O 
informa O 
al O 
paciente O 
(consentimiento O 
informado) O 
del O 
plan O 
terapéutico O 
y O 
es O 
el O 
que O 
está O 
mejor O 
capacitado O 
para O 
evaluar O 
si O 
el O 
paciente O 
ha O 
entendido O 
todo: O 
cuál O 
es O 
el O 
problema O 
médico, O 
qué O 
tratamiento O 
se O 
le O 
propone, O 
las O 
alternativas O 
si O 
las O 
hubiera, O 
tener O 
opción O 
de O 
aceptar O 
alguna O 
o O 
rechazarlas O 
y O 
por O 
qué, O 
consecuencias O 
de O 
tomar O 
esas O 
decisiones O 
(también O 
las O 
de O 
no O 
querer O 
tratamiento), O 
incluso O 
valorar O 
psicopatología O 
susceptible O 
de O 
un O 
PIC O 
a O 
Psiquiatría. O 

QUESTION O 
TYPE: O 
INFECTIOUS O 
DISEASES O 
AND O 
MICROBIOLOGY O 

CLINICAL O 
CASE: O 

Luis B-Premise HighQuality
es I-Premise HighQuality
un I-Premise HighQuality
joven I-Premise HighQuality
de I-Premise HighQuality
25 I-Premise HighQuality
años I-Premise HighQuality
que I-Premise HighQuality
sufrió I-Premise HighQuality
esplenectomía I-Premise HighQuality
tras I-Premise HighQuality
accidente I-Premise HighQuality
de I-Premise HighQuality
bicicleta I-Premise HighQuality
hace I-Premise HighQuality
1 I-Premise HighQuality
año. I-Premise HighQuality

Tiene B-Premise HighQuality
un I-Premise HighQuality
perro I-Premise HighQuality
que I-Premise HighQuality
Ie I-Premise HighQuality
mordió I-Premise HighQuality
hace I-Premise HighQuality
24 I-Premise HighQuality
horas I-Premise HighQuality
y I-Premise HighQuality
le I-Premise HighQuality
ha I-Premise HighQuality
producido I-Premise HighQuality
una I-Premise HighQuality
pequeña I-Premise HighQuality
herida I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
mano I-Premise HighQuality
derecha. I-Premise HighQuality

Acude B-Premise HighQuality
a I-Premise HighQuality
su I-Premise HighQuality
centro I-Premise HighQuality
de I-Premise HighQuality
salud I-Premise HighQuality
(situada I-Premise HighQuality
a I-Premise HighQuality
3 I-Premise HighQuality
horas I-Premise HighQuality
del I-Premise HighQuality
hospital I-Premise HighQuality
más I-Premise HighQuality
cercano) I-Premise HighQuality
por I-Premise HighQuality
fiebre I-Premise HighQuality
de I-Premise HighQuality
39ºC, I-Premise HighQuality
dolor I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
herida I-Premise HighQuality
y I-Premise HighQuality
malestar I-Premise HighQuality
general. I-Premise HighQuality

A B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
PA I-Premise HighQuality
100/60 I-Premise HighQuality
mm I-Premise HighQuality
Hg, I-Premise HighQuality
FC I-Premise HighQuality
110 I-Premise HighQuality
latidos I-Premise HighQuality
por I-Premise HighQuality
minuto, I-Premise HighQuality
ligera I-Premise HighQuality
inflamación I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
herida I-Premise HighQuality
sin I-Premise HighQuality
pus. I-Premise HighQuality

¿Cual O 
de O 
las O 
siguientes O 
actuaciones O 
está O 
más O 
indicada O 
en O 
este O 
momento? O 

1- O 
Enviar B-Claim HighQuality
al I-Claim HighQuality
hospital I-Claim HighQuality
para I-Claim HighQuality
vacunar I-Claim HighQuality
de I-Claim HighQuality
rabia I-Claim HighQuality
y I-Claim HighQuality
tétanos I-Claim HighQuality
y I-Claim HighQuality
mantener I-Claim HighQuality
en I-Claim HighQuality
observación. I-Claim HighQuality

2- O 
Limpiar B-Claim HighQuality
la I-Claim HighQuality
herida I-Claim HighQuality
y I-Claim HighQuality
administrar I-Claim HighQuality
gamaglobulina I-Claim HighQuality
inespecífica I-Claim HighQuality
intramuscular. I-Claim HighQuality

3- O 
Dar B-Claim HighQuality
400 I-Claim HighQuality
mg I-Claim HighQuality
de I-Claim HighQuality
moxifloxacino I-Claim HighQuality
oral I-Claim HighQuality
y I-Claim HighQuality
enviar I-Claim HighQuality
al I-Claim HighQuality
hospital. I-Claim HighQuality

4- O 
Dar B-Claim HighQuality
clindamicina I-Claim HighQuality
600 I-Claim HighQuality
mg I-Claim HighQuality
oral I-Claim HighQuality
cada I-Claim HighQuality
8 I-Claim HighQuality
horas I-Claim HighQuality
y I-Claim HighQuality
observación. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Esta O 
pregunta O 
nos O 
ha O 
resultado O 
complicada. O 

La O 
pregunta O 
no O 
tiene O 
toda O 
la O 
información O 
necesaria, O 
pero O 
usando O 
lo O 
que O 
tenemos O 
podemos O 
intentar O 
responder. O 

El B-Premise HighQuality
perro I-Premise HighQuality
es I-Premise HighQuality
doméstico, I-Premise HighQuality
conocido I-Premise HighQuality
y I-Premise HighQuality
puede I-Premise HighQuality
ser I-Premise HighQuality
sometido I-Premise HighQuality
a I-Premise HighQuality
vigilancia, I-Premise HighQuality
por O 
lo O 
tanto O 
habría B-Claim HighQuality
que I-Claim HighQuality
esperar I-Claim HighQuality
a I-Claim HighQuality
que I-Claim HighQuality
pase I-Claim HighQuality
el I-Claim HighQuality
periodo I-Claim HighQuality
de I-Claim HighQuality
observación I-Claim HighQuality
y I-Claim HighQuality
no I-Claim HighQuality
se I-Claim HighQuality
recomienda I-Claim HighQuality
profilaxis. I-Claim HighQuality

En B-Claim HighQuality
este I-Claim HighQuality
punto I-Claim HighQuality
solo I-Claim HighQuality
tendremos I-Claim HighQuality
que I-Claim HighQuality
preocuparnos I-Claim HighQuality
por I-Claim HighQuality
la I-Claim HighQuality
posible I-Claim HighQuality
bacteriemia I-Claim HighQuality
que I-Claim HighQuality
puede I-Claim HighQuality
estar I-Claim HighQuality
ocurriendo I-Claim HighQuality
en I-Claim HighQuality
un I-Claim HighQuality
paciente I-Claim HighQuality
con I-Claim HighQuality
posibilidad I-Claim HighQuality
de I-Claim HighQuality
alto I-Claim HighQuality
riesgo I-Claim HighQuality
por I-Claim HighQuality
asplenia. I-Claim HighQuality

El B-Claim HighQuality
tratamiento I-Claim HighQuality
de I-Claim HighQuality
elección I-Claim HighQuality
en I-Claim HighQuality
mordedura I-Claim HighQuality
de I-Claim HighQuality
perro I-Claim HighQuality
es I-Claim HighQuality
amoxicilina/clavulánico I-Claim HighQuality
pero I-Claim HighQuality
no I-Claim HighQuality
está, I-Claim HighQuality
así O 
que O 
podemos B-Claim HighQuality
usar I-Claim HighQuality
otro I-Claim HighQuality
como I-Claim HighQuality
clindamicina I-Claim HighQuality
más I-Claim HighQuality
una I-Claim HighQuality
cefalosporina I-Claim HighQuality
o I-Claim HighQuality
clindamicina I-Claim HighQuality
+ I-Claim HighQuality
moxifloxacino I-Claim HighQuality
pero I-Claim HighQuality
de I-Claim HighQuality
igual I-Claim HighQuality
forma I-Claim HighQuality
no I-Claim HighQuality
está I-Claim HighQuality
contemplado I-Claim HighQuality
entre I-Claim HighQuality
las I-Claim HighQuality
alternativas. I-Claim HighQuality

En B-Claim HighQuality
un I-Claim HighQuality
primer I-Claim HighQuality
intento I-Claim HighQuality
contestamos I-Claim HighQuality
la I-Claim HighQuality
4, I-Claim HighQuality
pero O 
la B-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
3, I-Claim HighQuality
por I-Claim HighQuality
la I-Claim HighQuality
segunda I-Claim HighQuality
parte I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
pregunta; I-Claim HighQuality
es B-Premise HighQuality
un I-Premise HighQuality
paciente I-Premise HighQuality
de I-Premise HighQuality
alto I-Premise HighQuality
riesgo I-Premise HighQuality
con I-Premise HighQuality
signos I-Premise HighQuality
incipiente I-Premise HighQuality
de I-Premise HighQuality
sepsis I-Premise HighQuality
por O 
lo O 
que O 
debe B-Claim HighQuality
de I-Claim HighQuality
enviarse I-Claim HighQuality
al I-Claim HighQuality
hospital, I-Claim HighQuality
aquí O 
la O 
clave O 
más O 
que O 
en O 
el O 
antibiótico O 
está O 
en O 
la O 
postura O 
a O 
tomar, O 
en O 
la O 
segunda O 
parte O 
de O 
cada O 
respuesta.. O 

Se B-Claim HighQuality
podría I-Claim HighQuality
impugnar I-Claim HighQuality
ya I-Claim HighQuality
que I-Claim HighQuality
no I-Claim HighQuality
dicen I-Claim HighQuality
en I-Claim HighQuality
cual I-Claim HighQuality
comunidad I-Claim HighQuality
ocurrió I-Claim HighQuality
la I-Claim HighQuality
mordedura I-Claim HighQuality
(si B-Claim HighQuality
fuera I-Claim HighQuality
en I-Claim HighQuality
Ceuta I-Claim HighQuality
o I-Claim HighQuality
Melilla I-Claim HighQuality
el I-Claim HighQuality
protocolo I-Claim HighQuality
puede I-Claim HighQuality
variar). I-Claim HighQuality

QUESTION O 
TYPE: O 
NEUROSURGERY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
niño I-Premise HighQuality
de I-Premise HighQuality
13 I-Premise HighQuality
años I-Premise HighQuality
presenta I-Premise HighQuality
un I-Premise HighQuality
cuadro I-Premise HighQuality
subagudo I-Premise HighQuality
de I-Premise HighQuality
cefalea I-Premise HighQuality
y I-Premise HighQuality
diplopia. I-Premise HighQuality

La B-Premise HighQuality
exploración I-Premise HighQuality
neurológica I-Premise HighQuality
muestra I-Premise HighQuality
una I-Premise HighQuality
parálisis I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
mirada I-Premise HighQuality
vertical I-Premise HighQuality
y I-Premise HighQuality
la I-Premise HighQuality
resonancia I-Premise HighQuality
magnética I-Premise HighQuality
una I-Premise HighQuality
lesión I-Premise HighQuality
captante I-Premise HighQuality
de I-Premise HighQuality
contraste I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
región I-Premise HighQuality
pineal I-Premise HighQuality
que I-Premise HighQuality
obstruye I-Premise HighQuality
el I-Premise HighQuality
acueducto I-Premise HighQuality
de I-Premise HighQuality
Silvio. I-Premise HighQuality

El O 
diagnóstico O 
más O 
probable O 
es: O 

1- O 
Glioblastoma. B-Claim HighQuality

2- O 
Meduloblastoma. B-Claim HighQuality

3- O 
Tumor B-Claim HighQuality
de I-Claim HighQuality
células I-Claim HighQuality
germinales. I-Claim HighQuality

4- O 
Meningioma. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Los B-Claim HighQuality
tumores I-Claim HighQuality
germinales I-Claim HighQuality
son I-Claim HighQuality
los I-Claim HighQuality
más I-Claim HighQuality
frecuentes I-Claim HighQuality
en I-Claim HighQuality
niños I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
región I-Claim HighQuality
pineal. I-Claim HighQuality

Suelen B-Claim HighQuality
captar I-Claim HighQuality
homogéneamente I-Claim HighQuality
y I-Claim HighQuality
provocar I-Claim HighQuality
hidrocefalia I-Claim HighQuality
triventricular I-Claim HighQuality
y I-Claim HighQuality
Parinaud. I-Claim HighQuality

Los B-Claim HighQuality
glioblastomas I-Claim HighQuality
suelen I-Claim HighQuality
darse I-Claim HighQuality
en I-Claim HighQuality
adultos I-Claim HighQuality
a I-Claim HighQuality
nivel I-Claim HighQuality
lobar, I-Claim HighQuality
los B-Claim HighQuality
meduloblastomas I-Claim HighQuality
son I-Claim HighQuality
los I-Claim HighQuality
tumores I-Claim HighQuality
malignos I-Claim HighQuality
más I-Claim HighQuality
frecuentes I-Claim HighQuality
a I-Claim HighQuality
nivel I-Claim HighQuality
de I-Claim HighQuality
fosa I-Claim HighQuality
posterior I-Claim HighQuality
en I-Claim HighQuality
niños I-Claim HighQuality
(vermis I-Claim HighQuality
y I-Claim HighQuality
techo I-Claim HighQuality
del I-Claim HighQuality
IV I-Claim HighQuality
ventrículo) I-Claim HighQuality
pero I-Claim HighQuality
raros I-Claim HighQuality
a I-Claim HighQuality
nivel I-Claim HighQuality
pineal I-Claim HighQuality
y O 
los B-Claim HighQuality
meningiomas I-Claim HighQuality
son I-Claim HighQuality
raros I-Claim HighQuality
en I-Claim HighQuality
niños I-Claim HighQuality
y I-Claim HighQuality
también I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
región I-Claim HighQuality
pineal. I-Claim HighQuality

QUESTION O 
TYPE: O 
OPHTHALMOLOGY O 

CLINICAL O 
CASE: O 

Hombre B-Premise HighQuality
de I-Premise HighQuality
67 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
edad, I-Premise HighQuality
diabético I-Premise HighQuality
y I-Premise HighQuality
asmático, I-Premise HighQuality
con I-Premise HighQuality
un I-Premise HighQuality
glaucoma I-Premise HighQuality
primario I-Premise HighQuality
de I-Premise HighQuality
ángulo I-Premise HighQuality
abierto I-Premise HighQuality
en I-Premise HighQuality
ambos I-Premise HighQuality
ojos. I-Premise HighQuality

Presenta B-Premise HighQuality
una I-Premise HighQuality
presión I-Premise HighQuality
ocular I-Premise HighQuality
de I-Premise HighQuality
34 I-Premise HighQuality
mmHg I-Premise HighQuality
en I-Premise HighQuality
su I-Premise HighQuality
ojo I-Premise HighQuality
derecho I-Premise HighQuality
y I-Premise HighQuality
31 I-Premise HighQuality
mmHg I-Premise HighQuality
en I-Premise HighQuality
su I-Premise HighQuality
ojo I-Premise HighQuality
izquierdo. I-Premise HighQuality

¿Cuál O 
de O 
los O 
siguientes O 
grupos O 
farmacológicos O 
es O 
el O 
más O 
indicado O 
como O 
primera O 
elección O 
como O 
tratamiento O 
hipotensor? O 

1- O 
Inhibidores B-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
anhidrasa I-Claim HighQuality
carbónica. I-Claim HighQuality

2- O 
Beta-bloqueantes. B-Claim HighQuality

3- O 
Agonistas B-Claim HighQuality
alfa-2. I-Claim HighQuality

4- O 
Derivados B-Claim HighQuality
de I-Claim HighQuality
prostaglandinas. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
4 O 

Nos B-Claim HighQuality
preguntan I-Claim HighQuality
por I-Claim HighQuality
el I-Claim HighQuality
tratamiento I-Claim HighQuality
de I-Claim HighQuality
primera I-Claim HighQuality
elección I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
glaucoma. I-Claim HighQuality

Antiguamente B-Claim HighQuality
la I-Claim HighQuality
primera I-Claim HighQuality
elección I-Claim HighQuality
eran I-Claim HighQuality
los I-Claim HighQuality
betabloqueantes, I-Claim HighQuality
pero I-Claim HighQuality
actualmente I-Claim HighQuality
han I-Claim HighQuality
sido I-Claim HighQuality
desplazados I-Claim HighQuality
por I-Claim HighQuality
el I-Claim HighQuality
grupo I-Claim HighQuality
que I-Claim HighQuality
más I-Claim HighQuality
baja I-Claim HighQuality
la I-Claim HighQuality
presión I-Claim HighQuality
intaocular: I-Claim HighQuality
las I-Claim HighQuality
prostaglandinas. I-Claim HighQuality

Su B-Claim HighQuality
eficacia I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
posología I-Claim HighQuality
más I-Claim HighQuality
cómoda I-Claim HighQuality
(una I-Claim HighQuality
vez I-Claim HighQuality
al I-Claim HighQuality
día), I-Claim HighQuality
los I-Claim HighQuality
hacen I-Claim HighQuality
en I-Claim HighQuality
general I-Claim HighQuality
el I-Claim HighQuality
grupo I-Claim HighQuality
de I-Claim HighQuality
elección. I-Claim HighQuality

Los B-Claim HighQuality
betabloqueantes I-Claim HighQuality
quedarían I-Claim HighQuality
como I-Claim HighQuality
segunda I-Claim HighQuality
elección I-Claim HighQuality
en I-Claim HighQuality
casos I-Claim HighQuality
en I-Claim HighQuality
los I-Claim HighQuality
que I-Claim HighQuality
los I-Claim HighQuality
efectos I-Claim HighQuality
secundarios I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
prostaglandinos I-Claim HighQuality
(cambio I-Claim HighQuality
de I-Claim HighQuality
color I-Claim HighQuality
de I-Claim HighQuality
ojos, I-Claim HighQuality
aumento I-Claim HighQuality
del I-Claim HighQuality
tamaño I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
pestañas) I-Claim HighQuality
nos I-Claim HighQuality
hagan I-Claim HighQuality
dejarlas I-Claim HighQuality
inicialmente I-Claim HighQuality
de I-Claim HighQuality
lado. I-Claim HighQuality

Debido B-Claim HighQuality
a I-Claim HighQuality
que I-Claim HighQuality
el I-Claim HighQuality
paciente I-Claim HighQuality
es I-Claim HighQuality
asmático, I-Claim HighQuality
deberíamos I-Claim HighQuality
descartar I-Claim HighQuality
los I-Claim HighQuality
betabloqueantes I-Claim HighQuality
(respuesta I-Claim HighQuality
2 I-Claim HighQuality
incorrecta). I-Claim HighQuality

Además B-Claim HighQuality
como I-Claim HighQuality
necesitamos I-Claim HighQuality
una I-Claim HighQuality
bajada I-Claim HighQuality
importante I-Claim HighQuality
de I-Claim HighQuality
presión I-Claim HighQuality
intraocular I-Claim HighQuality
porque I-Claim HighQuality
las I-Claim HighQuality
cifras I-Claim HighQuality
son I-Claim HighQuality
altas I-Claim HighQuality
(34 I-Claim HighQuality
y I-Claim HighQuality
31), I-Claim HighQuality
podemos I-Claim HighQuality
también I-Claim HighQuality
descartar I-Claim HighQuality
los I-Claim HighQuality
inhibidores I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
anhidrasa I-Claim HighQuality
carbónica I-Claim HighQuality
y I-Claim HighQuality
los I-Claim HighQuality
agonistas I-Claim HighQuality
alfa-2 I-Claim HighQuality
(opciones I-Claim HighQuality
1 I-Claim HighQuality
y I-Claim HighQuality
3 I-Claim HighQuality
incorrectas). I-Claim HighQuality

