extended/it/dev.tsv

QUESTION	O		
TYPE:	O		
GENETICA	O		
E	O		
IMMUNOLOGIA	O		

CLINICAL	O		
CASE:	O		

A	B-Premise	HighQuality	
una	I-Premise	HighQuality	
bambina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
8	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
(caso	I-Premise	HighQuality	
indice)	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
diagnosticata	I-Premise	HighQuality	
clinicamente	I-Premise	HighQuality	
una	I-Premise	HighQuality	
neurofibromatosi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tipo	I-Premise	HighQuality	
1	I-Premise	HighQuality	
(NF1)	I-Premise	HighQuality	
o	I-Premise	HighQuality	
malattia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Von	I-Premise	HighQuality	
Recklinghausen	I-Premise	HighQuality	
con	I-Premise	HighQuality	
neurofibromi	I-Premise	HighQuality	
multipli,	I-Premise	HighQuality	
macchie	I-Premise	HighQuality	
café-au-lait	I-Premise	HighQuality	
e	I-Premise	HighQuality	
noduli	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Lisch.	I-Premise	HighQuality	

Suo	B-Premise	HighQuality	
padre	I-Premise	HighQuality	
(a	I-Premise	HighQuality	
cui	I-Premise	HighQuality	
non	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
diagnosticata	I-Premise	HighQuality	
la	I-Premise	HighQuality	
NF1)	I-Premise	HighQuality	
è	I-Premise	HighQuality	
morto	I-Premise	HighQuality	
in	I-Premise	HighQuality	
un	I-Premise	HighQuality	
incidente	I-Premise	HighQuality	
stradale	I-Premise	HighQuality	
all'età	I-Premise	HighQuality	
di	I-Premise	HighQuality	
38	I-Premise	HighQuality	
anni.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
madre	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
due	I-Premise	HighQuality	
macchie	I-Premise	HighQuality	
color	I-Premise	HighQuality	
caffelatte	I-Premise	HighQuality	
all'esame	I-Premise	HighQuality	
e	I-Premise	HighQuality	
partecipa	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
consulenza	I-Premise	HighQuality	
genetica	I-Premise	HighQuality	
con	I-Premise	HighQuality	
il	I-Premise	HighQuality	
suo	I-Premise	HighQuality	
nuovo	I-Premise	HighQuality	
partner,	I-Premise	HighQuality	
dove	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
presa	I-Premise	HighQuality	
in	I-Premise	HighQuality	
considerazione	I-Premise	HighQuality	
una	I-Premise	HighQuality	
diagnosi	I-Premise	HighQuality	
genetica	I-Premise	HighQuality	
preimpianto	I-Premise	HighQuality	
(DGP).	I-Premise	HighQuality	

È	O		
indicata	O		
una	O		
DGP	O		
in	O		
questo	O		
caso?	O		

1-	O		
Sì,	B-Claim	LowQuality	
poiché	I-Claim	LowQuality	
la	I-Claim	LowQuality	
madre	I-Claim	LowQuality	
ha	I-Claim	LowQuality	
2	I-Claim	LowQuality	
macchie	I-Claim	LowQuality	
café-au-lait,	I-Claim	LowQuality	
è	I-Claim	LowQuality	
portatrice	I-Claim	LowQuality	
e	I-Claim	LowQuality	
la	I-Claim	LowQuality	
PGD	I-Claim	LowQuality	
è	I-Claim	LowQuality	
indicata	I-Claim	LowQuality	
con	I-Claim	LowQuality	
questi	I-Claim	LowQuality	
dati.	I-Claim	LowQuality	

2-	O		
È	B-Claim	HighQuality	
indicata	I-Claim	HighQuality	
dopo	I-Claim	HighQuality	
l'individuazione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
mutazione	I-Claim	HighQuality	
causale	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
indice	I-Claim	HighQuality	
ed	I-Claim	HighQuality	
eventualmente	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
madre.	I-Claim	HighQuality	

3-	O		
Non	B-Claim	HighQuality	
indicato	I-Claim	HighQuality	
in	I-Claim	HighQuality	
quanto	I-Claim	HighQuality	
la	I-Claim	HighQuality	
NF1	I-Claim	HighQuality	
risponde	I-Claim	HighQuality	
a	I-Claim	HighQuality	
mutazioni	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
gene	I-Claim	HighQuality	
della	I-Claim	HighQuality	
neurofibromina	I-Claim	HighQuality	
(17q11.2),	I-Claim	HighQuality	
con	I-Claim	HighQuality	
eredità	I-Claim	HighQuality	
recessiva.	I-Claim	HighQuality	

4-	O		
No,	B-Claim	HighQuality	
due	I-Claim	HighQuality	
macchie	I-Claim	HighQuality	
color	I-Claim	HighQuality	
caffelatte	I-Claim	HighQuality	
non	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
diagnostiche	I-Claim	HighQuality	
ed	I-Claim	HighQuality	
è	I-Claim	HighQuality	
molto	I-Claim	HighQuality	
improbabile	I-Claim	HighQuality	
che	I-Claim	HighQuality	
il	I-Claim	HighQuality	
vostro	I-Claim	HighQuality	
nuovo	I-Claim	HighQuality	
partner	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
portatore	I-Claim	HighQuality	
(la	I-Claim	HighQuality	
NF1	I-Claim	HighQuality	
è	I-Claim	HighQuality	
una	I-Claim	HighQuality	
malattia	I-Claim	HighQuality	
rara).	I-Claim	HighQuality	

5-	O		
Alla	B-Claim	HighQuality	
luce	I-Claim	HighQuality	
di	I-Claim	HighQuality	
questi	I-Claim	HighQuality	
dati,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
indicata	I-Claim	HighQuality	
la	I-Claim	HighQuality	
DGP,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
consiste	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
selezionare	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
embrioni	I-Claim	HighQuality	
in	I-Claim	HighQuality	
vitro,	I-Claim	HighQuality	
al	I-Claim	HighQuality	
fine	I-Claim	HighQuality	
di	I-Claim	HighQuality	
impiantare	I-Claim	HighQuality	
quelli	I-Claim	HighQuality	
privi	I-Claim	HighQuality	
della	I-Claim	HighQuality	
mutazione	I-Claim	HighQuality	
nell'utero	I-Claim	HighQuality	
materno.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
2	O		

Il	B-Claim	HighQuality	
primo	I-Claim	HighQuality	
passo	I-Claim	HighQuality	
è	I-Claim	HighQuality	
individuare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
mutazione	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
una	I-Claim	HighQuality	
volta	I-Claim	HighQuality	
individuata,	I-Claim	HighQuality	
se	I-Claim	HighQuality	
la	I-Claim	HighQuality	
madre	I-Claim	HighQuality	
è	I-Claim	HighQuality	
portatrice,	I-Claim	HighQuality	
procedere	I-Claim	HighQuality	
con	I-Claim	HighQuality	
la	I-Claim	HighQuality	
PGD.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
EMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
43	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
si	I-Premise	HighQuality	
rivolge	I-Premise	HighQuality	
al	I-Premise	HighQuality	
medico	I-Premise	HighQuality	
di	I-Premise	HighQuality	
base	I-Premise	HighQuality	
per	I-Premise	HighQuality	
affaticamento,	I-Premise	HighQuality	
gengivorrea	I-Premise	HighQuality	
e	I-Premise	HighQuality	
petecchie.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
esami	I-Premise	HighQuality	
di	I-Premise	HighQuality	
laboratorio	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
evidenziato	I-Premise	HighQuality	
un'anemia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
8	I-Premise	HighQuality	
gr/dl,	I-Premise	HighQuality	
una	I-Premise	HighQuality	
trombopenia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
4000/microlitro	I-Premise	HighQuality	
e	I-Premise	HighQuality	
una	I-Premise	HighQuality	
leucopenia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
1200/microlitro	I-Premise	HighQuality	
con	I-Premise	HighQuality	
neutropenia	I-Premise	HighQuality	
assoluta.	I-Premise	HighQuality	

Lo	B-Premise	HighQuality	
studio	I-Premise	HighQuality	
della	I-Premise	HighQuality	
coagulazione	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
evidenziato	I-Premise	HighQuality	
un	I-Premise	HighQuality	
allungamento	I-Premise	HighQuality	
dell'APTT	I-Premise	HighQuality	
(43″),	I-Premise	HighQuality	
una	I-Premise	HighQuality	
diminuzione	I-Premise	HighQuality	
dell'attività	I-Premise	HighQuality	
protrombinica	I-Premise	HighQuality	
(55%),	I-Premise	HighQuality	
ipofibrinogenemia	I-Premise	HighQuality	
(98	I-Premise	HighQuality	
mg/dl)	I-Premise	HighQuality	
e	I-Premise	HighQuality	
la	I-Premise	HighQuality	
presenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
elevate	I-Premise	HighQuality	
concentrazioni	I-Premise	HighQuality	
di	I-Premise	HighQuality	
D-Dimero	I-Premise	HighQuality	
e	I-Premise	HighQuality	
monomeri	I-Premise	HighQuality	
di	I-Premise	HighQuality	
fibrina.	I-Premise	HighQuality	

Il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stato	I-Premise	HighQuality	
sottoposto	I-Premise	HighQuality	
a	I-Premise	HighQuality	
un	I-Premise	HighQuality	
esame	I-Premise	HighQuality	
ematologico	I-Premise	HighQuality	
urgente	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stato	I-Premise	HighQuality	
eseguito	I-Premise	HighQuality	
un	I-Premise	HighQuality	
aspirato	I-Premise	HighQuality	
del	I-Premise	HighQuality	
midollo	I-Premise	HighQuality	
osseo,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
massiccia	I-Premise	HighQuality	
infiltrazione	I-Premise	HighQuality	
di	I-Premise	HighQuality	
elementi	I-Premise	HighQuality	
immaturi	I-Premise	HighQuality	
con	I-Premise	HighQuality	
nuclei	I-Premise	HighQuality	
scissi	I-Premise	HighQuality	
e	I-Premise	HighQuality	
bastoncelli	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Auer	I-Premise	HighQuality	
nel	I-Premise	HighQuality	
citoplasma.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
diagnosi	O		
più	O		
probabile	O		
per	O		
questo	O		
paziente?	O		

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

2-	O		
Leucemia	B-Claim	HighQuality	
promielocitica	I-Claim	HighQuality	
acuta.	I-Claim	HighQuality	

3-	O		
Leucemia	B-Claim	HighQuality	
monoblastica	I-Claim	HighQuality	
acuta.	I-Claim	HighQuality	

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

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

RISPOSTA	O		
CORRETTA:	O		
2	O		

Dopo	O		
aver	O		
letto	O		
la	O		
lunga	O		
dichiarazione,	O		
aver	O		
perso	O		
il	O		
fiato,	O		
averla	O		
riletta	O		
e	O		
essersi	O		
lasciati	O		
sopraffare,	O		
è	O		
il	O		
momento	O		
di	O		
dare	O		
un	O		
volto	O		
e	O		
di	O		
afferrare	O		
qualcosa	O		
di	O		
molto	O		
caratteristico.	O		

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

Un	B-Premise	HighQuality	
midollo	I-Premise	HighQuality	
osseo	I-Premise	HighQuality	
che	I-Premise	HighQuality	
mostra	I-Premise	HighQuality	
una	I-Premise	HighQuality	
massiccia	I-Premise	HighQuality	
infiltrazione	I-Premise	HighQuality	
di	I-Premise	HighQuality	
elementi	I-Premise	HighQuality	
immaturi	I-Premise	HighQuality	
che	I-Premise	HighQuality	
proliferano	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
sosta...	I-Premise	HighQuality	
con	I-Premise	HighQuality	
bastoncelli	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Auer?	I-Premise	HighQuality	

Leucemia	B-Claim	HighQuality	
promielocitica	I-Claim	HighQuality	
acuta.	I-Claim	HighQuality	

Queste	B-Claim	HighQuality	
barre	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
la	I-Claim	HighQuality	
fusione	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
granuli	I-Claim	HighQuality	
primari	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
mielociti	I-Claim	HighQuality	
in	I-Claim	HighQuality	
via	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sviluppo.	I-Claim	HighQuality	

Lo	O		
affermano	O		
Robin	O		
&	O		
Cotran	O		
a	O		
pagina	O		
696	O		
del	O		
loro	O		
libro	O		
General O 
Pathology	O		
[1].	O		

Lo	O		
affermano	O		
anche	O		
Carr	O		
e	O		
Rodak	O		
nel	O		
loro	O		
libro	O		
Atlas O 
of O 
clinical O 
ematology	O		
a	O		
pagina	O		
157	O		
[2].	O		

QUESTION	O		
TYPE:	O		
MICROBIOLOGIA	O		

CLINICAL	O		
CASE:	O		

Donna	B-Premise	HighQuality	
di	I-Premise	HighQuality	
47	I-Premise	HighQuality	
anni.	I-Premise	HighQuality	

Nato	B-Premise	HighQuality	
a	I-Premise	HighQuality	
Cochabamba	I-Premise	HighQuality	
(Bolivia),	I-Premise	HighQuality	
vive	I-Premise	HighQuality	
in	I-Premise	HighQuality	
Spagna	I-Premise	HighQuality	
da	I-Premise	HighQuality	
8	I-Premise	HighQuality	
anni.	I-Premise	HighQuality	

A	B-Premise	HighQuality	
metà	I-Premise	HighQuality	
del	I-Premise	HighQuality	
2009	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
iniziato	I-Premise	HighQuality	
a	I-Premise	HighQuality	
manifestare	I-Premise	HighQuality	
palpitazioni,	I-Premise	HighQuality	
dispnea	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
edema	I-Premise	HighQuality	
progressivo	I-Premise	HighQuality	
agli	I-Premise	HighQuality	
arti	I-Premise	HighQuality	
inferiori.	I-Premise	HighQuality	

Le	B-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
diagnosticata	I-Premise	HighQuality	
un'insufficienza	I-Premise	HighQuality	
cardiaca	I-Premise	HighQuality	
secondaria	I-Premise	HighQuality	
a	I-Premise	HighQuality	
cardiomiopatia	I-Premise	HighQuality	
dovuta	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
malattia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Chagas.	I-Premise	HighQuality	

Qual	O		
è	O		
l'agente	O		
eziologico	O		
di	O		
questa	O		
malattia	O		
endemica	O		
in	O		
diversi	O		
paesi	O		
dell'America	O		
Latina?	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	

RISPOSTA	O		
CORRETTA:	O		
5	O		

La	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
la	I-Claim	HighQuality	
quinta.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
malattia	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Chagas	I-Claim	HighQuality	
è	I-Claim	HighQuality	
causata	I-Claim	HighQuality	
dal	I-Claim	HighQuality	
Trypanosoma	I-Claim	HighQuality	
cruzi.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
CHIRURGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
bambino	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
anno	I-Premise	HighQuality	
e	I-Premise	HighQuality	
mezzo	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
addominale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
ittero.	I-Premise	HighQuality	

All'esame,	O		
si	B-Premise	HighQuality	
palpa	I-Premise	HighQuality	
una	I-Premise	HighQuality	
massa	I-Premise	HighQuality	
addominale.	I-Premise	HighQuality	

Un	B-Premise	HighQuality	
esame	I-Premise	HighQuality	
ecografico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
la	I-Premise	HighQuality	
presenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
una	I-Premise	HighQuality	
cisti	I-Premise	HighQuality	
del	I-Premise	HighQuality	
dotto	I-Premise	HighQuality	
biliare	I-Premise	HighQuality	
comune.	I-Premise	HighQuality	

Quale	O		
approccio	O		
terapeutico	O		
adottare?	O		

1-	O		
Verrà	B-Claim	HighQuality	
eseguita	I-Claim	HighQuality	
una	I-Claim	HighQuality	
puntura	I-Claim	HighQuality	
percutanea	I-Claim	HighQuality	
per	I-Claim	HighQuality	
il	I-Claim	HighQuality	
lavaggio	I-Claim	HighQuality	
peritoneale	I-Claim	HighQuality	
per	I-Claim	HighQuality	
verificare	I-Claim	HighQuality	
che	I-Claim	HighQuality	
la	I-Claim	HighQuality	
cisti	I-Claim	HighQuality	
contenga	I-Claim	HighQuality	
bile,	I-Claim	HighQuality	
al	I-Claim	HighQuality	
fine	I-Claim	HighQuality	
di	I-Claim	HighQuality	
lasciare	I-Claim	HighQuality	
un	I-Claim	HighQuality	
drenaggio	I-Claim	HighQuality	
per	I-Claim	HighQuality	
migliorare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
dolore	I-Claim	HighQuality	
addominale.	I-Claim	HighQuality	

2-	O		
È	B-Claim	HighQuality	
indicata	I-Claim	HighQuality	
la	I-Claim	HighQuality	
resezione	I-Claim	HighQuality	
radicale	I-Claim	HighQuality	
dell'intero	I-Claim	HighQuality	
dotto	I-Claim	HighQuality	
biliare	I-Claim	HighQuality	
per	I-Claim	HighQuality	
sostituirlo	I-Claim	HighQuality	
con	I-Claim	HighQuality	
un'ansa	I-Claim	HighQuality	
intestinale.	I-Claim	HighQuality	

3-	O		
Sarà	B-Claim	HighQuality	
indicata	I-Claim	HighQuality	
una	I-Claim	HighQuality	
laparotomia	I-Claim	HighQuality	
esplorativa	I-Claim	HighQuality	
e	I-Claim	HighQuality	
un	I-Claim	HighQuality	
drenaggio	I-Claim	HighQuality	
della	I-Claim	HighQuality	
cisti;	I-Claim	HighQuality	
quando	I-Claim	HighQuality	
la	I-Claim	HighQuality	
dilatazione	I-Claim	HighQuality	
si	I-Claim	HighQuality	
riduce,	I-Claim	HighQuality	
il	I-Claim	HighQuality	
drenaggio	I-Claim	HighQuality	
verrà	I-Claim	HighQuality	
rimosso.	I-Claim	HighQuality	

4-	O		
Verrà	B-Claim	HighQuality	
eseguita	I-Claim	HighQuality	
una	I-Claim	HighQuality	
colangio-risonanza	I-Claim	HighQuality	
per	I-Claim	HighQuality	
delimitare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
cisti	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sarà	I-Claim	HighQuality	
indicata	I-Claim	HighQuality	
una	I-Claim	HighQuality	
laparotomia	I-Claim	HighQuality	
per	I-Claim	HighQuality	
la	I-Claim	HighQuality	
resezione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
cisti	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'anastomosi	I-Claim	HighQuality	
del	I-Claim	HighQuality	
dotto	I-Claim	HighQuality	
biliare.	I-Claim	HighQuality	

5-	O		
La	B-Claim	HighQuality	
scintigrafia	I-Claim	HighQuality	
HIDA	I-Claim	HighQuality	
è	I-Claim	HighQuality	
necessaria	I-Claim	HighQuality	
per	I-Claim	HighQuality	
delimitare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
cisti	I-Claim	HighQuality	
e	I-Claim	HighQuality	
per	I-Claim	HighQuality	
poter	I-Claim	HighQuality	
eseguire	I-Claim	HighQuality	
il	I-Claim	HighQuality	
drenaggio	I-Claim	HighQuality	
percutaneo	I-Claim	HighQuality	
in	I-Claim	HighQuality	
sicurezza.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
4	O		

Credo	B-Claim	HighQuality	
che	I-Claim	HighQuality	
la	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
4	I-Claim	HighQuality	
La	B-Claim	HighQuality	
cisti	I-Claim	HighQuality	
del	I-Claim	HighQuality	
dotto	I-Claim	HighQuality	
biliare	I-Claim	HighQuality	
comune	I-Claim	HighQuality	
è	I-Claim	HighQuality	
una	I-Claim	HighQuality	
patologia	I-Claim	HighQuality	
rara,	I-Claim	HighQuality	
ma	O		
il	B-Claim	HighQuality	
suo	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
è	I-Claim	HighQuality	
chirurgico	I-Claim	HighQuality	
e	I-Claim	HighQuality	
consiste	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
resezione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
cisti	I-Claim	HighQuality	
e	I-Claim	HighQuality	
nell'epatico-giunosotomia.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
colangioresonanza	I-Claim	HighQuality	
è	I-Claim	HighQuality	
necessaria	I-Claim	HighQuality	
per	I-Claim	HighQuality	
scegliere	I-Claim	HighQuality	
la	I-Claim	HighQuality	
tecnica	I-Claim	HighQuality	
appropriata	I-Claim	HighQuality	
per	I-Claim	HighQuality	
le	I-Claim	HighQuality	
quattro	I-Claim	HighQuality	
classi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
cisti	I-Claim	HighQuality	
del	I-Claim	HighQuality	
dotto	I-Claim	HighQuality	
biliare	I-Claim	HighQuality	
comune	I-Claim	HighQuality	
(classificazione	I-Claim	HighQuality	
Todani).	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PEDIATRIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
neonato	I-Premise	HighQuality	
di	I-Premise	HighQuality	
7	I-Premise	HighQuality	
mesi	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stato	I-Premise	HighQuality	
portato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
dal	I-Premise	HighQuality	
pediatra	I-Premise	HighQuality	
locale	I-Premise	HighQuality	
per	I-Premise	HighQuality	
sospetta	I-Premise	HighQuality	
malattia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Kawasaki.	I-Premise	HighQuality	

Il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
riportato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
febbre	I-Premise	HighQuality	
fino	I-Premise	HighQuality	
a	I-Premise	HighQuality	
39,5ºC	I-Premise	HighQuality	
per	I-Premise	HighQuality	
5	I-Premise	HighQuality	
giorni,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
non	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
attenuata	I-Premise	HighQuality	
nonostante	I-Premise	HighQuality	
il	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
con	I-Premise	HighQuality	
amoxicillina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
72	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
fa	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
sospetta	I-Premise	HighQuality	
faringotonsillite	I-Premise	HighQuality	
acuta.	I-Premise	HighQuality	

Nelle	B-Premise	HighQuality	
ultime	I-Premise	HighQuality	
24	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
sviluppato	I-Premise	HighQuality	
un'eruzione	I-Premise	HighQuality	
cutanea	I-Premise	HighQuality	
cefalocaudale	I-Premise	HighQuality	
eritematosa	I-Premise	HighQuality	
e	I-Premise	HighQuality	
non	I-Premise	HighQuality	
pruritica	I-Premise	HighQuality	
e	I-Premise	HighQuality	
negli	I-Premise	HighQuality	
ultimi	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
i	I-Premise	HighQuality	
genitori	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
notato	I-Premise	HighQuality	
tosse	I-Premise	HighQuality	
e	I-Premise	HighQuality	
congiuntivite	I-Premise	HighQuality	
intensa.	I-Premise	HighQuality	

Non	B-Premise	HighQuality	
riferiscono	I-Premise	HighQuality	
rinorrea.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
clinico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
suoni	I-Premise	HighQuality	
subcrepitanti	I-Premise	HighQuality	
in	I-Premise	HighQuality	
entrambe	I-Premise	HighQuality	
le	I-Premise	HighQuality	
basi	I-Premise	HighQuality	
polmonari	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
tachipnea	I-Premise	HighQuality	
o	I-Premise	HighQuality	
segni	I-Premise	HighQuality	
di	I-Premise	HighQuality	
sofferenza	I-Premise	HighQuality	
respiratoria.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
orofaringeo	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
macchie	I-Premise	HighQuality	
biancastre	I-Premise	HighQuality	
sulla	I-Premise	HighQuality	
mucosa	I-Premise	HighQuality	
jugale.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
diagnosi	O		
più	O		
probabile?	O		

1-	O		
Malattia	B-Claim	HighQuality	
di	I-Claim	HighQuality	
Kawasaki.	I-Claim	HighQuality	

2-	O		
Scarlattina.	B-Claim	HighQuality	

3-	O		
Reazione	B-Claim	HighQuality	
allergica	I-Claim	HighQuality	
all'amoxicillina.	I-Claim	HighQuality	

4-	O		
Mononucleosi	B-Claim	HighQuality	
infettiva.	I-Claim	HighQuality	

5-	O		
Morbillo.	B-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
5	O		

La	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
5	I-Claim	HighQuality	

L'indizio	B-Claim	HighQuality	
sta	I-Claim	HighQuality	
nelle	I-Claim	HighQuality	
lesioni	I-Claim	HighQuality	
biancastre	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
mucosa	I-Claim	HighQuality	
jugale,	I-Claim	HighQuality	
corrispondenti	I-Claim	HighQuality	
alle	I-Claim	HighQuality	
macchie	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Koplik,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
patognomoniche	I-Claim	HighQuality	
del	I-Claim	HighQuality	
morbillo,	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
se	I-Claim	HighQuality	
come	I-Claim	HighQuality	
osservazione	I-Claim	HighQuality	
direi	I-Claim	HighQuality	
che	I-Claim	HighQuality	
di	I-Claim	HighQuality	
solito	I-Claim	HighQuality	
compaiono	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
fase	I-Claim	HighQuality	
prodromica	I-Claim	HighQuality	
della	I-Claim	HighQuality	
malattia	I-Claim	HighQuality	
e	I-Claim	HighQuality	
spesso	I-Claim	HighQuality	
non	I-Claim	HighQuality	
si	I-Claim	HighQuality	
vedono	I-Claim	HighQuality	
più	I-Claim	HighQuality	
quando	I-Claim	HighQuality	
compare	I-Claim	HighQuality	
l'esantema.	I-Claim	HighQuality	

In	B-Claim	HighQuality	
questo	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
sta	I-Claim	HighQuality	
descrivendo	I-Claim	HighQuality	
il	I-Claim	HighQuality	
morbillo	I-Claim	HighQuality	
complicato	I-Claim	HighQuality	
da	I-Claim	HighQuality	
polmonite.	I-Claim	HighQuality	

È	O		
una	O		
domanda	O		
molto	O		
attuale	O		
in	O		
questo	O		
momento.	O		

QUESTION	O		
TYPE:	O		
UROLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
maschio	I-Premise	HighQuality	
di	I-Premise	HighQuality	
45	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un'anamnesi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
litiasi	I-Premise	HighQuality	
urica	I-Premise	HighQuality	
e	I-Premise	HighQuality	
ripetute	I-Premise	HighQuality	
coliche	I-Premise	HighQuality	
nefritiche	I-Premise	HighQuality	
espulsive	I-Premise	HighQuality	
negli	I-Premise	HighQuality	
ultimi	I-Premise	HighQuality	
25	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
lamentando	I-Premise	HighQuality	
palpitazioni	I-Premise	HighQuality	
e	I-Premise	HighQuality	
forte	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
lombare	I-Premise	HighQuality	
destro	I-Premise	HighQuality	
da	I-Premise	HighQuality	
2	I-Premise	HighQuality	
ore.	I-Premise	HighQuality	

Le	B-Premise	HighQuality	
analisi	I-Premise	HighQuality	
delle	I-Premise	HighQuality	
urine	I-Premise	HighQuality	
mostrano	I-Premise	HighQuality	
un	I-Premise	HighQuality	
pH	I-Premise	HighQuality	
di	I-Premise	HighQuality	
5,5	I-Premise	HighQuality	
e	I-Premise	HighQuality	
leucocituria	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
proteinuria.	I-Premise	HighQuality	

L'ECG	B-Premise	HighQuality	
conferma	I-Premise	HighQuality	
una	I-Premise	HighQuality	
fibrillazione	I-Premise	HighQuality	
atriale	I-Premise	HighQuality	
precedentemente	I-Premise	HighQuality	
sconosciuta.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
biochimica	I-Premise	HighQuality	
del	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
mostrava	I-Premise	HighQuality	
una	I-Premise	HighQuality	
creatinina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
0,9	I-Premise	HighQuality	
mg/dl,	I-Premise	HighQuality	
un	I-Premise	HighQuality	
calcio	I-Premise	HighQuality	
di	I-Premise	HighQuality	
11	I-Premise	HighQuality	
mg/dl	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un	I-Premise	HighQuality	
LDH	I-Premise	HighQuality	
di	I-Premise	HighQuality	
950	I-Premise	HighQuality	
U/l.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
manovra	O		
diagnostica	O		
più	O		
utile	O		
da	O		
eseguire?	O		

1-	O		
Radiografia	B-Claim	HighQuality	
addominale	I-Claim	HighQuality	
semplice.	I-Claim	HighQuality	

2-	O		
UIV.	B-Claim	HighQuality	

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

4-	O		
Ecografia	B-Claim	HighQuality	
addominale.	I-Claim	HighQuality	

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

RISPOSTA	O		
CORRETTA:	O		
3	O		

In	B-Claim	HighQuality	
questa	I-Claim	HighQuality	
domanda	I-Claim	HighQuality	
ho	I-Claim	HighQuality	
più	I-Claim	HighQuality	
dubbi	I-Claim	HighQuality	
su	I-Claim	HighQuality	
quale	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
la	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta,	I-Claim	HighQuality	
poiché	I-Claim	HighQuality	
dobbiamo	I-Claim	HighQuality	
interpretare	I-Claim	HighQuality	
quale	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
il	I-Claim	HighQuality	
test	I-Claim	HighQuality	
più	I-Claim	HighQuality	
utile,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
il	I-Claim	HighQuality	
quale	I-Claim	HighQuality	
possiamo	I-Claim	HighQuality	
ottenere	I-Claim	HighQuality	
maggiori	I-Claim	HighQuality	
prestazioni.	I-Claim	HighQuality	

Tuttavia,	B-Claim	HighQuality	
questa	I-Claim	HighQuality	
situazione	I-Claim	HighQuality	
dipende	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
dai	I-Claim	HighQuality	
servizi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
radiologia	I-Claim	HighQuality	
di	I-Claim	HighQuality	
ciascun	I-Claim	HighQuality	
centro	I-Claim	HighQuality	
e	I-Claim	HighQuality	
dalle	I-Claim	HighQuality	
loro	I-Claim	HighQuality	
preferenze.	I-Claim	HighQuality	

Mi	B-Claim	HighQuality	
concentrerò	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
urologica,	I-Claim	HighQuality	
tralasciando	I-Claim	HighQuality	
il	I-Claim	HighQuality	
resto	I-Claim	HighQuality	
della	I-Claim	HighQuality	
sintomatologia.	I-Claim	HighQuality	

-	O		
La	B-Claim	HighQuality	
radiografia	I-Claim	HighQuality	
addominale	I-Claim	HighQuality	
è	I-Claim	HighQuality	
il	I-Claim	HighQuality	
primo	I-Claim	HighQuality	
esame	I-Claim	HighQuality	
di	I-Claim	HighQuality	
diagnostica	I-Claim	HighQuality	
per	I-Claim	HighQuality	
immagini	I-Claim	HighQuality	
da	I-Claim	HighQuality	
eseguire,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
quanto	I-Claim	HighQuality	
è	I-Claim	HighQuality	
rapida,	I-Claim	HighQuality	
semplice	I-Claim	HighQuality	
e	I-Claim	HighQuality	
praticamente	I-Claim	HighQuality	
innocua	I-Claim	HighQuality	
(tranne	I-Claim	HighQuality	
che	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
bambini	I-Claim	HighQuality	
e	I-Claim	HighQuality	
nelle	I-Claim	HighQuality	
donne	I-Claim	HighQuality	
in	I-Claim	HighQuality	
gravidanza).	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
90%	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
calcoli	I-Claim	HighQuality	
è	I-Claim	HighQuality	
radiopaco	I-Claim	HighQuality	
e	I-Claim	HighQuality	
quindi	I-Claim	HighQuality	
visibile,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sensibilità	I-Claim	HighQuality	
di	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
test,	I-Claim	HighQuality	
usato	I-Claim	HighQuality	
isolatamente,	I-Claim	HighQuality	
scende	I-Claim	HighQuality	
al	I-Claim	HighQuality	
45-59%.	I-Claim	HighQuality	

È	B-Claim	HighQuality	
un	I-Claim	HighQuality	
test	I-Claim	HighQuality	
obbligatorio	I-Claim	HighQuality	
per	I-Claim	HighQuality	
tutti	I-Claim	HighQuality	
i	I-Claim	HighQuality	
casi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sospetto	I-Claim	HighQuality	
dolore	I-Claim	HighQuality	
da	I-Claim	HighQuality	
colica.	I-Claim	HighQuality	

Tuttavia,	B-Claim	HighQuality	
con	I-Claim	HighQuality	
prestazioni	I-Claim	HighQuality	
inferiori	I-Claim	HighQuality	
rispetto	I-Claim	HighQuality	
agli	I-Claim	HighQuality	
altri.	I-Claim	HighQuality	

Sebbene	B-Claim	HighQuality	
l'anamnesi	I-Claim	HighQuality	
urologica	I-Claim	HighQuality	
parli	I-Claim	HighQuality	
di	I-Claim	HighQuality	
litiasi	I-Claim	HighQuality	
da	I-Claim	HighQuality	
urato	I-Claim	HighQuality	
(radiotrasparente),	I-Claim	HighQuality	
con	I-Claim	HighQuality	
un	I-Claim	HighQuality	
pH	I-Claim	HighQuality	
acido	I-Claim	HighQuality	
che	I-Claim	HighQuality	
ribadisce	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
origine	I-Claim	HighQuality	
da	I-Claim	HighQuality	
urato,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
si	I-Claim	HighQuality	
può	I-Claim	HighQuality	
mai	I-Claim	HighQuality	
escludere	I-Claim	HighQuality	
la	I-Claim	HighQuality	
litiasi	I-Claim	HighQuality	
da	I-Claim	HighQuality	
ossalato	I-Claim	HighQuality	
di	I-Claim	HighQuality	
calcio,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
può	I-Claim	HighQuality	
comparire	I-Claim	HighQuality	
in	I-Claim	HighQuality	
modo	I-Claim	HighQuality	
sincrono.	I-Claim	HighQuality	

-	O		
L'IVU	B-Claim	HighQuality	
mi	I-Claim	HighQuality	
sembra	I-Claim	HighQuality	
una	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
opzioni	I-Claim	HighQuality	
più	I-Claim	HighQuality	
performanti.	I-Claim	HighQuality	

Ci	B-Claim	HighQuality	
darà	I-Claim	HighQuality	
chiarezza	I-Claim	HighQuality	
diagnostica	I-Claim	HighQuality	
sull'ostruzione,	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
sua	I-Claim	HighQuality	
entità	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sulle	I-Claim	HighQuality	
sue	I-Claim	HighQuality	
ripercussioni	I-Claim	HighQuality	
renali.	I-Claim	HighQuality	

È	B-Claim	HighQuality	
stato	I-Claim	HighQuality	
a	I-Claim	HighQuality	
lungo	I-Claim	HighQuality	
considerato	I-Claim	HighQuality	
l'esame	I-Claim	HighQuality	
di	I-Claim	HighQuality	
scelta	I-Claim	HighQuality	
per	I-Claim	HighQuality	
lo	I-Claim	HighQuality	
studio	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
con	I-Claim	HighQuality	
litiasi	I-Claim	HighQuality	
renale.	I-Claim	HighQuality	

Si	B-Claim	HighQuality	
tratta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un	I-Claim	HighQuality	
test	I-Claim	HighQuality	
con	I-Claim	HighQuality	
sensibilità	I-Claim	HighQuality	
e	I-Claim	HighQuality	
specificità	I-Claim	HighQuality	
elevate	I-Claim	HighQuality	
(87-90%	I-Claim	HighQuality	
e	I-Claim	HighQuality	
94-100%,	I-Claim	HighQuality	
rispettivamente),	I-Claim	HighQuality	
relativamente	I-Claim	HighQuality	
sicuro	I-Claim	HighQuality	
e	I-Claim	HighQuality	
disponibile	I-Claim	HighQuality	
in	I-Claim	HighQuality	
tutti	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
ospedali.	I-Claim	HighQuality	

Ci	B-Claim	HighQuality	
dice	I-Claim	HighQuality	
il	I-Claim	HighQuality	
numero,	I-Claim	HighQuality	
le	I-Claim	HighQuality	
dimensioni,	I-Claim	HighQuality	
la	I-Claim	HighQuality	
forma	I-Claim	HighQuality	
e	I-Claim	HighQuality	
la	I-Claim	HighQuality	
posizione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
calcolo,	I-Claim	HighQuality	
nonché	I-Claim	HighQuality	
lo	I-Claim	HighQuality	
stato	I-Claim	HighQuality	
funzionale	I-Claim	HighQuality	
del	I-Claim	HighQuality	
rene	I-Claim	HighQuality	
interessato.	I-Claim	HighQuality	

-	O		
La	B-Claim	HighQuality	
TC	I-Claim	HighQuality	
con	I-Claim	HighQuality	
contrasto	I-Claim	HighQuality	
mi	I-Claim	HighQuality	
sembra	I-Claim	HighQuality	
l'opzione	I-Claim	HighQuality	
più	I-Claim	HighQuality	
performante.	I-Claim	HighQuality	

Viene	B-Claim	HighQuality	
utilizzato	I-Claim	HighQuality	
per	I-Claim	HighQuality	
scoprire	I-Claim	HighQuality	
litiasi	I-Claim	HighQuality	
che	I-Claim	HighQuality	
altri	I-Claim	HighQuality	
esami	I-Claim	HighQuality	
non	I-Claim	HighQuality	
riescono	I-Claim	HighQuality	
a	I-Claim	HighQuality	
individuare	I-Claim	HighQuality	
e	I-Claim	HighQuality	
fornisce	I-Claim	HighQuality	
un	I-Claim	HighQuality	
quadro	I-Claim	HighQuality	
complessivo	I-Claim	HighQuality	
del	I-Claim	HighQuality	
resto	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
strutture.	I-Claim	HighQuality	

Ottime	B-Claim	HighQuality	
prestazioni,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
più	I-Claim	HighQuality	
costose,	I-Claim	HighQuality	
più	I-Claim	HighQuality	
tempo,	I-Claim	HighQuality	
più	I-Claim	HighQuality	
radiazioni.	I-Claim	HighQuality	

Si	B-Claim	HighQuality	
è	I-Claim	HighQuality	
confermato	I-Claim	HighQuality	
un	I-Claim	HighQuality	
test	I-Claim	HighQuality	
altamente	I-Claim	HighQuality	
sensibile	I-Claim	HighQuality	
e	I-Claim	HighQuality	
specifico,	I-Claim	HighQuality	
superiore	I-Claim	HighQuality	
ai	I-Claim	HighQuality	
test	I-Claim	HighQuality	
precedenti	I-Claim	HighQuality	
(94-100%	I-Claim	HighQuality	
e	I-Claim	HighQuality	
92-100%,	I-Claim	HighQuality	
rispettivamente,	I-Claim	HighQuality	
per	I-Claim	HighQuality	
l'individuazione	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
calcoli	I-Claim	HighQuality	
ureterali)	I-Claim	HighQuality	
e	I-Claim	HighQuality	
con	I-Claim	HighQuality	
i	I-Claim	HighQuality	
suoi	I-Claim	HighQuality	
numerosi	I-Claim	HighQuality	
vantaggi	I-Claim	HighQuality	
è	I-Claim	HighQuality	
diventato	I-Claim	HighQuality	
il	I-Claim	HighQuality	
test	I-Claim	HighQuality	
gold	I-Claim	HighQuality	
standard	I-Claim	HighQuality	
e	I-Claim	HighQuality	
si	I-Claim	HighQuality	
prevede	I-Claim	HighQuality	
che	I-Claim	HighQuality	
sostituirà	I-Claim	HighQuality	
l'IVUS	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'ecografia	I-Claim	HighQuality	
in	I-Claim	HighQuality	
tutto	I-Claim	HighQuality	
il	I-Claim	HighQuality	
mondo.	I-Claim	HighQuality	

Esegue	B-Claim	HighQuality	
una	I-Claim	HighQuality	
scansione	I-Claim	HighQuality	
elicoidale	I-Claim	HighQuality	
con	I-Claim	HighQuality	
fette	I-Claim	HighQuality	
di	I-Claim	HighQuality	
5	I-Claim	HighQuality	
mm	I-Claim	HighQuality	
che	I-Claim	HighQuality	
consente	I-Claim	HighQuality	
di	I-Claim	HighQuality	
rilevare	I-Claim	HighQuality	
calcoli	I-Claim	HighQuality	
fino	I-Claim	HighQuality	
a	I-Claim	HighQuality	
2	I-Claim	HighQuality	
mm.	I-Claim	HighQuality	

Con	B-Claim	HighQuality	
la	I-Claim	HighQuality	
somministrazione	I-Claim	HighQuality	
di	I-Claim	HighQuality	
contrasto,	I-Claim	HighQuality	
consente	I-Claim	HighQuality	
di	I-Claim	HighQuality	
valutare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
funzione	I-Claim	HighQuality	
renale.	I-Claim	HighQuality	

-	O		
L'ecografia	B-Claim	HighQuality	
è	I-Claim	HighQuality	
un	I-Claim	HighQuality	
esame	I-Claim	HighQuality	
rapido,	I-Claim	HighQuality	
economico	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sicuro,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
molto	I-Claim	HighQuality	
dipendente	I-Claim	HighQuality	
dal	I-Claim	HighQuality	
radiologo.	I-Claim	HighQuality	

Fornisce	B-Claim	HighQuality	
ottime	I-Claim	HighQuality	
informazioni	I-Claim	HighQuality	
renali	I-Claim	HighQuality	
sulle	I-Claim	HighQuality	
ripercussioni	I-Claim	HighQuality	
ostruttive,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
meno	I-Claim	HighQuality	
qualità	I-Claim	HighQuality	
in	I-Claim	HighQuality	
termini	I-Claim	HighQuality	
di	I-Claim	HighQuality	
individuazione	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
litiasi.	I-Claim	HighQuality	

L'ecografia	B-Claim	HighQuality	
rileva	I-Claim	HighQuality	
solo	I-Claim	HighQuality	
i	I-Claim	HighQuality	
calcoli	I-Claim	HighQuality	
di	I-Claim	HighQuality	
dimensioni	I-Claim	HighQuality	
superiori	I-Claim	HighQuality	
a	I-Claim	HighQuality	
4	I-Claim	HighQuality	
mm,	I-Claim	HighQuality	
localizzati	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
giunzione	I-Claim	HighQuality	
pielo-ureterale	I-Claim	HighQuality	
o	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
giunzione	I-Claim	HighQuality	
uretero-vescicale,	I-Claim	HighQuality	
mentre	I-Claim	HighQuality	
l'uretere	I-Claim	HighQuality	
lombare	I-Claim	HighQuality	
e	I-Claim	HighQuality	
pelvico	I-Claim	HighQuality	
è	I-Claim	HighQuality	
scarsamente	I-Claim	HighQuality	
accessibile	I-Claim	HighQuality	
a	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
dell'interposizione	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
anse	I-Claim	HighQuality	
intestinali.	I-Claim	HighQuality	

L'ecografia	B-Claim	HighQuality	
da	I-Claim	HighQuality	
sola	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
quindi	I-Claim	HighQuality	
molto	I-Claim	HighQuality	
sensibile	I-Claim	HighQuality	
(20-45%)	I-Claim	HighQuality	
per	I-Claim	HighQuality	
il	I-Claim	HighQuality	
rilevamento	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
calcoli,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
in	I-Claim	HighQuality	
combinazione	I-Claim	HighQuality	
con	I-Claim	HighQuality	
la	I-Claim	HighQuality	
radiografia	I-Claim	HighQuality	
addominale	I-Claim	HighQuality	
semplice	I-Claim	HighQuality	
aumenta	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sensibilità	I-Claim	HighQuality	
e	I-Claim	HighQuality	
la	I-Claim	HighQuality	
specificità.	I-Claim	HighQuality	

-	O		
L'ecocardiografia	B-Claim	HighQuality	
Doppler	I-Claim	HighQuality	
non	I-Claim	HighQuality	
ha	I-Claim	HighQuality	
alcuna	I-Claim	HighQuality	
utilità	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
urologica.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
mia	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
la	I-Claim	HighQuality	
TC	I-Claim	HighQuality	
con	I-Claim	HighQuality	
contrasto	I-Claim	HighQuality	
ev	I-Claim	HighQuality	
e	I-Claim	HighQuality	
fase	I-Claim	HighQuality	
escretoria	I-Claim	HighQuality	
(risposta	I-Claim	HighQuality	
(c).),	I-Claim	HighQuality	
in	I-Claim	HighQuality	
termini	I-Claim	HighQuality	
di	I-Claim	HighQuality	
prestazioni,	I-Claim	HighQuality	
sensibilità	I-Claim	HighQuality	
e	I-Claim	HighQuality	
specificità.	I-Claim	HighQuality	

Alcuni	B-Claim	HighQuality	
servizi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
radiologia	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
più	I-Claim	HighQuality	
esperti	I-Claim	HighQuality	
o	I-Claim	HighQuality	
predisposti	I-Claim	HighQuality	
all'uno	I-Claim	HighQuality	
o	I-Claim	HighQuality	
all'altro.	I-Claim	HighQuality	

Senza	B-Claim	HighQuality	
dimenticare	I-Claim	HighQuality	
che,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sospetto	I-Claim	HighQuality	
di	I-Claim	HighQuality	
colica,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
sempre	I-Claim	HighQuality	
opportuno	I-Claim	HighQuality	
eseguire	I-Claim	HighQuality	
una	I-Claim	HighQuality	
radiografia	I-Claim	HighQuality	
addominale.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
DERMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
62	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
forte	I-Premise	HighQuality	
abuso	I-Premise	HighQuality	
di	I-Premise	HighQuality	
alcol,	I-Premise	HighQuality	
portatore	I-Premise	HighQuality	
del	I-Premise	HighQuality	
virus	I-Premise	HighQuality	
dell'epatite	I-Premise	HighQuality	
C,	I-Premise	HighQuality	
in	I-Premise	HighQuality	
cura	I-Premise	HighQuality	
con	I-Premise	HighQuality	
Ibuprofene	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
tendinite	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
spalla	I-Premise	HighQuality	
destra,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
recato	I-Premise	HighQuality	
dal	I-Premise	HighQuality	
dermatologo	I-Premise	HighQuality	
perché	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
aver	I-Premise	HighQuality	
trascorso	I-Premise	HighQuality	
due	I-Premise	HighQuality	
settimane	I-Premise	HighQuality	
di	I-Premise	HighQuality	
vacanza	I-Premise	HighQuality	
al	I-Premise	HighQuality	
mare	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
notato	I-Premise	HighQuality	
la	I-Premise	HighQuality	
comparsa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
vesciche	I-Premise	HighQuality	
tese	I-Premise	HighQuality	
sul	I-Premise	HighQuality	
dorso	I-Premise	HighQuality	
delle	I-Premise	HighQuality	
mani.	I-Premise	HighQuality	

All'esame	B-Premise	HighQuality	
sono	I-Premise	HighQuality	
presenti	I-Premise	HighQuality	
anche	I-Premise	HighQuality	
localizzazione	I-Premise	HighQuality	
e	I-Premise	HighQuality	
lieve	I-Premise	HighQuality	
ipertricosi	I-Premise	HighQuality	
malare.	I-Premise	HighQuality	

La	O		
diagnosi	O		
più	O		
probabile	O		
è:	O		

1-	O		
Epidermolisi	B-Claim	HighQuality	
bollosa	I-Claim	HighQuality	
acquisita.	I-Claim	HighQuality	

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

3-	O		
Reazione	B-Claim	HighQuality	
fototossica.	I-Claim	HighQuality	

4-	O		
Dermatite	B-Claim	HighQuality	
da	I-Claim	HighQuality	
contatto.	I-Claim	HighQuality	

5-	O		
Porfiria	B-Claim	HighQuality	
acuta	I-Claim	HighQuality	
intermittente.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
2	O		

Porfiria	B-Claim	HighQuality	
Cutanea	I-Claim	HighQuality	
Tarda:	I-Claim	HighQuality	
il	B-Claim	HighQuality	
60%	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
affetti	I-Claim	HighQuality	
da	I-Claim	HighQuality	
PCT	I-Claim	HighQuality	
è	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sesso	I-Claim	HighQuality	
maschile,	I-Claim	HighQuality	
molti	I-Claim	HighQuality	
di	I-Claim	HighQuality	
loro	I-Claim	HighQuality	
bevono	I-Claim	HighQuality	
alcolici	I-Claim	HighQuality	
in	I-Claim	HighQuality	
eccesso	I-Claim	HighQuality	
e	I-Claim	HighQuality	
le	I-Claim	HighQuality	
donne	I-Claim	HighQuality	
che	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sviluppano	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
solitamente	I-Claim	HighQuality	
trattate	I-Claim	HighQuality	
con	I-Claim	HighQuality	
farmaci	I-Claim	HighQuality	
contenenti	I-Claim	HighQuality	
estrogeni.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
maggior	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
soggetti	I-Claim	HighQuality	
è	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sesso	I-Claim	HighQuality	
maschile	I-Claim	HighQuality	
e	I-Claim	HighQuality	
presenta	I-Claim	HighQuality	
segni	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sovraccarico	I-Claim	HighQuality	
di	I-Claim	HighQuality	
ferro;	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
sovraccarico	I-Claim	HighQuality	
riduce	I-Claim	HighQuality	
l'attività	I-Claim	HighQuality	
dell'enzima	I-Claim	HighQuality	
uroporfirinogeno	I-Claim	HighQuality	
decarbossilato,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
conseguente	I-Claim	HighQuality	
aumento	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
uroporfirine.	I-Claim	HighQuality	

Le	B-Claim	HighQuality	
infezioni	I-Claim	HighQuality	
da	I-Claim	HighQuality	
HCV	I-Claim	HighQuality	
e	I-Claim	HighQuality	
HIV	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
state	I-Claim	HighQuality	
implicate	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
precipitazione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
PCT	I-Claim	HighQuality	
acquisita.	I-Claim	HighQuality	

Esiste	B-Claim	HighQuality	
una	I-Claim	HighQuality	
forma	I-Claim	HighQuality	
ereditaria	I-Claim	HighQuality	
con	I-Claim	HighQuality	
modello	I-Claim	HighQuality	
AD.	I-Claim	HighQuality	

I	B-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
con	I-Claim	HighQuality	
PCT	I-Claim	HighQuality	
presentano	I-Claim	HighQuality	
vesciche	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
pelle	I-Claim	HighQuality	
fotoesposta,	I-Claim	HighQuality	
più	I-Claim	HighQuality	
frequentemente	I-Claim	HighQuality	
sul	I-Claim	HighQuality	
dorso	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
mani	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sul	I-Claim	HighQuality	
cuoio	I-Claim	HighQuality	
capelluto.	I-Claim	HighQuality	