Y B-Claim HighQuality
decantarnos I-Claim HighQuality
por I-Claim HighQuality
el I-Claim HighQuality
grupo I-Claim HighQuality
que I-Claim HighQuality
más I-Claim HighQuality
puede I-Claim HighQuality
bajar I-Claim HighQuality
la I-Claim HighQuality
presión I-Claim HighQuality
intraocular. I-Claim HighQuality

Respuesta B-Claim HighQuality
4 I-Claim HighQuality
correcta. I-Claim HighQuality

Y O 
luego O 
un O 
par O 
de O 
matices O 
del O 
enunciado. O 

Sería O 
más O 
correcto O 
hablar O 
de O 
presión O 
intraocular O 
y O 
no O 
de O 
“presión O 
ocular”. O 

Y O 
la O 
redacción O 
podría O 
mejorarse O 
para O 
no O 
repetir O 
la O 
palabra O 
“como” O 
en O 
la O 
última O 
frase. O 

QUESTION O 
TYPE: O 
TRAUMATOLOGY O 
AND O 
ORTHOPEDICS O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
60 I-Premise HighQuality
años, I-Premise HighQuality
diabética I-Premise HighQuality
insulinodependiente, I-Premise HighQuality
que I-Premise HighQuality
presenta I-Premise HighQuality
omalgia I-Premise HighQuality
derecha I-Premise HighQuality
de I-Premise HighQuality
predominio I-Premise HighQuality
nocturno I-Premise HighQuality
de I-Premise HighQuality
varias I-Premise HighQuality
semanas I-Premise HighQuality
de I-Premise HighQuality
evolución. I-Premise HighQuality

No B-Premise HighQuality
refiere I-Premise HighQuality
traumatismo. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
física I-Premise HighQuality
destaca I-Premise HighQuality
una I-Premise HighQuality
limitación I-Premise HighQuality
activa I-Premise HighQuality
y I-Premise HighQuality
pasiva I-Premise HighQuality
de I-Premise HighQuality
todos I-Premise HighQuality
los I-Premise HighQuality
arcos I-Premise HighQuality
de I-Premise HighQuality
movimiento I-Premise HighQuality
del I-Premise HighQuality
hombro. I-Premise HighQuality

¿Qué O 
cuadro O 
clínico O 
sospecha O 
como O 
primera O 
posibilidad O 
diagnóstica? O 

1- O 
Una B-Claim HighQuality
tumoración I-Claim HighQuality
maligna I-Claim HighQuality
localizada I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
epífisis I-Claim HighQuality
proximal I-Claim HighQuality
de I-Claim HighQuality
húmero. I-Claim HighQuality

2- O 
Una B-Claim HighQuality
artritis I-Claim HighQuality
séptica I-Claim HighQuality
de I-Claim HighQuality
hombro. I-Claim HighQuality

3- O 
Una B-Claim HighQuality
capsulitis I-Claim HighQuality
adhesiva. I-Claim HighQuality

4- O 
Un B-Claim HighQuality
proceso I-Claim HighQuality
degenerativo I-Claim HighQuality
artrósico I-Claim HighQuality
acromioclavicular. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Todo B-Claim HighQuality
apunta I-Claim HighQuality
a I-Claim HighQuality
una I-Claim HighQuality
capsulitis I-Claim HighQuality
adhesiva, I-Claim HighQuality
como I-Claim HighQuality
bien I-Claim HighQuality
dices. I-Claim HighQuality

La B-Claim HighQuality
edad, I-Claim HighQuality
el I-Claim HighQuality
sexo, I-Claim HighQuality
la I-Claim HighQuality
clínica… I-Claim HighQuality
lo I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
DM… I-Claim HighQuality

QUESTION O 
TYPE: O 
ORTHOPEDIC O 
SURGERY O 
AND O 
TRAUMATOLOGY O 

CLINICAL O 
CASE: O 

Niña B-Premise HighQuality
de I-Premise HighQuality
11 I-Premise HighQuality
años I-Premise HighQuality
y I-Premise HighQuality
6 I-Premise HighQuality
meses, I-Premise HighQuality
premenárquica, I-Premise HighQuality
con I-Premise HighQuality
escoliosis I-Premise HighQuality
idiopática I-Premise HighQuality
conocida. I-Premise HighQuality

La B-Premise HighQuality
radiografía I-Premise HighQuality
de I-Premise HighQuality
raquis I-Premise HighQuality
realizada I-Premise HighQuality
hace I-Premise HighQuality
6 I-Premise HighQuality
meses I-Premise HighQuality
mostraba I-Premise HighQuality
una I-Premise HighQuality
curva I-Premise HighQuality
tórca-lumbar I-Premise HighQuality
izquierda I-Premise HighQuality
de I-Premise HighQuality
18º I-Premise HighQuality
(ángulo I-Premise HighQuality
de I-Premise HighQuality
Cobb). I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
actual I-Premise HighQuality
se I-Premise HighQuality
observa I-Premise HighQuality
un I-Premise HighQuality
ángulo I-Premise HighQuality
de I-Premise HighQuality
Cobb I-Premise HighQuality
de I-Premise HighQuality
28º, I-Premise HighQuality
con I-Premise HighQuality
una I-Premise HighQuality
maduración I-Premise HighQuality
de I-Premise HighQuality
cresta I-Premise HighQuality
iliaca I-Premise HighQuality
(signo I-Premise HighQuality
de I-Premise HighQuality
Risser) I-Premise HighQuality
de I-Premise HighQuality
2. I-Premise HighQuality

En O 
este O 
momento O 
evolutivo, O 
¿qué O 
tratamiento O 
es O 
el O 
más O 
adecuado O 
para O 
intentar O 
detener O 
la O 
progresión O 
de O 
la O 
curva?: O 

1- O 
Ejercicios B-Claim HighQuality
de I-Claim HighQuality
natación. I-Claim HighQuality

2- O 
Ejercicios B-Claim HighQuality
de I-Claim HighQuality
reeducación I-Claim HighQuality
postural. I-Claim HighQuality

3- O 
Corsé B-Claim HighQuality
ortopédico I-Claim HighQuality
corrector. I-Claim HighQuality

4- O 
La B-Claim HighQuality
intervención I-Claim HighQuality
quirúrgica I-Claim HighQuality
mediante I-Claim HighQuality
artrodesis I-Claim HighQuality
espinal. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

En B-Claim HighQuality
las I-Claim HighQuality
formas I-Claim HighQuality
juvenil I-Claim HighQuality
y I-Claim HighQuality
del I-Claim HighQuality
adolescente I-Claim HighQuality
el I-Claim HighQuality
tratamiento I-Claim HighQuality
depende I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
grados I-Claim HighQuality
de I-Claim HighQuality
deformidad: I-Claim HighQuality
• B-Claim HighQuality
10 I-Claim HighQuality
– I-Claim HighQuality
20°: I-Claim HighQuality
observación I-Claim HighQuality
seriada. I-Claim HighQuality

• B-Claim HighQuality
20-50°: I-Claim HighQuality
corsés I-Claim HighQuality
de I-Claim HighQuality
termoplástico I-Claim HighQuality
(Boston, I-Claim HighQuality
Cheneau I-Claim HighQuality
o I-Claim HighQuality
Milwaukee, I-Claim HighQuality
según I-Claim HighQuality
dónde I-Claim HighQuality
se I-Claim HighQuality
localice I-Claim HighQuality
el I-Claim HighQuality
ápex I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
curva I-Claim HighQuality
principal). I-Claim HighQuality

• O 
40-50°: B-Claim HighQuality
con I-Claim HighQuality
Risser I-Claim HighQuality
menor I-Claim HighQuality
de I-Claim HighQuality
3 I-Claim HighQuality
estaría I-Claim HighQuality
indicada I-Claim HighQuality
la I-Claim HighQuality
artrodesis I-Claim HighQuality
quirúrgica; I-Claim HighQuality
con I-Claim HighQuality
Risser I-Claim HighQuality
mayor I-Claim HighQuality
o I-Claim HighQuality
igual I-Claim HighQuality
de I-Claim HighQuality
3 I-Claim HighQuality
el I-Claim HighQuality
potencial I-Claim HighQuality
remanente I-Claim HighQuality
de I-Claim HighQuality
crecimiento I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
curva I-Claim HighQuality
es I-Claim HighQuality
escaso I-Claim HighQuality
y I-Claim HighQuality
se I-Claim HighQuality
puede I-Claim HighQuality
valorar I-Claim HighQuality
la I-Claim HighQuality
observación I-Claim HighQuality
por I-Claim HighQuality
si I-Claim HighQuality
tendiera I-Claim HighQuality
a I-Claim HighQuality
progresar I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
edad I-Claim HighQuality
adulta. I-Claim HighQuality

QUESTION O 
TYPE: O 
ORTHOPEDIC O 
SURGERY O 
AND O 
TRAUMATOLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
que I-Premise HighQuality
presenta I-Premise HighQuality
dificultad I-Premise HighQuality
para I-Premise HighQuality
caminar I-Premise HighQuality
tras I-Premise HighQuality
una I-Premise HighQuality
cirugía I-Premise HighQuality
ginecológica. I-Premise HighQuality

Tiene B-Premise HighQuality
dolor I-Premise HighQuality
leve I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
muslo I-Premise HighQuality
y I-Premise HighQuality
le I-Premise HighQuality
falla I-Premise HighQuality
la I-Premise HighQuality
pierna I-Premise HighQuality
al I-Premise HighQuality
apoyar. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
presenta I-Premise HighQuality
debilidad I-Premise HighQuality
para I-Premise HighQuality
la I-Premise HighQuality
flexión I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
cadera I-Premise HighQuality
y I-Premise HighQuality
para I-Premise HighQuality
la I-Premise HighQuality
extensión I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
rodilla, I-Premise HighQuality
y I-Premise HighQuality
disestesias I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
cara I-Premise HighQuality
anterior I-Premise HighQuality
del I-Premise HighQuality
muslo. I-Premise HighQuality

¿Cuál O 
es O 
el O 
diagnóstico O 
de O 
sospecha O 
más O 
probable?: O 

1- O 
Neuropatía B-Claim HighQuality
del I-Claim HighQuality
nervio I-Claim HighQuality
femoral. I-Claim HighQuality

2- O 
Meralgia B-Claim HighQuality
parestésica I-Claim HighQuality
del I-Claim HighQuality
nervio I-Claim HighQuality
fémoro I-Claim HighQuality
cutáneo. I-Claim HighQuality

3- O 
Neuropatía B-Claim HighQuality
del I-Claim HighQuality
nervio I-Claim HighQuality
obturador. I-Claim HighQuality

4- O 
Neuropatía B-Claim HighQuality
del I-Claim HighQuality
nervio I-Claim HighQuality
ciático. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
1 O 

El B-Claim HighQuality
nervio I-Claim HighQuality
femoral I-Claim HighQuality
(aunque I-Claim HighQuality
poco I-Claim HighQuality
habitual) I-Claim HighQuality
puede I-Claim HighQuality
ser I-Claim HighQuality
dañado I-Claim HighQuality
en I-Claim HighQuality
una I-Claim HighQuality
operación I-Claim HighQuality
cesárea, I-Claim HighQuality
una I-Claim HighQuality
histerectomía I-Claim HighQuality
o I-Claim HighQuality
una I-Claim HighQuality
operación I-Claim HighQuality
abdominal I-Claim HighQuality
baja. I-Claim HighQuality

Esta B-Claim HighQuality
lesión I-Claim HighQuality
nerviosa I-Claim HighQuality
produce I-Claim HighQuality
hipoestesia I-Claim HighQuality
y I-Claim HighQuality
debilidad I-Claim HighQuality
a I-Claim HighQuality
lo I-Claim HighQuality
largo I-Claim HighQuality
de I-Claim HighQuality
su I-Claim HighQuality
distribución. I-Claim HighQuality

La B-Claim HighQuality
femoroneuropatía I-Claim HighQuality
se I-Claim HighQuality
manifiesta I-Claim HighQuality
por I-Claim HighQuality
una I-Claim HighQuality
parálisis I-Claim HighQuality
(25% I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
casos) I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
músculos I-Claim HighQuality
cuádriceps, I-Claim HighQuality
abolición I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
reflejos I-Claim HighQuality
rotulianos I-Claim HighQuality
e I-Claim HighQuality
hipoestesia I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
cara I-Claim HighQuality
anterior I-Claim HighQuality
e I-Claim HighQuality
interna I-Claim HighQuality
del I-Claim HighQuality
muslo. I-Claim HighQuality

Por B-Claim HighQuality
lo I-Claim HighQuality
tanto, I-Claim HighQuality
respuesta I-Claim HighQuality
1 I-Claim HighQuality
correcta. I-Claim HighQuality

El B-Claim HighQuality
nervio I-Claim HighQuality
fémoro I-Claim HighQuality
cutáneo I-Claim HighQuality
o I-Claim HighQuality
cutáneo I-Claim HighQuality
femoral I-Claim HighQuality
lateral I-Claim HighQuality
(L2,L3) I-Claim HighQuality
es I-Claim HighQuality
solo I-Claim HighQuality
sensitivo I-Claim HighQuality
encargándose I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
sensibilidad I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
piel I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
cara I-Claim HighQuality
lateral I-Claim HighQuality
y I-Claim HighQuality
anterior I-Claim HighQuality
del I-Claim HighQuality
muslo I-Claim HighQuality
hasta I-Claim HighQuality
la I-Claim HighQuality
rodilla, I-Claim HighQuality
por O 
lo O 
que O 
no B-Claim HighQuality
explicaría I-Claim HighQuality
el I-Claim HighQuality
problema I-Claim HighQuality
motor I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
marcha I-Claim HighQuality
y O 
2 B-Claim HighQuality
es I-Claim HighQuality
falsa. I-Claim HighQuality

El B-Claim HighQuality
nervio I-Claim HighQuality
obturador I-Claim HighQuality
(L2-L4) I-Claim HighQuality
es I-Claim HighQuality
un I-Claim HighQuality
nervio I-Claim HighQuality
mixto. I-Claim HighQuality

A B-Claim HighQuality
nivel I-Claim HighQuality
motor I-Claim HighQuality
inverva I-Claim HighQuality
el I-Claim HighQuality
obturador I-Claim HighQuality
externo, I-Claim HighQuality
pectíneo, I-Claim HighQuality
aproximador I-Claim HighQuality
corto, I-Claim HighQuality
los I-Claim HighQuality
aproximadores I-Claim HighQuality
(aductores) I-Claim HighQuality
y I-Claim HighQuality
grácil. I-Claim HighQuality

A B-Claim HighQuality
nivel I-Claim HighQuality
sensitivo I-Claim HighQuality
la I-Claim HighQuality
cápsula I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
articulación I-Claim HighQuality
coxofemoral, I-Claim HighQuality
cara I-Claim HighQuality
medial I-Claim HighQuality
del I-Claim HighQuality
muslo I-Claim HighQuality
por I-Claim HighQuality
encima I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
rodilla. I-Claim HighQuality

Por B-Claim HighQuality
tanto I-Claim HighQuality
ni I-Claim HighQuality
afecta I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
sensibilidad I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
cara I-Claim HighQuality
anterior I-Claim HighQuality
del I-Claim HighQuality
muslo I-Claim HighQuality
ni I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
extensión I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
rodilla I-Claim HighQuality
de I-Claim HighQuality
modo I-Claim HighQuality
que I-Claim HighQuality
3 I-Claim HighQuality
es I-Claim HighQuality
falsa. I-Claim HighQuality

Una B-Claim HighQuality
lesión I-Claim HighQuality
del I-Claim HighQuality
nervio I-Claim HighQuality
ciático I-Claim HighQuality
a I-Claim HighQuality
nivel I-Claim HighQuality
motor I-Claim HighQuality
afecta I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
flexión I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
rodilla I-Claim HighQuality
no I-Claim HighQuality
a I-Claim HighQuality
su I-Claim HighQuality
extensión I-Claim HighQuality
y I-Claim HighQuality
a I-Claim HighQuality
nivel I-Claim HighQuality
distal I-Claim HighQuality
a I-Claim HighQuality
esta I-Claim HighQuality
(no I-Claim HighQuality
cuentan I-Claim HighQuality
nada I-Claim HighQuality
de I-Claim HighQuality
clínica I-Claim HighQuality
distal) I-Claim HighQuality
y I-Claim HighQuality
a I-Claim HighQuality
nivel I-Claim HighQuality
sensitivo I-Claim HighQuality
también I-Claim HighQuality
es I-Claim HighQuality
distal I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
cara I-Claim HighQuality
externa I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
pierna I-Claim HighQuality
y I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
pie I-Claim HighQuality
por I-Claim HighQuality
lo I-Claim HighQuality
que I-Claim HighQuality
4 I-Claim HighQuality
también I-Claim HighQuality
es I-Claim HighQuality
falsa. I-Claim HighQuality

QUESTION O 
TYPE: O 
CRITICAL O 
CARE O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
hombre I-Premise HighQuality
de I-Premise HighQuality
18 I-Premise HighQuality
años I-Premise HighQuality
llega I-Premise HighQuality
al I-Premise HighQuality
servicio I-Premise HighQuality
de I-Premise HighQuality
urgencias I-Premise HighQuality
del I-Premise HighQuality
hospital I-Premise HighQuality
trasladado I-Premise HighQuality
por I-Premise HighQuality
una I-Premise HighQuality
unidad I-Premise HighQuality
de I-Premise HighQuality
soporte I-Premise HighQuality
vital I-Premise HighQuality
básico. I-Premise HighQuality

Ha B-Premise HighQuality
sido I-Premise HighQuality
atropellado I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
automóvil I-Premise HighQuality
cuando I-Premise HighQuality
iba I-Premise HighQuality
en I-Premise HighQuality
bicicleta. I-Premise HighQuality

A B-Premise HighQuality
su I-Premise HighQuality
llegada I-Premise HighQuality
tiene I-Premise HighQuality
una I-Premise HighQuality
frecuencia I-Premise HighQuality
cardíaca I-Premise HighQuality
de I-Premise HighQuality
115 I-Premise HighQuality
lpm, I-Premise HighQuality
una I-Premise HighQuality
presión I-Premise HighQuality
arterial I-Premise HighQuality
de I-Premise HighQuality
110/75 I-Premise HighQuality
mmHg, I-Premise HighQuality
pulso I-Premise HighQuality
radial I-Premise HighQuality
palpable, I-Premise HighQuality
un I-Premise HighQuality
relleno I-Premise HighQuality
capilar I-Premise HighQuality
de I-Premise HighQuality
2,5 I-Premise HighQuality
segundos I-Premise HighQuality
y I-Premise HighQuality
una I-Premise HighQuality
frecuencia I-Premise HighQuality
respiratoria I-Premise HighQuality
de I-Premise HighQuality
25 I-Premise HighQuality
rpm. I-Premise HighQuality

¿Qué O 
nos O 
indican O 
estos O 
datos?: O 

1- O 
Ha B-Claim HighQuality
perdido I-Claim HighQuality
entre I-Claim HighQuality
un I-Claim HighQuality
15 I-Claim HighQuality
y I-Claim HighQuality
un I-Claim HighQuality
30 I-Claim HighQuality
% I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
volemia I-Claim HighQuality
y I-Claim HighQuality
precisa I-Claim HighQuality
reposición I-Claim HighQuality
de I-Claim HighQuality
volumen. I-Claim HighQuality

2- O 
Ha B-Claim HighQuality
perdido I-Claim HighQuality
más I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
30 I-Claim HighQuality
% I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
volemia I-Claim HighQuality
y I-Claim HighQuality
precisa I-Claim HighQuality
reposición I-Claim HighQuality
de I-Claim HighQuality
volumen I-Claim HighQuality
y I-Claim HighQuality
de I-Claim HighQuality
sangre. I-Claim HighQuality

3- O 
Ha B-Claim HighQuality
perdido I-Claim HighQuality
más I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
40 I-Claim HighQuality
% I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
volemia I-Claim HighQuality
y I-Claim HighQuality
precisará I-Claim HighQuality
tratamiento I-Claim HighQuality
quirúrgico. I-Claim HighQuality