Oltre	B-Claim	HighQuality	
alla	I-Claim	HighQuality	
fragilità,	I-Claim	HighQuality	
possono	I-Claim	HighQuality	
sviluppare	I-Claim	HighQuality	
ipertricosi,	I-Claim	HighQuality	
iperpigmentazione,	I-Claim	HighQuality	
alopecia	I-Claim	HighQuality	
cicatriziale	I-Claim	HighQuality	
e	I-Claim	HighQuality	
indurimento	I-Claim	HighQuality	
sclerodermico.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
CARDIOLOGIA	O		
E	O		
CHIRURGIA	O		
CARDIOVASCOLARE	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
maschio	I-Premise	HighQuality	
di	I-Premise	HighQuality	
26	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
atleta	I-Premise	HighQuality	
agonista,	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
studiato	I-Premise	HighQuality	
perché	I-Premise	HighQuality	
il	I-Premise	HighQuality	
fratello	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
avuto	I-Premise	HighQuality	
una	I-Premise	HighQuality	
morte	I-Premise	HighQuality	
improvvisa.	I-Premise	HighQuality	

I	B-Premise	HighQuality	
test	I-Premise	HighQuality	
complementari	I-Premise	HighQuality	
rilevano	I-Premise	HighQuality	
l'esistenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
una	I-Premise	HighQuality	
cardiomiopatia	I-Premise	HighQuality	
ipertrofica	I-Premise	HighQuality	
ostruttiva.	I-Premise	HighQuality	

Contrassegnare	O		
l'opzione	O		
FALSO	O		
per	O		
questa	O		
patologia:	O		

1-	O		
Il	B-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
con	I-Claim	HighQuality	
beta-bloccanti	I-Claim	HighQuality	
aiuta	I-Claim	HighQuality	
a	I-Claim	HighQuality	
ridurre	I-Claim	HighQuality	
i	I-Claim	HighQuality	
sintomi.	I-Claim	HighQuality	

2-	O		
Si	B-Claim	HighQuality	
raccomanda	I-Claim	HighQuality	
l'abbandono	I-Claim	HighQuality	
dello	I-Claim	HighQuality	
sport	I-Claim	HighQuality	
agonistico.	I-Claim	HighQuality	

3-	O		
La	B-Claim	HighQuality	
digossina	I-Claim	HighQuality	
è	I-Claim	HighQuality	
utile	I-Claim	HighQuality	
per	I-Claim	HighQuality	
ridurre	I-Claim	HighQuality	
il	I-Claim	HighQuality	
gradiente	I-Claim	HighQuality	
subaortico.	I-Claim	HighQuality	

4-	O		
I	B-Claim	HighQuality	
diuretici	I-Claim	HighQuality	
devono	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
evitati	I-Claim	HighQuality	
o	I-Claim	HighQuality	
utilizzati	I-Claim	HighQuality	
con	I-Claim	HighQuality	
grande	I-Claim	HighQuality	
attenzione.	I-Claim	HighQuality	

5-	O		
Data	B-Claim	HighQuality	
la	I-Claim	HighQuality	
natura	I-Claim	HighQuality	
ereditaria	I-Claim	HighQuality	
della	I-Claim	HighQuality	
patologia,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
necessario	I-Claim	HighQuality	
effettuare	I-Claim	HighQuality	
uno	I-Claim	HighQuality	
studio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
screening	I-Claim	HighQuality	
sul	I-Claim	HighQuality	
resto	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
parenti	I-Claim	HighQuality	
diretti.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
3	O		

Il	B-Claim	HighQuality	
miocardio	I-Claim	HighQuality	
è	I-Claim	HighQuality	
più	I-Claim	HighQuality	
spesso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
quanto	I-Claim	HighQuality	
dovrebbe	I-Claim	HighQuality	
essere,	I-Claim	HighQuality	
prevalentemente	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
setto,	I-Claim	HighQuality	
ed	I-Claim	HighQuality	
è	I-Claim	HighQuality	
così	I-Claim	HighQuality	
spesso	I-Claim	HighQuality	
da	I-Claim	HighQuality	
ostruire	I-Claim	HighQuality	
l'efflusso	I-Claim	HighQuality	
LV,	I-Claim	HighQuality	
producendo	I-Claim	HighQuality	
una	I-Claim	HighQuality	
stenosi	I-Claim	HighQuality	
funzionale	I-Claim	HighQuality	
con	I-Claim	HighQuality	
un	I-Claim	HighQuality	
gradiente	I-Claim	HighQuality	
di	I-Claim	HighQuality	
pressione.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
nostro	I-Claim	HighQuality	
obiettivo	I-Claim	HighQuality	
sarà,	I-Claim	HighQuality	
innanzitutto,	I-Claim	HighQuality	
quello	I-Claim	HighQuality	
di	I-Claim	HighQuality	
rilassare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
miocardio:	I-Claim	HighQuality	
per	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
abbiamo	I-Claim	HighQuality	
bisogno	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un	I-Claim	HighQuality	
beta-bloccante,	I-Claim	HighQuality	
mentre	I-Claim	HighQuality	
la	I-Claim	HighQuality	
digossina,	I-Claim	HighQuality	
da	I-Claim	HighQuality	
buon	I-Claim	HighQuality	
inotropo	I-Claim	HighQuality	
positivo,	I-Claim	HighQuality	
aumenta	I-Claim	HighQuality	
il	I-Claim	HighQuality	
gradiente	I-Claim	HighQuality	
ed	I-Claim	HighQuality	
è	I-Claim	HighQuality	
controindicata.	I-Claim	HighQuality	

Lo	B-Claim	HighQuality	
sport	I-Claim	HighQuality	
è	I-Claim	HighQuality	
sconsigliato,	I-Claim	HighQuality	
dato	I-Claim	HighQuality	
l'aumento	I-Claim	HighQuality	
del	I-Claim	HighQuality	
rischio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
morte	I-Claim	HighQuality	
improvvisa	I-Claim	HighQuality	
associato	I-Claim	HighQuality	
a	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
patologia.	I-Claim	HighQuality	

E	B-Claim	HighQuality	
se	I-Claim	HighQuality	
abbiamo	I-Claim	HighQuality	
un	I-Claim	HighQuality	
setto	I-Claim	HighQuality	
adiposo,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
sporge	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
cavità	I-Claim	HighQuality	
LV,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
consigliabile	I-Claim	HighQuality	
eseguire	I-Claim	HighQuality	
una	I-Claim	HighQuality	
deplezione	I-Claim	HighQuality	
di	I-Claim	HighQuality	
volume,	I-Claim	HighQuality	
perché	I-Claim	HighQuality	
aumenteremmo	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
il	I-Claim	HighQuality	
gradiente.	I-Claim	HighQuality	

Per	B-Claim	HighQuality	
quanto	I-Claim	HighQuality	
riguarda	I-Claim	HighQuality	
il	I-Claim	HighQuality	
punto	I-Claim	HighQuality	
5,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
vero:	I-Claim	HighQuality	
i	I-Claim	HighQuality	
parenti	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
ipertrofici	I-Claim	HighQuality	
devono	I-Claim	HighQuality	
sottoporsi	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un	I-Claim	HighQuality	
esame	I-Claim	HighQuality	
accurato	I-Claim	HighQuality	
e	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un	I-Claim	HighQuality	
ECG.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PULMONOLOGIA	O		

CLINICAL	O		
CASE:	O		

Uomo	B-Premise	HighQuality	
di	I-Premise	HighQuality	
71	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
cameriere	I-Premise	HighQuality	
in	I-Premise	HighQuality	
pensione,	I-Premise	HighQuality	
non	I-Premise	HighQuality	
fumatore,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
si	I-Premise	HighQuality	
rivolge	I-Premise	HighQuality	
al	I-Premise	HighQuality	
medico	I-Premise	HighQuality	
per	I-Premise	HighQuality	
russare	I-Premise	HighQuality	
di	I-Premise	HighQuality	
notte.	I-Premise	HighQuality	

Il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
un	I-Premise	HighQuality	
indice	I-Premise	HighQuality	
di	I-Premise	HighQuality	
massa	I-Premise	HighQuality	
corporea	I-Premise	HighQuality	
di	I-Premise	HighQuality	
31,5	I-Premise	HighQuality	
kg/m2	I-Premise	HighQuality	
e	I-Premise	HighQuality	
riferisce	I-Premise	HighQuality	
una	I-Premise	HighQuality	
lieve	I-Premise	HighQuality	
sonnolenza	I-Premise	HighQuality	
diurna	I-Premise	HighQuality	
postprandiale	I-Premise	HighQuality	
(Epworth	I-Premise	HighQuality	
Sleepiness	I-Premise	HighQuality	
Scale	I-Premise	HighQuality	
pari	I-Premise	HighQuality	
a	I-Premise	HighQuality	
3)	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
altri	I-Premise	HighQuality	
sintomi,	I-Premise	HighQuality	
segni	I-Premise	HighQuality	
o	I-Premise	HighQuality	
anamnesi	I-Premise	HighQuality	
rilevanti.	I-Premise	HighQuality	

L'indice	B-Premise	HighQuality	
di	I-Premise	HighQuality	
apnea-ipopnea	I-Premise	HighQuality	
ottenuto	I-Premise	HighQuality	
con	I-Premise	HighQuality	
la	I-Premise	HighQuality	
polisonnografia	I-Premise	HighQuality	
era	I-Premise	HighQuality	
pari	I-Premise	HighQuality	
a	I-Premise	HighQuality	
18	I-Premise	HighQuality	

Con	O		
questi	O		
dati,	O		
qual	O		
è	O		
la	O		
misura	O		
più	O		
appropriata	O		
da	O		
adottare	O		
in	O		
questo	O		
paziente?	O		

1-	O		
Misure	B-Claim	HighQuality	
igienico-dietetiche	I-Claim	HighQuality	
e	I-Claim	HighQuality	
controllo	I-Claim	HighQuality	
evolutivo.	I-Claim	HighQuality	

2-	O		
Uvulopalatofaringoplastica.	B-Claim	HighQuality	

3-	O		
CPAP	B-Claim	HighQuality	
nasale	I-Claim	HighQuality	
(pressione	I-Claim	HighQuality	
positiva	I-Claim	HighQuality	
continua	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
vie	I-Claim	HighQuality	
aeree).	I-Claim	HighQuality	

4-	O		
Ventilazione	B-Claim	HighQuality	
meccanica	I-Claim	HighQuality	
non	I-Claim	HighQuality	
invasiva.	I-Claim	HighQuality	

5-	O		
Ossigenoterapia	B-Claim	HighQuality	
notturna.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
1	O		

Con	B-Claim	HighQuality	
un	I-Claim	HighQuality	
indice	I-Claim	HighQuality	
di	I-Claim	HighQuality	
apnea-ipopnea	I-Claim	HighQuality	
inferiore	I-Claim	HighQuality	
a	I-Claim	HighQuality	
30,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
assenza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
eclatanti	I-Claim	HighQuality	
di	I-Claim	HighQuality	
OSAHS	I-Claim	HighQuality	
e	I-Claim	HighQuality	
in	I-Claim	HighQuality	
assenza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
professioni	I-Claim	HighQuality	
a	I-Claim	HighQuality	
rischio	I-Claim	HighQuality	
come	I-Claim	HighQuality	
l'autista	I-Claim	HighQuality	
professionista,	I-Claim	HighQuality	
ecc.	I-Claim	HighQuality	
la	I-Claim	HighQuality	
cosa	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
da	I-Claim	HighQuality	
fare	I-Claim	HighQuality	
è	I-Claim	HighQuality	
controllare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
peso	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
resto	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
misure	I-Claim	HighQuality	
igienico-dietetiche,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
un	I-Claim	HighQuality	
monitoraggio	I-Claim	HighQuality	
periodico.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
ENDOCRINOLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
di	I-Premise	HighQuality	
74	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
resezione	I-Premise	HighQuality	
intestinale	I-Premise	HighQuality	
in	I-Premise	HighQuality	
seguito	I-Premise	HighQuality	
a	I-Premise	HighQuality	
trombosi	I-Premise	HighQuality	
mesenterica	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
consultato	I-Premise	HighQuality	
a	I-Premise	HighQuality	
causa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
affaticamento	I-Premise	HighQuality	
e	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
osseo.	I-Premise	HighQuality	

Tre	B-Premise	HighQuality	
mesi	I-Premise	HighQuality	
prima	I-Premise	HighQuality	
aveva	I-Premise	HighQuality	
subito	I-Premise	HighQuality	
una	I-Premise	HighQuality	
frattura	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Colles.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
esami	I-Premise	HighQuality	
di	I-Premise	HighQuality	
laboratorio	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
un'anemia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
9,5	I-Premise	HighQuality	
g/dl,	I-Premise	HighQuality	
microcitica,	I-Premise	HighQuality	
albumina	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	
e	I-Premise	HighQuality	
fosfatasi	I-Premise	HighQuality	
alcalina	I-Premise	HighQuality	
224	I-Premise	HighQuality	
UI	I-Premise	HighQuality	
(normale	I-Premise	HighQuality	
fino	I-Premise	HighQuality	
a	I-Premise	HighQuality	
120	I-Premise	HighQuality	
UI).	I-Premise	HighQuality	

Le	B-Premise	HighQuality	
radiografie	I-Premise	HighQuality	
del	I-Premise	HighQuality	
femore	I-Premise	HighQuality	
mostrano	I-Premise	HighQuality	
bande	I-Premise	HighQuality	
radiotrasparenti	I-Premise	HighQuality	
perpendicolari	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
corteccia	I-Premise	HighQuality	
sul	I-Premise	HighQuality	
lato	I-Premise	HighQuality	
interno	I-Premise	HighQuality	
della	I-Premise	HighQuality	
parte	I-Premise	HighQuality	
superiore	I-Premise	HighQuality	
del	I-Premise	HighQuality	
femore.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
diagnosi	O		
più	O		
probabile?	O		

1-	O		
Osteoporosi.	B-Claim	HighQuality	

2-	O		
Malattia	B-Claim	HighQuality	
di	I-Claim	HighQuality	
Paget.	I-Claim	HighQuality	

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

4-	O		
Metastasi	B-Claim	HighQuality	
del	I-Claim	HighQuality	
cancro	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
prostata.	I-Claim	HighQuality	

5-	O		
Osteomalacia.	B-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
5	O		

Anche	O		
se	O		
questa	O		
non	O		
mi	O		
è	O		
stata	O		
assegnata,	O		
rispondo	O		
ugualmente	O		
poiché	O		
tratta	O		
un	O		
argomento	O		
di	O		
endocrinologia:	O		
la	O		
vitamina	O		
D.	O		

In	B-Claim	HighQuality	
questo	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
ci	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
dati	I-Claim	HighQuality	
importanti	I-Claim	HighQuality	
come	I-Claim	HighQuality	
l'anamnesi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
resezione	I-Claim	HighQuality	
intestinale,	I-Claim	HighQuality	
l'ipocalcemia	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'ipofosforemia;	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
dovrebbe	I-Claim	HighQuality	
far	I-Claim	HighQuality	
pensare	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un	I-Claim	HighQuality	
deficit	I-Claim	HighQuality	
di	I-Claim	HighQuality	
vitamina	I-Claim	HighQuality	
D	I-Claim	HighQuality	
dovuto	I-Claim	HighQuality	
al	I-Claim	HighQuality	
malassorbimento	I-Claim	HighQuality	
e	I-Claim	HighQuality	
quindi	I-Claim	HighQuality	
all'osteomalacia.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
resto	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
dati:	I-Claim	HighQuality	
frattura	I-Claim	HighQuality	
precedente,	I-Claim	HighQuality	
dolore	I-Claim	HighQuality	
e	I-Claim	HighQuality	
radiografia	I-Claim	HighQuality	
supportano	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diagnosi.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PEDIATRIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
neonato	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
mese	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
portato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
dell'ospedale	I-Premise	HighQuality	
dal	I-Premise	HighQuality	
pediatra	I-Premise	HighQuality	
per	I-Premise	HighQuality	
ittero.	I-Premise	HighQuality	

Si	B-Premise	HighQuality	
riferisce	I-Premise	HighQuality	
a	I-Premise	HighQuality	
questo	I-Premise	HighQuality	
negli	I-Premise	HighQuality	
ultimi	I-Premise	HighQuality	
10	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
e	I-Premise	HighQuality	
sta	I-Premise	HighQuality	
aumentando.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
esami	I-Premise	HighQuality	
del	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
un	I-Premise	HighQuality	
livello	I-Premise	HighQuality	
di	I-Premise	HighQuality	
bilirubina	I-Premise	HighQuality	
totale	I-Premise	HighQuality	
di	I-Premise	HighQuality	
7	I-Premise	HighQuality	
mg/dl	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un	I-Premise	HighQuality	
livello	I-Premise	HighQuality	
di	I-Premise	HighQuality	
bilirubina	I-Premise	HighQuality	
indiretta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
1,5	I-Premise	HighQuality	
mg/dl.	I-Premise	HighQuality	

Le	O		
cause	O		
più	O		
probabili	O		
di	O		
questo	O		
ittero	O		
sono	O		
le	O		
seguenti:	O		

1-	O		
Atresia	B-Claim	HighQuality	
del	I-Claim	HighQuality	
dotto	I-Claim	HighQuality	
biliare.	I-Claim	HighQuality	

2-	O		
Ittero	B-Claim	HighQuality	
da	I-Claim	HighQuality	
allattamento.	I-Claim	HighQuality	

3-	O		
Isoimmunizzazione	B-Claim	HighQuality	
0-A	I-Claim	HighQuality	
a	I-Claim	HighQuality	
insorgenza	I-Claim	HighQuality	
tardiva.	I-Claim	HighQuality	

4-	O		
Malattia	B-Claim	HighQuality	
di	I-Claim	HighQuality	
Gilbert.	I-Claim	HighQuality	

5-	O		
Sferocitosi	B-Claim	HighQuality	
ereditaria.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
1	O		

L'aumento	B-Claim	HighQuality	
della	I-Claim	HighQuality	
bilirubina	I-Claim	HighQuality	
diretta	I-Claim	HighQuality	
esclude	I-Claim	HighQuality	
immediatamente	I-Claim	HighQuality	
tutte	I-Claim	HighQuality	
le	I-Claim	HighQuality	
altre	I-Claim	HighQuality	
opzioni	I-Claim	HighQuality	
in	O		
cui	O		
l'aumento	B-Claim	HighQuality	
della	I-Claim	HighQuality	
bilirubina	I-Claim	HighQuality	
totale	I-Claim	HighQuality	
andrebbe	I-Claim	HighQuality	
a	I-Claim	HighQuality	
scapito	I-Claim	HighQuality	
della	I-Claim	HighQuality	
bilirubina	I-Claim	HighQuality	
indiretta.	I-Claim	HighQuality	

L'atresia	B-Claim	HighQuality	
del	I-Claim	HighQuality	
dotto	I-Claim	HighQuality	
biliare	I-Claim	HighQuality	
è	I-Claim	HighQuality	
la	I-Claim	HighQuality	
principale	I-Claim	HighQuality	
indicazione	I-Claim	HighQuality	
per	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trapianto	I-Claim	HighQuality	
di	I-Claim	HighQuality	
fegato	I-Claim	HighQuality	
infantile.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
EMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

In	B-Premise	HighQuality	
una	I-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
29	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
durante	I-Premise	HighQuality	
un	I-Premise	HighQuality	
esame	I-Premise	HighQuality	
del	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
di	I-Premise	HighQuality	
routine	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
stati	I-Premise	HighQuality	
rilevati	I-Premise	HighQuality	
i	I-Premise	HighQuality	
seguenti	I-Premise	HighQuality	
parametri:	I-Premise	HighQuality	
Hb	I-Premise	HighQuality	
11,5	I-Premise	HighQuality	
g/dL,	I-Premise	HighQuality	
MCV	I-Premise	HighQuality	
70	I-Premise	HighQuality	
fl,	I-Premise	HighQuality	
MCH	I-Premise	HighQuality	
28	I-Premise	HighQuality	
pg,	I-Premise	HighQuality	
Ferritina	I-Premise	HighQuality	
10	I-Premise	HighQuality	
ng/mL,	I-Premise	HighQuality	
leucociti	I-Premise	HighQuality	
5.200/mm3,	I-Premise	HighQuality	
piastrine	I-Premise	HighQuality	
335.000/mm3.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
fisico	I-Premise	HighQuality	
è	I-Premise	HighQuality	
normale.	I-Premise	HighQuality	

Lo	O		
screening	O		
più	O		
appropriato	O		
in	O		
questa	O		
situazione	O		
è:	O		

1-	O		
Esame	B-Claim	HighQuality	
ginecologico.	I-Claim	HighQuality	

2-	O		
Test	B-Claim	HighQuality	
del	I-Claim	HighQuality	
sangue	I-Claim	HighQuality	
occulto	I-Claim	HighQuality	
fecale.	I-Claim	HighQuality	

3-	O		
Studio	B-Claim	HighQuality	
radiologico	I-Claim	HighQuality	
dell'apparato	I-Claim	HighQuality	
digerente.	I-Claim	HighQuality	

4-	O		
Elettroforesi	B-Claim	HighQuality	
delle	I-Claim	HighQuality	
emoglobine.	I-Claim	HighQuality	

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

RISPOSTA	O		
CORRETTA:	O		
1	O		

La	B-Claim	HighQuality	
causa	I-Claim	HighQuality	
più	I-Claim	HighQuality	
comune	I-Claim	HighQuality	
di	I-Claim	HighQuality	
anemia	I-Claim	HighQuality	
microcitica	I-Claim	HighQuality	
da	I-Claim	HighQuality	
carenza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
ferro	I-Claim	HighQuality	
nelle	I-Claim	HighQuality	
giovani	I-Claim	HighQuality	
donne	I-Claim	HighQuality	
è	I-Claim	HighQuality	
rappresentata	I-Claim	HighQuality	
dalle	I-Claim	HighQuality	
perdite	I-Claim	HighQuality	
ginecologiche	I-Claim	HighQuality	
croniche.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
EMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
71	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
con	I-Premise	HighQuality	
esami	I-Premise	HighQuality	
del	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
che	I-Premise	HighQuality	
mostravano	I-Premise	HighQuality	
una	I-Premise	HighQuality	
grave	I-Premise	HighQuality	
pancitopenia	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
la	I-Premise	HighQuality	
presenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
cellule	I-Premise	HighQuality	
immature	I-Premise	HighQuality	
e	I-Premise	HighQuality	
uno	I-Premise	HighQuality	
studio	I-Premise	HighQuality	
del	I-Premise	HighQuality	
midollo	I-Premise	HighQuality	
osseo	I-Premise	HighQuality	
suggestivo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
una	I-Premise	HighQuality	
grave	I-Premise	HighQuality	
anemia	I-Premise	HighQuality	
aplastica.	I-Premise	HighQuality	

Quale	O		
sarebbe	O		
l'approccio	O		
terapeutico	O		
fondamentale?	O		

1-	O		
Trattamento	B-Claim	HighQuality	
con	I-Claim	HighQuality	
metilprednisolone	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
dose	I-Claim	HighQuality	
di	I-Claim	HighQuality	
1	I-Claim	HighQuality	
g/kg/die	I-Claim	HighQuality	
per	I-Claim	HighQuality	
5	I-Claim	HighQuality	
giorni.	I-Claim	HighQuality	

2-	O		
Studio	B-Claim	HighQuality	
dei	I-Claim	HighQuality	
fratelli	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
se	I-Claim	HighQuality	
questi	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
HLA	I-Claim	HighQuality	
compatibili,	I-Claim	HighQuality	
trapianto	I-Claim	HighQuality	
allogenico	I-Claim	HighQuality	
di	I-Claim	HighQuality	
progenitori	I-Claim	HighQuality	
ematopoietici.	I-Claim	HighQuality	

3-	O		
Terapia	B-Claim	HighQuality	
immunosoppressiva	I-Claim	HighQuality	
con	I-Claim	HighQuality	
ciclosporina	I-Claim	HighQuality	
e	I-Claim	HighQuality	
immunoglobuline	I-Claim	HighQuality	
anti-timociti.	I-Claim	HighQuality	

4-	O		
Supporto	B-Claim	HighQuality	
all'emoterapia.	I-Claim	HighQuality	

5-	O		
Chemioterapia	B-Claim	HighQuality	
e,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
risposta,	I-Claim	HighQuality	
trapianto	I-Claim	HighQuality	
autologo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
cellule	I-Claim	HighQuality	
staminali	I-Claim	HighQuality	
ematopoietiche.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
3	O		

Anemia	B-Claim	HighQuality	
aplastica	I-Claim	HighQuality	
grave	I-Claim	HighQuality	
e	I-Claim	HighQuality	
non	I-Claim	HighQuality	
candidato	I-Claim	HighQuality	
al	I-Claim	HighQuality	
trapianto	I-Claim	HighQuality	
allogenico	I-Claim	HighQuality	
a	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
dell'età.	I-Claim	HighQuality	