4- O 
Ha B-Claim HighQuality
perdido I-Claim HighQuality
más I-Claim HighQuality
de I-Claim HighQuality
un I-Claim HighQuality
50% I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
volemia I-Claim HighQuality
y I-Claim HighQuality
precisa I-Claim HighQuality
reposición I-Claim HighQuality
de I-Claim HighQuality
volumen I-Claim HighQuality
y I-Claim HighQuality
de I-Claim HighQuality
sangre. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
1 O 

Técnicamente B-Claim HighQuality
el I-Claim HighQuality
paciente I-Claim HighQuality
se I-Claim HighQuality
encuentra I-Claim HighQuality
en I-Claim HighQuality
un I-Claim HighQuality
grado I-Claim HighQuality
II I-Claim HighQuality
de I-Claim HighQuality
hemorragia I-Claim HighQuality
según I-Claim HighQuality
la I-Claim HighQuality
clasificación I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
ATLS, I-Claim HighQuality
en B-Claim HighQuality
principio I-Claim HighQuality
esto I-Claim HighQuality
nos I-Claim HighQuality
habla I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
pérdida I-Claim HighQuality
de I-Claim HighQuality
entre I-Claim HighQuality
750 I-Claim HighQuality
y I-Claim HighQuality
1500mL I-Claim HighQuality
de I-Claim HighQuality
sangre I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
actuación I-Claim HighQuality
indicada I-Claim HighQuality
es I-Claim HighQuality
reanimación I-Claim HighQuality
con I-Claim HighQuality
cristaloides; I-Claim HighQuality
no B-Claim HighQuality
obstante, I-Claim HighQuality
en I-Claim HighQuality
las I-Claim HighQuality
guías I-Claim HighQuality
de I-Claim HighQuality
atención I-Claim HighQuality
al I-Claim HighQuality
paciente I-Claim HighQuality
politraumatizado I-Claim HighQuality
grave, I-Claim HighQuality
cada I-Claim HighQuality
vez I-Claim HighQuality
se I-Claim HighQuality
preconiza I-Claim HighQuality
más I-Claim HighQuality
el I-Claim HighQuality
uso I-Claim HighQuality
precoz I-Claim HighQuality
de I-Claim HighQuality
hemoderivados, I-Claim HighQuality
sobre I-Claim HighQuality
todo I-Claim HighQuality
en I-Claim HighQuality
casos I-Claim HighQuality
límite I-Claim HighQuality
como I-Claim HighQuality
este, I-Claim HighQuality
y I-Claim HighQuality
en I-Claim HighQuality
pacientes I-Claim HighQuality
jóvenes, I-Claim HighQuality
que I-Claim HighQuality
pueden I-Claim HighQuality
no I-Claim HighQuality
llegar I-Claim HighQuality
a I-Claim HighQuality
traducir I-Claim HighQuality
la I-Claim HighQuality
gravedad I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
pérdida I-Claim HighQuality
sanguínea I-Claim HighQuality
hasta I-Claim HighQuality
que I-Claim HighQuality
esta I-Claim HighQuality
se I-Claim HighQuality
hace I-Claim HighQuality
mucho I-Claim HighQuality
más I-Claim HighQuality
significativa. I-Claim HighQuality

Por B-Claim HighQuality
tanto I-Claim HighQuality
dudaría I-Claim HighQuality
entre I-Claim HighQuality
las I-Claim HighQuality
opciones I-Claim HighQuality
1 I-Claim HighQuality
y I-Claim HighQuality
2. I-Claim HighQuality

QUESTION O 
TYPE: O 
HEMATOLOGY O 

CLINICAL O 
CASE: O 

Paciente B-Premise HighQuality
de I-Premise HighQuality
18 I-Premise HighQuality
años I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
con I-Premise HighQuality
epistaxis I-Premise HighQuality
de I-Premise HighQuality
varios I-Premise HighQuality
días I-Premise HighQuality
de I-Premise HighQuality
evolución, I-Premise HighQuality
sin I-Premise HighQuality
antecedentes I-Premise HighQuality
personales I-Premise HighQuality
ni I-Premise HighQuality
familiares I-Premise HighQuality
de I-Premise HighQuality
interés. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
está I-Premise HighQuality
afebril, I-Premise HighQuality
se I-Premise HighQuality
observan I-Premise HighQuality
equimosis I-Premise HighQuality
múltiples, I-Premise HighQuality
no I-Premise HighQuality
se I-Premise HighQuality
palpa I-Premise HighQuality
esplenomegalia. I-Premise HighQuality

Analítica: B-Premise HighQuality
Leucocitos I-Premise HighQuality
7,2 I-Premise HighQuality
x103/μL, I-Premise HighQuality
Hb I-Premise HighQuality
12,3 I-Premise HighQuality
g/dL, I-Premise HighQuality
Plaquetas I-Premise HighQuality
6,0 I-Premise HighQuality
x103/μL. I-Premise HighQuality

La B-Premise HighQuality
trombocitopenia I-Premise HighQuality
se I-Premise HighQuality
confirma I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
frotis, I-Premise HighQuality
donde I-Premise HighQuality
se I-Premise HighQuality
observan I-Premise HighQuality
plaquetas I-Premise HighQuality
de I-Premise HighQuality
tamaño I-Premise HighQuality
aumentado. I-Premise HighQuality

Estudio B-Premise HighQuality
de I-Premise HighQuality
coagulación I-Premise HighQuality
y I-Premise HighQuality
bioquímica I-Premise HighQuality
normales. I-Premise HighQuality

¿Cuál O 
considera O 
el O 
diagnóstico O 
más O 
probable?: O 

1- O 
Púrpura B-Claim HighQuality
trombótica I-Claim HighQuality
trombocitopénica. I-Claim HighQuality

2- O 
Coagulación B-Claim HighQuality
intravascular I-Claim HighQuality
diseminada. I-Claim HighQuality

3- O 
Trombocitopenia B-Claim HighQuality
inducida I-Claim HighQuality
por I-Claim HighQuality
infección. I-Claim HighQuality

4- O 
Trombocitopenia B-Claim HighQuality
inmune I-Claim HighQuality
primaria. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
4 O 

Si B-Claim HighQuality
quisieran I-Claim HighQuality
que I-Claim HighQuality
respondiéramos I-Claim HighQuality
que I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
PTT I-Claim HighQuality
(respuesta I-Claim HighQuality
1) I-Claim HighQuality
probablemente I-Claim HighQuality
asociarían I-Claim HighQuality
anemia I-Claim HighQuality
y I-Claim HighQuality
de I-Claim HighQuality
seguro I-Claim HighQuality
que I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
frotis I-Claim HighQuality
nos I-Claim HighQuality
hablarían I-Claim HighQuality
de I-Claim HighQuality
esquistocitos. I-Claim HighQuality

Por B-Claim HighQuality
no I-Claim HighQuality
decir, I-Claim HighQuality
que I-Claim HighQuality
probablemente I-Claim HighQuality
la I-Claim HighQuality
clínica I-Claim HighQuality
del I-Claim HighQuality
paciente I-Claim HighQuality
sería I-Claim HighQuality
mucho I-Claim HighQuality
más I-Claim HighQuality
que I-Claim HighQuality
una I-Claim HighQuality
epistaxis. I-Claim HighQuality

Las B-Claim HighQuality
otras I-Claim HighQuality
dos I-Claim HighQuality
respuestas, I-Claim HighQuality
no I-Claim HighQuality
tenéis I-Claim HighQuality
que I-Claim HighQuality
dudar I-Claim HighQuality
con I-Claim HighQuality
ellas. I-Claim HighQuality

Nada B-Claim HighQuality
orienta I-Claim HighQuality
a I-Claim HighQuality
eso. I-Claim HighQuality

QUESTION O 
TYPE: O 
PEDIATRICS O 

CLINICAL O 
CASE: O 

Ante B-Premise HighQuality
un I-Premise HighQuality
trastorno I-Premise HighQuality
obsesivo-compulsivo I-Premise HighQuality
(TOC) I-Premise HighQuality
de I-Premise HighQuality
inicio I-Premise HighQuality
súbito I-Premise HighQuality
en I-Premise HighQuality
un I-Premise HighQuality
niño I-Premise HighQuality
de I-Premise HighQuality
9 I-Premise HighQuality
años I-Premise HighQuality
que I-Premise HighQuality
además I-Premise HighQuality
presenta I-Premise HighQuality
tics I-Premise HighQuality
y I-Premise HighQuality
corea I-Premise HighQuality
como I-Premise HighQuality
manifestaciones I-Premise HighQuality
neurológicas I-Premise HighQuality
se O 
debería O 
descartar O 
una O 
infección O 
por: O 

1- O 
Estreptococo B-Claim HighQuality
viridans. I-Claim HighQuality

2- O 
Estreptococo B-Claim HighQuality
alfa-hemolítico. I-Claim HighQuality

3- O 
Estreptococo B-Claim HighQuality
beta-hemolítico, I-Claim HighQuality
grupo I-Claim HighQuality
A. I-Claim HighQuality

4- O 
Enterococo. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Nos B-Claim HighQuality
presentan I-Claim HighQuality
un I-Claim HighQuality
caso I-Claim HighQuality
de I-Claim HighQuality
Síndrome I-Claim HighQuality
PANDAS, I-Claim HighQuality
complicación I-Claim HighQuality
rara I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
infección I-Claim HighQuality
producida I-Claim HighQuality
por I-Claim HighQuality
el I-Claim HighQuality
estreptococo I-Claim HighQuality
beta-hemolítico I-Claim HighQuality
del I-Claim HighQuality
grupo I-Claim HighQuality
A. I-Claim HighQuality

QUESTION O 
TYPE: O 
PEDIATRICS O 

CLINICAL O 
CASE: O 

Niña B-Premise HighQuality
de I-Premise HighQuality
5 I-Premise HighQuality
años, I-Premise HighQuality
completamente I-Premise HighQuality
asintomática, I-Premise HighQuality
y I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
revisión I-Premise HighQuality
habitual I-Premise HighQuality
del I-Premise HighQuality
pediatra. I-Premise HighQuality

Consulta O 
porque O 
su B-Premise HighQuality
madre I-Premise HighQuality
fue I-Premise HighQuality
operada I-Premise HighQuality
de I-Premise HighQuality
un I-Premise HighQuality
tumor I-Premise HighQuality
de I-Premise HighQuality
tiroides I-Premise HighQuality
y I-Premise HighQuality
una I-Premise HighQuality
abuela I-Premise HighQuality
falleció I-Premise HighQuality
hace I-Premise HighQuality
10 I-Premise HighQuality
años I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
feocromocitoma. I-Premise HighQuality

La O 
actitud O 
terapéutica O 
prioritaria O 
que O 
adoptaremos O 
será: O 

1- O 
Exploración B-Claim HighQuality
física I-Claim HighQuality
exhaustiva I-Claim HighQuality
con I-Claim HighQuality
control I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
tensión I-Claim HighQuality
arterial I-Claim HighQuality
para I-Claim HighQuality
valorar I-Claim HighQuality
si I-Claim HighQuality
el I-Claim HighQuality
niño I-Claim HighQuality
puede I-Claim HighQuality
presentar I-Claim HighQuality
alguna I-Claim HighQuality
enfermedad I-Claim HighQuality
familiar. I-Claim HighQuality

2- O 
Análisis B-Claim HighQuality
bioquímico I-Claim HighQuality
con I-Claim HighQuality
calcitonina. I-Claim HighQuality
Si I-Claim HighQuality
ésta I-Claim HighQuality
es I-Claim HighQuality
normal I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
preciso I-Claim HighQuality
más I-Claim HighQuality
control I-Claim HighQuality
a I-Claim HighQuality
esta I-Claim HighQuality
edad. I-Claim HighQuality

3- O 
Seguimiento B-Claim HighQuality
anual I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
niveles I-Claim HighQuality
de I-Claim HighQuality
calcitonina I-Claim HighQuality
con I-Claim HighQuality
estimulación I-Claim HighQuality
con I-Claim HighQuality
pentagastrina I-Claim HighQuality
y, I-Claim HighQuality
si I-Claim HighQuality
se I-Claim HighQuality
eleva, I-Claim HighQuality
indicar I-Claim HighQuality
una I-Claim HighQuality
tiroidectomía I-Claim HighQuality
profiláctica. I-Claim HighQuality

4- O 
Estudio B-Claim HighQuality
genético I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
mutación I-Claim HighQuality
del I-Claim HighQuality
proto-oncogen I-Claim HighQuality
RET I-Claim HighQuality
c634, I-Claim HighQuality
y I-Claim HighQuality
si I-Claim HighQuality
es I-Claim HighQuality
positivo I-Claim HighQuality
se I-Claim HighQuality
realizará I-Claim HighQuality
la I-Claim HighQuality
tiroidectomía I-Claim HighQuality
radical I-Claim HighQuality
profiláctica I-Claim HighQuality
a I-Claim HighQuality
esta I-Claim HighQuality
edad. I-Claim HighQuality

5- O 
Estudio B-Claim HighQuality
genético I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
mutación I-Claim HighQuality
proto-oncogen I-Claim HighQuality
RET I-Claim HighQuality
c634, I-Claim HighQuality
niveles I-Claim HighQuality
de I-Claim HighQuality
calcitonina I-Claim HighQuality
y I-Claim HighQuality
PAAF I-Claim HighQuality
(punción I-Claim HighQuality
aspiración I-Claim HighQuality
con I-Claim HighQuality
aguja I-Claim HighQuality
fina) I-Claim HighQuality
y I-Claim HighQuality
si I-Claim HighQuality
son I-Claim HighQuality
positivas I-Claim HighQuality
se I-Claim HighQuality
realizará I-Claim HighQuality
la I-Claim HighQuality
tiroidectomía I-Claim HighQuality
radical. I-Claim HighQuality

CORRECT O 
ANSWER: O 
4 O 

La B-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
4. I-Claim HighQuality

Me O 
parece O 
una O 
pregunta O 
más O 
de O 
Endocrino O 
que O 
de O 
Pediatría. O 

Los B-Claim HighQuality
portadores I-Claim HighQuality
del I-Claim HighQuality
protooncogen I-Claim HighQuality
suelen I-Claim HighQuality
tener I-Claim HighQuality
tumoraciones I-Claim HighQuality
tiroideas I-Claim HighQuality
precoces I-Claim HighQuality
por O 
lo O 
que O 
se B-Claim HighQuality
suele I-Claim HighQuality
recomendar I-Claim HighQuality
la I-Claim HighQuality
tiroidectomía I-Claim HighQuality
radical I-Claim HighQuality
antes I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
5 I-Claim HighQuality
años. I-Claim HighQuality

Obviamente O 
esto O 
lo O 
he O 
tenido O 
que O 
buscar…no O 
es O 
muy O 
frecuente O 
en O 
nuestra O 
práctica O 
habitual. O 

QUESTION O 
TYPE: O 
DIGESTIVE O 

CLINICAL O 
CASE: O 

Paciente B-Premise HighQuality
diagnosticado I-Premise HighQuality
de I-Premise HighQuality
diverticulitis I-Premise HighQuality
aguda, I-Premise HighQuality
tratado I-Premise HighQuality
con I-Premise HighQuality
amoxicilina/clavulánico. I-Premise HighQuality

Al B-Premise HighQuality
cabo I-Premise HighQuality
de I-Premise HighQuality
5 I-Premise HighQuality
días I-Premise HighQuality
comienza I-Premise HighQuality
con I-Premise HighQuality
fiebre I-Premise HighQuality
y I-Premise HighQuality
diarrea. I-Premise HighQuality

Se B-Premise HighQuality
le I-Premise HighQuality
diagnostica I-Premise HighQuality
de I-Premise HighQuality
colitis I-Premise HighQuality
por I-Premise HighQuality
Clostridium I-Premise HighQuality
difficile, I-Premise HighQuality
se I-Premise HighQuality
suspende I-Premise HighQuality
la I-Premise HighQuality
amoxicilina/clavulánico I-Premise HighQuality
y I-Premise HighQuality
se I-Premise HighQuality
pauta I-Premise HighQuality
metronidazol. I-Premise HighQuality

A B-Premise HighQuality
los I-Premise HighQuality
4 I-Premise HighQuality
días I-Premise HighQuality
no I-Premise HighQuality
ha I-Premise HighQuality
respondido I-Premise HighQuality
al I-Premise HighQuality
metronidazol, I-Premise HighQuality
pero I-Premise HighQuality
se I-Premise HighQuality
encuentra I-Premise HighQuality
clínicamente I-Premise HighQuality
estable. I-Premise HighQuality

El O 
siguiente O 
paso O 
del O 
tratamiento O 
es: O 

1- O 
Cambiar B-Claim HighQuality
el I-Claim HighQuality
metronidazol I-Claim HighQuality
por I-Claim HighQuality
vancomicina I-Claim HighQuality
oral I-Claim HighQuality
(125 I-Claim HighQuality
mg, I-Claim HighQuality
cuatro I-Claim HighQuality
veces I-Claim HighQuality
al I-Claim HighQuality
día I-Claim HighQuality
durante I-Claim HighQuality
10 I-Claim HighQuality
días). I-Claim HighQuality

2- O 
Cambiar B-Claim HighQuality
el I-Claim HighQuality
metronidazol I-Claim HighQuality
por I-Claim HighQuality
piperacilina/ I-Claim HighQuality
tazobactam I-Claim HighQuality
(4 I-Claim HighQuality
g I-Claim HighQuality
de I-Claim HighQuality
piperacilina/0,5 I-Claim HighQuality
g I-Claim HighQuality
de I-Claim HighQuality
tazobactam I-Claim HighQuality
cada I-Claim HighQuality
8 I-Claim HighQuality
horas). I-Claim HighQuality

3- O 
Indicar B-Claim HighQuality
una I-Claim HighQuality
colectomía I-Claim HighQuality
subtotal. I-Claim HighQuality

4- O 
Realizar B-Claim HighQuality
una I-Claim HighQuality
ileostomía I-Claim HighQuality
en I-Claim HighQuality
asa I-Claim HighQuality
con I-Claim HighQuality
lavado I-Claim HighQuality
anterógrado I-Claim HighQuality
de I-Claim HighQuality
polietilenglicol. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
1 O 

El B-Claim HighQuality
tratamiento I-Claim HighQuality
de I-Claim HighQuality
elección I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
infección I-Claim HighQuality
por I-Claim HighQuality
Clostridioides I-Claim HighQuality
difficile I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
vancomicina I-Claim HighQuality
vía I-Claim HighQuality
oral I-Claim HighQuality
125mg/6h I-Claim HighQuality
durante I-Claim HighQuality
10 I-Claim HighQuality
días. I-Claim HighQuality

El B-Claim HighQuality
metronidazol I-Claim HighQuality
ha I-Claim HighQuality
quedado I-Claim HighQuality
relegado I-Claim HighQuality
a I-Claim HighQuality
situaciones I-Claim HighQuality
en I-Claim HighQuality
las I-Claim HighQuality
que I-Claim HighQuality
no I-Claim HighQuality
se I-Claim HighQuality
dispone I-Claim HighQuality
de I-Claim HighQuality
vancomicina. I-Claim HighQuality

QUESTION O 
TYPE: O 
PSYCHIATRY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
paciente I-Premise HighQuality
de I-Premise HighQuality
36 I-Premise HighQuality
años, I-Premise HighQuality
oriundo I-Premise HighQuality
de I-Premise HighQuality
otra I-Premise HighQuality
cultura I-Premise HighQuality
que I-Premise HighQuality
vive I-Premise HighQuality
en I-Premise HighQuality
España I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
4 I-Premise HighQuality
años I-Premise HighQuality
se I-Premise HighQuality
presenta I-Premise HighQuality
en I-Premise HighQuality
una I-Premise HighQuality
consulta I-Premise HighQuality
de I-Premise HighQuality
S.N. I-Premise HighQuality
de I-Premise HighQuality
Salud. I-Premise HighQuality

Refiere B-Premise HighQuality
presentar I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
10 I-Premise HighQuality
meses I-Premise HighQuality
sintomatología I-Premise HighQuality
ansiosa I-Premise HighQuality
y I-Premise HighQuality
humor I-Premise HighQuality
depresivo. I-Premise HighQuality

Este O 
cuadro O 
interfiere O 
moderadamente O 
en O 
su O 
actividad O 
cotidiana. O 

No B-Premise HighQuality
tiene I-Premise HighQuality
antecedentes I-Premise HighQuality
psiquiátricos I-Premise HighQuality
previos. I-Premise HighQuality

Dicha O 
situación O 
se O 
produce O 
a O 
raíz O 
del O 
fallecimiento, O 
en O 
un O 
accidente O 
automovilístico, O 
de O 
un O 
hermano O 
mayor O 
con O 
quien O 
se O 
encontraba O 
muy O 
unido. O 

Señalar O 
cuál O 
de O 
los O 
siguientes O 
diagnósticos O 
es O 
el O 
apropiado: O 

1- O 
Depresión B-Claim HighQuality
mayor. I-Claim HighQuality

2- O 
Trastorno B-Claim HighQuality
bipolar I-Claim HighQuality
II. I-Claim HighQuality

3- O 
Trastorno B-Claim HighQuality
de I-Claim HighQuality
adaptación. I-Claim HighQuality

4- O 
Distimia. B-Claim HighQuality

5- O 
Ciclotimia. B-Claim HighQuality

CORRECT O 
ANSWER: O 
3 O 

La B-Claim HighQuality
relativa I-Claim HighQuality
levedad I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
síntomas, I-Claim HighQuality
que I-Claim HighQuality
no I-Claim HighQuality
interfieren I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
grave I-Claim HighQuality
en I-Claim HighQuality
su I-Claim HighQuality
actividad I-Claim HighQuality
diaria, I-Claim HighQuality
excluye I-Claim HighQuality
en I-Claim HighQuality
principio I-Claim HighQuality
el I-Claim HighQuality
diagnóstico I-Claim HighQuality
de I-Claim HighQuality
depresión I-Claim HighQuality
mayor. I-Claim HighQuality

No B-Claim HighQuality
hay I-Claim HighQuality
datos I-Claim HighQuality
de I-Claim HighQuality
fases I-Claim HighQuality
hipomaníacas I-Claim HighQuality
que I-Claim HighQuality
justifiquen I-Claim HighQuality
un I-Claim HighQuality
trastorno I-Claim HighQuality
bipolar I-Claim HighQuality
II. I-Claim HighQuality

La B-Claim HighQuality
distimia I-Claim HighQuality
precisa I-Claim HighQuality
una I-Claim HighQuality
duración I-Claim HighQuality
de I-Claim HighQuality
al I-Claim HighQuality
menos I-Claim HighQuality
dos I-Claim HighQuality
años. I-Claim HighQuality

La B-Claim HighQuality
ciclotimia I-Claim HighQuality
es I-Claim HighQuality
un I-Claim HighQuality
diagnóstico I-Claim HighQuality
hoy I-Claim HighQuality
en I-Claim HighQuality
día I-Claim HighQuality
muy I-Claim HighQuality
raro I-Claim HighQuality
(porque, B-Claim HighQuality
como I-Claim HighQuality
decía I-Claim HighQuality
Castilla I-Claim HighQuality
del I-Claim HighQuality
Pino I-Claim HighQuality
en I-Claim HighQuality
una I-Claim HighQuality
entrevista, I-Claim HighQuality
lo I-Claim HighQuality
que I-Claim HighQuality
antes I-Claim HighQuality
eran I-Claim HighQuality
ciclotímicos I-Claim HighQuality
los I-Claim HighQuality
llamamos I-Claim HighQuality
ahora I-Claim HighQuality
bipolares, I-Claim HighQuality
contribuyendo I-Claim HighQuality
a I-Claim HighQuality
una I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
múltiples I-Claim HighQuality
epidemias I-Claim HighQuality
psiquiátricas I-Claim HighQuality
de I-Claim HighQuality
nuestro I-Claim HighQuality
tiempo), I-Claim HighQuality
que B-Claim HighQuality
consta I-Claim HighQuality
de I-Claim HighQuality
oscilaciones I-Claim HighQuality
entre I-Claim HighQuality
el I-Claim HighQuality
polo I-Claim HighQuality
depresivo I-Claim HighQuality
y I-Claim HighQuality
el I-Claim HighQuality
maniforme, I-Claim HighQuality
leves. I-Claim HighQuality

Pero B-Premise HighQuality
no I-Premise HighQuality
hay I-Premise HighQuality
datos I-Premise HighQuality
de I-Premise HighQuality
tales I-Premise HighQuality
oscilaciones. I-Premise HighQuality

La B-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es, I-Claim HighQuality
con I-Claim HighQuality
toda I-Claim HighQuality
probabilidad, I-Claim HighQuality
la I-Claim HighQuality
3. I-Claim HighQuality

El B-Claim HighQuality
trastorno I-Claim HighQuality
adaptativo I-Claim HighQuality
aparece I-Claim HighQuality
en I-Claim HighQuality
los I-Claim HighQuality
3 I-Claim HighQuality
meses I-Claim HighQuality
posteriores I-Claim HighQuality
al I-Claim HighQuality
acontecimiento I-Claim HighQuality
estresante I-Claim HighQuality
y I-Claim HighQuality
no I-Claim HighQuality
dura I-Claim HighQuality
más I-Claim HighQuality
de I-Claim HighQuality
6 I-Claim HighQuality
meses I-Claim HighQuality
si I-Claim HighQuality
ha I-Claim HighQuality
cesado I-Claim HighQuality
el I-Claim HighQuality
mismo I-Claim HighQuality
o I-Claim HighQuality
sus I-Claim HighQuality
consecuencias I-Claim HighQuality
(lo I-Claim HighQuality
que I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
caso I-Claim HighQuality
porque I-Claim HighQuality
el I-Claim HighQuality
hermano I-Claim HighQuality
del I-Claim HighQuality
imaginario I-Claim HighQuality
paciente I-Claim HighQuality
sigue I-Claim HighQuality
muerto). I-Claim HighQuality

Los O 
síntomas O 
ansioso-depresivos O 
leves O 
encajan O 
con O 
tal O 
diagnóstico. O 

Una O 
muestra O 
más O 
de O 
cómo O 
conceptualizar O 
como O 
enfermedad O 
lo O 
que O 
son O 
hechos O 
(aunque O 
dolorosos) O 
de O 
la O 
vida. O 

Seguro O 
que O 
el O 
imaginario O 
paciente O 
se O 
lleva O 
algún O 
antidepresivo O 
porque O 
a O 
lo O 
mejor O 
algo O 
ayuda O 
(1). O 

QUESTION O 
TYPE: O 
ONCOLOGY O 

CLINICAL O 
CASE: O 

Ante O 
un B-Premise HighQuality
paciente I-Premise HighQuality
que I-Premise HighQuality
presenta I-Premise HighQuality
una I-Premise HighQuality
lesión I-Premise HighQuality
úlcerovegetante I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
encía I-Premise HighQuality
mandibular I-Premise HighQuality
a I-Premise HighQuality
nivel I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
región I-Premise HighQuality
de I-Premise HighQuality
los I-Premise HighQuality
molares I-Premise HighQuality
de I-Premise HighQuality
5 I-Premise HighQuality
meses I-Premise HighQuality
de I-Premise HighQuality
evolución, I-Premise HighQuality
la I-Premise HighQuality
aparición I-Premise HighQuality
de I-Premise HighQuality
hipoestesia I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
región I-Premise HighQuality
mentoniana I-Premise HighQuality
requiere I-Premise HighQuality
descartar: I-Premise HighQuality

1- O 
Una B-Claim HighQuality
neuropatía I-Claim HighQuality
paraneoplásica. I-Claim HighQuality

2- O 
El B-Claim HighQuality
diagnóstico I-Claim HighQuality
de I-Claim HighQuality
sarcoidosis I-Claim HighQuality
con I-Claim HighQuality
parálisis I-Claim HighQuality
facial I-Claim HighQuality
«en I-Claim HighQuality
báscula». I-Claim HighQuality

3- O 
Infección B-Claim HighQuality
por I-Claim HighQuality
virus I-Claim HighQuality
herpes I-Claim HighQuality
en I-Claim HighQuality
paciente I-Claim HighQuality
inmunodeprimido. I-Claim HighQuality

4- O 
El B-Claim HighQuality
diagnóstico I-Claim HighQuality
de I-Claim HighQuality
carcinoma I-Claim HighQuality
con I-Claim HighQuality
infiltración I-Claim HighQuality
del I-Claim HighQuality
canal I-Claim HighQuality
mandibular. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
4 O 

Las B-Claim HighQuality
parestesias I-Claim HighQuality
mentonianas I-Claim HighQuality
(signo I-Claim HighQuality
de I-Claim HighQuality
Roger) I-Claim HighQuality
se I-Claim HighQuality
asocian I-Claim HighQuality
a I-Claim HighQuality
metástasis I-Claim HighQuality
óseas I-Claim HighQuality
(no B-Claim HighQuality
es I-Claim HighQuality
paraneoplásico I-Claim HighQuality
sino I-Claim HighQuality
infiltración I-Claim HighQuality
directa). I-Claim HighQuality

En B-Claim HighQuality
este I-Claim HighQuality
caso I-Claim HighQuality
lo I-Claim HighQuality
que I-Claim HighQuality
describen I-Claim HighQuality
es I-Claim HighQuality
un I-Claim HighQuality
tumor I-Claim HighQuality
oral I-Claim HighQuality
creciendo I-Claim HighQuality
localmente I-Claim HighQuality
e I-Claim HighQuality
infiltrando I-Claim HighQuality
el I-Claim HighQuality
canal I-Claim HighQuality
mandibular, I-Claim HighQuality
creo. I-Claim HighQuality

QUESTION O 
TYPE: O 
ENDOCRINOLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
55 I-Premise HighQuality
años I-Premise HighQuality
con I-Premise HighQuality
diabetes I-Premise HighQuality
tipo I-Premise HighQuality
1 I-Premise HighQuality
diagnosticada I-Premise HighQuality
a I-Premise HighQuality
los I-Premise HighQuality
15 I-Premise HighQuality
años I-Premise HighQuality
que I-Premise HighQuality
refiere I-Premise HighQuality
náuseas I-Premise HighQuality
y I-Premise HighQuality
distensión I-Premise HighQuality
abdominal, I-Premise HighQuality
especialmente I-Premise HighQuality
después I-Premise HighQuality
de I-Premise HighQuality
las I-Premise HighQuality
comidas. I-Premise HighQuality

La B-Premise HighQuality
evaluación I-Premise HighQuality
es I-Premise HighQuality
compatible I-Premise HighQuality
con I-Premise HighQuality
una I-Premise HighQuality
gastroparesia I-Premise HighQuality
diabética. I-Premise HighQuality

¿Cuál O 
de O 
los O 
siguientes O 
medicamentos O 
sería O 
el O 
tratamiento O 
más O 
adecuado O 
para O 
mejorar O 
sus O 
síntomas?: O 

1- O 
Lansoprazol. B-Claim HighQuality

2- O 
Ondansetrón. B-Claim HighQuality

3- O 
Loperamida. B-Claim HighQuality

4- O 
Metoclopramida. B-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
4 O 

Fue B-Claim HighQuality
aprobada I-Claim HighQuality
como I-Claim HighQuality
tratamiento I-Claim HighQuality
para I-Claim HighQuality
la I-Claim HighQuality
gastroparesia I-Claim HighQuality
por I-Claim HighQuality
la I-Claim HighQuality
Food I-Claim HighQuality
and I-Claim HighQuality
Drug I-Claim HighQuality
Administration I-Claim HighQuality
(FDA) I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
Estados I-Claim HighQuality
Unidos I-Claim HighQuality
en I-Claim HighQuality
1979 I-Claim HighQuality
y I-Claim HighQuality
sigue I-Claim HighQuality
siendo I-Claim HighQuality
el I-Claim HighQuality
fármaco I-Claim HighQuality
de I-Claim HighQuality
primera I-Claim HighQuality
línea. I-Claim HighQuality

Actúa B-Claim HighQuality
como I-Claim HighQuality
procinético I-Claim HighQuality
por I-Claim HighQuality
su I-Claim HighQuality
efecto I-Claim HighQuality
antagónico I-Claim HighQuality
sobre I-Claim HighQuality
la I-Claim HighQuality
dopamina I-Claim HighQuality
2 I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
receptores I-Claim HighQuality
(D2) I-Claim HighQuality
promoviendo I-Claim HighQuality
el I-Claim HighQuality
vaciamiento I-Claim HighQuality
gástrico I-Claim HighQuality
y, I-Claim HighQuality
además, I-Claim HighQuality
se I-Claim HighQuality
une I-Claim HighQuality
al I-Claim HighQuality
receptor I-Claim HighQuality
5-hidroxitriptamina I-Claim HighQuality
4 I-Claim HighQuality
(serotonina I-Claim HighQuality
5-HT4) I-Claim HighQuality
para I-Claim HighQuality
estimular I-Claim HighQuality
las I-Claim HighQuality
vías I-Claim HighQuality
nerviosas I-Claim HighQuality
colinérgicas I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
estómago. I-Claim HighQuality

Fisiológicamente, B-Claim HighQuality
acelera I-Claim HighQuality
el I-Claim HighQuality
tránsito I-Claim HighQuality
intestinal I-Claim HighQuality
al I-Claim HighQuality
aumentar I-Claim HighQuality
el I-Claim HighQuality
tono I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
amplitud I-Claim HighQuality
de I-Claim HighQuality
las I-Claim HighQuality
contracciones I-Claim HighQuality
gástricas, I-Claim HighQuality
incrementa I-Claim HighQuality
la I-Claim HighQuality
presión I-Claim HighQuality
del I-Claim HighQuality
esfínter I-Claim HighQuality
esofágico I-Claim HighQuality
inferior I-Claim HighQuality
y I-Claim HighQuality
mejora I-Claim HighQuality
la I-Claim HighQuality
coordinación I-Claim HighQuality
antropiloroduodenal. I-Claim HighQuality

Además, B-Claim HighQuality
este I-Claim HighQuality
agente I-Claim HighQuality
antiemético I-Claim HighQuality
proporciona I-Claim HighQuality
alivio I-Claim HighQuality
a I-Claim HighQuality
través I-Claim HighQuality
del I-Claim HighQuality
antagonismo I-Claim HighQuality
de I-Claim HighQuality
receptores I-Claim HighQuality
centrales I-Claim HighQuality
y I-Claim HighQuality
periféricos I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
dopamina. I-Claim HighQuality

QUESTION O 
TYPE: O 
NEPHROLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
67 I-Premise HighQuality
años I-Premise HighQuality
con I-Premise HighQuality
enfermedad I-Premise HighQuality
renal I-Premise HighQuality
crónica I-Premise HighQuality
secundaria I-Premise HighQuality
a I-Premise HighQuality
nefropatía I-Premise HighQuality
diabética. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
actualidad I-Premise HighQuality
presenta I-Premise HighQuality
una I-Premise HighQuality
creatinina I-Premise HighQuality
de I-Premise HighQuality
3,2 I-Premise HighQuality
mg/dl I-Premise HighQuality
con I-Premise HighQuality
filtrado I-Premise HighQuality
glomerular I-Premise HighQuality
estimado I-Premise HighQuality
(CKD-EPI) I-Premise HighQuality
14 I-Premise HighQuality
ml/min. I-Premise HighQuality

¿Cuál O 
de O 
las O 
siguientes O 
afirmaciones O 
es O 
cierta?: O 

1- O 
Presenta B-Claim HighQuality
una I-Claim HighQuality
enfermedad I-Claim HighQuality
renal I-Claim HighQuality
crónica I-Claim HighQuality
estadio I-Claim HighQuality
3 I-Claim HighQuality
y I-Claim HighQuality
debe I-Claim HighQuality
iniciar I-Claim HighQuality
quelantes I-Claim HighQuality
del I-Claim HighQuality
fósforo. I-Claim HighQuality

2- O 
Presenta B-Claim HighQuality
una I-Claim HighQuality
enfermedad I-Claim HighQuality
renal I-Claim HighQuality
crónica I-Claim HighQuality
estadio I-Claim HighQuality
5 I-Claim HighQuality
y I-Claim HighQuality
debe I-Claim HighQuality
considerarse I-Claim HighQuality
el I-Claim HighQuality
tratamiento I-Claim HighQuality
renal I-Claim HighQuality
sustitutivo. I-Claim HighQuality

3- O 
Un B-Claim HighQuality
buen I-Claim HighQuality
control I-Claim HighQuality
glucémico I-Claim HighQuality
puede I-Claim HighQuality
revertir I-Claim HighQuality
la I-Claim HighQuality
insuficiencia I-Claim HighQuality
renal. I-Claim HighQuality

4- O 
Es B-Claim HighQuality
poco I-Claim HighQuality
probable I-Claim HighQuality
que I-Claim HighQuality
presente I-Claim HighQuality
una I-Claim HighQuality
proteinuria I-Claim HighQuality
superior I-Claim HighQuality
a I-Claim HighQuality
500 I-Claim HighQuality
mg/24 I-Claim HighQuality
h. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
2 O 

Un B-Claim HighQuality
filtrado I-Claim HighQuality
glomerular I-Claim HighQuality
inferior I-Claim HighQuality
a I-Claim HighQuality
15 I-Claim HighQuality
ml/min I-Claim HighQuality
se I-Claim HighQuality
clasifica I-Claim HighQuality
como I-Claim HighQuality
estadio I-Claim HighQuality
5 I-Claim HighQuality
(G5), I-Claim HighQuality
indicando O 
que O 
la B-Claim HighQuality
enfermedad I-Claim HighQuality
renal I-Claim HighQuality
se I-Claim HighQuality
encuentra I-Claim HighQuality
en I-Claim HighQuality
estadio I-Claim HighQuality
terminal I-Claim HighQuality
y B-Claim HighQuality
debe I-Claim HighQuality
plantearse I-Claim HighQuality
el I-Claim HighQuality
inicio I-Claim HighQuality
de I-Claim HighQuality
terapia I-Claim HighQuality
sustitutiva I-Claim HighQuality
(opción B-Claim HighQuality
2 I-Claim HighQuality
cierta, I-Claim HighQuality
opción B-Claim HighQuality
1 I-Claim HighQuality
falsa). I-Claim HighQuality

En B-Claim HighQuality
esta I-Claim HighQuality
situación I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
esperable I-Claim HighQuality
que I-Claim HighQuality
un I-Claim HighQuality
buen I-Claim HighQuality
control I-Claim HighQuality
glucémico I-Claim HighQuality
pueda I-Claim HighQuality
revertir I-Claim HighQuality
el I-Claim HighQuality
daño I-Claim HighQuality
renal, I-Claim HighQuality
aunque I-Claim HighQuality
sí I-Claim HighQuality
podría I-Claim HighQuality
ayudar I-Claim HighQuality
a I-Claim HighQuality
retrasar I-Claim HighQuality
la I-Claim HighQuality
progresión I-Claim HighQuality
(opción B-Claim HighQuality
3 I-Claim HighQuality
falsa). I-Claim HighQuality

Estos B-Claim HighQuality
pacientes I-Claim HighQuality
suelen I-Claim HighQuality
presentar I-Claim HighQuality
una I-Claim HighQuality
albuminuria I-Claim HighQuality
estadio I-Claim HighQuality
A3 I-Claim HighQuality
(superior I-Claim HighQuality
a I-Claim HighQuality
300 I-Claim HighQuality
mg/24 I-Claim HighQuality
h), I-Claim HighQuality
pudiendo I-Claim HighQuality
llegar I-Claim HighQuality
al I-Claim HighQuality
rango I-Claim HighQuality
nefrótico I-Claim HighQuality
(opción B-Claim HighQuality
4 I-Claim HighQuality
falsa). I-Claim HighQuality