Gli	B-Claim	HighQuality	
antisoppressori	I-Claim	HighQuality	
sembrano	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
i	I-Claim	HighQuality	
più	I-Claim	HighQuality	
adatti.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
NEUROLOGIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
obesa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
29	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
precedenti	I-Premise	HighQuality	
di	I-Premise	HighQuality	
interesse,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
consultata	I-Premise	HighQuality	
per	I-Premise	HighQuality	
un'intensa	I-Premise	HighQuality	
cefalea	I-Premise	HighQuality	
pulsante	I-Premise	HighQuality	
bilaterale	I-Premise	HighQuality	
della	I-Premise	HighQuality	
durata	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
mese,	I-Premise	HighQuality	
accompagnata	I-Premise	HighQuality	
da	I-Premise	HighQuality	
diplopia	I-Premise	HighQuality	
orizzontale	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
episodi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
amaurosi	I-Premise	HighQuality	
monoculare	I-Premise	HighQuality	
della	I-Premise	HighQuality	
durata	I-Premise	HighQuality	
di	I-Premise	HighQuality	
secondi.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
è	I-Premise	HighQuality	
normale,	I-Premise	HighQuality	
tranne	I-Premise	HighQuality	
che	I-Premise	HighQuality	
per	I-Premise	HighQuality	
la	I-Premise	HighQuality	
presenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
papilledema	I-Premise	HighQuality	
bilaterale.	I-Premise	HighQuality	

Quale	O		
di	O		
questi	O		
esami	O		
pensa	O		
che	O		
le	O		
permetterà	O		
di	O		
confermare	O		
completamente	O		
la	O		
sua	O		
diagnosi?	O		

1-	O		
Ecografia	B-Claim	HighQuality	
dei	I-Claim	HighQuality	
tronchi	I-Claim	HighQuality	
sovraaortici.	I-Claim	HighQuality	

2-	O		
Risonanza	B-Claim	HighQuality	
magnetica	I-Claim	HighQuality	
del	I-Claim	HighQuality	
cranio.	I-Claim	HighQuality	

3-	O		
Elettroencefalogramma.	B-Claim	HighQuality	

4-	O		
Puntura	B-Claim	HighQuality	
lombare.	I-Claim	HighQuality	

5-	O		
Potenziali	B-Claim	LowQuality	
visivi	I-Claim	LowQuality	corrected
evocati.	I-Claim	LowQuality	corrected

RISPOSTA	O		
CORRETTA:	O		
4	O		

Anche	O		
in	O		
questo	O		
caso,	O		
ci	O		
viene	O		
presentato	O		
un	O		
caso	O		
per	O		
fare	O		
una	O		
diagnosi	O		
e	O		
poi,	O		
in	O		
questo	O		
caso,	O		
per	O		
eseguire	O		
un	O		
test	O		
di	O		
conferma.	O		

Il	B-Claim	HighQuality	
sintomo	I-Claim	HighQuality	
guida	I-Claim	HighQuality	
è	I-Claim	HighQuality	
ora	I-Claim	HighQuality	
il	I-Claim	HighQuality	
papilledema	I-Claim	HighQuality	
bilaterale,	I-Claim	HighQuality	
indicativo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
ipertensione	I-Claim	HighQuality	
intracranica.	I-Claim	HighQuality	

Sebbene	B-Premise	HighQuality	
non	I-Premise	HighQuality	
sia	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
esclusa	I-Premise	HighQuality	
una	I-Premise	HighQuality	
lesione	I-Premise	HighQuality	
occupante	I-Premise	HighQuality	
spazio,	I-Premise	HighQuality	
dato	I-Premise	HighQuality	
l'esame	I-Premise	HighQuality	
neurologico	I-Premise	HighQuality	
normale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
il	I-Premise	HighQuality	
resto	I-Premise	HighQuality	
dei	I-Premise	HighQuality	
sintomi,	I-Premise	HighQuality	
si	B-Claim	HighQuality	
può	I-Claim	HighQuality	
dedurre	I-Claim	HighQuality	
che	I-Claim	HighQuality	
si	I-Claim	HighQuality	
tratti	I-Claim	HighQuality	
di	I-Claim	HighQuality	
ipertensione	I-Claim	HighQuality	
intracranica	I-Claim	HighQuality	
idiopatica	I-Claim	HighQuality	
o	I-Claim	HighQuality	
pseudotumor	I-Claim	HighQuality	
cerebri.	I-Claim	HighQuality	

Altri	B-Premise	HighQuality	
dati	I-Premise	HighQuality	
suggestivi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
questa	I-Premise	HighQuality	
entità	I-Premise	HighQuality	
sono:	I-Premise	HighQuality	
donne	I-Premise	HighQuality	
in	I-Premise	HighQuality	
età	I-Premise	HighQuality	
riproduttiva,	I-Premise	HighQuality	
obesità	I-Premise	HighQuality	
e	I-Premise	HighQuality	
diplopia	I-Premise	HighQuality	
(dovuta	I-Premise	HighQuality	
al	I-Premise	HighQuality	
coinvolgimento	I-Premise	HighQuality	
del	I-Premise	HighQuality	
VI	I-Premise	HighQuality	
nervo	I-Premise	HighQuality	
cranico).	I-Premise	HighQuality	

È	B-Claim	HighQuality	
caratteristico	I-Claim	HighQuality	
che	I-Claim	HighQuality	
il	I-Claim	HighQuality	
mal	I-Claim	HighQuality	
di	I-Claim	HighQuality	
testa	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'offuscamento	I-Claim	HighQuality	
visivo	I-Claim	HighQuality	
peggiorino	I-Claim	HighQuality	
improvvisamente	I-Claim	HighQuality	
al	I-Claim	HighQuality	
mattino	I-Claim	HighQuality	
quando	I-Claim	HighQuality	
ci	I-Claim	HighQuality	
si	I-Claim	HighQuality	
alza	I-Claim	HighQuality	
o	I-Claim	HighQuality	
si	I-Claim	HighQuality	
cambia	I-Claim	HighQuality	
postura,	I-Claim	HighQuality	
producendo	I-Claim	HighQuality	
una	I-Claim	HighQuality	
cecità	I-Claim	HighQuality	
transitoria	I-Claim	HighQuality	
(Neurologia,	I-Claim	HighQuality	
Zarranz).	I-Claim	HighQuality	

La	B-Claim	HighQuality	
puntura	I-Claim	HighQuality	
lombare	I-Claim	HighQuality	
mostra	I-Claim	HighQuality	
invariabilmente	I-Claim	HighQuality	
un	I-Claim	HighQuality	
aumento	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
liquido	I-Claim	HighQuality	
cerebrospinale,	I-Claim	HighQuality	
quindi	I-Claim	HighQuality	
la	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
4	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
TRATTO	O		
DIGESTIVO	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
ragazzo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
17	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
sportivo	I-Premise	HighQuality	
e	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
precedenti,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
reca	I-Premise	HighQuality	
dal	I-Premise	HighQuality	
medico	I-Premise	HighQuality	
per	I-Premise	HighQuality	
un	I-Premise	HighQuality	
ittero	I-Premise	HighQuality	
congiuntivale	I-Premise	HighQuality	
occasionale.	I-Premise	HighQuality	

Nega	B-Premise	HighQuality	
di	I-Premise	HighQuality	
aver	I-Premise	HighQuality	
assunto	I-Premise	HighQuality	
farmaci	I-Premise	HighQuality	
e	I-Premise	HighQuality	
di	I-Premise	HighQuality	
avere	I-Premise	HighQuality	
dolori	I-Premise	HighQuality	
addominali.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
esami	I-Premise	HighQuality	
di	I-Premise	HighQuality	
laboratorio	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
ALT,	I-Premise	HighQuality	
AST,	I-Premise	HighQuality	
GGT	I-Premise	HighQuality	
e	I-Premise	HighQuality	
FA	I-Premise	HighQuality	
normali,	I-Premise	HighQuality	
con	I-Premise	HighQuality	
bilirubina	I-Premise	HighQuality	
totale	I-Premise	HighQuality	
di	I-Premise	HighQuality	
3,2	I-Premise	HighQuality	
mg/dl	I-Premise	HighQuality	
e	I-Premise	HighQuality	
bilirubina	I-Premise	HighQuality	
diretta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
0,4	I-Premise	HighQuality	
mg/dl.	I-Premise	HighQuality	

Non	B-Premise	HighQuality	
c'è	I-Premise	HighQuality	
anemia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
il	I-Premise	HighQuality	
fegato	I-Premise	HighQuality	
è	I-Premise	HighQuality	
normale	I-Premise	HighQuality	
dal	I-Premise	HighQuality	
punto	I-Premise	HighQuality	
di	I-Premise	HighQuality	
vista	I-Premise	HighQuality	
ecografico.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
sua	O		
diagnosi?	O		

1-	O		
Sindrome	B-Claim	HighQuality	
del	I-Claim	HighQuality	
rotore.	I-Claim	HighQuality	

2-	O		
Coledocolitiasi.	B-Claim	HighQuality	

3-	O		
Sindrome	B-Claim	HighQuality	
di	I-Claim	HighQuality	
Dubin-Johnson.	I-Claim	HighQuality	

4-	O		
Epatite	B-Claim	LowQuality	
aguta.	I-Claim	LowQuality	corrected

5-	O		
Sindrome	B-Claim	HighQuality	
di	I-Claim	HighQuality	
Gilbert.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
5	O		

Un	B-Claim	HighQuality	
aumento	I-Claim	HighQuality	
della	I-Claim	HighQuality	
bilirubina	I-Claim	HighQuality	
indiretta	I-Claim	HighQuality	
inferiore	I-Claim	HighQuality	
a	I-Claim	HighQuality	
5	I-Claim	HighQuality	
(a	I-Claim	HighQuality	
intermittenza,	I-Claim	HighQuality	
sotto	I-Claim	HighQuality	
stress)	I-Claim	HighQuality	
in	I-Claim	HighQuality	
un	I-Claim	HighQuality	
ragazzo	I-Claim	HighQuality	
sano	I-Claim	HighQuality	
dovrebbe	I-Claim	HighQuality	
suggerire	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sindrome	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Gilbert.	I-Claim	HighQuality	

Nella	B-Claim	HighQuality	
sindrome	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Rotor,	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
sindrome	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Dubin-Johnson	I-Claim	HighQuality	
e	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
coledo-colitiasi	I-Claim	HighQuality	
si	I-Claim	HighQuality	
verifica	I-Claim	HighQuality	
un	I-Claim	HighQuality	
aumento	I-Claim	HighQuality	
della	I-Claim	HighQuality	
bilirubina	I-Claim	HighQuality	
diretta.	I-Claim	HighQuality	

In	B-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
epatite	I-Claim	HighQuality	
acuta	I-Claim	HighQuality	
deve	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
presente	I-Claim	HighQuality	
un	I-Claim	HighQuality	
innalzamento	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
transaminasi.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PNEUMOLOGIA	O		

CLINICAL	O		
CASE:	O		

In	B-Premise	HighQuality	
un	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
con	I-Premise	HighQuality	
lieve	I-Premise	HighQuality	
broncopneumopatia	I-Premise	HighQuality	
cronica	I-Premise	HighQuality	
ostruttiva	I-Premise	HighQuality	
(BPCO)	I-Premise	HighQuality	
in	I-Premise	HighQuality	
fase	I-Premise	HighQuality	
stabile,	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
evidenti	I-Premise	HighQuality	
poliglobulia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
insufficienza	I-Premise	HighQuality	
respiratoria.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
radiografia	I-Premise	HighQuality	
del	I-Premise	HighQuality	
torace	I-Premise	HighQuality	
non	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
anomalie	I-Premise	HighQuality	
degne	I-Premise	HighQuality	
di	I-Premise	HighQuality	
nota.	I-Premise	HighQuality	

Quale	O		
delle	O		
seguenti	O		
procedure	O		
considererebbe	O		
di	O		
eseguire	O		
prima	O		
per	O		
escludere	O		
la	O		
coesistenza	O		
di	O		
altre	O		
malattie	O		
che	O		
potrebbero	O		
giustificare	O		
i	O		
risultati	O		
descritti?	O		

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

2-	O		
Ecocardiogramma.	B-Claim	HighQuality	

3-	O		
TAC	B-Claim	HighQuality	
toracica.	I-Claim	HighQuality	

4-	O		
Scintigrafia	B-Claim	HighQuality	
polmonare.	I-Claim	HighQuality	

5-	O		
Puntura	B-Claim	HighQuality	
del	I-Claim	HighQuality	
midollo	I-Claim	HighQuality	
osseo.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
1	O		

L'approccio	O		
è	O		
discutibile	O		
a	O		
causa	O		
della	O		
mancanza	O		
di	O		
dati	O		
sufficienti.	O		

In	O		
termini	O		
di	O		
frequenza,	O		
la	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
potrebbe	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
la	I-Claim	HighQuality	
poligrafia	I-Claim	HighQuality	
respiratoria,	I-Claim	HighQuality	
soprattutto	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
obeso,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
non	I-Claim	HighQuality	
conosciamo,	I-Claim	HighQuality	
ma	O		
potrebbe	B-Claim	HighQuality	
anche	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
la	I-Claim	HighQuality	
2	I-Claim	HighQuality	
(ecocardiogramma)	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sospetto	I-Claim	HighQuality	
di	I-Claim	HighQuality	
cardiopatia	I-Claim	HighQuality	
associata,	I-Claim	HighQuality	
meno	I-Claim	HighQuality	
frequente	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
altrettanto	I-Claim	HighQuality	
possibile.	I-Claim	HighQuality	

L'associazione	O		
della	O		
BPCO	O		
con	O		
l'OSA	O		
è	O		
una	O		
causa	O		
frequente	O		
di	O		
deterioramento	O		
della	O		
BPCO,	O		
maggiore	O		
di	O		
quello	O		
che	O		
corrisponderebbe	O		
a	O		
una	O		
compromissione	O		
funzionale.	O		

QUESTION	O		
TYPE:	O		
APPARATO	O		
DIGERENTE	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
52	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
malattie	I-Premise	HighQuality	
concomitanti	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
melena	I-Premise	HighQuality	
di	I-Premise	HighQuality	
24	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
ripercussioni	I-Premise	HighQuality	
emodinamiche.	I-Premise	HighQuality	

Nega	B-Premise	HighQuality	
di	I-Premise	HighQuality	
aver	I-Premise	HighQuality	
assunto	I-Premise	HighQuality	
farmaci	I-Premise	HighQuality	
antinfiammatori	I-Premise	HighQuality	
non	I-Premise	HighQuality	
steroidei.	I-Premise	HighQuality	

L'ematocrito	B-Premise	HighQuality	
è	I-Premise	HighQuality	
del	I-Premise	HighQuality	
33%	I-Premise	HighQuality	
e	I-Premise	HighQuality	
il	I-Premise	HighQuality	
resto	I-Premise	HighQuality	
degli	I-Premise	HighQuality	
esami	I-Premise	HighQuality	
del	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
è	I-Premise	HighQuality	
normale.	I-Premise	HighQuality	

L'endoscopia	B-Premise	HighQuality	
superiore	I-Premise	HighQuality	
eseguita	I-Premise	HighQuality	
d'urgenza	I-Premise	HighQuality	
6	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
il	I-Premise	HighQuality	
ricovero	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
uno	I-Premise	HighQuality	
stomaco	I-Premise	HighQuality	
normale	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
o	I-Premise	HighQuality	
detriti	I-Premise	HighQuality	
ematici	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un'ulcera	I-Premise	HighQuality	
di	I-Premise	HighQuality	
8	I-Premise	HighQuality	
mm	I-Premise	HighQuality	
di	I-Premise	HighQuality	
diametro	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
parte	I-Premise	HighQuality	
anteriore	I-Premise	HighQuality	
del	I-Premise	HighQuality	
bulbo	I-Premise	HighQuality	
duodenale	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
vaso I-Premise HighQuality
visibile	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
base	I-Premise	HighQuality	
e	I-Premise	HighQuality	
nessuna	I-Premise	HighQuality	
emorragia	I-Premise	HighQuality	
attiva.	I-Premise	HighQuality	

Quale	O		
delle	O		
seguenti	O		
affermazioni	O		
è	O		
vera?	O		

1-	O		
È	B-Claim	HighQuality	
indicata	I-Claim	HighQuality	
una	I-Claim	HighQuality	
terapia	I-Claim	HighQuality	
endoscopica	I-Claim	HighQuality	
iniziale	I-Claim	HighQuality	
seguita	I-Claim	HighQuality	
da	I-Claim	HighQuality	
un	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
endovenoso	I-Claim	HighQuality	
con	I-Claim	HighQuality	
alte	I-Claim	HighQuality	
dosi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
inibitore	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pompa	I-Claim	HighQuality	
protonica.	I-Claim	HighQuality	
È	I-Claim	HighQuality	
stato	I-Claim	HighQuality	
dimostrato	I-Claim	HighQuality	
che	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
strategia	I-Claim	HighQuality	
riduce	I-Claim	HighQuality	
il	I-Claim	HighQuality	
rischio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
recidiva	I-Claim	HighQuality	
emorragica	I-Claim	HighQuality	
e	I-Claim	HighQuality	
di	I-Claim	HighQuality	
mortalità.	I-Claim	HighQuality	

2-	O		
Nell'endoscopia	B-Claim	HighQuality	
iniziale,	I-Claim	HighQuality	
data	I-Claim	HighQuality	
l'assenza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
emorragia	I-Claim	HighQuality	
attiva,	I-Claim	HighQuality	
la	I-Claim	HighQuality	
terapia	I-Claim	HighQuality	
endoscopica	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
indicata.	I-Claim	HighQuality	
Successivamente,	I-Claim	HighQuality	
per	I-Claim	HighQuality	
ridurre	I-Claim	HighQuality	
il	I-Claim	HighQuality	
rischio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
recidiva	I-Claim	HighQuality	
emorragica,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
necessario	I-Claim	HighQuality	
iniziare	I-Claim	HighQuality	
un	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
endovenoso	I-Claim	HighQuality	
con	I-Claim	HighQuality	
dosi	I-Claim	HighQuality	
elevate	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un	I-Claim	HighQuality	
inibitore	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pompa	I-Claim	HighQuality	
protonica.	I-Claim	HighQuality	

3-	O		
n	B-Claim	HighQuality	
endoscopia	I-Claim	HighQuality	
iniziale,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
indicata	I-Claim	HighQuality	
una	I-Claim	HighQuality	
terapia	I-Claim	HighQuality	
endoscopica.	I-Claim	HighQuality	
Il	I-Claim	HighQuality	
successivo	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
con	I-Claim	HighQuality	
dosi	I-Claim	HighQuality	
elevate	I-Claim	HighQuality	
di	I-Claim	HighQuality	
inibitore	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pompa	I-Claim	HighQuality	
protonica	I-Claim	HighQuality	
non	I-Claim	HighQuality	
ha	I-Claim	HighQuality	
dimostrato	I-Claim	HighQuality	
alcun	I-Claim	HighQuality	
beneficio	I-Claim	HighQuality	
aggiuntivo.	I-Claim	HighQuality	

4-	O		
Trattandosi	B-Claim	HighQuality	
di	I-Claim	HighQuality	
un'ulcera	I-Claim	HighQuality	
complicata	I-Claim	HighQuality	
(emorragia),	I-Claim	HighQuality	
la	I-Claim	HighQuality	
migliore	I-Claim	HighQuality	
opzione	I-Claim	HighQuality	
terapeutica,	I-Claim	HighQuality	
una	I-Claim	HighQuality	
volta	I-Claim	HighQuality	
risolto	I-Claim	HighQuality	
l'episodio	I-Claim	HighQuality	
emorragico,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
la	I-Claim	HighQuality	
vagotomia	I-Claim	HighQuality	
e	I-Claim	HighQuality	
la	I-Claim	HighQuality	
piloroplastica.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
1	O		

Si	B-Claim	HighQuality	
tratta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un'ulcera	I-Claim	HighQuality	
di	I-Claim	HighQuality	
grado	I-Claim	HighQuality	
IIa	I-Claim	HighQuality	
(classificazione	I-Claim	HighQuality	
Forrest),	I-Claim	HighQuality	
con	I-Claim	HighQuality	
un	I-Claim	HighQuality	
elevato	I-Claim	HighQuality	
rischio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
recidiva.	I-Claim	HighQuality	

Pertanto,	B-Claim	HighQuality	
è	I-Claim	HighQuality	
chiaramente	I-Claim	HighQuality	
indicato	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
endoscopico	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'ospedalizzazione	I-Claim	HighQuality	
con	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
endovenoso	I-Claim	HighQuality	
con	I-Claim	HighQuality	
IPP	I-Claim	HighQuality	
(di	I-Claim	HighQuality	
solito	I-Claim	HighQuality	
omeprazolo	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
nostro	I-Claim	HighQuality	
contesto)	I-Claim	HighQuality	
per	I-Claim	HighQuality	
almeno	I-Claim	HighQuality	
72	I-Claim	HighQuality	
ore.	I-Claim	HighQuality	

L'intervento	B-Claim	HighQuality	
chirurgico	I-Claim	HighQuality	
è	I-Claim	HighQuality	
indicato	I-Claim	HighQuality	
nelle	I-Claim	HighQuality	
emorragie	I-Claim	HighQuality	
massive	I-Claim	HighQuality	
o	I-Claim	HighQuality	
refrattarie	I-Claim	HighQuality	
al	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
medico.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
MALATTIE	O		
INFETTIVE	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
47	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
fumatore	I-Premise	HighQuality	
attivo,	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
abuso	I-Premise	HighQuality	
di	I-Premise	HighQuality	
droghe	I-Premise	HighQuality	
per	I-Premise	HighQuality	
via	I-Premise	HighQuality	
parenterale,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
2	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
di	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
pleuritico	I-Premise	HighQuality	
al	I-Premise	HighQuality	
costato	I-Premise	HighQuality	
sinistro	I-Premise	HighQuality	
a	I-Premise	HighQuality	
insorgenza	I-Premise	HighQuality	
acuta	I-Premise	HighQuality	
e	I-Premise	HighQuality	
dispnea	I-Premise	HighQuality	
progressiva	I-Premise	HighQuality	
fino	I-Premise	HighQuality	
al	I-Premise	HighQuality	
riposo.	I-Premise	HighQuality	

Nelle	B-Premise	HighQuality	
2	I-Premise	HighQuality	
settimane	I-Premise	HighQuality	
precedenti	I-Premise	HighQuality	
aveva	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
febbre,	I-Premise	HighQuality	
malessere	I-Premise	HighQuality	
generale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
tosse	I-Premise	HighQuality	
secca.	I-Premise	HighQuality	

All'esame,	B-Premise	HighQuality	
il	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
è	I-Premise	HighQuality	
tachipnoico	I-Premise	HighQuality	
a	I-Premise	HighQuality	
36	I-Premise	HighQuality	
giri/minuto,	I-Premise	HighQuality	
con	I-Premise	HighQuality	
trazione	I-Premise	HighQuality	
sopraclaveare,	I-Premise	HighQuality	
saturazione	I-Premise	HighQuality	
di	I-Premise	HighQuality	
ossigeno	I-Premise	HighQuality	
mediante	I-Premise	HighQuality	
pulsossimetria	I-Premise	HighQuality	
dell'81%,	I-Premise	HighQuality	
cianosi,	I-Premise	HighQuality	
sudorazione,	I-Premise	HighQuality	
tachicardia	I-Premise	HighQuality	
a	I-Premise	HighQuality	
135	I-Premise	HighQuality	
battiti	I-Premise	HighQuality	
al	I-Premise	HighQuality	
minuto	I-Premise	HighQuality	
e	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
75/47	I-Premise	HighQuality	
mm	I-Premise	HighQuality	
Hg.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
trachea	I-Premise	HighQuality	
è	I-Premise	HighQuality	
deviata	I-Premise	HighQuality	
verso	I-Premise	HighQuality	
destra	I-Premise	HighQuality	
e	I-Premise	HighQuality	
l'auscultazione	I-Premise	HighQuality	
dimostra	I-Premise	HighQuality	
la	I-Premise	HighQuality	
completa	I-Premise	HighQuality	
assenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
soffio	I-Premise	HighQuality	
vescicolare	I-Premise	HighQuality	
nell'emitorace	I-Premise	HighQuality	
sinistro.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
sierologia	I-Premise	HighQuality	
per	I-Premise	HighQuality	
l'HIV	I-Premise	HighQuality	
era	I-Premise	HighQuality	
positiva	I-Premise	HighQuality	
e	I-Premise	HighQuality	
mostrava	I-Premise	HighQuality	
una	I-Premise	HighQuality	
conta	I-Premise	HighQuality	
linfocitaria	I-Premise	HighQuality	
ADC	I-Premise	HighQuality	
di	I-Premise	HighQuality	
176	I-Premise	HighQuality	
cellule/ml.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
diagnosi	O		
più	O		
probabile?	O		

1-	O		
Rottura	B-Claim	LowQuality	
del	I-Claim	LowQuality	
bulla	I-Claim	LowQuality	
enfisematoso	I-Claim	LowQuality	
subpleurico.	I-Claim	LowQuality	

2-	O		
Polmonite	B-Claim	HighQuality	
batterica	I-Claim	HighQuality	
necrotizzante	I-Claim	HighQuality	
acquisita	I-Claim	HighQuality	
in	I-Claim	HighQuality	
comunità.	I-Claim	HighQuality	

3-	O		
Tubercolosi	B-Claim	HighQuality	
polmonare.	I-Claim	HighQuality	

4-	O		
Polmonite	B-Claim	HighQuality	
da	I-Claim	HighQuality	
Pneumocystis	I-Claim	HighQuality	
jiroveci.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
4	O		

Paziente	B-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
fattore	I-Premise	HighQuality	
di	I-Premise	HighQuality	
rischio	I-Premise	HighQuality	
per	I-Premise	HighQuality	
l'acquisizione	I-Premise	HighQuality	
dell'HIV,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
si	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
esordio	I-Premise	HighQuality	
subacuto	I-Premise	HighQuality	
di	I-Premise	HighQuality	
2	I-Premise	HighQuality	
settimane	I-Premise	HighQuality	
(febbre,	I-Premise	HighQuality	
malessere	I-Premise	HighQuality	
generale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
tosse	I-Premise	HighQuality	
secca)	I-Premise	HighQuality	
che	I-Premise	HighQuality	
peggiora	I-Premise	HighQuality	
bruscamente	I-Premise	HighQuality	
(dolore	I-Premise	HighQuality	
pleuritico)	I-Premise	HighQuality	
e	I-Premise	HighQuality	
progressivamente	I-Premise	HighQuality	
(dispnea).	I-Premise	HighQuality	

L'esame	B-Claim	HighQuality	
fisico	I-Claim	HighQuality	
suggerisce	I-Claim	HighQuality	
uno	I-Claim	HighQuality	
pneumotorace	I-Claim	HighQuality	
(tachipnea,	B-Premise	HighQuality	
strattoni,	I-Premise	HighQuality	
bassa	I-Premise	HighQuality	
saturazione,	I-Premise	HighQuality	
cianosi,	I-Premise	HighQuality	
diaforesi,	I-Premise	HighQuality	
tachicardia,	I-Premise	HighQuality	
trachea	I-Premise	HighQuality	
deviata	I-Premise	HighQuality	
e	I-Premise	HighQuality	
assenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
soffio	I-Premise	HighQuality	
vescicolare).	I-Premise	HighQuality	

Ha	B-Premise	HighQuality	
una	I-Premise	HighQuality	
sierologia	I-Premise	HighQuality	
HIV	I-Premise	HighQuality	
positiva	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un	I-Premise	HighQuality	
CD4	I-Premise	HighQuality	
inferiore	I-Premise	HighQuality	
a	I-Premise	HighQuality	
200	I-Premise	HighQuality	
cellule/mL.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
radiografia	I-Premise	HighQuality	
mostra	I-Premise	HighQuality	
iperclarità	I-Premise	HighQuality	
nel	I-Premise	HighQuality	
campo	I-Premise	HighQuality	
polmonare	I-Premise	HighQuality	
sinistro	I-Premise	HighQuality	
con	I-Premise	HighQuality	
assenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
vasi	I-Premise	HighQuality	
tra	I-Premise	HighQuality	
il	I-Premise	HighQuality	
bordo	I-Premise	HighQuality	
polmonare	I-Premise	HighQuality	
e	I-Premise	HighQuality	
la	I-Premise	HighQuality	
parete	I-Premise	HighQuality	
toracica	I-Premise	HighQuality	
sul	I-Premise	HighQuality	
lato	I-Premise	HighQuality	
sinistro,	I-Premise	HighQuality	
spostamento	I-Premise	HighQuality	
del	I-Premise	HighQuality	
mediastino	I-Premise	HighQuality	
e	I-Premise	HighQuality	
della	I-Premise	HighQuality	
trachea	I-Premise	HighQuality	
sul	I-Premise	HighQuality	
lato	I-Premise	HighQuality	
destro	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un	I-Premise	HighQuality	
moncone	I-Premise	HighQuality	
nell'ilo	I-Premise	HighQuality	
polmonare	I-Premise	HighQuality	
sinistro	I-Premise	HighQuality	
corrispondente	I-Premise	HighQuality	
al	I-Premise	HighQuality	
polmone	I-Premise	HighQuality	
collassato.	I-Premise	HighQuality	

Il	B-Claim	HighQuality	
sospetto	I-Claim	HighQuality	
di	I-Claim	HighQuality	
HIV	I-Claim	HighQuality	
è	I-Claim	HighQuality	
elevato	I-Claim	HighQuality	
e,	O		
sebbene	B-Claim	HighQuality	
sia	I-Claim	HighQuality	
in	I-Claim	HighQuality	
attesa	I-Claim	HighQuality	
di	I-Claim	HighQuality	
conferma,	I-Claim	HighQuality	
nell'emergenza	I-Claim	HighQuality	
è	I-Claim	HighQuality	
valido	I-Claim	HighQuality	
ipotizzare	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
opzione.	I-Claim	HighQuality	

Detto	B-Claim	HighQuality	
questo,	I-Claim	HighQuality	
sto	I-Claim	HighQuality	
cercando	I-Claim	HighQuality	
patologie	I-Claim	HighQuality	
che	I-Claim	HighQuality	
si	I-Claim	HighQuality	
associno	I-Claim	HighQuality	
a	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
quadro,	I-Claim	HighQuality	
la	B-Claim	HighQuality	
rottura	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
bulla	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
se	I-Claim	HighQuality	
è	I-Claim	HighQuality	
correlata	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
comparsa	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
improvvisi	I-Claim	HighQuality	
non	I-Claim	HighQuality	
va	I-Claim	HighQuality	
di	I-Claim	HighQuality	
pari	I-Claim	HighQuality	
passo	I-Claim	HighQuality	
con	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
altri	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
(bisogna	B-Claim	HighQuality	
cercare	I-Claim	HighQuality	
qualcosa	I-Claim	HighQuality	
che	I-Claim	HighQuality	
spieghi	I-Claim	HighQuality	
tutto	I-Claim	HighQuality	
o	I-Claim	HighQuality	
quasi),	I-Claim	HighQuality	
la	B-Claim	HighQuality	
polmonite	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
se	I-Claim	HighQuality	
è	I-Claim	HighQuality	
vero	I-Claim	HighQuality	
che	I-Claim	HighQuality	
può	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
correlata	I-Claim	HighQuality	
a	I-Claim	HighQuality	
molti	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
non	I-Claim	HighQuality	
si	I-Claim	HighQuality	
correla	I-Claim	HighQuality	
con	I-Claim	HighQuality	
il	I-Claim	HighQuality	
quadro,	I-Claim	HighQuality	
La	B-Claim	HighQuality	
TBC	I-Claim	HighQuality	
polmonare	I-Claim	HighQuality	
potrebbe	I-Claim	HighQuality	
manifestarsi	I-Claim	HighQuality	
con	I-Claim	HighQuality	
tutti	I-Claim	HighQuality	
i	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
sopra	I-Claim	HighQuality	
elencati	I-Claim	HighQuality	
e	I-Claim	HighQuality	
causare	I-Claim	HighQuality	
uno	I-Claim	HighQuality	
pneumotorace,	I-Claim	HighQuality	
ma	O		
in	O		
questo	O		
caso,	O		
in	O		
un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
quadro	I-Premise	HighQuality	
respiratorio	I-Premise	HighQuality	
con	I-Premise	HighQuality	
più	I-Premise	HighQuality	
di	I-Premise	HighQuality	
7	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
di	I-Premise	HighQuality	
evoluzione	I-Premise	HighQuality	
che	I-Premise	HighQuality	
si	I-Premise	HighQuality	
complica	I-Premise	HighQuality	
bruscamente,	I-Premise	HighQuality	
in	O		
un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
elevato	I-Premise	HighQuality	
sospetto	I-Premise	HighQuality	
di	I-Premise	HighQuality	
infezione	I-Premise	HighQuality	
da	I-Premise	HighQuality	
HIV,	I-Premise	HighQuality	
l'opzione	B-Claim	HighQuality	
più	I-Claim	HighQuality	
chiara	I-Claim	HighQuality	
è	I-Claim	HighQuality	
la	I-Claim	HighQuality	
polmonite	I-Claim	HighQuality	
da	I-Claim	HighQuality	
P.	I-Claim	HighQuality	
jirovecii.	I-Claim	HighQuality	
polmonite	I-Claim	HighQuality	
da	I-Claim	HighQuality	
P.	I-Claim	HighQuality	
jirovecii.	I-Claim	HighQuality	

Nel	B-Claim	HighQuality	
10%	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
affetti	I-Claim	HighQuality	
da	I-Claim	HighQuality	
Pneumocystis	I-Claim	HighQuality	
si	I-Claim	HighQuality	
sviluppano	I-Claim	HighQuality	
pneumatoceli,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
talvolta	I-Claim	HighQuality	
possono	I-Claim	HighQuality	
aprirsi	I-Claim	HighQuality	
nello	I-Claim	HighQuality	
spazio	I-Claim	HighQuality	
pleurico	I-Claim	HighQuality	
portando	I-Claim	HighQuality	
a	I-Claim	HighQuality	
uno	I-Claim	HighQuality	
pneumotorace	I-Claim	HighQuality	
spontaneo.	I-Claim	HighQuality	

Come	B-Claim	HighQuality	
promemoria,	I-Claim	HighQuality	
i	I-Claim	HighQuality	
germi	I-Claim	HighQuality	
più	I-Claim	HighQuality	
frequenti	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
coinvolgimento	I-Claim	HighQuality	
polmonare	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
con	I-Claim	HighQuality	
infezione	I-Claim	HighQuality	
da	I-Claim	HighQuality	
HIV/AIDS	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
P.	I-Claim	HighQuality	
jiroveci	I-Claim	HighQuality	
(da	I-Claim	HighQuality	
solo	I-Claim	HighQuality	
o	I-Claim	HighQuality	
in	I-Claim	HighQuality	
associazione	I-Claim	HighQuality	
con	I-Claim	HighQuality	
la	I-Claim	HighQuality	
tubercolosi	I-Claim	HighQuality	
o	I-Claim	HighQuality	
altri	I-Claim	HighQuality	
micobatteri),	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	
stafilococchi	I-Claim	HighQuality	
e	I-Claim	HighQuality	
bacilli	I-Claim	HighQuality	
gram-negativi	I-Claim	HighQuality	
(Pseudomonas).	I-Claim	HighQuality	

I	B-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
con	I-Claim	HighQuality	
polmonite	I-Claim	HighQuality	
da	I-Claim	HighQuality	
P.	I-Claim	HighQuality	
jirovecii	I-Claim	HighQuality	
hanno	I-Claim	HighQuality	
una	I-Claim	HighQuality	
conta	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
CD4	I-Claim	HighQuality	
inferiore	I-Claim	HighQuality	
a	I-Claim	HighQuality	
250	I-Claim	HighQuality	
cellule/mL	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
90%	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
casi.	I-Claim	HighQuality	

Altri	O		
agenti	O		
che	O		
possono	O		
causare	O		
un	O		
coinvolgimento	O		
polmonare	O		
meno	O		
frequentemente	O		
sono	O		
Rhodococcus	O		
equi,	O		
Nocardia,	O		
Aspergillus,	O		
Cryptococcus,	O		
Toxoplasma	O		
e	O		
Leishmania.	O		

Sebbene	O		
la	O		
frequenza	O		
di	O		
diverse	O		
infezioni	O		
opportunistiche	O		
sia	O		
variata	O		
in	O		
seguito	O		
alla	O		
somministrazione	O		
di	O		
trattamenti	O		
antiretrovirali	O		
altamente	O		
efficaci,	O		
il	O		
nostro	O		
paziente	O		
si	O		
troverebbe	O		
in	O		
un	O		
contesto	O		
in	O		
cui	O		
non	O		
ha	O		
ancora	O		
ricevuto	O		
la	O		
HAART.	O		

QUESTION	O		
TYPE:	O		
MALATTIE	O		
INFETTIVE	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
58	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
riferito	I-Premise	HighQuality	
una	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
settimane	I-Premise	HighQuality	
di	I-Premise	HighQuality	
lesioni	I-Premise	HighQuality	
cutanee	I-Premise	HighQuality	
progressive	I-Premise	HighQuality	
e	I-Premise	HighQuality	
lievemente	I-Premise	HighQuality	
dolorose	I-Premise	HighQuality	
sul	I-Premise	HighQuality	
braccio	I-Premise	HighQuality	
sinistro.	I-Premise	HighQuality	

Era	B-Premise	HighQuality	
iniziata	I-Premise	HighQuality	
come	I-Premise	HighQuality	
una	I-Premise	HighQuality	
lesione	I-Premise	HighQuality	
eritematosa	I-Premise	HighQuality	
sul	I-Premise	HighQuality	
pollice	I-Premise	HighQuality	
sinistro.	I-Premise	HighQuality	

Le	B-Premise	HighQuality	
striature	I-Premise	HighQuality	
rossastre	I-Premise	HighQuality	
erano	I-Premise	HighQuality	
visibili	I-Premise	HighQuality	
come	I-Premise	HighQuality	
linee	I-Premise	HighQuality	
di	I-Premise	HighQuality	
collegamento	I-Premise	HighQuality	
tra	I-Premise	HighQuality	
le	I-Premise	HighQuality	
lesioni.	I-Premise	HighQuality	

Il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
non	I-Premise	HighQuality	
aveva	I-Premise	HighQuality	
febbre	I-Premise	HighQuality	
né	I-Premise	HighQuality	
altri	I-Premise	HighQuality	
sintomi	I-Premise	HighQuality	
generali.	I-Premise	HighQuality	

Aveva	B-Premise	HighQuality	
lavorato	I-Premise	HighQuality	
nel	I-Premise	HighQuality	
suo	I-Premise	HighQuality	
giardino,	I-Premise	HighQuality	
ma	I-Premise	HighQuality	
non	I-Premise	HighQuality	
ricordava	I-Premise	HighQuality	
di	I-Premise	HighQuality	
essersi	I-Premise	HighQuality	
ferito.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
diagnosi	I-Premise	HighQuality	
eziologica	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
fatta	I-Premise	HighQuality	
tramite	I-Premise	HighQuality	
la	I-Premise	HighQuality	
coltura	I-Premise	HighQuality	
di	I-Premise	HighQuality	
una	I-Premise	HighQuality	
biopsia	I-Premise	HighQuality	
cutanea.	I-Premise	HighQuality	

Qual	O		
è	O		
l'agente	O		
causale	O		
più	O		
probabile	O		
di	O		
questo	O		
processo?	O		

1-	O		
Dermatofitosi	B-Claim	HighQuality	
dovuta	I-Claim	HighQuality	
a	I-Claim	HighQuality	
Microsporum	I-Claim	HighQuality	
gypseum.	I-Claim	HighQuality	

2-	O		
Infezione	B-Claim	HighQuality	
cutanea	I-Claim	HighQuality	
da	I-Claim	HighQuality	
Staphylococcus	I-Claim	HighQuality	
aureus.	I-Claim	HighQuality	

3-	O		
Sporotricosi.	B-Claim	HighQuality	

4-	O		
Infezione	B-Claim	HighQuality	
cutanea	I-Claim	HighQuality	
da	I-Claim	HighQuality	
Mycobacterium	I-Claim	HighQuality	
marinum.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
svolge	I-Premise	HighQuality	
un'attività	I-Premise	HighQuality	
a	I-Premise	HighQuality	
contatto	I-Premise	HighQuality	
con	I-Premise	HighQuality	
il	I-Premise	HighQuality	
suolo	I-Premise	HighQuality	
e	I-Premise	HighQuality	
le	I-Premise	HighQuality	
piante	I-Premise	HighQuality	
(che	I-Premise	HighQuality	
non	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
fornite	I-Premise	HighQuality	
gratuitamente).	I-Premise	HighQuality	

I	B-Premise	HighQuality	
sintomi	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
cronici,	I-Premise	HighQuality	
iniziano	I-Premise	HighQuality	
distalmente	I-Premise	HighQuality	
(pollice	I-Premise	HighQuality	
sinistro)	I-Premise	HighQuality	
e	I-Premise	HighQuality	
interessano	I-Premise	HighQuality	
progressivamente	I-Premise	HighQuality	
il	I-Premise	HighQuality	
braccio	I-Premise	HighQuality	
omolaterale	I-Premise	HighQuality	
(strie	I-Premise	HighQuality	
rossastre).	I-Premise	HighQuality	

Non	B-Premise	HighQuality	
sono	I-Premise	HighQuality	
stati	I-Premise	HighQuality	
riscontrati	I-Premise	HighQuality	
sintomi	I-Premise	HighQuality	
sistemici.	I-Premise	HighQuality	

Commentano	B-Premise	HighQuality	
inoltre	I-Premise	HighQuality	
che	I-Premise	HighQuality	
la	I-Premise	HighQuality	
diagnosi	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
fatta	I-Premise	HighQuality	
sulla	I-Premise	HighQuality	
base	I-Premise	HighQuality	
di	I-Premise	HighQuality	
una	I-Premise	HighQuality	
biopsia	I-Premise	HighQuality	
cutanea.	I-Premise	HighQuality	

Dei	B-Claim	HighQuality	
microrganismi	I-Claim	HighQuality	
citati,	I-Claim	HighQuality	
Microsporum	I-Claim	HighQuality	
gypseum	I-Claim	HighQuality	
non	I-Claim	HighQuality	
manifesta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
solito	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diffusione	I-Claim	HighQuality	
dell'infezione	I-Claim	HighQuality	
in	I-Claim	HighQuality	
un	I-Claim	HighQuality	
aspetto	I-Claim	HighQuality	
linfangitico,	I-Claim	HighQuality	
in	B-Claim	HighQuality	
generale	I-Claim	HighQuality	
i	I-Claim	HighQuality	
funghi	I-Claim	HighQuality	
cheratinofili	I-Claim	HighQuality	
(dermatofiti)	I-Claim	HighQuality	
non	I-Claim	HighQuality	
hanno	I-Claim	HighQuality	
la	I-Claim	HighQuality	
capacità	I-Claim	HighQuality	
di	I-Claim	HighQuality	
invadere	I-Claim	HighQuality	
i	I-Claim	HighQuality	
tessuti	I-Claim	HighQuality	
profondi,	I-Claim	HighQuality	
quindi	O		
scartiamo	B-Claim	HighQuality	
questa	I-Claim	HighQuality	
opzione.	I-Claim	HighQuality	

L'infezione	B-Claim	LowQuality	
da	I-Claim	LowQuality	
Staphylococcus	I-Claim	LowQuality	
aureus	I-Claim	LowQuality	
può	I-Claim	LowQuality	
colpire	I-Claim	LowQuality	
gli	I-Claim	LowQuality	
strati	I-Claim	LowQuality	
tissutali	I-Claim	LowQuality	
superficiali	I-Claim	LowQuality	
e	I-Claim	LowQuality	
profondi,	I-Claim	LowQuality	
può	I-Claim	LowQuality	
diffondersi	I-Claim	LowQuality	
seguendo	I-Claim	LowQuality	
una	I-Claim	LowQuality	
via	I-Claim	LowQuality	
linfangitica,	I-Claim	LowQuality	
ma	I-Claim	LowQuality	
un	I-Claim	LowQuality	
decorso	I-Claim	LowQuality	
così	I-Claim	LowQuality	
lungo	I-Claim	LowQuality	
non	I-Claim	LowQuality	
è	I-Claim	LowQuality	
usuale,	I-Claim	LowQuality	
è	I-Claim	LowQuality	
solitamente	I-Claim	LowQuality	
acuto	I-Claim	LowQuality	corrected
(giorni)	I-Claim	LowQuality	
e	I-Claim	LowQuality	
di	I-Claim	LowQuality	
solito	I-Claim	LowQuality	
accompagnato	I-Claim	LowQuality	corrected
da	I-Claim	LowQuality	
sintomi	I-Claim	LowQuality	
sistemici,	I-Claim	LowQuality	
quindi	O		
scartiamo	B-Claim	LowQuality	
questa	I-Claim	LowQuality	
opzione.	I-Claim	LowQuality	

Il	B-Claim	HighQuality	
Mycobacterium	I-Claim	HighQuality	
marinum	I-Claim	HighQuality	
(e	I-Claim	HighQuality	
non	I-Claim	HighQuality	
il	I-Claim	HighQuality	
Mycobacterum	I-Claim	HighQuality	
marinum)	I-Claim	HighQuality	
è	I-Claim	HighQuality	
un	I-Claim	HighQuality	
micobatterio	I-Claim	HighQuality	
non	I-Claim	HighQuality	
tubercoloso	I-Claim	HighQuality	
caratterizzato	I-Claim	HighQuality	
come	I-Claim	HighQuality	
ambientale,	I-Claim	HighQuality	
opportunistico	I-Claim	HighQuality	
e	I-Claim	HighQuality	
fotocromogeno.	I-Claim	HighQuality	

Ha	B-Claim	HighQuality	
una	I-Claim	HighQuality	
crescita	I-Claim	HighQuality	
lenta,	I-Claim	HighQuality	
da	I-Claim	HighQuality	
2	I-Claim	HighQuality	
a	I-Claim	HighQuality	
8	I-Claim	HighQuality	
settimane,	I-Claim	HighQuality	
ad	I-Claim	HighQuality	
una	I-Claim	HighQuality	
temperatura	I-Claim	HighQuality	
compresa	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
30	I-Claim	HighQuality	
e	I-Claim	HighQuality	
37	I-Claim	HighQuality	
°C.	I-Claim	HighQuality	

Colpisce	B-Claim	HighQuality	
diverse	I-Claim	HighQuality	
specie	I-Claim	HighQuality	
di	I-Claim	HighQuality	
pesci	I-Claim	HighQuality	
in	I-Claim	HighQuality	
acque	I-Claim	HighQuality	
fredde,	I-Claim	HighQuality	
calde,	I-Claim	HighQuality	
dolci	I-Claim	HighQuality	
o	I-Claim	HighQuality	
salate,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
particolare	I-Claim	HighQuality	
l'acqua	I-Claim	HighQuality	
stagnante	I-Claim	HighQuality	
di	I-Claim	HighQuality	
vasche	I-Claim	HighQuality	
e	I-Claim	HighQuality	
piscine	I-Claim	HighQuality	
senza	I-Claim	HighQuality	
cloro.	I-Claim	HighQuality	

L'infezione	B-Claim	HighQuality	
nell'uomo	I-Claim	HighQuality	
avviene	I-Claim	HighQuality	
attraverso	I-Claim	HighQuality	
il	I-Claim	HighQuality	
contatto	I-Claim	HighQuality	
diretto	I-Claim	HighQuality	
con	I-Claim	HighQuality	
il	I-Claim	HighQuality	
pesce	I-Claim	HighQuality	
o	I-Claim	HighQuality	
con	I-Claim	HighQuality	
l'acqua	I-Claim	HighQuality	
contaminata	I-Claim	HighQuality	
in	I-Claim	HighQuality	
presenza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
perdita	I-Claim	HighQuality	
di	I-Claim	HighQuality	
continuità	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pelle	I-Claim	HighQuality	
dell'ospite.	I-Claim	HighQuality	

Il	B-Premise	HighQuality	
nostro	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
non	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
un'anamnesi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
esposizione	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pesce	I-Premise	HighQuality	
o	I-Premise	HighQuality	
all'acqua	I-Premise	HighQuality	
(non	I-Premise	HighQuality	
lo	I-Premise	HighQuality	
dicono),	I-Premise	HighQuality	
quindi	O		
considerando	B-Claim	HighQuality	
che	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
si	I-Claim	HighQuality	
basa	I-Claim	HighQuality	
solitamente	I-Claim	HighQuality	
su	I-Claim	HighQuality	
un	I-Claim	HighQuality	
alto	I-Claim	HighQuality	
indice	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sospetto	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
richiesta	I-Claim	HighQuality	
specifica	I-Claim	HighQuality	
di	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
anamnesi,	I-Claim	HighQuality	
il	I-Claim	HighQuality	
nostro	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
è	I-Claim	HighQuality	
lontano	I-Claim	HighQuality	
da	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
possibilità.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
complesso	I-Claim	HighQuality	
Sporothrix	I-Claim	HighQuality	
schenckii	I-Claim	HighQuality	
è	I-Claim	HighQuality	
l'agente	I-Claim	HighQuality	
causale	I-Claim	HighQuality	
della	I-Claim	HighQuality	
sporotricosi;	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
fungo	I-Claim	HighQuality	
dimorfico	I-Claim	HighQuality	
si	I-Claim	HighQuality	
trova	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
suolo;	I-Claim	HighQuality	
il	I-Claim	HighQuality	
complesso	I-Claim	HighQuality	
è	I-Claim	HighQuality	
composto	I-Claim	HighQuality	
da	I-Claim	HighQuality	
5	I-Claim	HighQuality	
specie,	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	
e	I-Claim	HighQuality	
S.	I-Claim	HighQuality	
globosa,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
grado	I-Claim	HighQuality	
di	I-Claim	HighQuality	
causare	I-Claim	HighQuality	
malattie	I-Claim	HighQuality	
umane	I-Claim	HighQuality	
e	I-Claim	HighQuality	
animali;	I-Claim	HighQuality	
le	I-Claim	HighQuality	
altre	I-Claim	HighQuality	
due	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
S.	I-Claim	HighQuality	
mexicana	I-Claim	HighQuality	
e	I-Claim	HighQuality	
S.	I-Claim	HighQuality	
albicana	I-Claim	HighQuality	
non	I-Claim	HighQuality	
associate	I-Claim	HighQuality	
ad	I-Claim	HighQuality	
alcuna	I-Claim	HighQuality	
malattia.	I-Claim	HighQuality	