QUESTION O 
TYPE: O 
NEPHROLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
75 I-Premise HighQuality
años I-Premise HighQuality
en I-Premise HighQuality
tratamiento I-Premise HighQuality
con I-Premise HighQuality
sertralina I-Premise HighQuality
que I-Premise HighQuality
acude I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
cuadro I-Premise HighQuality
confusional. I-Premise HighQuality

No B-Premise HighQuality
se I-Premise HighQuality
evidencian I-Premise HighQuality
edemas I-Premise HighQuality
y I-Premise HighQuality
la I-Premise HighQuality
tensión I-Premise HighQuality
arterial I-Premise HighQuality
es I-Premise HighQuality
de I-Premise HighQuality
130/70. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
analítica I-Premise HighQuality
destaca I-Premise HighQuality
Na I-Premise HighQuality
126 I-Premise HighQuality
mEq/l I-Premise HighQuality
y I-Premise HighQuality
K I-Premise HighQuality
4 I-Premise HighQuality
mEq/l, I-Premise HighQuality
la I-Premise HighQuality
natriuria I-Premise HighQuality
es I-Premise HighQuality
de I-Premise HighQuality
45 I-Premise HighQuality
mEq/l I-Premise HighQuality
y I-Premise HighQuality
se I-Premise HighQuality
ha I-Premise HighQuality
descartado I-Premise HighQuality
la I-Premise HighQuality
ingesta I-Premise HighQuality
de I-Premise HighQuality
diuréticos. I-Premise HighQuality

¿De O 
las O 
siguientes O 
cuál O 
es O 
la O 
actitud O 
más O 
correcta?: O 

1- O 
Se B-Claim HighQuality
trata I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
enfermedad I-Claim HighQuality
de I-Claim HighQuality
Addison I-Claim HighQuality
y I-Claim HighQuality
deben I-Claim HighQuality
administrarse I-Claim HighQuality
corticoides I-Claim HighQuality
de I-Claim HighQuality
inmediato. I-Claim HighQuality

2- O 
Administrar B-Claim HighQuality
suero I-Claim HighQuality
salino I-Claim HighQuality
hipertónico I-Claim HighQuality
a I-Claim HighQuality
fin I-Claim HighQuality
de I-Claim HighQuality
restablecer I-Claim HighQuality
cuanto I-Claim HighQuality
antes I-Claim HighQuality
la I-Claim HighQuality
natremia. I-Claim HighQuality

3- O 
Indicar B-Claim HighQuality
restricción I-Claim HighQuality
hídrica I-Claim HighQuality
y I-Claim HighQuality
si I-Claim HighQuality
no I-Claim HighQuality
se I-Claim HighQuality
eleva I-Claim HighQuality
la I-Claim HighQuality
natremia I-Claim HighQuality
pasar I-Claim HighQuality
a I-Claim HighQuality
infusión I-Claim HighQuality
lenta I-Claim HighQuality
de I-Claim HighQuality
suero I-Claim HighQuality
salino. I-Claim HighQuality

4- O 
Solicitar B-Claim HighQuality
resonancia I-Claim HighQuality
magnética I-Claim HighQuality
cerebral, I-Claim HighQuality
ya I-Claim HighQuality
que I-Claim HighQuality
seguramente I-Claim HighQuality
se I-Claim HighQuality
trata I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
diabetes I-Claim HighQuality
insípida. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Nos B-Claim HighQuality
presentan I-Claim HighQuality
a I-Claim HighQuality
una I-Claim HighQuality
paciente I-Claim HighQuality
con I-Claim HighQuality
una I-Claim HighQuality
hiponatremia I-Claim HighQuality
moderada I-Claim HighQuality
euvolémica, I-Claim HighQuality
orientando I-Claim HighQuality
hacia I-Claim HighQuality
un I-Claim HighQuality
síndrome I-Claim HighQuality
de I-Claim HighQuality
antidiuresis I-Claim HighQuality
inadecuada I-Claim HighQuality
(SIAD) I-Claim HighQuality
secundario I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
sertralina, I-Claim HighQuality
aunque I-Claim HighQuality
sería I-Claim HighQuality
necesario I-Claim HighQuality
disponer I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
osmolalidad I-Claim HighQuality
urinaria I-Claim HighQuality
para I-Claim HighQuality
confirmarlo. I-Claim HighQuality

La B-Claim HighQuality
insuficiencia I-Claim HighQuality
suprarrenal I-Claim HighQuality
primaria I-Claim HighQuality
produce I-Claim HighQuality
hiponatremia I-Claim HighQuality
hipovolémica I-Claim HighQuality
(opción B-Claim HighQuality
1 I-Claim HighQuality
incorrecta). I-Claim HighQuality

La B-Claim HighQuality
diabetes I-Claim HighQuality
insípida I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
contraposición I-Claim HighQuality
a I-Claim HighQuality
esta I-Claim HighQuality
patología, I-Claim HighQuality
presentándose I-Claim HighQuality
habitualmente I-Claim HighQuality
con I-Claim HighQuality
hipernatremia I-Claim HighQuality
(opción B-Claim HighQuality
4 I-Claim HighQuality
incorrecta). I-Claim HighQuality

La B-Claim HighQuality
duda I-Claim HighQuality
queda I-Claim HighQuality
entre I-Claim HighQuality
si I-Claim HighQuality
hay I-Claim HighQuality
que I-Claim HighQuality
tratar I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
agresiva I-Claim HighQuality
con I-Claim HighQuality
suero I-Claim HighQuality
salino I-Claim HighQuality
hipertónico, I-Claim HighQuality
o I-Claim HighQuality
ser I-Claim HighQuality
más I-Claim HighQuality
conservador I-Claim HighQuality
indicando I-Claim HighQuality
restricción I-Claim HighQuality
hídrica. I-Claim HighQuality

Con B-Claim HighQuality
natremias I-Claim HighQuality
superiores I-Claim HighQuality
a I-Claim HighQuality
125 I-Claim HighQuality
mmol/l I-Claim HighQuality
no I-Claim HighQuality
está I-Claim HighQuality
indicado I-Claim HighQuality
tratar I-Claim HighQuality
con I-Claim HighQuality
SSH I-Claim HighQuality
salvo I-Claim HighQuality
que I-Claim HighQuality
el I-Claim HighQuality
paciente I-Claim HighQuality
tenga I-Claim HighQuality
clínica I-Claim HighQuality
neurológica I-Claim HighQuality
grave, I-Claim HighQuality
que I-Claim HighQuality
no I-Claim HighQuality
parece I-Claim HighQuality
el I-Claim HighQuality
caso I-Claim HighQuality
(describen B-Premise HighQuality
un I-Premise HighQuality
cuadro I-Premise HighQuality
confusional I-Premise HighQuality
que B-Claim HighQuality
sería I-Claim HighQuality
una I-Claim HighQuality
encefalopatía I-Claim HighQuality
hiponatrémica I-Claim HighQuality
moderada), I-Claim HighQuality
y O 
tampoco B-Claim HighQuality
está I-Claim HighQuality
indicado I-Claim HighQuality
restablecer I-Claim HighQuality
cuanto I-Claim HighQuality
antes I-Claim HighQuality
la I-Claim HighQuality
natremia I-Claim HighQuality
(por I-Claim HighQuality
el I-Claim HighQuality
riesgo I-Claim HighQuality
de I-Claim HighQuality
síndrome I-Claim HighQuality
de I-Claim HighQuality
desmielinización I-Claim HighQuality
osmótica). I-Claim HighQuality

Por B-Claim HighQuality
tanto, I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
sería I-Claim HighQuality
la I-Claim HighQuality
3. I-Claim HighQuality

Lo B-Claim HighQuality
que I-Claim HighQuality
no I-Claim HighQuality
me I-Claim HighQuality
gusta I-Claim HighQuality
de I-Claim HighQuality
esa I-Claim HighQuality
respuesta I-Claim HighQuality
es I-Claim HighQuality
que I-Claim HighQuality
la I-Claim HighQuality
segunda I-Claim HighQuality
parte I-Claim HighQuality
(“si I-Claim HighQuality
no I-Claim HighQuality
se I-Claim HighQuality
eleva I-Claim HighQuality
la I-Claim HighQuality
natremia I-Claim HighQuality
pasar I-Claim HighQuality
a I-Claim HighQuality
infusión I-Claim HighQuality
lenta I-Claim HighQuality
de I-Claim HighQuality
suero I-Claim HighQuality
salino”) I-Claim HighQuality
es I-Claim HighQuality
incorrecta, I-Claim HighQuality
ya B-Claim HighQuality
que I-Claim HighQuality
en I-Claim HighQuality
ese I-Claim HighQuality
caso I-Claim HighQuality
habría I-Claim HighQuality
que I-Claim HighQuality
plantearse I-Claim HighQuality
el I-Claim HighQuality
uso I-Claim HighQuality
de I-Claim HighQuality
furosemida, I-Claim HighQuality
tolvaptan I-Claim HighQuality
o I-Claim HighQuality
urea, I-Claim HighQuality
no I-Claim HighQuality
suero I-Claim HighQuality
salino I-Claim HighQuality
(y B-Claim HighQuality
tampoco I-Claim HighQuality
indica I-Claim HighQuality
la I-Claim HighQuality
tonicidad, I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
lo I-Claim HighQuality
mismo I-Claim HighQuality
un I-Claim HighQuality
isotónico I-Claim HighQuality
que I-Claim HighQuality
un I-Claim HighQuality
hipertónico). I-Claim HighQuality

En B-Claim HighQuality
cualquier I-Claim HighQuality
caso, I-Claim HighQuality
no I-Claim HighQuality
la I-Claim HighQuality
veo I-Claim HighQuality
muy I-Claim HighQuality
susceptible I-Claim HighQuality
de I-Claim HighQuality
anularse. I-Claim HighQuality

QUESTION O 
TYPE: O 
NEUROLOGY O 

CLINICAL O 
CASE: O 

Varón B-Premise HighQuality
de I-Premise HighQuality
30 I-Premise HighQuality
años I-Premise HighQuality
que I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
cefaleas I-Premise HighQuality
perioculares I-Premise HighQuality
unilaterales I-Premise HighQuality
que I-Premise HighQuality
progresan I-Premise HighQuality
rápidamente I-Premise HighQuality
hasta I-Premise HighQuality
hacerse I-Premise HighQuality
muy I-Premise HighQuality
intensas. I-Premise HighQuality

Las B-Premise HighQuality
crisis I-Premise HighQuality
de I-Premise HighQuality
dolor I-Premise HighQuality
duran I-Premise HighQuality
entre I-Premise HighQuality
30-60 I-Premise HighQuality
minutos, I-Premise HighQuality
ocurren I-Premise HighQuality
2-3 I-Premise HighQuality
veces I-Premise HighQuality
al I-Premise HighQuality
día I-Premise HighQuality
y I-Premise HighQuality
se I-Premise HighQuality
acompañan I-Premise HighQuality
de I-Premise HighQuality
lagrimeo I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
ojo I-Premise HighQuality
que I-Premise HighQuality
le I-Premise HighQuality
duele I-Premise HighQuality
y I-Premise HighQuality
rinorrea I-Premise HighQuality
unilateral. I-Premise HighQuality

¿Cuál O 
es O 
el O 
tratamiento O 
preventivo O 
más O 
adecuado?: O 

1- O 
Prednisona B-Claim HighQuality
oral I-Claim HighQuality
con I-Claim HighQuality
retirada I-Claim HighQuality
en I-Claim HighQuality
2-3 I-Claim HighQuality
meses. I-Claim HighQuality

2- O 
Prednisona B-Claim HighQuality
oral I-Claim HighQuality
con I-Claim HighQuality
retirada I-Claim HighQuality
en I-Claim HighQuality
un I-Claim HighQuality
mes, I-Claim HighQuality
asociada I-Claim HighQuality
a I-Claim HighQuality
verapamilo I-Claim HighQuality
oral I-Claim HighQuality
a I-Claim HighQuality
dosis I-Claim HighQuality
de I-Claim HighQuality
80-180 I-Claim HighQuality
mg I-Claim HighQuality
cada I-Claim HighQuality
8 I-Claim HighQuality
horas. I-Claim HighQuality

3- O 
Carbamazepina B-Claim HighQuality
a I-Claim HighQuality
dosis I-Claim HighQuality
de I-Claim HighQuality
600-1200 I-Claim HighQuality
mg I-Claim HighQuality
al I-Claim HighQuality
día. I-Claim HighQuality

4- O 
Indometacina B-Claim HighQuality
a I-Claim HighQuality
dosis I-Claim HighQuality
de I-Claim HighQuality
50 I-Claim HighQuality
mg I-Claim HighQuality
cada I-Claim HighQuality
8 I-Claim HighQuality
horas I-Claim HighQuality
durante I-Claim HighQuality
un I-Claim HighQuality
mes. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
2 O 

Describen B-Claim HighQuality
un I-Claim HighQuality
caso I-Claim HighQuality
característico I-Claim HighQuality
de I-Claim HighQuality
cefalea I-Claim HighQuality
en I-Claim HighQuality
racimos. I-Claim HighQuality

Es B-Claim HighQuality
más I-Claim HighQuality
frecuente I-Claim HighQuality
en I-Claim HighQuality
varones, I-Claim HighQuality
el B-Claim HighQuality
dolor I-Claim HighQuality
es I-Claim HighQuality
característicamente I-Claim HighQuality
periocular I-Claim HighQuality
unilateral I-Claim HighQuality
de I-Claim HighQuality
gran I-Claim HighQuality
intensidad, I-Claim HighQuality
de I-Claim HighQuality
duración I-Claim HighQuality
variable, I-Claim HighQuality
generalmente I-Claim HighQuality
minutos I-Claim HighQuality
y I-Claim HighQuality
asocia I-Claim HighQuality
signos I-Claim HighQuality
trigeminoautonómicos I-Claim HighQuality
como I-Claim HighQuality
la I-Claim HighQuality
rinorrea I-Claim HighQuality
e I-Claim HighQuality
inyección I-Claim HighQuality
conjuntival I-Claim HighQuality
unilateral. I-Claim HighQuality

El B-Claim HighQuality
tratamiento I-Claim HighQuality
preventivo I-Claim HighQuality
por I-Claim HighQuality
excelencia I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
verapamilo I-Claim HighQuality
asociado I-Claim HighQuality
a I-Claim HighQuality
pauta I-Claim HighQuality
descendente I-Claim HighQuality
de I-Claim HighQuality
corticoides, I-Claim HighQuality
tal I-Claim HighQuality
y I-Claim HighQuality
como I-Claim HighQuality
se I-Claim HighQuality
expone I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
2. I-Claim HighQuality

QUESTION O 
TYPE: O 
NEUROLOGY O 

CLINICAL O 
CASE: O 

Varón B-Premise HighQuality
de I-Premise HighQuality
45 I-Premise HighQuality
años I-Premise HighQuality
traído I-Premise HighQuality
a I-Premise HighQuality
la I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
sus I-Premise HighQuality
familiares I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
cuadro I-Premise HighQuality
de I-Premise HighQuality
un I-Premise HighQuality
año I-Premise HighQuality
de I-Premise HighQuality
evolución I-Premise HighQuality
de I-Premise HighQuality
pérdida I-Premise HighQuality
de I-Premise HighQuality
memoria, I-Premise HighQuality
que I-Premise HighQuality
ha I-Premise HighQuality
ido I-Premise HighQuality
progresando I-Premise HighQuality
hasta I-Premise HighQuality
necesitar I-Premise HighQuality
ayuda I-Premise HighQuality
para I-Premise HighQuality
algunas I-Premise HighQuality
actividades I-Premise HighQuality
de I-Premise HighQuality
su I-Premise HighQuality
vida I-Premise HighQuality
cotidiana. I-Premise HighQuality

Tiene B-Premise HighQuality
antecedentes I-Premise HighQuality
de I-Premise HighQuality
migrañas I-Premise HighQuality
y I-Premise HighQuality
algún I-Premise HighQuality
episodio I-Premise HighQuality
de I-Premise HighQuality
focalidad I-Premise HighQuality
neurológica I-Premise HighQuality
autolimitada I-Premise HighQuality
por I-Premise HighQuality
los I-Premise HighQuality
que I-Premise HighQuality
no I-Premise HighQuality
ha I-Premise HighQuality
consultado I-Premise HighQuality
nunca. I-Premise HighQuality

La B-Premise HighQuality
exploración I-Premise HighQuality
neuropsicológica I-Premise HighQuality
es I-Premise HighQuality
compatible I-Premise HighQuality
con I-Premise HighQuality
una I-Premise HighQuality
demencia I-Premise HighQuality
inicial I-Premise HighQuality
y I-Premise HighQuality
la I-Premise HighQuality
RM I-Premise HighQuality
cerebral I-Premise HighQuality
muestra I-Premise HighQuality
una I-Premise HighQuality
leucoencefalopatía I-Premise HighQuality
grave. I-Premise HighQuality

¿Qué O 
prueba O 
habría O 
que O 
solicitar?: O 

1- O 
Punción B-Claim HighQuality
lumbar I-Claim HighQuality
para I-Claim HighQuality
analizar I-Claim HighQuality
amiloide I-Claim HighQuality
y I-Claim HighQuality
proteína I-Claim HighQuality
tau I-Claim HighQuality
en I-Claim HighQuality
LCR. I-Claim HighQuality

2- O 
Estudio B-Claim HighQuality
genético I-Claim HighQuality
para I-Claim HighQuality
presenilina I-Claim HighQuality
1 I-Claim HighQuality
(PSEN1). I-Claim HighQuality

3- O 
Estudio B-Claim HighQuality
genético I-Claim HighQuality
para I-Claim HighQuality
NOTCH3. I-Claim HighQuality

4- O 
Estudio B-Claim HighQuality
genético I-Claim HighQuality
para I-Claim HighQuality
progranulina. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
3 O 

Describen B-Claim HighQuality
un I-Claim HighQuality
caso I-Claim HighQuality
característico I-Claim HighQuality
de I-Claim HighQuality
CADASIL I-Claim HighQuality
(Cerebral I-Claim HighQuality
Autosomal I-Claim HighQuality
Dominant I-Claim HighQuality
Arteriopathy I-Claim HighQuality
with I-Claim HighQuality
Sub-cortical I-Claim HighQuality
Infarcts I-Claim HighQuality
and I-Claim HighQuality
Leukoencephalopathy). I-Claim HighQuality

Es B-Claim HighQuality
una I-Claim HighQuality
enfermedad I-Claim HighQuality
genética, I-Claim HighQuality
de I-Claim HighQuality
herencia I-Claim HighQuality
autosómica I-Claim HighQuality
dominante I-Claim HighQuality
por I-Claim HighQuality
mutación I-Claim HighQuality
del I-Claim HighQuality
gen I-Claim HighQuality
NOTCH3. I-Claim HighQuality

Esta B-Claim HighQuality
mutación I-Claim HighQuality
provoca I-Claim HighQuality
afectación I-Claim HighQuality
vascular I-Claim HighQuality
de I-Claim HighQuality
pequeño I-Claim HighQuality
vaso I-Claim HighQuality
que I-Claim HighQuality
genera I-Claim HighQuality
leucoencefalopatía I-Claim HighQuality
grave I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
precoz, I-Claim HighQuality
lo I-Claim HighQuality
que I-Claim HighQuality
genera I-Claim HighQuality
sintomatología I-Claim HighQuality
variada. I-Claim HighQuality