I	B-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
solitamente	I-Claim	HighQuality	
infettati	I-Claim	HighQuality	
dall'esposizione	I-Claim	HighQuality	
al	I-Claim	HighQuality	
suolo	I-Claim	HighQuality	
attraverso	I-Claim	HighQuality	
un	I-Claim	HighQuality	
oggetto	I-Claim	HighQuality	
tagliente	I-Claim	HighQuality	
(spine,	I-Claim	HighQuality	
steli,	I-Claim	HighQuality	
artigli	I-Claim	HighQuality	
di	I-Claim	HighQuality	
animali,	I-Claim	HighQuality	
ecc.)	I-Claim	HighQuality	
e	I-Claim	HighQuality	
hanno	I-Claim	HighQuality	
un	I-Claim	HighQuality	
decorso	I-Claim	HighQuality	
lento,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
un	I-Claim	HighQuality	
coinvolgimento	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
tessuti	I-Claim	HighQuality	
profondi	I-Claim	HighQuality	
e	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diffusione	I-Claim	HighQuality	
segue	I-Claim	HighQuality	
tipicamente	I-Claim	HighQuality	
un	I-Claim	HighQuality	
percorso	I-Claim	HighQuality	
come	I-Claim	HighQuality	
descritto	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
domanda.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
MALATTIE	O		
INFETTIVE	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
46	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
consumatore	I-Premise	HighQuality	
di	I-Premise	HighQuality	
droghe	I-Premise	HighQuality	
per	I-Premise	HighQuality	
via	I-Premise	HighQuality	
parenterale,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
febbre	I-Premise	HighQuality	
con	I-Premise	HighQuality	
brividi,	I-Premise	HighQuality	
confusione	I-Premise	HighQuality	
mentale,	I-Premise	HighQuality	
mialgie	I-Premise	HighQuality	
diffuse	I-Premise	HighQuality	
e	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
intenso	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
mano	I-Premise	HighQuality	
sinistra	I-Premise	HighQuality	
per	I-Premise	HighQuality	
24	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
chiari	I-Premise	HighQuality	
segni	I-Premise	HighQuality	
locali	I-Premise	HighQuality	
di	I-Premise	HighQuality	
flogosi.	I-Premise	HighQuality	

Non	B-Premise	HighQuality	
fa	I-Premise	HighQuality	
riferimento	I-Premise	HighQuality	
ad	I-Premise	HighQuality	
alcuna	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
traumatica.	I-Premise	HighQuality	

All'esame:	B-Premise	HighQuality	
temperatura	I-Premise	HighQuality	
38,9°C,	I-Premise	HighQuality	
120	I-Premise	HighQuality	
battiti	I-Premise	HighQuality	
al	I-Premise	HighQuality	
minuto,	I-Premise	HighQuality	
frequenza	I-Premise	HighQuality	
respiratoria	I-Premise	HighQuality	
30/min,	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
90/54	I-Premise	HighQuality	
mm	I-Premise	HighQuality	
Hg.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
esami	I-Premise	HighQuality	
di	I-Premise	HighQuality	
laboratorio	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
leucocitosi	I-Premise	HighQuality	
con	I-Premise	HighQuality	
spostamento	I-Premise	HighQuality	
a	I-Premise	HighQuality	
sinistra	I-Premise	HighQuality	
(25.000	I-Premise	HighQuality	
leucociti/mm3,	I-Premise	HighQuality	
80%	I-Premise	HighQuality	
neutrofili);	I-Premise	HighQuality	
aumento	I-Premise	HighQuality	
della	I-Premise	HighQuality	
creatinina	I-Premise	HighQuality	
(1,6	I-Premise	HighQuality	
mg/dL)	I-Premise	HighQuality	
e	I-Premise	HighQuality	
della	I-Premise	HighQuality	
CK	I-Premise	HighQuality	
(138	I-Premise	HighQuality	
U/L).	I-Premise	HighQuality	

Quale	O		
delle	O		
seguenti	O		
è	O		
la	O		
diagnosi	O		
più	O		
probabile?	O		

1-	O		
Fascite	B-Claim	HighQuality	
necrotizzante	I-Claim	HighQuality	
streptococcica.	I-Claim	HighQuality	

2-	O		
Gangrena	B-Claim	HighQuality	
dovuta	I-Claim	HighQuality	
a	I-Claim	HighQuality	
Clostridium	I-Claim	HighQuality	
spp.	I-Claim	HighQuality	

3-	O		
Cellulite	B-Claim	HighQuality	
dovuta	I-Claim	HighQuality	
a	I-Claim	HighQuality	
micobatteri.	I-Claim	HighQuality	

4-	O		
Paletta	B-Claim	LowQuality	
speciale.	I-Claim	LowQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
1	O		

Ho	B-Claim	HighQuality	
dei	I-Claim	HighQuality	
dubbi	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
il	I-Claim	HighQuality	
primo	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
secondo;	I-Claim	HighQuality	
eccezionalmente	B-Claim	HighQuality	
il	I-Claim	HighQuality	
C.	I-Claim	HighQuality	
botulinum	I-Claim	HighQuality	
può	I-Claim	HighQuality	
infettare	I-Claim	HighQuality	
ferite	I-Claim	HighQuality	
traumatiche	I-Claim	HighQuality	
o	I-Claim	HighQuality	
da	I-Claim	HighQuality	
puntura	I-Claim	HighQuality	
in	I-Claim	HighQuality	
UDVP	I-Claim	HighQuality	
che	I-Claim	HighQuality	
fanno	I-Claim	HighQuality	
uso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
eroina	I-Claim	HighQuality	
brown	I-Claim	HighQuality	
o	I-Claim	HighQuality	
causare	I-Claim	HighQuality	
sinusiti	I-Claim	HighQuality	
in	I-Claim	HighQuality	
cocainomani.	I-Claim	HighQuality	

D'altra	B-Claim	HighQuality	
parte,	I-Claim	HighQuality	
il	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
può	I-Claim	HighQuality	
riferirsi	I-Claim	HighQuality	
a	I-Claim	HighQuality	
una	I-Claim	HighQuality	
sepsi	I-Claim	HighQuality	
grave	I-Claim	HighQuality	
con	I-Claim	HighQuality	
manifestazioni	I-Claim	HighQuality	
iniziali	I-Claim	HighQuality	
scarse	I-Claim	HighQuality	
a	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
vista,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
rabdomiolisi	I-Claim	HighQuality	
incipiente	I-Claim	HighQuality	
e	I-Claim	HighQuality	
dolore	I-Claim	HighQuality	
muscolare;	I-Claim	HighQuality	
in	B-Claim	HighQuality	
questo	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
potrebbe	I-Claim	HighQuality	
trattarsi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
fascite	I-Claim	HighQuality	
necrotizzante,	I-Claim	HighQuality	
dove	I-Claim	HighQuality	
il	I-Claim	HighQuality	
germe	I-Claim	HighQuality	
più	I-Claim	HighQuality	
frequentemente	I-Claim	HighQuality	
coinvolto	I-Claim	HighQuality	
è	I-Claim	HighQuality	
S.	I-Claim	HighQuality	
pyogenes.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
REUMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Uomo	B-Premise	HighQuality	
di	I-Premise	HighQuality	
40	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
pregressa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
interesse,	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
un'artrite	I-Premise	HighQuality	
acuta	I-Premise	HighQuality	
del	I-Premise	HighQuality	
ginocchio	I-Premise	HighQuality	
destro	I-Premise	HighQuality	
della	I-Premise	HighQuality	
durata	I-Premise	HighQuality	
di	I-Premise	HighQuality	
5	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
e	I-Premise	HighQuality	
febbre	I-Premise	HighQuality	
fino	I-Premise	HighQuality	
a	I-Premise	HighQuality	
37,7	I-Premise	HighQuality	
°C.	I-Premise	HighQuality	

Nessuna	B-Premise	HighQuality	
storia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
traumi.	I-Premise	HighQuality	

Sono	B-Premise	HighQuality	
presenti	I-Premise	HighQuality	
versamento	I-Premise	HighQuality	
articolare,	I-Premise	HighQuality	
calore	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
palpazione	I-Premise	HighQuality	
e	I-Premise	HighQuality	
limitazione	I-Premise	HighQuality	
funzionale	I-Premise	HighQuality	
dovuta	I-Premise	HighQuality	
al	I-Premise	HighQuality	
dolore.	I-Premise	HighQuality	

È	B-Premise	HighQuality	
stata	I-Premise	HighQuality	
eseguita	I-Premise	HighQuality	
un'artrocentesi	I-Premise	HighQuality	
diagnostica	I-Premise	HighQuality	
che	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
30000	I-Premise	HighQuality	
cellule/microlitro	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
predominanza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
neutrofili.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
con	I-Premise	HighQuality	
luce	I-Premise	HighQuality	
polarizzata	I-Premise	HighQuality	
rivela	I-Premise	HighQuality	
cristalli	I-Premise	HighQuality	
romboidali	I-Premise	HighQuality	
e	I-Premise	HighQuality	
cilindrici	I-Premise	HighQuality	
con	I-Premise	HighQuality	
birifrangenza	I-Premise	HighQuality	
debolmente	I-Premise	HighQuality	
positiva.	I-Premise	HighQuality	

Le	B-Premise	HighQuality	
radiografie	I-Premise	HighQuality	
normali	I-Premise	HighQuality	
del	I-Premise	HighQuality	
ginocchio	I-Premise	HighQuality	
mostrano	I-Premise	HighQuality	
depositi	I-Premise	HighQuality	
radiodensi	I-Premise	HighQuality	
nel	I-Premise	HighQuality	
menisco	I-Premise	HighQuality	
esterno	I-Premise	HighQuality	
del	I-Premise	HighQuality	
ginocchio.	I-Premise	HighQuality	

Contrassegnare	O		
la	O		
risposta	O		
FALSA:	O		

1-	O		
Il	B-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
iniziale	I-Claim	HighQuality	
consiste	I-Claim	HighQuality	
in	I-Claim	HighQuality	
farmaci	I-Claim	HighQuality	
antinfiammatori	I-Claim	HighQuality	
non	I-Claim	HighQuality	
steroidei	I-Claim	HighQuality	
e	I-Claim	HighQuality	
nell'aspirazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
liquido	I-Claim	HighQuality	
sinoviale.	I-Claim	HighQuality	

2-	O		
È	B-Claim	HighQuality	
necessario	I-Claim	HighQuality	
eseguire	I-Claim	HighQuality	
una	I-Claim	HighQuality	
coltura	I-Claim	HighQuality	
del	I-Claim	HighQuality	
liquido	I-Claim	HighQuality	
sinoviale	I-Claim	HighQuality	
per	I-Claim	HighQuality	
escludere	I-Claim	HighQuality	
una	I-Claim	HighQuality	
sinovite	I-Claim	HighQuality	
infettiva.	I-Claim	HighQuality	

3-	O		
Una	B-Claim	HighQuality	
volta	I-Claim	HighQuality	
superata	I-Claim	HighQuality	
la	I-Claim	HighQuality	
riacutizzazione	I-Claim	HighQuality	
acuta,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
opportuno	I-Claim	HighQuality	
iniziare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
con	I-Claim	HighQuality	
allopurinolo	I-Claim	HighQuality	
per	I-Claim	HighQuality	
ridurre	I-Claim	HighQuality	
l'incidenza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
ulteriori	I-Claim	HighQuality	
riacutizzazioni	I-Claim	HighQuality	
dell'artrite	I-Claim	HighQuality	
in	I-Claim	HighQuality	
futuro.	I-Claim	HighQuality	

4-	O		
La	B-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
più	I-Claim	HighQuality	
probabile	I-Claim	HighQuality	
è	I-Claim	HighQuality	
quella	I-Claim	HighQuality	
di	I-Claim	HighQuality	
artrite	I-Claim	HighQuality	
acuta	I-Claim	HighQuality	
dovuta	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
deposizione	I-Claim	HighQuality	
di	I-Claim	HighQuality	
cristalli	I-Claim	HighQuality	
di	I-Claim	HighQuality	
pirofosfato	I-Claim	HighQuality	
di	I-Claim	HighQuality	
calcio	I-Claim	HighQuality	
(pseudogotta).	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Si	B-Claim	HighQuality	
tratta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
condrocalcinosi.	I-Claim	HighQuality	

Non	B-Claim	HighQuality	
esiste	I-Claim	HighQuality	
una	I-Claim	HighQuality	
cura	I-Claim	HighQuality	
per	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
malattia,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
solo	I-Claim	HighQuality	
un	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
per	I-Claim	HighQuality	
le	I-Claim	HighQuality	
riacutizzazioni	I-Claim	HighQuality	
(colchicina,	I-Claim	HighQuality	
FANS	I-Claim	HighQuality	
o	I-Claim	HighQuality	
corticosteroidi),	I-Claim	HighQuality	
anche	B-Claim	HighQuality	
se	I-Claim	HighQuality	
a	I-Claim	HighQuality	
volte,	I-Claim	HighQuality	
se	I-Claim	HighQuality	
le	I-Claim	HighQuality	
riacutizzazioni	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
regolari,	I-Claim	HighQuality	
si	I-Claim	HighQuality	
lascia	I-Claim	HighQuality	
la	I-Claim	HighQuality	
colchicina.	I-Claim	HighQuality	

L'allopurinolo	B-Claim	HighQuality	
non	I-Claim	HighQuality	
ha	I-Claim	HighQuality	
dimostrato	I-Claim	HighQuality	
alcuna	I-Claim	HighQuality	
efficacia	I-Claim	HighQuality	
in	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
artropatia	I-Claim	HighQuality	
da	I-Claim	HighQuality	
microcristalli,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
ha	I-Claim	HighQuality	
dimostrato	I-Claim	HighQuality	
efficacia	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
gotta.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
CURE	O		
CRITICHE,	O		
PALLIATIVE	O		
E	O		
DI	O		
EMERGENZA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
35	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
subisce	I-Premise	HighQuality	
un'ustione	I-Premise	HighQuality	
elettrica	I-Premise	HighQuality	
ad	I-Premise	HighQuality	
alta	I-Premise	HighQuality	
tensione	I-Premise	HighQuality	
(3000	I-Premise	HighQuality	
volt)	I-Premise	HighQuality	
a	I-Premise	HighQuality	
causa	I-Premise	HighQuality	
del	I-Premise	HighQuality	
contatto	I-Premise	HighQuality	
diretto	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
filo	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
mano	I-Premise	HighQuality	
sinistra.	I-Premise	HighQuality	

Al	B-Premise	HighQuality	
momento	I-Premise	HighQuality	
del	I-Premise	HighQuality	
ricovero,	I-Premise	HighQuality	
il	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
una	I-Premise	HighQuality	
contrattura	I-Premise	HighQuality	
in	I-Premise	HighQuality	
flessione	I-Premise	HighQuality	
della	I-Premise	HighQuality	
mano,	I-Premise	HighQuality	
pallore	I-Premise	HighQuality	
delle	I-Premise	HighQuality	
dita	I-Premise	HighQuality	
e	I-Premise	HighQuality	
assenza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
polso	I-Premise	HighQuality	
radiale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
ulnare	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
palpazione.	I-Premise	HighQuality	
Qual	O		
è	O		
la	O		
misura	O		
invasiva	O		
di	O		
emergenza	O		
da	O		
eseguire?	O		

1-	O		
Blocco	B-Claim	HighQuality	
ascellare	I-Claim	HighQuality	
con	I-Claim	HighQuality	
catetere.	I-Claim	HighQuality	

2-	O		
Scarotomia	B-Claim	HighQuality	
decompressiva.	I-Claim	HighQuality	

3-	O		
Monitoraggio	B-Claim	HighQuality	
della	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
intracompartimentale.	I-Claim	HighQuality	

4-	O		
Scarectomia.	B-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

I	O		
3	O		

In	B-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sospetta	I-Claim	HighQuality	
sindrome	I-Claim	HighQuality	
compartimentale,	I-Claim	HighQuality	
la	I-Claim	HighQuality	
misura	I-Claim	HighQuality	
d'emergenza	I-Claim	HighQuality	
invasiva	I-Claim	HighQuality	
da	I-Claim	HighQuality	
eseguire	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
quella	I-Claim	HighQuality	
di	I-Claim	HighQuality	
misurare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
intracompartimentale	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
a	I-Claim	HighQuality	
seconda	I-Claim	HighQuality	
del	I-Claim	HighQuality	
risultato,	I-Claim	HighQuality	
procedere	I-Claim	HighQuality	
con	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
ENDOCRINOLOGIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
35	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
si	I-Premise	HighQuality	
consulta	I-Premise	HighQuality	
per	I-Premise	HighQuality	
un	I-Premise	HighQuality	
nodulo	I-Premise	HighQuality	
tiroideo	I-Premise	HighQuality	
destro	I-Premise	HighQuality	
rilevato	I-Premise	HighQuality	
incidentalmente	I-Premise	HighQuality	
una	I-Premise	HighQuality	
mattina,	I-Premise	HighQuality	
quando	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
notato	I-Premise	HighQuality	
allo	I-Premise	HighQuality	
specchio	I-Premise	HighQuality	
un	I-Premise	HighQuality	
nodulo	I-Premise	HighQuality	
sulla	I-Premise	HighQuality	
faccia	I-Premise	HighQuality	
anteriore	I-Premise	HighQuality	
del	I-Premise	HighQuality	
collo.	I-Premise	HighQuality	

Dopo	B-Premise	HighQuality	
gli	I-Premise	HighQuality	
studi	I-Premise	HighQuality	
del	I-Premise	HighQuality	
caso,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
deciso	I-Premise	HighQuality	
di	I-Premise	HighQuality	
eseguire	I-Premise	HighQuality	
una	I-Premise	HighQuality	
tiroidectomia	I-Premise	HighQuality	
totale	I-Premise	HighQuality	
con	I-Premise	HighQuality	
asportazione	I-Premise	HighQuality	
della	I-Premise	HighQuality	
componente	I-Premise	HighQuality	
linfonodale	I-Premise	HighQuality	
centrale.	I-Premise	HighQuality	

Il	O		
referto	O		
del	O		
patologo	O		
parlava	O		
di	O		
un	B-Premise	HighQuality	
nodulo	I-Premise	HighQuality	
tiroideo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
2,3	I-Premise	HighQuality	
cm	I-Premise	HighQuality	
interamente	I-Premise	HighQuality	
occupato	I-Premise	HighQuality	
da	I-Premise	HighQuality	
un	I-Premise	HighQuality	
carcinoma	I-Premise	HighQuality	
papillare	I-Premise	HighQuality	
della	I-Premise	HighQuality	
tiroide,	I-Premise	HighQuality	
variante	I-Premise	HighQuality	
a	I-Premise	HighQuality	
cellule	I-Premise	HighQuality	
alte,	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
infiltrazione	I-Premise	HighQuality	
vascolare	I-Premise	HighQuality	
ma	I-Premise	HighQuality	
con	I-Premise	HighQuality	
infiltrazione	I-Premise	HighQuality	
capsulare.	I-Premise	HighQuality	

Le	B-Premise	HighQuality	
concentrazioni	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tireoglobulina	I-Premise	HighQuality	
24	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
la	I-Premise	HighQuality	
tiroidectomia	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
di	I-Premise	HighQuality	
14	I-Premise	HighQuality	
ng/mL.	I-Premise	HighQuality	

Quale	O		
sarebbe	O		
il	O		
prossimo	O		
passo	O		
da	O		
fare	O		
con	O		
questo	O		
paziente?	O		

1-	O		
Rimandare	B-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
al	I-Claim	HighQuality	
chirurgo	I-Claim	HighQuality	
per	I-Claim	HighQuality	
eseguire	I-Claim	HighQuality	
un	I-Claim	HighQuality	
drenaggio	I-Claim	HighQuality	
linfonodale	I-Claim	HighQuality	
laterocervicale	I-Claim	HighQuality	
destro.	I-Claim	HighQuality	

2-	O		
Iniziare	B-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
dose	I-Claim	HighQuality	
di	I-Claim	HighQuality	
levotiroxina	I-Claim	HighQuality	
soppressiva	I-Claim	HighQuality	
del	I-Claim	HighQuality	
TSH	I-Claim	HighQuality	
e	I-Claim	HighQuality	
programmare	I-Claim	HighQuality	
una	I-Claim	HighQuality	
revisione	I-Claim	HighQuality	
6	I-Claim	HighQuality	
mesi	I-Claim	HighQuality	
dopo	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
nuova	I-Claim	HighQuality	
determinazione	I-Claim	HighQuality	
analitica	I-Claim	HighQuality	
della	I-Claim	HighQuality	
tireoglobulina	I-Claim	HighQuality	
e	I-Claim	HighQuality	
un'ecografia	I-Claim	HighQuality	
cervicale.	I-Claim	HighQuality	

3-	O		
Richiedere	B-Claim	HighQuality	
una	I-Claim	HighQuality	
PET-TC	I-Claim	HighQuality	
per	I-Claim	HighQuality	
verificare	I-Claim	HighQuality	
l'eventuale	I-Claim	HighQuality	
coinvolgimento	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
linfonodi.	I-Claim	HighQuality	

4-	O		
Ritardare	B-Claim	HighQuality	
l'inizio	I-Claim	HighQuality	
del	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
sostitutivo	I-Claim	HighQuality	
del	I-Claim	HighQuality	
TSH	I-Claim	HighQuality	
con	I-Claim	HighQuality	
levotiroxina	I-Claim	HighQuality	
e	I-Claim	HighQuality	
indirizzare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
al	I-Claim	HighQuality	
reparto	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Medicina	I-Claim	HighQuality	
Nucleare	I-Claim	HighQuality	
per	I-Claim	HighQuality	
la	I-Claim	HighQuality	
somministrazione	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
dose	I-Claim	HighQuality	
ablativa	I-Claim	HighQuality	
di	I-Claim	HighQuality	
100	I-Claim	HighQuality	
mCi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
I131.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
4	O		

L'analisi	O		
della	O		
tireoglobulina	O		
nel	O		
sangue	O		
e	O		
lo	O		
sviluppo	O		
di	O		
tecniche	O		
per	O		
la	O		
sua	O		
determinazione	O		
hanno	O		
fornito	O		
una	O		
nuova	O		
procedura	O		
per	O		
il	O		
monitoraggio	O		
dei	O		
pazienti	O		
con	O		
carcinoma	O		
papillare	O		
o	O		
follicolare	O		
della	O		
tiroide.	O		

La	B-Claim	HighQuality	
tireoglobulina	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
sintetizzata	I-Claim	HighQuality	
nelle	I-Claim	HighQuality	
cellule	I-Claim	HighQuality	
follicolari	I-Claim	HighQuality	
e	I-Claim	HighQuality	
poi	I-Claim	HighQuality	
secreta	I-Claim	HighQuality	
in	I-Claim	HighQuality	
circolo,	I-Claim	HighQuality	
pertanto	B-Claim	HighQuality	
dopo	I-Claim	HighQuality	
la	I-Claim	HighQuality	
tiroidectomia	I-Claim	HighQuality	
totale	I-Claim	HighQuality	
dovrebbe	I-Claim	HighQuality	
scomparire;	I-Claim	HighQuality	
se	O		
ciò	O		
non	O		
avviene,	O		
si	O		
deve	O		
considerare	O		
l'esistenza	O		
di	O		
resti	O		
di	O		
tessuto	O		
metastatico.	O		

QUESTION	O		
TYPE:	O		
GINECOLOGIA	O		
E	O		
OSTETRICIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
20	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
tumore	I-Premise	HighQuality	
ovarico	I-Premise	HighQuality	
solido-cistico	I-Premise	HighQuality	
di	I-Premise	HighQuality	
15	I-Premise	HighQuality	
cm	I-Premise	HighQuality	
rilevato	I-Premise	HighQuality	
con	I-Premise	HighQuality	
l'ecografia	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
aver	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
sintomi	I-Premise	HighQuality	
addominali	I-Premise	HighQuality	
non	I-Premise	HighQuality	
specifici.	I-Premise	HighQuality	

Nello	B-Premise	HighQuality	
studio	I-Premise	HighQuality	
istopatologico	I-Premise	HighQuality	
del	I-Premise	HighQuality	
campione	I-Premise	HighQuality	
corrispondente,	I-Premise	HighQuality	
in	I-Premise	HighQuality	
diversi	I-Premise	HighQuality	
preparati	I-Premise	HighQuality	
istologici	I-Premise	HighQuality	
si	I-Premise	HighQuality	
trovano	I-Premise	HighQuality	
denti,	I-Premise	HighQuality	
peli,	I-Premise	HighQuality	
aree	I-Premise	HighQuality	
di	I-Premise	HighQuality	
epitelio	I-Premise	HighQuality	
intestinale,	I-Premise	HighQuality	
aree	I-Premise	HighQuality	
di	I-Premise	HighQuality	
epitelio	I-Premise	HighQuality	
squamoso	I-Premise	HighQuality	
(15%)	I-Premise	HighQuality	
e	I-Premise	HighQuality	
di	I-Premise	HighQuality	
epitelio	I-Premise	HighQuality	
bronchiale,	I-Premise	HighQuality	
nonché	I-Premise	HighQuality	
elementi	I-Premise	HighQuality	
neuroectodermici	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
embrionali.	I-Premise	HighQuality	

Con	O		
riferimento	O		
a	O		
questo	O		
caso,	O		
indicare	O		
la	O		
diagnosi	O		
corretta:	O		