Destacan B-Claim HighQuality
las I-Claim HighQuality
migrañas, I-Claim HighQuality
la I-Claim HighQuality
enfermedad I-Claim HighQuality
cerebrovascular I-Claim HighQuality
y I-Claim HighQuality
deterioro I-Claim HighQuality
cognitivo I-Claim HighQuality
a I-Claim HighQuality
edades I-Claim HighQuality
tempranas, I-Claim HighQuality
tal I-Claim HighQuality
y I-Claim HighQuality
como I-Claim HighQuality
muestra I-Claim HighQuality
el I-Claim HighQuality
caso I-Claim HighQuality
clínico I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
pregunta. I-Claim HighQuality

QUESTION O 
TYPE: O 
RHEUMATOLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
26 I-Premise HighQuality
años I-Premise HighQuality
diagnosticada I-Premise HighQuality
de I-Premise HighQuality
lupus I-Premise HighQuality
eritematoso I-Premise HighQuality
sistémico, I-Premise HighQuality
en I-Premise HighQuality
tratamiento I-Premise HighQuality
con I-Premise HighQuality
hidroxicloroquina, I-Premise HighQuality
que I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
sensación I-Premise HighQuality
de I-Premise HighQuality
debilidad I-Premise HighQuality
generalizada I-Premise HighQuality
que I-Premise HighQuality
se I-Premise HighQuality
ha I-Premise HighQuality
instaurado I-Premise HighQuality
progresivamente I-Premise HighQuality
en I-Premise HighQuality
los I-Premise HighQuality
últimos I-Premise HighQuality
15 I-Premise HighQuality
días. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
física I-Premise HighQuality
se I-Premise HighQuality
aprecia I-Premise HighQuality
palidez I-Premise HighQuality
cutánea I-Premise HighQuality
y I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
analítica I-Premise HighQuality
destaca I-Premise HighQuality
Hb I-Premise HighQuality
7,4 I-Premise HighQuality
gr/dL, I-Premise HighQuality
Hcto I-Premise HighQuality
31 I-Premise HighQuality
%, I-Premise HighQuality
VCM I-Premise HighQuality
108. I-Premise HighQuality

¿Cuál O 
de O 
las O 
siguientes O 
determinaciones O 
será O 
más O 
útil O 
para O 
decidir O 
la O 
actuación? O 

1- O 
Haptoglobina. B-Claim HighQuality

2- O 
Test B-Claim HighQuality
de I-Claim HighQuality
Coombs. I-Claim HighQuality

3- O 
Vitamina B-Claim HighQuality
B12. I-Claim HighQuality

4- O 
Anticuerpos B-Claim HighQuality
antinucleares. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
2 O 

En B-Claim HighQuality
esta I-Claim HighQuality
pregunta, I-Claim HighQuality
nos I-Claim HighQuality
plantean I-Claim HighQuality
una I-Claim HighQuality
paciente I-Claim HighQuality
con I-Claim HighQuality
lupus I-Claim HighQuality
eritematoso I-Claim HighQuality
sistémico I-Claim HighQuality
que I-Claim HighQuality
presenta I-Claim HighQuality
una I-Claim HighQuality
anemia I-Claim HighQuality
hemolítica I-Claim HighQuality
autoinmune. I-Claim HighQuality

Para B-Claim HighQuality
ello, I-Claim HighQuality
la I-Claim HighQuality
mejor I-Claim HighQuality
opción I-Claim HighQuality
sería I-Claim HighQuality
solicitar I-Claim HighQuality
unos I-Claim HighQuality
reticulocitos, I-Claim HighQuality
no I-Claim HighQuality
obstante, I-Claim HighQuality
como I-Claim HighQuality
no I-Claim HighQuality
se I-Claim HighQuality
encuentra I-Claim HighQuality
entre I-Claim HighQuality
las I-Claim HighQuality
opciones, I-Claim HighQuality
deberíamos I-Claim HighQuality
solicitar I-Claim HighQuality
un I-Claim HighQuality
test I-Claim HighQuality
de I-Claim HighQuality
Coombs, I-Claim HighQuality
por O 
lo O 
que O 
la B-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
2. I-Claim HighQuality

Si B-Premise HighQuality
bien, I-Premise HighQuality
nos I-Premise HighQuality
quieren I-Premise HighQuality
confundir I-Premise HighQuality
con I-Premise HighQuality
un I-Premise HighQuality
VCM I-Premise HighQuality
108, I-Premise HighQuality
para B-Claim HighQuality
que I-Claim HighQuality
pensemos I-Claim HighQuality
en I-Claim HighQuality
una I-Claim HighQuality
anemia I-Claim HighQuality
megalobástica, I-Claim HighQuality
el B-Claim HighQuality
VCM I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
excesivamente I-Claim HighQuality
elevado, I-Claim HighQuality
la I-Claim HighQuality
instauración I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
anemia I-Claim HighQuality
en I-Claim HighQuality
nuestra I-Claim HighQuality
paciente I-Claim HighQuality
ha I-Claim HighQuality
sido I-Claim HighQuality
rápida I-Claim HighQuality
y I-Claim HighQuality
no I-Claim HighQuality
cuadraría I-Claim HighQuality
con I-Claim HighQuality
el I-Claim HighQuality
LES I-Claim HighQuality
ni I-Claim HighQuality
la I-Claim HighQuality
forma I-Claim HighQuality
de I-Claim HighQuality
presentación. I-Claim HighQuality

Los B-Claim HighQuality
anticuerpos I-Claim HighQuality
antinucleares I-Claim HighQuality
se I-Claim HighQuality
utilizan I-Claim HighQuality
para I-Claim HighQuality
el I-Claim HighQuality
diagnóstico, I-Claim HighQuality
pero I-Claim HighQuality
no I-Claim HighQuality
para I-Claim HighQuality
el I-Claim HighQuality
seguimiento I-Claim HighQuality
del I-Claim HighQuality
LES. I-Claim HighQuality

QUESTION O 
TYPE: O 
TRAUMATOLOGY O 

CLINICAL O 
CASE: O 

Varón B-Premise HighQuality
de I-Premise HighQuality
41 I-Premise HighQuality
años I-Premise HighQuality
que I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
gonalgia I-Premise HighQuality
de I-Premise HighQuality
varios I-Premise HighQuality
días I-Premise HighQuality
de I-Premise HighQuality
evolución. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
se I-Premise HighQuality
realiza I-Premise HighQuality
el I-Premise HighQuality
test I-Premise HighQuality
de I-Premise HighQuality
Thessaly I-Premise HighQuality
(dolor I-Premise HighQuality
con I-Premise HighQuality
los I-Premise HighQuality
movimientos I-Premise HighQuality
de I-Premise HighQuality
rotación I-Premise HighQuality
interna I-Premise HighQuality
y I-Premise HighQuality
externa I-Premise HighQuality
con I-Premise HighQuality
la I-Premise HighQuality
rodilla I-Premise HighQuality
flexionada) I-Premise HighQuality
que I-Premise HighQuality
resulta I-Premise HighQuality
positivo. I-Premise HighQuality

¿Cuál O 
de O 
las O 
siguientes O 
lesiones O 
es O 
más O 
probable?: O 

1- O 
Lesión B-Claim HighQuality
meniscal. I-Claim HighQuality

2- O 
Lesión B-Claim HighQuality
por I-Claim HighQuality
rotura I-Claim HighQuality
del I-Claim HighQuality
ligamento I-Claim HighQuality
cruzado I-Claim HighQuality
anterior. I-Claim HighQuality

3- O 
Lesión B-Claim HighQuality
por I-Claim HighQuality
rotura I-Claim HighQuality
del I-Claim HighQuality
ligamento I-Claim HighQuality
cruzado I-Claim HighQuality
posterior. I-Claim HighQuality

4- O 
Lesión B-Claim HighQuality
por I-Claim HighQuality
artropatía I-Claim HighQuality
degenerativa. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
1 O 

Respuesta B-Claim HighQuality
1 I-Claim HighQuality
correcta: I-Claim HighQuality
El B-Claim HighQuality
test I-Claim HighQuality
de I-Claim HighQuality
Thessaly I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
maniobra I-Claim HighQuality
de I-Claim HighQuality
exploración I-Claim HighQuality
meniscal. I-Claim HighQuality

El B-Premise HighQuality
enunciado I-Premise HighQuality
se I-Premise HighQuality
centra I-Premise HighQuality
exclusivamente I-Premise HighQuality
en I-Premise HighQuality
esta I-Premise HighQuality
parte I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
y I-Premise HighQuality
nos I-Premise HighQuality
explica, I-Premise HighQuality
además, I-Premise HighQuality
que I-Premise HighQuality
efectivamente I-Premise HighQuality
es I-Premise HighQuality
positiva I-Premise HighQuality
lo B-Claim HighQuality
que I-Claim HighQuality
hace I-Claim HighQuality
sospechar I-Claim HighQuality
que I-Claim HighQuality
existe I-Claim HighQuality
lesión I-Claim HighQuality
meniscal. I-Claim HighQuality

"The B-Claim HighQuality
Thessaly I-Claim HighQuality
test I-Claim HighQuality
is I-Claim HighQuality
a I-Claim HighQuality
dynamic I-Claim HighQuality
reproduction I-Claim HighQuality
of I-Claim HighQuality
load I-Claim HighQuality
transmission I-Claim HighQuality
in I-Claim HighQuality
the I-Claim HighQuality
knee I-Claim HighQuality
joint I-Claim HighQuality
and I-Claim HighQuality
is I-Claim HighQuality
performed I-Claim HighQuality
at I-Claim HighQuality
5° I-Claim HighQuality
and I-Claim HighQuality
20° I-Claim HighQuality
of I-Claim HighQuality
flexion. I-Claim HighQuality

The B-Claim HighQuality
examiner I-Claim HighQuality
supports I-Claim HighQuality
the I-Claim HighQuality
patient I-Claim HighQuality
by I-Claim HighQuality
holding I-Claim HighQuality
his I-Claim HighQuality
or I-Claim HighQuality
her I-Claim HighQuality
outstretched I-Claim HighQuality
hands I-Claim HighQuality
while I-Claim HighQuality
the I-Claim HighQuality
patient I-Claim HighQuality
stands I-Claim HighQuality
flatfooted I-Claim HighQuality
on I-Claim HighQuality
the I-Claim HighQuality
floor. I-Claim HighQuality

The B-Claim HighQuality
patient I-Claim HighQuality
then I-Claim HighQuality
rotates I-Claim HighQuality
his I-Claim HighQuality
or I-Claim HighQuality
her I-Claim HighQuality
knee I-Claim HighQuality
and I-Claim HighQuality
body, I-Claim HighQuality
internally I-Claim HighQuality
and I-Claim HighQuality
externally, I-Claim HighQuality
three I-Claim HighQuality
times, I-Claim HighQuality
keeping I-Claim HighQuality
the I-Claim HighQuality
knee I-Claim HighQuality
in I-Claim HighQuality
slight I-Claim HighQuality
flexion I-Claim HighQuality
(5°). I-Claim HighQuality

Then B-Claim HighQuality
the I-Claim HighQuality
same I-Claim HighQuality
procedure I-Claim HighQuality
is I-Claim HighQuality
carried I-Claim HighQuality
out I-Claim HighQuality
with I-Claim HighQuality
the I-Claim HighQuality
knee I-Claim HighQuality
flexed I-Claim HighQuality
at I-Claim HighQuality
20°. I-Claim HighQuality

Patients B-Claim HighQuality
with I-Claim HighQuality
suspected I-Claim HighQuality
meniscal I-Claim HighQuality
tears I-Claim HighQuality
experience I-Claim HighQuality
medial I-Claim HighQuality
or I-Claim HighQuality
lateral I-Claim HighQuality
joint-line I-Claim HighQuality
discomfort I-Claim HighQuality
and I-Claim HighQuality
may I-Claim HighQuality
have I-Claim HighQuality
a I-Claim HighQuality
sense I-Claim HighQuality
of I-Claim HighQuality
locking I-Claim HighQuality
or I-Claim HighQuality
catching. I-Claim HighQuality

The B-Claim HighQuality
theory I-Claim HighQuality
behind I-Claim HighQuality
the I-Claim HighQuality
test I-Claim HighQuality
is I-Claim HighQuality
that, I-Claim HighQuality
with I-Claim HighQuality
this I-Claim HighQuality
maneuver, I-Claim HighQuality
the I-Claim HighQuality
knee I-Claim HighQuality
with I-Claim HighQuality
a I-Claim HighQuality
meniscal I-Claim HighQuality
tear I-Claim HighQuality
is I-Claim HighQuality
subjected I-Claim HighQuality
to I-Claim HighQuality
excessive I-Claim HighQuality
loading I-Claim HighQuality
conditions I-Claim HighQuality
and I-Claim HighQuality
almost I-Claim HighQuality
certainly I-Claim HighQuality
will I-Claim HighQuality
have I-Claim HighQuality
the I-Claim HighQuality
same I-Claim HighQuality
symptoms I-Claim HighQuality
that I-Claim HighQuality
the I-Claim HighQuality
patient I-Claim HighQuality
reported. I-Claim HighQuality

The B-Claim HighQuality
test I-Claim HighQuality
is I-Claim HighQuality
always I-Claim HighQuality
performed I-Claim HighQuality
first I-Claim HighQuality
on I-Claim HighQuality
the I-Claim HighQuality
normal I-Claim HighQuality
knee I-Claim HighQuality
so I-Claim HighQuality
that I-Claim HighQuality
the I-Claim HighQuality
patient I-Claim HighQuality
may I-Claim HighQuality
be I-Claim HighQuality
trained, I-Claim HighQuality
especially I-Claim HighQuality
with I-Claim HighQuality
regard I-Claim HighQuality
to I-Claim HighQuality
how I-Claim HighQuality
to I-Claim HighQuality
keep I-Claim HighQuality
the I-Claim HighQuality
knee I-Claim HighQuality
in I-Claim HighQuality
5° I-Claim HighQuality
and I-Claim HighQuality
then I-Claim HighQuality
in I-Claim HighQuality
20° I-Claim HighQuality
of I-Claim HighQuality
flexion I-Claim HighQuality
and I-Claim HighQuality
how I-Claim HighQuality
to I-Claim HighQuality
recognize, I-Claim HighQuality
by I-Claim HighQuality
comparison, I-Claim HighQuality
a I-Claim HighQuality
possible I-Claim HighQuality
positive I-Claim HighQuality
result I-Claim HighQuality
in I-Claim HighQuality
the I-Claim HighQuality
symptomatic I-Claim HighQuality
knee." I-Claim HighQuality
Respuesta B-Claim HighQuality
2 I-Claim HighQuality
incorrecta: I-Claim HighQuality
No B-Premise HighQuality
nos I-Premise HighQuality
describen I-Premise HighQuality
en I-Premise HighQuality
ningún I-Premise HighQuality
momento I-Premise HighQuality
maniobras I-Premise HighQuality
de I-Premise HighQuality
exploración I-Premise HighQuality
del I-Premise HighQuality
ligamento I-Premise HighQuality
cruzado I-Premise HighQuality
anterior, I-Premise HighQuality
tampoco I-Premise HighQuality
nos I-Premise HighQuality
hablan I-Premise HighQuality
de I-Premise HighQuality
un I-Premise HighQuality
traumatismo I-Premise HighQuality
que I-Premise HighQuality
lo I-Premise HighQuality
haya I-Premise HighQuality
podido I-Premise HighQuality
lesionar. I-Premise HighQuality

Respuesta B-Claim HighQuality
3 I-Claim HighQuality
incorrecta: I-Claim HighQuality
No B-Premise HighQuality
nos I-Premise HighQuality
describen I-Premise HighQuality
en I-Premise HighQuality
ningún I-Premise HighQuality
momento I-Premise HighQuality
maniobras I-Premise HighQuality
de I-Premise HighQuality
exploración I-Premise HighQuality
del I-Premise HighQuality
ligamento I-Premise HighQuality
cruzado I-Premise HighQuality
posterior, I-Premise HighQuality
tampoco I-Premise HighQuality
nos I-Premise HighQuality
hablan I-Premise HighQuality
de I-Premise HighQuality
un I-Premise HighQuality
traumatismo I-Premise HighQuality
que I-Premise HighQuality
lo I-Premise HighQuality
haya I-Premise HighQuality
podido I-Premise HighQuality
lesionar. I-Premise HighQuality

Respuesta B-Claim HighQuality
4 I-Claim HighQuality
incorrecta: I-Claim HighQuality
Aunque B-Claim HighQuality
podría I-Claim HighQuality
darse I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
lo I-Claim HighQuality
esperable I-Claim HighQuality
en I-Claim HighQuality
una I-Claim HighQuality
persona I-Claim HighQuality
de I-Claim HighQuality
41 I-Claim HighQuality
años I-Claim HighQuality
con I-Claim HighQuality
una I-Claim HighQuality
clínica I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
ha I-Claim HighQuality
establecido I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
aguda. I-Claim HighQuality

QUESTION O 
TYPE: O 
TRAUMATOLOGY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
13 I-Premise HighQuality
años, I-Premise HighQuality
sin I-Premise HighQuality
antecedentes I-Premise HighQuality
relevantes, I-Premise HighQuality
con I-Premise HighQuality
menarquia I-Premise HighQuality
hace I-Premise HighQuality
3 I-Premise HighQuality
meses, I-Premise HighQuality
seguida I-Premise HighQuality
desde I-Premise HighQuality
los I-Premise HighQuality
10 I-Premise HighQuality
años I-Premise HighQuality
por I-Premise HighQuality
escoliosis I-Premise HighQuality
idiopática I-Premise HighQuality
que I-Premise HighQuality
ha I-Premise HighQuality
empeorado. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
física I-Premise HighQuality
presenta I-Premise HighQuality
una I-Premise HighQuality
giba I-Premise HighQuality
de I-Premise HighQuality
7 I-Premise HighQuality
grados I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
test I-Premise HighQuality
de I-Premise HighQuality
Adams I-Premise HighQuality
y I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
escoliograma I-Premise HighQuality
una I-Premise HighQuality
curva I-Premise HighQuality
toracolumbar I-Premise HighQuality
T4-L1 I-Premise HighQuality
de I-Premise HighQuality
35 I-Premise HighQuality
grados I-Premise HighQuality
de I-Premise HighQuality
Cobb I-Premise HighQuality
y I-Premise HighQuality
un I-Premise HighQuality
Risser I-Premise HighQuality
0. I-Premise HighQuality

1- O 
Recomendar B-Claim HighQuality
natación I-Claim HighQuality
y I-Claim HighQuality
revisión I-Claim HighQuality
en I-Claim HighQuality
tres I-Claim HighQuality
meses. I-Claim HighQuality

2- O 
Prescribir B-Claim HighQuality
una I-Claim HighQuality
ortesis I-Claim HighQuality
tipo I-Claim HighQuality
corsé. I-Claim HighQuality

3- O 
Derivar B-Claim HighQuality
a I-Claim HighQuality
fisioterapia I-Claim HighQuality
para I-Claim HighQuality
elastificación I-Claim HighQuality
del I-Claim HighQuality
raquis. I-Claim HighQuality

4- O 
Revisar B-Claim HighQuality
en I-Claim HighQuality
6 I-Claim HighQuality
meses I-Claim HighQuality
con I-Claim HighQuality
una I-Claim HighQuality
nueva I-Claim HighQuality
radiografía. I-Claim HighQuality

5- O 
nan O 

CORRECT O 
ANSWER: O 
2 O 

Nos B-Premise HighQuality
presentan I-Premise HighQuality
el I-Premise HighQuality
caso I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
paciente I-Premise HighQuality
de I-Premise HighQuality
13 I-Premise HighQuality
años, I-Premise HighQuality
con I-Premise HighQuality
la I-Premise HighQuality
menarquia I-Premise HighQuality
hace I-Premise HighQuality
3 I-Premise HighQuality
meses, I-Premise HighQuality
una I-Premise HighQuality
curva I-Premise HighQuality
toracolumbar I-Premise HighQuality
T4-L1 I-Premise HighQuality
de I-Premise HighQuality
35º I-Premise HighQuality
y I-Premise HighQuality
un I-Premise HighQuality
Risser I-Premise HighQuality
0. I-Premise HighQuality