1-	O		
Teratocarcinoma.	B-Claim	HighQuality	

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

3-	O		
Teratoma	B-Claim	HighQuality	
cistico	I-Claim	HighQuality	
maturo.	I-Claim	HighQuality	

4-	O		
Disgerminoma.	B-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

La	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
3,	I-Claim	HighQuality	
teratoma	I-Claim	HighQuality	
cistico	I-Claim	HighQuality	
maturo.	I-Claim	HighQuality	

Ciò	B-Claim	HighQuality	
è	I-Claim	HighQuality	
dovuto	I-Claim	HighQuality	
alle	I-Claim	HighQuality	
caratteristiche	I-Claim	HighQuality	
specifiche	I-Claim	HighQuality	
del	I-Claim	HighQuality	
tumore:	I-Claim	HighQuality	
i	I-Claim	HighQuality	
teratomi	I-Claim	HighQuality	
maturi	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
costituiti	I-Claim	HighQuality	
da	I-Claim	HighQuality	
tessuti	I-Claim	HighQuality	
adulti	I-Claim	HighQuality	
provenienti	I-Claim	HighQuality	
dai	I-Claim	HighQuality	
tre	I-Claim	HighQuality	
foglietti	I-Claim	HighQuality	
embrionali,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
netta	I-Claim	HighQuality	
predominanza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
elementi	I-Claim	HighQuality	
ectodermici	I-Claim	HighQuality	
(epidermide,	I-Claim	HighQuality	
strutture	I-Claim	HighQuality	
pilosebacee	I-Claim	HighQuality	
e	I-Claim	HighQuality	
tessuto	I-Claim	HighQuality	
neurale).	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
teratoma	I-Claim	HighQuality	
maturo	I-Claim	HighQuality	
è	I-Claim	HighQuality	
un	I-Claim	HighQuality	
tumore	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
cellule	I-Claim	HighQuality	
germinali	I-Claim	HighQuality	
ovariche.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
GINECOLOGIA	O		
E	O		
OSTETRICIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
incinta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
10	I-Premise	HighQuality	
settimane	I-Premise	HighQuality	
di	I-Premise	HighQuality	
gestazione	I-Premise	HighQuality	
si	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
160/105	I-Premise	HighQuality	
mmHg.	I-Premise	HighQuality	

Buone	B-Premise	HighQuality	
condizioni	I-Premise	HighQuality	
generali,	I-Premise	HighQuality	
solo	I-Premise	HighQuality	
un	I-Premise	HighQuality	
leggero	I-Premise	HighQuality	
mal	I-Premise	HighQuality	
di	I-Premise	HighQuality	
testa,	I-Premise	HighQuality	
per	I-Premise	HighQuality	
cui	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
misurata	I-Premise	HighQuality	
la	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
sanguigna.	I-Premise	HighQuality	

Dopo	B-Premise	HighQuality	
4	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
di	I-Premise	HighQuality	
riposo,	I-Premise	HighQuality	
la	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
era	I-Premise	HighQuality	
di	I-Premise	HighQuality	
150/95	I-Premise	HighQuality	
mmHg.	I-Premise	HighQuality	

L'emogramma	B-Premise	HighQuality	
era	I-Premise	HighQuality	
normale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
la	I-Premise	HighQuality	
proteinuria	I-Premise	HighQuality	
era	I-Premise	HighQuality	
negativa.	I-Premise	HighQuality	

Che	O		
tipo	O		
di	O		
ipertensione	O		
ha?	O		

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

2-	O		
Ipertensione	B-Claim	HighQuality	
indotta	I-Claim	HighQuality	
dalla	I-Claim	HighQuality	
gravidanza.	I-Claim	HighQuality	

3-	O		
Ipertensione	B-Claim	HighQuality	
cronica.	I-Claim	HighQuality	

4-	O		
Eclampsia.	B-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

L'ipertensione	B-Claim	HighQuality	
cronica	I-Claim	HighQuality	
è	I-Claim	HighQuality	
definita	I-Claim	HighQuality	
come	I-Claim	HighQuality	
ipertensione	I-Claim	HighQuality	
presente	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
della	I-Claim	HighQuality	
gravidanza	I-Claim	HighQuality	
o	I-Claim	HighQuality	
diagnosticata	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
20	I-Claim	HighQuality	
settimane	I-Claim	HighQuality	
di	I-Claim	HighQuality	
gestazione.	I-Claim	HighQuality	

In	B-Premise	HighQuality	
questo	I-Premise	HighQuality	
caso,	I-Premise	HighQuality	
la	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
è	I-Premise	HighQuality	
incinta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
10	I-Premise	HighQuality	
settimane,	I-Premise	HighQuality	
quindi	O		
la	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
3	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PNEUMOLOGIA	O		
E	O		
CHIRURGIA	O		
TORACICA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
38	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
non	I-Premise	HighQuality	
fumatrice,	I-Premise	HighQuality	
a	I-Premise	HighQuality	
cui	I-Premise	HighQuality	
era	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
precedentemente	I-Premise	HighQuality	
diagnosticata	I-Premise	HighQuality	
una	I-Premise	HighQuality	
rinite	I-Premise	HighQuality	
atopica,	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
due	I-Premise	HighQuality	
mesi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tosse	I-Premise	HighQuality	
intermittente	I-Premise	HighQuality	
e	I-Premise	HighQuality	
respiro	I-Premise	HighQuality	
affannoso,	I-Premise	HighQuality	
prevalentemente	I-Premise	HighQuality	
di	I-Premise	HighQuality	
notte.	I-Premise	HighQuality	

Radiografia	B-Premise	HighQuality	
del	I-Premise	HighQuality	
torace	I-Premise	HighQuality	
normale.	I-Premise	HighQuality	

Spirometria	B-Premise	HighQuality	
nella	I-Premise	HighQuality	
norma	I-Premise	HighQuality	
con	I-Premise	HighQuality	
test	I-Premise	HighQuality	
broncodilatatore	I-Premise	HighQuality	
negativo.	I-Premise	HighQuality	

Quale	O		
dei	O		
seguenti	O		
test	O		
richiedereste	O		
successivamente?	O		

1-	O		
Radiografia	B-Claim	HighQuality	
dei	I-Claim	HighQuality	
seni	I-Claim	HighQuality	
paranasali.	I-Claim	HighQuality	

2-	O		
TC	B-Claim	HighQuality	
toracica.	I-Claim	HighQuality	

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

4-	O		
Prick-test.	B-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Una	B-Premise	HighQuality	
spirometria	I-Premise	HighQuality	
normale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un	I-Premise	HighQuality	
test	I-Premise	HighQuality	
broncodilatatore	I-Premise	HighQuality	
puntualmente	I-Premise	HighQuality	
negativo	I-Premise	HighQuality	
non	I-Premise	HighQuality	
escludono	I-Premise	HighQuality	
l'asma,	I-Premise	HighQuality	
e	O		
il	B-Premise	HighQuality	
quadro	I-Premise	HighQuality	
clinico	I-Premise	HighQuality	
del	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
è	I-Premise	HighQuality	
altamente	I-Premise	HighQuality	
suggestivo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
asma,	I-Premise	HighQuality	
quindi	O		
un	B-Claim	HighQuality	
test	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
metacolina	I-Claim	HighQuality	
confermerebbe	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diagnosi,	I-Claim	HighQuality	
almeno	I-Claim	HighQuality	
di	I-Claim	HighQuality	
iperreattività	I-Claim	HighQuality	
bronchiale.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PSICHIATRIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
80	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
portato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
dalla	I-Premise	HighQuality	
polizia	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
essere	I-Premise	HighQuality	
stato	I-Premise	HighQuality	
trovato	I-Premise	HighQuality	
di	I-Premise	HighQuality	
notte,	I-Premise	HighQuality	
per	I-Premise	HighQuality	
strada,	I-Premise	HighQuality	
a	I-Premise	HighQuality	
diversi	I-Premise	HighQuality	
isolati	I-Premise	HighQuality	
da	I-Premise	HighQuality	
casa	I-Premise	HighQuality	
sua,	I-Premise	HighQuality	
un	I-Premise	HighQuality	
po'	I-Premise	HighQuality	
smarrito.	I-Premise	HighQuality	

Al	B-Premise	HighQuality	
medico	I-Premise	HighQuality	
d'urgenza	I-Premise	HighQuality	
dice:	I-Premise	HighQuality	
Mi	I-Premise	HighQuality	
sento	I-Premise	HighQuality	
bene,	I-Premise	HighQuality	
stavo	I-Premise	HighQuality	
camminando	I-Premise	HighQuality	
e	I-Premise	HighQuality	
mi	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
perso.	I-Premise	HighQuality	

La	O		
recensione,	O		
in	O		
termini	O		
di	O		
sistemi,	O		
è	O		
blanda.	O		

Quando	B-Premise	HighQuality	
gli	I-Premise	HighQuality	
si	I-Premise	HighQuality	
chiede	I-Premise	HighQuality	
di	I-Premise	HighQuality	
parlare	I-Premise	HighQuality	
dei	I-Premise	HighQuality	
suoi	I-Premise	HighQuality	
farmaci,	I-Premise	HighQuality	
non	I-Premise	HighQuality	
se	I-Premise	HighQuality	
ne	I-Premise	HighQuality	
ricorda.	I-Premise	HighQuality	

Ha	B-Premise	HighQuality	
un'anamnesi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
glipizide,	I-Premise	HighQuality	
atenololo	I-Premise	HighQuality	
e	I-Premise	HighQuality	
acenocumarolo.	I-Premise	HighQuality	

Negli	B-Premise	HighQuality	
ultimi	I-Premise	HighQuality	
tre	I-Premise	HighQuality	
mesi	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
recato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
Pronto	I-Premise	HighQuality	
Soccorso	I-Premise	HighQuality	
3	I-Premise	HighQuality	
volte	I-Premise	HighQuality	
per	I-Premise	HighQuality	
vertigini,	I-Premise	HighQuality	
dolori	I-Premise	HighQuality	
lombari	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un	I-Premise	HighQuality	
INR	I-Premise	HighQuality	
di	I-Premise	HighQuality	
5	I-Premise	HighQuality	

Si	B-Premise	HighQuality	
riferisce	I-Premise	HighQuality	
all'indipendenza	I-Premise	HighQuality	
nelle	I-Premise	HighQuality	
attività	I-Premise	HighQuality	
di	I-Premise	HighQuality	
base	I-Premise	HighQuality	
e	I-Premise	HighQuality	
strumentali	I-Premise	HighQuality	
della	I-Premise	HighQuality	
vita	I-Premise	HighQuality	
quotidiana.	I-Premise	HighQuality	

Non	O		
c'è	O		
traccia	O		
di	O		
familiari	O		
o	O		
amici	O		
intimi.	O		

Diverse	O		
segnalazioni	O		
da	O		
parte	O		
dell'assistenza	O		
sociale	O		
della	O		
zona	O		
indicano	O		
che	O		
rifiuta	O		
aiuti	O		
o	O		
visite	O		
mediche	O		
o	O		
infermieristiche.	O		

L'esame	B-Premise	HighQuality	
fisico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
temperatura	I-Premise	HighQuality	
di	I-Premise	HighQuality	
37,7,	I-Premise	HighQuality	
un	I-Premise	HighQuality	
IMC	I-Premise	HighQuality	
di	I-Premise	HighQuality	
16,	I-Premise	HighQuality	
una	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
160/90,	I-Premise	HighQuality	
una	I-Premise	HighQuality	
frequenza	I-Premise	HighQuality	
cardiaca	I-Premise	HighQuality	
di	I-Premise	HighQuality	
90	I-Premise	HighQuality	
e	I-Premise	HighQuality	
una	I-Premise	HighQuality	
SO2	I-Premise	HighQuality	
del	I-Premise	HighQuality	
99%.	I-Premise	HighQuality	

Ha	B-Premise	HighQuality	
una	I-Premise	HighQuality	
perdita	I-Premise	HighQuality	
complessiva	I-Premise	HighQuality	
di	I-Premise	HighQuality	
massa	I-Premise	HighQuality	
muscolare.	I-Premise	HighQuality	

È	B-Premise	HighQuality	
vestito	I-Premise	HighQuality	
in	I-Premise	HighQuality	
vestaglia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
puzza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
urina.	I-Premise	HighQuality	

Si	B-Premise	HighQuality	
rifiuta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
rispondere	I-Premise	HighQuality	
alle	I-Premise	HighQuality	
domande	I-Premise	HighQuality	
del	I-Premise	HighQuality	
Minimental.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
esami	I-Premise	HighQuality	
di	I-Premise	HighQuality	
laboratorio	I-Premise	HighQuality	
includono	I-Premise	HighQuality	
13	I-Premise	HighQuality	
leucociti,	I-Premise	HighQuality	
glicemia	I-Premise	HighQuality	
300,	I-Premise	HighQuality	
emoglobina	I-Premise	HighQuality	
glicosilata	I-Premise	HighQuality	
11%,	I-Premise	HighQuality	
INR	I-Premise	HighQuality	
0,9,	I-Premise	HighQuality	
urine	I-Premise	HighQuality	
con	I-Premise	HighQuality	
più	I-Premise	HighQuality	
di	I-Premise	HighQuality	
50	I-Premise	HighQuality	
leucociti/campo,	I-Premise	HighQuality	
nitriti+	I-Premise	HighQuality	
e	I-Premise	HighQuality	
urinocoltura	I-Premise	HighQuality	
>	I-Premise	HighQuality	
100	I-Premise	HighQuality	
bacilli	I-Premise	HighQuality	
Gram-negativi.	I-Premise	HighQuality	

È	B-Premise	HighQuality	
stato	I-Premise	HighQuality	
ricoverato	I-Premise	HighQuality	
in	I-Premise	HighQuality	
ospedale,	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
ricevuto	I-Premise	HighQuality	
antibiotici,	I-Premise	HighQuality	
insulina	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stato	I-Premise	HighQuality	
riavviato	I-Premise	HighQuality	
l'acenocumarolo	I-Premise	HighQuality	
con	I-Premise	HighQuality	
buoni	I-Premise	HighQuality	
progressi.	I-Premise	HighQuality	

È	B-Premise	HighQuality	
stabile	I-Premise	HighQuality	
e	I-Premise	HighQuality	
vuole	I-Premise	HighQuality	
tornare	I-Premise	HighQuality	
a	I-Premise	HighQuality	
casa.	I-Premise	HighQuality	

L'infermiera	B-Premise	HighQuality	
del	I-Premise	HighQuality	
reparto	I-Premise	HighQuality	
dice	I-Premise	HighQuality	
che	I-Premise	HighQuality	
non	I-Premise	HighQuality	
è	I-Premise	HighQuality	
in	I-Premise	HighQuality	
grado	I-Premise	HighQuality	
di	I-Premise	HighQuality	
autosomministrarsi	I-Premise	HighQuality	
l'insulina.	I-Premise	HighQuality	

Quale	O		
dei	O		
seguenti	O		
è	O		
il	O		
passo	O		
successivo	O		
per	O		
determinare	O		
la	O		
sicurezza	O		
del	O		
paziente	O		
a	O		
domicilio?	O		

1-	O		
Rivolgersi	B-Claim	HighQuality	
alle	I-Claim	HighQuality	
cure	I-Claim	HighQuality	
primarie	I-Claim	HighQuality	
e	I-Claim	HighQuality	
all'assistenza	I-Claim	HighQuality	
sociale	I-Claim	HighQuality	
della	I-Claim	HighQuality	
zona	I-Claim	HighQuality	
per	I-Claim	HighQuality	
determinare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sicurezza	I-Claim	HighQuality	
a	I-Claim	HighQuality	
casa.	I-Claim	HighQuality	

2-	O		
Valutazione	B-Claim	HighQuality	
formale	I-Claim	HighQuality	
della	I-Claim	HighQuality	
capacità	I-Claim	HighQuality	
di	I-Claim	HighQuality	
prendere	I-Claim	HighQuality	
decisioni	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
propria	I-Claim	HighQuality	
salute.	I-Claim	HighQuality	

3-	O		
Valutazione	B-Claim	HighQuality	
per	I-Claim	HighQuality	
escludere	I-Claim	HighQuality	
la	I-Claim	HighQuality	
demenza.	I-Claim	HighQuality	

4-	O		
Valutazione	B-Claim	HighQuality	
per	I-Claim	HighQuality	
escludere	I-Claim	HighQuality	
la	I-Claim	HighQuality	
depressione.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
2	O		

Valutare	B-Claim	HighQuality	
la	I-Claim	HighQuality	
capacità	I-Claim	HighQuality	
non	I-Claim	HighQuality	
significa	I-Claim	HighQuality	
togliere	I-Claim	HighQuality	
al	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sua	I-Claim	HighQuality	
autonomia,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
assicurarsi	I-Claim	HighQuality	
che	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
comprenda	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
consapevole	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
conseguenze	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
sue	I-Claim	HighQuality	
decisioni.	I-Claim	HighQuality	

Si	B-Claim	HighQuality	
tratta	I-Claim	HighQuality	
infatti	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
misura	I-Claim	HighQuality	
di	I-Claim	HighQuality	
protezione	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
più	I-Claim	HighQuality	
fragili	I-Claim	HighQuality	
per	I-Claim	HighQuality	
garantire	I-Claim	HighQuality	
le	I-Claim	HighQuality	
migliori	I-Claim	HighQuality	
cure.	I-Claim	HighQuality	

Questo	B-Claim	HighQuality	
non	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
fatto	I-Claim	HighQuality	
da	I-Claim	HighQuality	
uno	I-Claim	HighQuality	
psichiatra,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
dal	I-Claim	HighQuality	
medico	I-Claim	HighQuality	
curante.	I-Claim	HighQuality	

Esistono	B-Claim	HighQuality	
diversi	I-Claim	HighQuality	
test	I-Claim	HighQuality	
o	I-Claim	HighQuality	
interviste	I-Claim	HighQuality	
semistrutturate	I-Claim	HighQuality	
per	I-Claim	HighQuality	
valutare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
capacità	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
e	I-Claim	HighQuality	
tutti	I-Claim	HighQuality	
i	I-Claim	HighQuality	
medici	I-Claim	HighQuality	
dovrebbero	I-Claim	HighQuality	
avere	I-Claim	HighQuality	
familiarità	I-Claim	HighQuality	
con	I-Claim	HighQuality	
questi	I-Claim	HighQuality	
strumenti.	I-Claim	HighQuality	

È	O		
importante	O		
che	O		
sia	O		
il	O		
medico	O		
curante	O		
a	O		
effettuare	O		
questa	O		
valutazione,	O		
perché	O		
è	O		
lui	O		
che	O		
informa	O		
preventivamente	O		
il	O		
paziente	O		
(consenso	O		
informato)	O		
del	O		
piano	O		
terapeutico	O		
ed	O		
è	O		
quello	O		
più	O		
qualificato	O		
per	O		
valutare	O		
se	O		
il	O		
paziente	O		
ha	O		
capito	O		
tutto:	O		
qual	O		
è	O		
il	O		
problema	O		
medico,	O		
quale	O		
trattamento	O		
viene	O		
proposto,	O		
le	O		
eventuali	O		
alternative,	O		
la	O		
possibilità	O		
di	O		
accettarle	O		
o	O		
rifiutarle	O		
e	O		
perché,	O		
le	O		
conseguenze	O		
di	O		
prendere	O		
queste	O		
decisioni	O		
(anche	O		
quelle	O		
di	O		
non	O		
volere	O		
il	O		
trattamento),	O		
anche	O		
valutando	O		
la	O		
psicopatologia	O		
suscettibile	O		
di	O		
un	O		
ICP	O		
in	O		
Psichiatria.	O		

QUESTION	O		
TYPE:	O		
MALATTIE	O		
INFETTIVE	O		
E	O		
MICROBIOLOGIA	O		

CLINICAL	O		
CASE:	O		

Luis	B-Premise	HighQuality	
è	I-Premise	HighQuality	
un	I-Premise	HighQuality	
giovane	I-Premise	HighQuality	
di	I-Premise	HighQuality	
25	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
che	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
subito	I-Premise	HighQuality	
una	I-Premise	HighQuality	
splenectomia	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
un	I-Premise	HighQuality	
incidente	I-Premise	HighQuality	
in	I-Premise	HighQuality	
bicicletta	I-Premise	HighQuality	
1	I-Premise	HighQuality	
anno	I-Premise	HighQuality	
fa.	I-Premise	HighQuality	

Un	B-Premise	HighQuality	
cane	I-Premise	HighQuality	
lo	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
morso	I-Premise	HighQuality	
24	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
fa	I-Premise	HighQuality	
e	I-Premise	HighQuality	
gli	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
procurato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
piccola	I-Premise	HighQuality	
ferita	I-Premise	HighQuality	
sulla	I-Premise	HighQuality	
mano	I-Premise	HighQuality	
destra.	I-Premise	HighQuality	

Si	B-Premise	HighQuality	
reca	I-Premise	HighQuality	
al	I-Premise	HighQuality	
centro	I-Premise	HighQuality	
sanitario	I-Premise	HighQuality	
(situato	I-Premise	HighQuality	
a	I-Premise	HighQuality	
3	I-Premise	HighQuality	
ore	I-Premise	HighQuality	
dall'ospedale	I-Premise	HighQuality	
più	I-Premise	HighQuality	
vicino)	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
febbre	I-Premise	HighQuality	
di	I-Premise	HighQuality	
39°C,	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
ferita	I-Premise	HighQuality	
e	I-Premise	HighQuality	
malessere	I-Premise	HighQuality	
generale.	I-Premise	HighQuality	

All'esame	B-Premise	HighQuality	
la	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
è	I-Premise	HighQuality	
di	I-Premise	HighQuality	
100/60	I-Premise	HighQuality	
mm	I-Premise	HighQuality	
Hg,	I-Premise	HighQuality	
la	I-Premise	HighQuality	
frequenza	I-Premise	HighQuality	
cardiaca	I-Premise	HighQuality	
è	I-Premise	HighQuality	
di	I-Premise	HighQuality	
110	I-Premise	HighQuality	
battiti	I-Premise	HighQuality	
al	I-Premise	HighQuality	
minuto,	I-Premise	HighQuality	
la	I-Premise	HighQuality	
ferita	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
un	I-Premise	HighQuality	
leggero	I-Premise	HighQuality	
gonfiore	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
pus.	I-Premise	HighQuality	

Quale	O		
delle	O		
seguenti	O		
azioni	O		
è	O		
più	O		
appropriata	O		
in	O		
questo	O		
momento?	O		

1-	O		
Inviare	B-Claim	HighQuality	
all'ospedale	I-Claim	HighQuality	
per	I-Claim	HighQuality	
la	I-Claim	HighQuality	
vaccinazione	I-Claim	HighQuality	
antirabbica	I-Claim	HighQuality	
e	I-Claim	HighQuality	
antitetanica	I-Claim	HighQuality	
e	I-Claim	HighQuality	
tenere	I-Claim	HighQuality	
sotto	I-Claim	HighQuality	
osservazione.	I-Claim	HighQuality	

2-	O		
Pulire	B-Claim	HighQuality	
la	I-Claim	HighQuality	
ferita	I-Claim	HighQuality	
e	I-Claim	HighQuality	
somministrare	I-Claim	HighQuality	
gammaglobulina	I-Claim	HighQuality	
non	I-Claim	HighQuality	
specifica	I-Claim	HighQuality	
per	I-Claim	HighQuality	
via	I-Claim	HighQuality	
intramuscolare.	I-Claim	HighQuality	

3-	O		
Somministrare	B-Claim	HighQuality	
400	I-Claim	HighQuality	
mg	I-Claim	HighQuality	
di	I-Claim	HighQuality	
moxifloxacina	I-Claim	HighQuality	
per	I-Claim	HighQuality	
via	I-Claim	HighQuality	
orale	I-Claim	HighQuality	
e	I-Claim	HighQuality	
inviare	I-Claim	HighQuality	
in	I-Claim	HighQuality	
ospedale.	I-Claim	HighQuality	

4-	O		
Somministrare	B-Claim	HighQuality	
clindamicina	I-Claim	HighQuality	
600	I-Claim	HighQuality	
mg	I-Claim	HighQuality	
per	I-Claim	HighQuality	
via	I-Claim	HighQuality	
orale	I-Claim	HighQuality	
ogni	I-Claim	HighQuality	
8	I-Claim	HighQuality	
ore	I-Claim	HighQuality	
e	I-Claim	HighQuality	
tenere	I-Claim	HighQuality	
sotto	I-Claim	HighQuality	
osservazione.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Questa	O		
domanda	O		
è	O		
stata	O		
difficile	O		
per	O		
noi.	O		

La	O		
domanda	O		
non	O		
contiene	O		
tutte	O		
le	O		
informazioni	O		
necessarie,	O		
ma	O		
utilizzando	O		
ciò	O		
che	O		
abbiamo	O		
possiamo	O		
provare	O		
a	O		
rispondere.	O		