Como B-Claim HighQuality
norma I-Claim HighQuality
general I-Claim HighQuality
podríamos I-Claim HighQuality
decir I-Claim HighQuality
que I-Claim HighQuality
por I-Claim HighQuality
debajo I-Claim HighQuality
de I-Claim HighQuality
los I-Claim HighQuality
50º I-Claim HighQuality
el I-Claim HighQuality
tratamiento I-Claim HighQuality
suele I-Claim HighQuality
ser I-Claim HighQuality
conservador, I-Claim HighQuality
existiendo I-Claim HighQuality
dos I-Claim HighQuality
opciones: I-Claim HighQuality
observación I-Claim HighQuality
o I-Claim HighQuality
uso I-Claim HighQuality
de I-Claim HighQuality
corsé I-Claim HighQuality
para I-Claim HighQuality
enlentecer I-Claim HighQuality
la I-Claim HighQuality
evolución. I-Claim HighQuality

En B-Claim HighQuality
este I-Claim HighQuality
caso I-Claim HighQuality
teniendo I-Claim HighQuality
en I-Claim HighQuality
cuenta I-Claim HighQuality
el I-Claim HighQuality
crecimiento I-Claim HighQuality
remanente I-Claim HighQuality
que I-Claim HighQuality
queda I-Claim HighQuality
(menarquia I-Claim HighQuality
hace I-Claim HighQuality
3 I-Claim HighQuality
meses I-Claim HighQuality
y I-Claim HighQuality
Risser I-Claim HighQuality
0) I-Claim HighQuality
lo I-Claim HighQuality
más I-Claim HighQuality
indicado I-Claim HighQuality
sería I-Claim HighQuality
utilizar I-Claim HighQuality
corsé I-Claim HighQuality
(Respuesta B-Claim HighQuality
2 I-Claim HighQuality
correcta). I-Claim HighQuality

QUESTION O 
TYPE: O 
ANESTHESIOLOGY O 
AND O 
CRITICAL O 
CARE O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
hombre I-Premise HighQuality
de I-Premise HighQuality
30 I-Premise HighQuality
años I-Premise HighQuality
sufre I-Premise HighQuality
caída I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
altura I-Premise HighQuality
de I-Premise HighQuality
2 I-Premise HighQuality
metros I-Premise HighQuality
de I-Premise HighQuality
pie. I-Premise HighQuality

A B-Claim HighQuality
su I-Claim HighQuality
llegada I-Claim HighQuality
a I-Claim HighQuality
Urgencias, I-Claim HighQuality
está I-Claim HighQuality
cyo, I-Claim HighQuality
con I-Claim HighQuality
sondaje I-Claim HighQuality
vesical I-Claim HighQuality
con I-Claim HighQuality
orina I-Claim HighQuality
clara. I-Claim HighQuality

Muestra B-Premise HighQuality
tumefacción I-Premise HighQuality
de I-Premise HighQuality
talón I-Premise HighQuality
izquierdo, I-Premise HighQuality
así I-Premise HighQuality
como I-Premise HighQuality
hormigueos I-Premise HighQuality
leves I-Premise HighQuality
por I-Premise HighQuality
cara I-Premise HighQuality
anterior I-Premise HighQuality
de I-Premise HighQuality
muslo I-Premise HighQuality
derecho I-Premise HighQuality
y I-Premise HighQuality
escroto, I-Premise HighQuality
así I-Premise HighQuality
como I-Premise HighQuality
disestesias I-Premise HighQuality
en I-Premise HighQuality
ambos I-Premise HighQuality
pies. I-Premise HighQuality

El O 
paciente O 
se O 
despide O 
del O 
camillero O 
con O 
un O 
apretón O 
de O 
manos, O 
con O 
una O 
palmada O 
simultánea O 
en O 
el O 
hombro. O 

La B-Premise HighQuality
rotación I-Premise HighQuality
de I-Premise HighQuality
los I-Premise HighQuality
MMII I-Premise HighQuality
en I-Premise HighQuality
la I-Premise HighQuality
camilla I-Premise HighQuality
cogidos I-Premise HighQuality
por I-Premise HighQuality
los I-Premise HighQuality
tobillos I-Premise HighQuality
es I-Premise HighQuality
indolora I-Premise HighQuality
y O 
la B-Premise HighQuality
compresión I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
pelvis I-Premise HighQuality
es I-Premise HighQuality
asintomática. I-Premise HighQuality

A O 
continuación: O 

1- O 
Lo B-Claim HighQuality
sentaremos I-Claim HighQuality
en I-Claim HighQuality
la I-Claim HighQuality
camilla I-Claim HighQuality
para I-Claim HighQuality
poder I-Claim HighQuality
explorar I-Claim HighQuality
la I-Claim HighQuality
columna I-Claim HighQuality
cervical. I-Claim HighQuality

2- O 
Remitiremos B-Claim HighQuality
a I-Claim HighQuality
Rx I-Claim HighQuality
para I-Claim HighQuality
realizar I-Claim HighQuality
estudio I-Claim HighQuality
de I-Claim HighQuality
extremidades I-Claim HighQuality
inferiores. I-Claim HighQuality

3- O 
Palparemos B-Claim HighQuality
el I-Claim HighQuality
abdomen I-Claim HighQuality
y I-Claim HighQuality
lo I-Claim HighQuality
rotaremos I-Claim HighQuality
en I-Claim HighQuality
bloque I-Claim HighQuality
para I-Claim HighQuality
palpar I-Claim HighQuality
la I-Claim HighQuality
columna I-Claim HighQuality
toraco-lumbar. I-Claim HighQuality

4- O 
Le B-Claim HighQuality
colocaremos I-Claim HighQuality
un I-Claim HighQuality
collarín I-Claim HighQuality
cervical I-Claim HighQuality
y I-Claim HighQuality
remitiremos I-Claim HighQuality
a I-Claim HighQuality
radiología I-Claim HighQuality
para I-Claim HighQuality
estudio I-Claim HighQuality
de I-Claim HighQuality
imagen I-Claim HighQuality
de I-Claim HighQuality
columna I-Claim HighQuality
cervical I-Claim HighQuality
y I-Claim HighQuality
extremidades I-Claim HighQuality
inferiores. I-Claim HighQuality

5- O 
Solicitaremos B-Claim HighQuality
una I-Claim HighQuality
eco I-Claim HighQuality
abdominal. I-Claim HighQuality

CORRECT O 
ANSWER: O 
3 O 

Por B-Premise HighQuality
los I-Premise HighQuality
síntomas I-Premise HighQuality
que I-Premise HighQuality
cuentan, I-Premise HighQuality
hormigueo I-Premise HighQuality
en I-Premise HighQuality
cara I-Premise HighQuality
anterior I-Premise HighQuality
de I-Premise HighQuality
muslo, I-Premise HighQuality
escroto I-Premise HighQuality
y I-Premise HighQuality
disestesias I-Premise HighQuality
en I-Premise HighQuality
pies, I-Premise HighQuality
parece B-Claim HighQuality
existir I-Claim HighQuality
una I-Claim HighQuality
afectación I-Claim HighQuality
vertebral I-Claim HighQuality
a I-Claim HighQuality
nivel I-Claim HighQuality
L2-3 I-Claim HighQuality
y I-Claim HighQuality
raíces I-Claim HighQuality
sacras, I-Claim HighQuality
con O 
lo O 
que O 
lo B-Claim HighQuality
correcto I-Claim HighQuality
sería I-Claim HighQuality
realizar I-Claim HighQuality
un I-Claim HighQuality
examen I-Claim HighQuality
radiológico I-Claim HighQuality
sin I-Claim HighQuality
estar I-Claim HighQuality
movilizando I-Claim HighQuality
al I-Claim HighQuality
paciente. I-Claim HighQuality

Pero B-Claim HighQuality
sí I-Claim HighQuality
hay I-Claim HighQuality
que I-Claim HighQuality
movilizarlo I-Claim HighQuality
para I-Claim HighQuality
explorarlo, I-Claim HighQuality
evidentemente, I-Claim HighQuality
en I-Claim HighQuality
bloque. I-Claim HighQuality

La B-Claim HighQuality
columna I-Claim HighQuality
cervical I-Claim HighQuality
parece I-Claim HighQuality
estar I-Claim HighQuality
indemne I-Claim HighQuality
porque O 
el B-Premise HighQuality
paciente I-Premise HighQuality
moviliza I-Premise HighQuality
adecuadamente I-Premise HighQuality
los I-Premise HighQuality
dos I-Premise HighQuality
brazos, I-Premise HighQuality
sin I-Premise HighQuality
parestesias. I-Premise HighQuality

QUESTION O 
TYPE: O 
PATHOLOGICAL O 
ANATOMY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
hombre I-Premise HighQuality
de I-Premise HighQuality
56 I-Premise HighQuality
años, I-Premise HighQuality
diabético I-Premise HighQuality
y I-Premise HighQuality
con I-Premise HighQuality
sobrepeso I-Premise HighQuality
moderado I-Premise HighQuality
presenta I-Premise HighQuality
una I-Premise HighQuality
discreta I-Premise HighQuality
hepatomegalia. I-Premise HighQuality

El B-Premise HighQuality
enfermo I-Premise HighQuality
indica I-Premise HighQuality
que I-Premise HighQuality
no I-Premise HighQuality
es I-Premise HighQuality
bebedor I-Premise HighQuality
habitual, I-Premise HighQuality
sólo O 
excepcionalmente O 
toma O 
algo O 
de O 
vino. O 

Una B-Premise HighQuality
biopsia I-Premise HighQuality
de I-Premise HighQuality
hígado I-Premise HighQuality
muestra I-Premise HighQuality
acúmulos I-Premise HighQuality
de I-Premise HighQuality
vacuolas I-Premise HighQuality
claras I-Premise HighQuality
citoplásmicas I-Premise HighQuality
en I-Premise HighQuality
un I-Premise HighQuality
50% I-Premise HighQuality
de I-Premise HighQuality
los I-Premise HighQuality
hepatocitos. I-Premise HighQuality

Focos B-Premise HighQuality
inflamatorios I-Premise HighQuality
múltiples I-Premise HighQuality
con I-Premise HighQuality
neutrófilos, I-Premise HighQuality
degeneración I-Premise HighQuality
hialina I-Premise HighQuality
de I-Premise HighQuality
Mallory I-Premise HighQuality
y I-Premise HighQuality
fibrosis I-Premise HighQuality
alrededor I-Premise HighQuality
de I-Premise HighQuality
las I-Premise HighQuality
vénulas I-Premise HighQuality
hepáticas I-Premise HighQuality
terminales. I-Premise HighQuality

Señale O 
la O 
respuesta O 
correcta O 
en O 
este O 
caso: O 

1- O 
Debe B-Claim HighQuality
repetirse I-Claim HighQuality
la I-Claim HighQuality
biopsia I-Claim HighQuality
para I-Claim HighQuality
saber I-Claim HighQuality
si I-Claim HighQuality
los I-Claim HighQuality
cambios I-Claim HighQuality
son I-Claim HighQuality
difusos. I-Claim HighQuality

2- O 
El B-Claim HighQuality
diagnóstico I-Claim HighQuality
es I-Claim HighQuality
una I-Claim HighQuality
glucogenosis I-Claim HighQuality
hepática I-Claim HighQuality
asociada I-Claim HighQuality
a I-Claim HighQuality
la I-Claim HighQuality
diabetes. I-Claim HighQuality

3- O 
Los B-Claim HighQuality
cambios I-Claim HighQuality
histológicos I-Claim HighQuality
son I-Claim HighQuality
irreversibles I-Claim HighQuality
y I-Claim HighQuality
acabarán I-Claim HighQuality
produciendo I-Claim HighQuality
una I-Claim HighQuality
cirrosis. I-Claim HighQuality

4- O 
La B-Claim HighQuality
lesión I-Claim HighQuality
está I-Claim HighQuality
causada I-Claim HighQuality
claramente I-Claim HighQuality
por I-Claim HighQuality
el I-Claim HighQuality
alcohol I-Claim HighQuality
a I-Claim HighQuality
pesar I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
negativa I-Claim HighQuality
del I-Claim HighQuality
enfermo. I-Claim HighQuality

5- O 
Es B-Claim HighQuality
importante I-Claim HighQuality
disminuir I-Claim HighQuality
peso I-Claim HighQuality
y I-Claim HighQuality
controlar I-Claim HighQuality
adecuadamente I-Claim HighQuality
la I-Claim HighQuality
diabetes I-Claim HighQuality
para I-Claim HighQuality
evitar I-Claim HighQuality
el I-Claim HighQuality
posible I-Claim HighQuality
desarrollo I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
cirrosis. I-Claim HighQuality

CORRECT O 
ANSWER: O 
5 O 

Los B-Claim HighQuality
cambios I-Claim HighQuality
descritos I-Claim HighQuality
en I-Claim HighQuality
el I-Claim HighQuality
enunciado I-Claim HighQuality
de I-Claim HighQuality
la I-Claim HighQuality
pregunta I-Claim HighQuality
corresponden I-Claim HighQuality
a I-Claim HighQuality
una I-Claim HighQuality
situación I-Claim HighQuality
precirrótica I-Claim HighQuality
precoz. I-Claim HighQuality

Si B-Claim HighQuality
bien I-Claim HighQuality
el I-Claim HighQuality
alcohol I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
tóxico I-Claim HighQuality
que I-Claim HighQuality
con I-Claim HighQuality
más I-Claim HighQuality
frecuencia I-Claim HighQuality
provoca I-Claim HighQuality
este I-Claim HighQuality
cuadro, I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
el I-Claim HighQuality
causante I-Claim HighQuality
en I-Claim HighQuality
exclusiva. I-Claim HighQuality

La B-Claim HighQuality
diabetes I-Claim HighQuality
mellitus I-Claim HighQuality
provoca I-Claim HighQuality
alteraciones I-Claim HighQuality
hepáticas I-Claim HighQuality
similares: I-Claim HighQuality
acúmulo I-Claim HighQuality
de I-Claim HighQuality
grasa I-Claim HighQuality
en I-Claim HighQuality
los I-Claim HighQuality
hepatocitos, I-Claim HighQuality
fibrosis I-Claim HighQuality
centroacinar, I-Claim HighQuality
infiltrado I-Claim HighQuality
inflamatorio I-Claim HighQuality
por I-Claim HighQuality
polimorfonucleares I-Claim HighQuality
neutrófilos I-Claim HighQuality
y I-Claim HighQuality
degeneración I-Claim HighQuality
hialina I-Claim HighQuality
de I-Claim HighQuality
mallory I-Claim HighQuality
perinuclear. I-Claim HighQuality

Teniendo O 
esto O 
en O 
consideración, O 
podemos B-Claim HighQuality
descartar I-Claim HighQuality
la I-Claim HighQuality
segunda I-Claim HighQuality
pregunta I-Claim HighQuality
(son I-Claim HighQuality
acúmulos I-Claim HighQuality
de I-Claim HighQuality
grasa I-Claim HighQuality
intracelular, I-Claim HighQuality
no I-Claim HighQuality
de I-Claim HighQuality
glucógeno) I-Claim HighQuality
y I-Claim HighQuality
la I-Claim HighQuality
cuarta I-Claim HighQuality
(si I-Claim HighQuality
la I-Claim HighQuality
diabetes I-Claim HighQuality
también I-Claim HighQuality
produce I-Claim HighQuality
dicha I-Claim HighQuality
situación I-Claim HighQuality
no I-Claim HighQuality
hay I-Claim HighQuality
por I-Claim HighQuality
qué I-Claim HighQuality
desconfiar I-Claim HighQuality
del I-Claim HighQuality
paciente). I-Claim HighQuality

Basándonos B-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
primum I-Premise HighQuality
non I-Premise HighQuality
nocere I-Premise HighQuality
y I-Premise HighQuality
el I-Premise HighQuality
no I-Premise HighQuality
tener I-Premise HighQuality
especial I-Premise HighQuality
relevancia I-Premise HighQuality
para I-Premise HighQuality
el I-Premise HighQuality
tratamiento I-Premise HighQuality
si I-Premise HighQuality
es I-Premise HighQuality
una I-Premise HighQuality
enfermedad I-Premise HighQuality
focal I-Premise HighQuality
o I-Premise HighQuality
generalizada, I-Premise HighQuality
no B-Claim HighQuality
es I-Claim HighQuality
necesario I-Claim HighQuality
repetir I-Claim HighQuality
una I-Claim HighQuality
biopsia I-Claim HighQuality
hepática I-Claim HighQuality
que I-Claim HighQuality
no I-Claim HighQuality
ampliaría I-Claim HighQuality
información, I-Claim HighQuality
descartándose I-Claim HighQuality
la I-Claim HighQuality
primera I-Claim HighQuality
pregunta. I-Claim HighQuality

Afortunadamente B-Claim HighQuality
para I-Claim HighQuality
el I-Claim HighQuality
hipotético I-Claim HighQuality
paciente, I-Claim HighQuality
en I-Claim HighQuality
fase I-Claim HighQuality
inicial I-Claim HighQuality
estos I-Claim HighQuality
cambios I-Claim HighQuality
son I-Claim HighQuality
reversibles I-Claim HighQuality
al I-Claim HighQuality
desaparecer I-Claim HighQuality
la I-Claim HighQuality
noxa, I-Claim HighQuality
por O 
lo O 
que O 
nos B-Claim HighQuality
quedamos I-Claim HighQuality
con I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
nº I-Claim HighQuality
5. I-Claim HighQuality

QUESTION O 
TYPE: O 
ANESTHESIOLOGY, O 
CRITICAL O 
CARE O 
AND O 
EMERGENCIES O 

CLINICAL O 
CASE: O 

Una B-Premise HighQuality
mujer I-Premise HighQuality
de I-Premise HighQuality
67 I-Premise HighQuality
años I-Premise HighQuality
con I-Premise HighQuality
antecedentes I-Premise HighQuality
de I-Premise HighQuality
insuficiencia I-Premise HighQuality
cardiaca I-Premise HighQuality
congestiva I-Premise HighQuality
(que I-Premise HighQuality
lleva I-Premise HighQuality
tratamiento I-Premise HighQuality
con I-Premise HighQuality
ramipril I-Premise HighQuality
y I-Premise HighQuality
furosemida) I-Premise HighQuality
y I-Premise HighQuality
diabetes I-Premise HighQuality
tipo I-Premise HighQuality
2 I-Premise HighQuality
(en I-Premise HighQuality
tratamiento I-Premise HighQuality
con I-Premise HighQuality
insulina) I-Premise HighQuality
acue I-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
por I-Premise HighQuality
disnea. I-Premise HighQuality

En B-Premise HighQuality
gasometría I-Premise HighQuality
realizada I-Premise HighQuality
respirando I-Premise HighQuality
aire I-Premise HighQuality
ambiente I-Premise HighQuality
se I-Premise HighQuality
observa I-Premise HighQuality
un I-Premise HighQuality
pH I-Premise HighQuality
7.45, I-Premise HighQuality
paO2 I-Premise HighQuality
56, I-Premise HighQuality
PaCO2 I-Premise HighQuality
30 I-Premise HighQuality
mm I-Premise HighQuality
Hg, I-Premise HighQuality
HCO3 I-Premise HighQuality
26 I-Premise HighQuality
mm I-Premise HighQuality
Hg. I-Premise HighQuality

¿Qué O 
alteración O 
gasométrica O 
presenta O 
la O 
paciente? O 

1- O 
Insuficiencia B-Claim HighQuality
respiratoria I-Claim HighQuality
hipoxémica I-Claim HighQuality
con I-Claim HighQuality
alcalosis I-Claim HighQuality
respiratoria I-Claim HighQuality
compensada. I-Claim HighQuality

2- O 
Alcalosis B-Claim HighQuality
metabólica I-Claim HighQuality
aguda I-Claim HighQuality
con I-Claim HighQuality
insuficiencia I-Claim HighQuality
respiratoria I-Claim HighQuality
hipoxémica I-Claim HighQuality
e I-Claim HighQuality
hipocápnica. I-Claim HighQuality

3- O 
Insuficiencia B-Claim HighQuality
respiratoria I-Claim HighQuality
normocapnica I-Claim HighQuality
crónica, I-Claim HighQuality
sin I-Claim HighQuality
alteración I-Claim HighQuality
del I-Claim HighQuality
equilibrio I-Claim HighQuality
acido-base. I-Claim HighQuality

4- O 
Insuficiencia B-Claim HighQuality
respiratoria I-Claim HighQuality
hipoxémica I-Claim HighQuality
crónica I-Claim HighQuality
con I-Claim HighQuality
acidosis I-Claim HighQuality
metabólica I-Claim HighQuality
compensada. I-Claim HighQuality

5- O 
Insuficiencia B-Claim HighQuality
respiratoria I-Claim HighQuality
hipoxémica I-Claim HighQuality
con I-Claim HighQuality
alcalosis I-Claim HighQuality
mixta I-Claim HighQuality
compensada. I-Claim HighQuality

CORRECT O 
ANSWER: O 
1 O 

Esta O 
pregunta O 
me O 
ha O 
parecido O 
complicadilla. O 

Los B-Premise HighQuality
hallazgos I-Premise HighQuality
por I-Premise HighQuality
separado I-Premise HighQuality
son: I-Premise HighQuality
pH I-Premise HighQuality
normal I-Premise HighQuality
pero I-Premise HighQuality
con I-Premise HighQuality
tendencia I-Premise HighQuality
alcalosis, I-Premise HighQuality
Insuficencia I-Premise HighQuality
respiratoria I-Premise HighQuality
aguda, I-Premise HighQuality
hipocapnia I-Premise HighQuality
y I-Premise HighQuality
bicarbonato I-Premise HighQuality
normal. I-Premise HighQuality

La B-Claim HighQuality
respuesta I-Claim HighQuality
mas I-Claim HighQuality
apropiada I-Claim HighQuality
me I-Claim HighQuality
parece I-Claim HighQuality
la I-Claim HighQuality
1, I-Claim HighQuality
dado O 
que O 
la B-Premise HighQuality
paciente I-Premise HighQuality
no I-Premise HighQuality
presenta I-Premise HighQuality
una I-Premise HighQuality
alcalosis I-Premise HighQuality
metabólica I-Premise HighQuality
(el I-Premise HighQuality
bicarbonato I-Premise HighQuality
estaría I-Premise HighQuality
mas I-Premise HighQuality
elevado), I-Premise HighQuality
mucho I-Premise HighQuality
menos I-Premise HighQuality
una I-Premise HighQuality
acidosis I-Premise HighQuality
(el I-Premise HighQuality
bicarbonato I-Premise HighQuality
estaría I-Premise HighQuality
bajo). I-Premise HighQuality

La B-Claim HighQuality
alcalosis I-Claim HighQuality
tampoco I-Claim HighQuality
es I-Claim HighQuality
mixta, I-Claim HighQuality
sino I-Claim HighQuality
que I-Claim HighQuality
es I-Claim HighQuality
principalmente I-Claim HighQuality
respiratoria. I-Claim HighQuality

Probablemente B-Premise HighQuality
la I-Premise HighQuality
paciente I-Premise HighQuality
esté I-Premise HighQuality
hiperventilando I-Premise HighQuality
por I-Premise HighQuality
su I-Premise HighQuality
insuficiencia I-Premise HighQuality
respiratoria, I-Premise HighQuality
y O 
el B-Premise HighQuality
riñón I-Premise HighQuality
que I-Premise HighQuality
siempre I-Premise HighQuality
compensa I-Premise HighQuality
mas I-Premise HighQuality
tarde I-Premise HighQuality
está I-Premise HighQuality
empezando I-Premise HighQuality
a I-Premise HighQuality
retener I-Premise HighQuality
HCO3 I-Premise HighQuality
para I-Premise HighQuality
compensar I-Premise HighQuality
y I-Premise HighQuality
mantener I-Premise HighQuality
el I-Premise HighQuality
pH. I-Premise HighQuality

Por O 
tanto O 
creo B-Claim HighQuality
que I-Claim HighQuality
la I-Claim HighQuality
respuesta I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
1. I-Claim HighQuality

QUESTION O 
TYPE: O 
ANESTHESIOLOGY, O 
CRITICAL O 
CARE O 
AND O 
EMERGENCIES O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
76 I-Premise HighQuality
años I-Premise HighQuality
con I-Premise HighQuality
obesidad I-Premise HighQuality
y I-Premise HighQuality
diabetes I-Premise HighQuality
mellitas I-Premise HighQuality
tipo I-Premise HighQuality
2 I-Premise HighQuality
en I-Premise HighQuality
tratamiento I-Premise HighQuality
con I-Premise HighQuality
metformina. I-Premise HighQuality

Acude B-Premise HighQuality
a I-Premise HighQuality
urgencias I-Premise HighQuality
porque I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
3 I-Premise HighQuality
días I-Premise HighQuality
presenta I-Premise HighQuality
fiebre I-Premise HighQuality
de I-Premise HighQuality
38ºC, I-Premise HighQuality
poliaquiuria, I-Premise HighQuality
disuria, I-Premise HighQuality
intensa I-Premise HighQuality
sed I-Premise HighQuality
y I-Premise HighQuality
disminución I-Premise HighQuality
progresiva I-Premise HighQuality
del I-Premise HighQuality
nivel I-Premise HighQuality
de I-Premise HighQuality
consciencia. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
exploración I-Premise HighQuality
física I-Premise HighQuality
se I-Premise HighQuality
aprecian I-Premise HighQuality
signos I-Premise HighQuality
de I-Premise HighQuality
deshidratación, I-Premise HighQuality
PA I-Premise HighQuality
de I-Premise HighQuality
95/54 I-Premise HighQuality
mm I-Premise HighQuality
Hg I-Premise HighQuality
y I-Premise HighQuality
no I-Premise HighQuality
hay I-Premise HighQuality
signos I-Premise HighQuality
de I-Premise HighQuality
localidad I-Premise HighQuality
neurológica. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
analítica I-Premise HighQuality
destaca I-Premise HighQuality
leucocitosis, I-Premise HighQuality
creatinina I-Premise HighQuality
de I-Premise HighQuality
1,8 I-Premise HighQuality
mg/dL I-Premise HighQuality
y I-Premise HighQuality
glucemia I-Premise HighQuality
de I-Premise HighQuality
855 I-Premise HighQuality
mg/dL. I-Premise HighQuality

¿Cuál O 
es O 
el O 
diagnóstico O 
mas O 
probable? O 

1- O 
Coma B-Claim HighQuality
hiperglucémico I-Claim HighQuality
hiperosmolar I-Claim HighQuality
no I-Claim HighQuality
cetósico. I-Claim HighQuality

2- O 
Insuficiencia B-Claim HighQuality
cardiaca. I-Claim HighQuality

3- O 
Hematoma B-Claim HighQuality
subdural. I-Claim HighQuality

4- O 
Insuficiencia B-Claim HighQuality
renal I-Claim HighQuality
de I-Claim HighQuality
causa I-Claim HighQuality
obstructiva. I-Claim HighQuality

5- O 
Cetoacidosis B-Claim HighQuality
diabética I-Claim HighQuality
con I-Claim HighQuality
coma. I-Claim HighQuality

CORRECT O 
ANSWER: O 
1 O 

La B-Premise HighQuality
pregunta I-Premise HighQuality
cuenta I-Premise HighQuality
el I-Premise HighQuality
caso I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
paciente I-Premise HighQuality
diabética I-Premise HighQuality
tipo I-Premise HighQuality
2 I-Premise HighQuality
con I-Premise HighQuality
hiperglucemia I-Premise HighQuality
y I-Premise HighQuality
disminución I-Premise HighQuality
del I-Premise HighQuality
nivel I-Premise HighQuality
de I-Premise HighQuality
conciencia I-Premise HighQuality
sin I-Premise HighQuality
focalidad I-Premise HighQuality
neurológica I-Premise HighQuality
en I-Premise HighQuality
el I-Premise HighQuality
contexto I-Premise HighQuality
de I-Premise HighQuality
una I-Premise HighQuality
infección I-Premise HighQuality
urinaria I-Premise HighQuality
y I-Premise HighQuality
que I-Premise HighQuality
ha I-Premise HighQuality
desarrollado I-Premise HighQuality
una I-Premise HighQuality
insuficiencia I-Premise HighQuality
renal I-Premise HighQuality
aguda I-Premise HighQuality
de I-Premise HighQuality
probable I-Premise HighQuality
origen I-Premise HighQuality
prerrenal. I-Premise HighQuality

La B-Claim HighQuality
opción I-Claim HighQuality
2 I-Claim HighQuality
se I-Claim HighQuality
descarta I-Claim HighQuality
de I-Claim HighQuality
forma I-Claim HighQuality
inmediata I-Claim HighQuality
puesto O 
que O 
el B-Premise HighQuality
cuadro I-Premise HighQuality
clínico I-Premise HighQuality
no I-Premise HighQuality
es I-Premise HighQuality
de I-Premise HighQuality
insuficiencia I-Premise HighQuality
cardiaca. I-Premise HighQuality

La B-Claim HighQuality
opción I-Claim HighQuality
3 I-Claim HighQuality
también I-Claim HighQuality
se I-Claim HighQuality
descarta I-Claim HighQuality
porque O 
no B-Premise HighQuality
cuadra I-Premise HighQuality
con I-Premise HighQuality
la I-Premise HighQuality
clínica I-Premise HighQuality
y O 
además B-Premise HighQuality
el I-Premise HighQuality
HSD I-Premise HighQuality
daría I-Premise HighQuality
clínica I-Premise HighQuality
neurológica I-Premise HighQuality
con I-Premise HighQuality
localidad. I-Premise HighQuality

La B-Claim HighQuality
opción I-Claim HighQuality
4 I-Claim HighQuality
se I-Claim HighQuality
descarta I-Claim HighQuality
puesto O 
que O 
la B-Premise HighQuality
insuficiencia I-Premise HighQuality
renal I-Premise HighQuality
obstructiva I-Premise HighQuality
no I-Premise HighQuality
da I-Premise HighQuality
poliaquiuria, I-Premise HighQuality
disuria I-Premise HighQuality
ni I-Premise HighQuality
el I-Premise HighQuality
resto I-Premise HighQuality
de I-Premise HighQuality
la I-Premise HighQuality
clínica. I-Premise HighQuality

La B-Claim HighQuality
opción I-Claim HighQuality
5 I-Claim HighQuality
es I-Claim HighQuality
menos I-Claim HighQuality
probable I-Claim HighQuality
porque O 
la B-Premise HighQuality
cetoacidosis I-Premise HighQuality
diabética I-Premise HighQuality
es I-Premise HighQuality
mas I-Premise HighQuality
tipica I-Premise HighQuality
de I-Premise HighQuality
DM I-Premise HighQuality
tipo I-Premise HighQuality
1. I-Premise HighQuality

Por O 
tanto O 
la B-Claim HighQuality
opción I-Claim HighQuality
correcta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
1. I-Claim HighQuality

QUESTION O 
TYPE: O 
CARDIOLOGY O 
AND O 
VASCULAR O 
SURGERY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
paciente I-Premise HighQuality
de I-Premise HighQuality
81 I-Premise HighQuality
años I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
un I-Premise HighQuality
episodio I-Premise HighQuality
de I-Premise HighQuality
síncope. I-Premise HighQuality

Refiere B-Premise HighQuality
disnea I-Premise HighQuality
de I-Premise HighQuality
esfuerzo I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
un I-Premise HighQuality
año. I-Premise HighQuality

En B-Premise HighQuality
la I-Premise HighQuality
auscultación I-Premise HighQuality
cardiaca I-Premise HighQuality
destaca I-Premise HighQuality
un I-Premise HighQuality
soplo I-Premise HighQuality
sistólico I-Premise HighQuality
3/6 I-Premise HighQuality
en I-Premise HighQuality
borde I-Premise HighQuality
esternal I-Premise HighQuality
izquierdo I-Premise HighQuality
que I-Premise HighQuality
irradia I-Premise HighQuality
a I-Premise HighQuality
carótidas I-Premise HighQuality
y I-Premise HighQuality
punta. I-Premise HighQuality

¿Qué O 
patología O 
le O 
parece O 
más O 
probable? O 

1- O 
Bloqueo B-Claim HighQuality
aurículo-ventricular I-Claim HighQuality
de I-Claim HighQuality
tercer I-Claim HighQuality
grado. I-Claim HighQuality

2- O 
Estenosis B-Claim HighQuality
valvular I-Claim HighQuality
aórtica I-Claim HighQuality
degenerativa. I-Claim HighQuality

3- O 
Insuficiencia B-Claim HighQuality
valvular I-Claim HighQuality
mitral. I-Claim HighQuality

4- O 
Miocardiopatía B-Claim HighQuality
hipertrófica. I-Claim HighQuality

5- O 
Miocardiopatía B-Claim HighQuality
dilatada. I-Claim HighQuality

CORRECT O 
ANSWER: O 
2 O 

Pregunta O 
muy O 
fácil. O 

Nos B-Claim HighQuality
están I-Claim HighQuality
describiendo I-Claim HighQuality
el I-Claim HighQuality
“retrato” I-Claim HighQuality
de I-Claim HighQuality
una I-Claim HighQuality
estenosis I-Claim HighQuality
aórtica I-Claim HighQuality
degenerativa… I-Claim HighQuality

Paciente B-Premise HighQuality
anciano I-Premise HighQuality
con I-Premise HighQuality
clínica I-Premise HighQuality
de I-Premise HighQuality
disnea I-Premise HighQuality
y I-Premise HighQuality
síncope, I-Premise HighQuality
y I-Premise HighQuality
soplo I-Premise HighQuality
sistólico I-Premise HighQuality
irradiado I-Premise HighQuality
a I-Premise HighQuality
carótidas I-Premise HighQuality
y I-Premise HighQuality
punta, I-Premise HighQuality
todo I-Premise HighQuality
ello I-Premise HighQuality
típico I-Premise HighQuality
de I-Premise HighQuality
esta I-Premise HighQuality
enfermedad. I-Premise HighQuality

QUESTION O 
TYPE: O 
GENERAL O 
SURGERY O 

CLINICAL O 
CASE: O 

Mujer B-Premise HighQuality
de I-Premise HighQuality
26 I-Premise HighQuality
años I-Premise HighQuality
que I-Premise HighQuality
presenta I-Premise HighQuality
incontinencia I-Premise HighQuality
fecal I-Premise HighQuality
después I-Premise HighQuality
de I-Premise HighQuality
un I-Premise HighQuality
parto I-Premise HighQuality
prolongado I-Premise HighQuality
e I-Premise HighQuality
instrumental. I-Premise HighQuality

Se B-Premise HighQuality
practica I-Premise HighQuality
ecografía I-Premise HighQuality
endoanal I-Premise HighQuality
apreciándose I-Premise HighQuality
una I-Premise HighQuality
sección I-Premise HighQuality
del I-Premise HighQuality
esfínter I-Premise HighQuality
anal I-Premise HighQuality
externo I-Premise HighQuality
de I-Premise HighQuality
30º I-Premise HighQuality
de I-Premise HighQuality
amplitud. I-Premise HighQuality

El B-Premise HighQuality
estudio I-Premise HighQuality
electrofisiológico I-Premise HighQuality
demuestra I-Premise HighQuality
una I-Premise HighQuality
inervación I-Premise HighQuality
normal. I-Premise HighQuality

¿Cuál O 
es O 
el O 
tratamiento O 
más O 
indicado? O 

1- O 
Tratamiento B-Claim HighQuality
médico I-Claim HighQuality
con I-Claim HighQuality
normas I-Claim HighQuality
higiénicodietéticas. I-Claim HighQuality

2- O 
Biofeedback B-Claim HighQuality
esfinteriano. I-Claim HighQuality

3- O 
Esfinteroplastia B-Claim HighQuality
quirúrgica. I-Claim HighQuality

4- O 
Reparación B-Claim HighQuality
quirúrgica I-Claim HighQuality
del I-Claim HighQuality
suelo I-Claim HighQuality
pélvico. I-Claim HighQuality

5- O 
Esfínter B-Claim HighQuality
anal I-Claim HighQuality
artificial. I-Claim HighQuality

CORRECT O 
ANSWER: O 
3 O 

La B-Claim HighQuality
respuesta I-Claim HighQuality
es I-Claim HighQuality
la I-Claim HighQuality
3 I-Claim HighQuality
esfinteroplastia I-Claim HighQuality
quirúrgica. I-Claim HighQuality

La B-Claim HighQuality
1 I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
eficaz I-Claim HighQuality
, I-Claim HighQuality
la B-Claim HighQuality
2 I-Claim HighQuality
tampoco I-Claim HighQuality
para I-Claim HighQuality
una I-Claim HighQuality
lesión I-Claim HighQuality
orgánica I-Claim HighQuality
con I-Claim HighQuality
electromiografía I-Claim HighQuality
normal, I-Claim HighQuality
la B-Claim HighQuality
4 I-Claim HighQuality
no I-Claim HighQuality
es I-Claim HighQuality
necesaria I-Claim HighQuality
ya B-Premise HighQuality
que I-Premise HighQuality
la I-Premise HighQuality
lesión I-Premise HighQuality
es I-Premise HighQuality
sólo I-Premise HighQuality
del I-Premise HighQuality
esfínter I-Premise HighQuality
externo, I-Premise HighQuality
la B-Claim HighQuality
5 I-Claim HighQuality
no I-Claim HighQuality
está I-Claim HighQuality
indicada I-Claim HighQuality
en I-Claim HighQuality
una I-Claim HighQuality
lesión I-Claim HighQuality
que I-Claim HighQuality
se I-Claim HighQuality
puede I-Claim HighQuality
reparar I-Claim HighQuality
con I-Claim HighQuality
cirugía I-Claim HighQuality
con I-Claim HighQuality
buenos I-Claim HighQuality
resultados. I-Claim HighQuality

QUESTION O 
TYPE: O 
DERMATOLOGY, O 
VENEREOLOGY O 
AND O 
PLASTIC O 
SURGERY O 

CLINICAL O 
CASE: O 

Un B-Premise HighQuality
muchacho I-Premise HighQuality
de I-Premise HighQuality
17 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
edad I-Premise HighQuality
con I-Premise HighQuality
enfermedad I-Premise HighQuality
de I-Premise HighQuality
Crohn I-Premise HighQuality
con I-Premise HighQuality
afectación I-Premise HighQuality
colónica I-Premise HighQuality
de I-Premise HighQuality
2 I-Premise HighQuality
años I-Premise HighQuality
de I-Premise HighQuality
evolución, I-Premise HighQuality
en I-Premise HighQuality
tratamiento I-Premise HighQuality
de I-Premise HighQuality
mantenimiento I-Premise HighQuality
con I-Premise HighQuality
azatioprina, I-Premise HighQuality
consulta I-Premise HighQuality
por I-Premise HighQuality
la I-Premise HighQuality
aparición I-Premise HighQuality
desde I-Premise HighQuality
hace I-Premise HighQuality
5 I-Premise HighQuality
días I-Premise HighQuality
de I-Premise HighQuality
nódulos I-Premise HighQuality
subcutáneos I-Premise HighQuality
rojo I-Premise HighQuality
violáceos, I-Premise HighQuality
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La O 
actitud O 
más O 
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1- O 
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ambas I-Claim HighQuality
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añadir I-Claim HighQuality
tratamiento I-Claim HighQuality
antidepresivo. I-Claim HighQuality

2- O 
Biopsiar B-Claim HighQuality
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3- O 
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4- O 
Sospechar B-Claim HighQuality
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5- O 
Ajuste B-Claim HighQuality
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CORRECT O 
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5 O 

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así O 
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