Il	B-Premise	HighQuality	
cane	I-Premise	HighQuality	
è	I-Premise	HighQuality	
domestico,	I-Premise	HighQuality	
conosciuto	I-Premise	HighQuality	
e	I-Premise	HighQuality	
può	I-Premise	HighQuality	
essere	I-Premise	HighQuality	
monitorato,	I-Premise	HighQuality	
pertanto	O		
si	B-Claim	HighQuality	
deve	I-Claim	HighQuality	
attendere	I-Claim	HighQuality	
il	I-Claim	HighQuality	
periodo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
osservazione	I-Claim	HighQuality	
e	I-Claim	HighQuality	
non	I-Claim	HighQuality	
si	I-Claim	HighQuality	
raccomanda	I-Claim	HighQuality	
la	I-Claim	HighQuality	
profilassi.	I-Claim	HighQuality	

A	B-Claim	HighQuality	
questo	I-Claim	HighQuality	
punto	I-Claim	HighQuality	
dobbiamo	I-Claim	HighQuality	
solo	I-Claim	HighQuality	
preoccuparci	I-Claim	HighQuality	
della	I-Claim	HighQuality	
possibile	I-Claim	HighQuality	
batteriemia	I-Claim	HighQuality	
che	I-Claim	HighQuality	
potrebbe	I-Claim	HighQuality	
verificarsi	I-Claim	HighQuality	
in	I-Claim	HighQuality	
un	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
con	I-Claim	HighQuality	
un	I-Claim	HighQuality	
rischio	I-Claim	HighQuality	
elevato	I-Claim	HighQuality	
a	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
dell'asplenia.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
di	I-Claim	HighQuality	
scelta	I-Claim	HighQuality	
per	I-Claim	HighQuality	
i	I-Claim	HighQuality	
morsi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
cane	I-Claim	HighQuality	
è	I-Claim	HighQuality	
l'amoxicillina/acido	I-Claim	HighQuality	
clavulanico,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
disponibile,	I-Claim	HighQuality	
quindi	O		
si	B-Claim	HighQuality	
può	I-Claim	HighQuality	
ricorrere	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un	I-Claim	HighQuality	
altro	I-Claim	HighQuality	
trattamento,	I-Claim	HighQuality	
come	I-Claim	HighQuality	
la	I-Claim	HighQuality	
clindamicina	I-Claim	HighQuality	
più	I-Claim	HighQuality	
una	I-Claim	HighQuality	
cefalosporina	I-Claim	HighQuality	
o	I-Claim	HighQuality	
la	I-Claim	HighQuality	
clindamicina	I-Claim	HighQuality	
+	I-Claim	HighQuality	
moxifloxacina,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
incluso	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
le	I-Claim	HighQuality	
alternative.	I-Claim	HighQuality	

In	B-Claim	HighQuality	
un	I-Claim	HighQuality	
primo	I-Claim	HighQuality	
tentativo	I-Claim	HighQuality	
abbiamo	I-Claim	HighQuality	
risposto	I-Claim	HighQuality	
4,	I-Claim	HighQuality	
ma	O		
la	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
3,	I-Claim	HighQuality	
a	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
della	I-Claim	HighQuality	
seconda	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
della	I-Claim	HighQuality	
domanda;	I-Claim	HighQuality	
si	B-Premise	HighQuality	
tratta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
ad	I-Premise	HighQuality	
alto	I-Premise	HighQuality	
rischio	I-Premise	HighQuality	
con	I-Premise	HighQuality	
segni	I-Premise	HighQuality	
incipienti	I-Premise	HighQuality	
di	I-Premise	HighQuality	
sepsi	I-Premise	HighQuality	
e	O		
dovrebbe	B-Claim	HighQuality	
essere	I-Claim	HighQuality	
inviato	I-Claim	HighQuality	
in	I-Claim	HighQuality	
ospedale,	I-Claim	HighQuality	
qui	O		
la	O		
chiave	O		
più	O		
che	O		
l'antibiotico	O		
è	O		
nella	O		
posizione	O		
da	O		
assumere,	O		
nella	O		
seconda	O		
parte	O		
di	O		
ogni	O		
risposta.	O		

Potrebbe	B-Claim	HighQuality	
essere	I-Claim	HighQuality	
contestato	I-Claim	HighQuality	
perché	I-Claim	HighQuality	
non	I-Claim	HighQuality	
si	I-Claim	HighQuality	
dice	I-Claim	HighQuality	
in	I-Claim	HighQuality	
quale	I-Claim	HighQuality	
comunità	I-Claim	HighQuality	
è	I-Claim	HighQuality	
avvenuto	I-Claim	HighQuality	
il	I-Claim	HighQuality	
morso	I-Claim	HighQuality	
(se	B-Claim	HighQuality	
a	I-Claim	HighQuality	
Ceuta	I-Claim	HighQuality	
o	I-Claim	HighQuality	
a	I-Claim	HighQuality	
Melilla	I-Claim	HighQuality	
il	I-Claim	HighQuality	
protocollo	I-Claim	HighQuality	
può	I-Claim	HighQuality	
variare).	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
NEUROCHIRURGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
ragazzo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
13	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
una	I-Premise	HighQuality	
cefalea	I-Premise	HighQuality	
subacuta	I-Premise	HighQuality	
e	I-Premise	HighQuality	
diplopia.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
neurologico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
evidenziato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
paralisi	I-Premise	HighQuality	
dello	I-Premise	HighQuality	
sguardo	I-Premise	HighQuality	
verticale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
la	I-Premise	HighQuality	
risonanza	I-Premise	HighQuality	
magnetica	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
lesione	I-Premise	HighQuality	
con	I-Premise	HighQuality	
contrasto	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
regione	I-Premise	HighQuality	
pineale	I-Premise	HighQuality	
che	I-Premise	HighQuality	
ostruisce	I-Premise	HighQuality	
l'acquedotto	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Sylvius.	I-Premise	HighQuality	

La	O		
diagnosi	O		
più	O		
probabile	O		
è:	O		

1-	O		
Glioblastoma.	B-Claim	HighQuality	

2-	O		
Medulloblastoma.	B-Claim	HighQuality	

3-	O		
Tumore	B-Claim	HighQuality	
delle	I-Claim	HighQuality	
cellule	I-Claim	HighQuality	
germinali.	I-Claim	HighQuality	

4-	O		
Meningioma.	B-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

I	B-Claim	HighQuality	
tumori	I-Claim	HighQuality	
germinali	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
i	I-Claim	HighQuality	
tumori	I-Claim	HighQuality	
più	I-Claim	HighQuality	
frequenti	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
bambini	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
regione	I-Claim	HighQuality	
pineale.	I-Claim	HighQuality	

Tendono	B-Claim	HighQuality	
ad	I-Claim	HighQuality	
avere	I-Claim	HighQuality	
una	I-Claim	HighQuality	
captazione	I-Claim	HighQuality	
omogenea	I-Claim	HighQuality	
e	I-Claim	HighQuality	
causano	I-Claim	HighQuality	
idrocefalo	I-Claim	HighQuality	
triventricolare	I-Claim	HighQuality	
e	I-Claim	HighQuality	
idrocefalo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Parinaud.	I-Claim	HighQuality	

I	B-Claim	HighQuality	
glioblastomi	I-Claim	HighQuality	
si	I-Claim	HighQuality	
verificano	I-Claim	HighQuality	
di	I-Claim	HighQuality	
solito	I-Claim	HighQuality	
negli	I-Claim	HighQuality	
adulti	I-Claim	HighQuality	
a	I-Claim	HighQuality	
livello	I-Claim	HighQuality	
lobare,	I-Claim	HighQuality	
i	B-Claim	HighQuality	
medulloblastomi	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
i	I-Claim	HighQuality	
tumori	I-Claim	HighQuality	
maligni	I-Claim	HighQuality	
più	I-Claim	HighQuality	
frequenti	I-Claim	HighQuality	
a	I-Claim	HighQuality	
livello	I-Claim	HighQuality	
della	I-Claim	HighQuality	
fossa	I-Claim	HighQuality	
posteriore	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
bambini	I-Claim	HighQuality	
(vermis	I-Claim	HighQuality	
e	I-Claim	HighQuality	
tetto	I-Claim	HighQuality	
del	I-Claim	HighQuality	
IV	I-Claim	HighQuality	
ventricolo)	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
rari	I-Claim	HighQuality	
a	I-Claim	HighQuality	
livello	I-Claim	HighQuality	
pineale	I-Claim	HighQuality	
e	O		
i	B-Claim	HighQuality	
meningiomi	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
rari	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
bambini	I-Claim	HighQuality	
e	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
regione	I-Claim	HighQuality	
pineale.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
OFTALMOLOGIA	O		

CLINICAL	O		
CASE:	O		

Uomo	B-Premise	HighQuality	
di	I-Premise	HighQuality	
67	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
diabetico	I-Premise	HighQuality	
e	I-Premise	HighQuality	
asmatico,	I-Premise	HighQuality	
con	I-Premise	HighQuality	
glaucoma	I-Premise	HighQuality	
primario	I-Premise	HighQuality	
ad	I-Premise	HighQuality	
angolo	I-Premise	HighQuality	
aperto	I-Premise	HighQuality	
in	I-Premise	HighQuality	
entrambi	I-Premise	HighQuality	
gli	I-Premise	HighQuality	
occhi.	I-Premise	HighQuality	

Ha	B-Premise	HighQuality	
una	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
oculare	I-Premise	HighQuality	
di	I-Premise	HighQuality	
34	I-Premise	HighQuality	
mmHg	I-Premise	HighQuality	
nell'occhio	I-Premise	HighQuality	
destro	I-Premise	HighQuality	
e	I-Premise	HighQuality	
di	I-Premise	HighQuality	
31	I-Premise	HighQuality	
mmHg	I-Premise	HighQuality	
nell'occhio	I-Premise	HighQuality	
sinistro.	I-Premise	HighQuality	

Quale	O		
dei	O		
seguenti	O		
gruppi	O		
farmacologici	O		
è	O		
il	O		
più	O		
indicato	O		
come	O		
prima	O		
scelta	O		
di	O		
trattamento	O		
antipertensivo?	O		

1-	O		
Inibitori	B-Claim	HighQuality	
dell'anidrasi	I-Claim	HighQuality	
carbonica.	I-Claim	HighQuality	

2-	O		
Beta-bloccanti.	B-Claim	HighQuality	

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

4-	O		
Derivati	B-Claim	HighQuality	
delle	I-Claim	HighQuality	
prostaglandine.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
4	O		

Ci	B-Claim	HighQuality	
viene	I-Claim	HighQuality	
chiesto	I-Claim	HighQuality	
quale	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
di	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
scelta	I-Claim	HighQuality	
per	I-Claim	HighQuality	
il	I-Claim	HighQuality	
glaucoma.	I-Claim	HighQuality	

In	B-Claim	HighQuality	
passato,	I-Claim	HighQuality	
i	I-Claim	HighQuality	
beta-bloccanti	I-Claim	HighQuality	
erano	I-Claim	HighQuality	
la	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
scelta,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
ora	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
stati	I-Claim	HighQuality	
soppiantati	I-Claim	HighQuality	
dal	I-Claim	HighQuality	
gruppo	I-Claim	HighQuality	
che	I-Claim	HighQuality	
abbassa	I-Claim	HighQuality	
maggiormente	I-Claim	HighQuality	
la	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
intraoculare:	I-Claim	HighQuality	
le	I-Claim	HighQuality	
prostaglandine.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
loro	I-Claim	HighQuality	
efficacia	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
comodo	I-Claim	HighQuality	
dosaggio	I-Claim	HighQuality	
una	I-Claim	HighQuality	
volta	I-Claim	HighQuality	
al	I-Claim	HighQuality	
giorno	I-Claim	HighQuality	
li	I-Claim	HighQuality	
rendono	I-Claim	HighQuality	
generalmente	I-Claim	HighQuality	
il	I-Claim	HighQuality	
gruppo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
scelta.	I-Claim	HighQuality	

I	B-Claim	HighQuality	
beta-bloccanti	I-Claim	HighQuality	
sarebbero	I-Claim	HighQuality	
una	I-Claim	HighQuality	
seconda	I-Claim	HighQuality	
scelta	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
casi	I-Claim	HighQuality	
in	I-Claim	HighQuality	
cui	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
effetti	I-Claim	HighQuality	
collaterali	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
prostaglandine	I-Claim	HighQuality	
(alterazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
colore	I-Claim	HighQuality	
degli	I-Claim	HighQuality	
occhi,	I-Claim	HighQuality	
aumento	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
dimensioni	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
ciglia)	I-Claim	HighQuality	
ci	I-Claim	HighQuality	
costringono	I-Claim	HighQuality	
inizialmente	I-Claim	HighQuality	
ad	I-Claim	HighQuality	
abbandonarle.	I-Claim	HighQuality	

Poiché	B-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
è	I-Claim	HighQuality	
asmatico,	I-Claim	HighQuality	
i	I-Claim	HighQuality	
beta-bloccanti	I-Claim	HighQuality	
devono	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
esclusi	I-Claim	HighQuality	
(risposta	I-Claim	HighQuality	
errata	I-Claim	HighQuality	
2).	I-Claim	HighQuality	

Inoltre,	B-Claim	HighQuality	
poiché	I-Claim	HighQuality	
è	I-Claim	HighQuality	
necessario	I-Claim	HighQuality	
un	I-Claim	HighQuality	
calo	I-Claim	HighQuality	
significativo	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
intraoculare	I-Claim	HighQuality	
perché	I-Claim	HighQuality	
i	I-Claim	HighQuality	
numeri	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
elevati	I-Claim	HighQuality	
(34	I-Claim	HighQuality	
e	I-Claim	HighQuality	
31),	I-Claim	HighQuality	
possiamo	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
escludere	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
inibitori	I-Claim	HighQuality	
dell'anidrasi	I-Claim	HighQuality	
carbonica	I-Claim	HighQuality	
e	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
agonisti	I-Claim	HighQuality	
alfa-2	I-Claim	HighQuality	
(opzioni	I-Claim	HighQuality	
1	I-Claim	HighQuality	
e	I-Claim	HighQuality	
3	I-Claim	HighQuality	
errate).	I-Claim	HighQuality	

E	B-Claim	HighQuality	
scegliere	I-Claim	HighQuality	
il	I-Claim	HighQuality	
gruppo	I-Claim	HighQuality	
che	I-Claim	HighQuality	
può	I-Claim	HighQuality	
ridurre	I-Claim	HighQuality	
maggiormente	I-Claim	HighQuality	
la	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
intraoculare.	I-Claim	HighQuality	

Risposta	B-Claim	HighQuality	
4	I-Claim	HighQuality	
corretta.	I-Claim	HighQuality	

E	O		
poi	O		
un	O		
paio	O		
di	O		
sfumature	O		
della	O		
dichiarazione.	O		

Sarebbe	O		
più	O		
corretto	O		
parlare	O		
di	O		
pressione	O		
intraoculare	O		
piuttosto	O		
che	O		
di	O		
pressione	O		
oculare.	O		

E	O		
la	O		
formulazione	O		
potrebbe	O		
essere	O		
migliorata	O		
per	O		
non	O		
ripetere	O		
la	O		
parola	O		
come	O		
nell'ultima	O		
frase.	O		

QUESTION	O		
TYPE:	O		
TRAUMATOLOGIA	O		
E	O		
ORTOPEDIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
60	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
diabetica	I-Premise	HighQuality	
insulino-dipendente,	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
un'omalgia	I-Premise	HighQuality	
destra,	I-Premise	HighQuality	
prevalentemente	I-Premise	HighQuality	
notturna,	I-Premise	HighQuality	
della	I-Premise	HighQuality	
durata	I-Premise	HighQuality	
di	I-Premise	HighQuality	
diverse	I-Premise	HighQuality	
settimane.	I-Premise	HighQuality	

Non	B-Premise	HighQuality	
sono	I-Premise	HighQuality	
stati	I-Premise	HighQuality	
segnalati	I-Premise	HighQuality	
traumi.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
fisico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
limitazione	I-Premise	HighQuality	
attiva	I-Premise	HighQuality	
e	I-Premise	HighQuality	
passiva	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tutti	I-Premise	HighQuality	
gli	I-Premise	HighQuality	
intervalli	I-Premise	HighQuality	
di	I-Premise	HighQuality	
movimento	I-Premise	HighQuality	
della	I-Premise	HighQuality	
spalla.	I-Premise	HighQuality	

Quale	O		
quadro	O		
clinico	O		
sospetta	O		
come	O		
prima	O		
possibilità	O		
diagnostica?	O		

1-	O		
Tumore	B-Claim	HighQuality	
maligno	I-Claim	HighQuality	
localizzato	I-Claim	HighQuality	
nell'epifisi	I-Claim	HighQuality	
prossimale	I-Claim	HighQuality	
dell'omero.	I-Claim	HighQuality	

2-	O		
Artrite	B-Claim	HighQuality	
settica	I-Claim	HighQuality	
della	I-Claim	HighQuality	
spalla.	I-Claim	HighQuality	

3-	O		
Capsulite	B-Claim	HighQuality	
adesiva.	I-Claim	HighQuality	

4-	O		
Un	B-Claim	HighQuality	
processo	I-Claim	HighQuality	
osteoartritico	I-Claim	HighQuality	
degenerativo	I-Claim	HighQuality	
acromioclavicolare.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Tutto	B-Claim	HighQuality	
fa	I-Claim	HighQuality	
pensare	I-Claim	HighQuality	
a	I-Claim	HighQuality	
una	I-Claim	HighQuality	
capsulite	I-Claim	HighQuality	
adesiva,	I-Claim	HighQuality	
come	I-Claim	HighQuality	
dice	I-Claim	HighQuality	
lei.	I-Claim	HighQuality	

Età,	B-Claim	HighQuality	
sesso,	I-Claim	HighQuality	
clinica...	I-Claim	HighQuality	
il	I-Claim	HighQuality	
DM...	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
CHIRURGIA	O		
ORTOPEDICA	O		
E	O		
TRAUMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
bambina	I-Premise	HighQuality	
premenarca	I-Premise	HighQuality	
di	I-Premise	HighQuality	
11	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
e	I-Premise	HighQuality	
6	I-Premise	HighQuality	
mesi	I-Premise	HighQuality	
con	I-Premise	HighQuality	
scoliosi	I-Premise	HighQuality	
idiopatica	I-Premise	HighQuality	
nota.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
radiografia	I-Premise	HighQuality	
della	I-Premise	HighQuality	
colonna	I-Premise	HighQuality	
vertebrale	I-Premise	HighQuality	
effettuata	I-Premise	HighQuality	
6	I-Premise	HighQuality	
mesi	I-Premise	HighQuality	
fa	I-Premise	HighQuality	
mostrava	I-Premise	HighQuality	
una	I-Premise	HighQuality	
curva	I-Premise	HighQuality	
toracolombare	I-Premise	HighQuality	
sinistra	I-Premise	HighQuality	
di	I-Premise	HighQuality	
18º	I-Premise	HighQuality	
(angolo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Cobb).	I-Premise	HighQuality	

L'angolo	B-Premise	HighQuality	
di	I-Premise	HighQuality	
Cobb	I-Premise	HighQuality	
attuale	I-Premise	HighQuality	
è	I-Premise	HighQuality	
di	I-Premise	HighQuality	
28°,	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
maturazione	I-Premise	HighQuality	
della	I-Premise	HighQuality	
cresta	I-Premise	HighQuality	
iliaca	I-Premise	HighQuality	
(segno	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Risser)	I-Premise	HighQuality	
pari	I-Premise	HighQuality	
a	I-Premise	HighQuality	
2	I-Premise	HighQuality	

A	O		
questo	O		
punto,	O		
qual	O		
è	O		
il	O		
trattamento	O		
più	O		
appropriato	O		
per	O		
cercare	O		
di	O		
arrestare	O		
la	O		
progressione	O		
della	O		
curva?	O		

1-	O		
Esercizi	B-Claim	HighQuality	
di	I-Claim	HighQuality	
nuoto.	I-Claim	HighQuality	

2-	O		
Esercizi	B-Claim	HighQuality	
di	I-Claim	HighQuality	
rieducazione	I-Claim	HighQuality	
posturale.	I-Claim	HighQuality	

3-	O		
Corsetto	B-Claim	HighQuality	
correttivo	I-Claim	HighQuality	
ortopedico.	I-Claim	HighQuality	

4-	O		
Intervento	B-Claim	HighQuality	
chirurgico	I-Claim	HighQuality	
mediante	I-Claim	HighQuality	
artrodesi	I-Claim	HighQuality	
spinale.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Nelle	B-Claim	HighQuality	
forme	I-Claim	HighQuality	
giovanili	I-Claim	HighQuality	
e	I-Claim	HighQuality	
adolescenziali	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
dipende	I-Claim	HighQuality	
dal	I-Claim	HighQuality	
grado	I-Claim	HighQuality	
di	I-Claim	HighQuality	
deformità:	I-Claim	HighQuality	
-	B-Claim	HighQuality	
10-20°:	I-Claim	HighQuality	
osservazione	I-Claim	HighQuality	
seriale.	I-Claim	HighQuality	

-	B-Claim	HighQuality	
20-50°:	I-Claim	HighQuality	
bretelle	I-Claim	HighQuality	
termoplastiche	I-Claim	HighQuality	
(Boston,	I-Claim	HighQuality	
Cheneau	I-Claim	HighQuality	
o	I-Claim	HighQuality	
Milwaukee,	I-Claim	HighQuality	
a	I-Claim	HighQuality	
seconda	I-Claim	HighQuality	
della	I-Claim	HighQuality	
posizione	I-Claim	HighQuality	
dell'apice	I-Claim	HighQuality	
della	I-Claim	HighQuality	
curva	I-Claim	HighQuality	
principale).	I-Claim	HighQuality	

-	O		
40-50°:	B-Claim	HighQuality	
con	I-Claim	HighQuality	
Risser	I-Claim	HighQuality	
inferiore	I-Claim	HighQuality	
a	I-Claim	HighQuality	
3	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
indicata	I-Claim	HighQuality	
l'artrodesi	I-Claim	HighQuality	
chirurgica;	I-Claim	HighQuality	
con	I-Claim	HighQuality	
Risser	I-Claim	HighQuality	
maggiore	I-Claim	HighQuality	
o	I-Claim	HighQuality	
uguale	I-Claim	HighQuality	
a	I-Claim	HighQuality	
3	I-Claim	HighQuality	
il	I-Claim	HighQuality	
potenziale	I-Claim	HighQuality	
di	I-Claim	HighQuality	
crescita	I-Claim	HighQuality	
residuo	I-Claim	HighQuality	
della	I-Claim	HighQuality	
curva	I-Claim	HighQuality	
è	I-Claim	HighQuality	
basso	I-Claim	HighQuality	
e	I-Claim	HighQuality	
si	I-Claim	HighQuality	
può	I-Claim	HighQuality	
considerare	I-Claim	HighQuality	
l'osservazione	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
in	I-Claim	HighQuality	
cui	I-Claim	HighQuality	
tenda	I-Claim	HighQuality	
a	I-Claim	HighQuality	
progredire	I-Claim	HighQuality	
in	I-Claim	HighQuality	
età	I-Claim	HighQuality	
adulta.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
CHIRURGIA	O		
ORTOPEDICA	O		
E	O		
TRAUMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Donna	B-Premise	HighQuality	
che	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
difficoltà	I-Premise	HighQuality	
di	I-Premise	HighQuality	
deambulazione	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
un	I-Premise	HighQuality	
intervento	I-Premise	HighQuality	
di	I-Premise	HighQuality	
chirurgia	I-Premise	HighQuality	
ginecologica.	I-Premise	HighQuality	

Ha	B-Premise	HighQuality	
un	I-Premise	HighQuality	
lieve	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
coscia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
la	I-Premise	HighQuality	
gamba	I-Premise	HighQuality	
non	I-Premise	HighQuality	
riesce	I-Premise	HighQuality	
a	I-Premise	HighQuality	
sostenerlo.	I-Premise	HighQuality	

All'esame,	B-Premise	HighQuality	
il	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
debolezza	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
flessione	I-Premise	HighQuality	
dell'anca	I-Premise	HighQuality	
e	I-Premise	HighQuality	
nell'estensione	I-Premise	HighQuality	
del	I-Premise	HighQuality	
ginocchio	I-Premise	HighQuality	
e	I-Premise	HighQuality	
disestesia	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
parte	I-Premise	HighQuality	
anteriore	I-Premise	HighQuality	
della	I-Premise	HighQuality	
coscia.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
diagnosi	O		
di	O		
sospetto	O		
più	O		
probabile?	O		

1-	O		
Neuropatia	B-Claim	HighQuality	
del	I-Claim	HighQuality	
nervo	I-Claim	HighQuality	
femorale.	I-Claim	HighQuality	

2-	O		
Meralgia	B-Claim	HighQuality	
paraestetica	I-Claim	HighQuality	
del	I-Claim	HighQuality	
nervo	I-Claim	HighQuality	
cutaneo	I-Claim	HighQuality	
femorale.	I-Claim	HighQuality	

3-	O		
Neuropatia	B-Claim	HighQuality	
del	I-Claim	HighQuality	
nervo	I-Claim	HighQuality	
otturatore.	I-Claim	HighQuality	

4-	O		
Neuropatia	B-Claim	HighQuality	
del	I-Claim	HighQuality	
nervo	I-Claim	HighQuality	
sciatico.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
1	O		

Il	B-Claim	HighQuality	
nervo	I-Claim	HighQuality	
femorale	I-Claim	HighQuality	
(sebbene	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
raro)	I-Claim	HighQuality	
può	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
danneggiato	I-Claim	HighQuality	
da	I-Claim	HighQuality	
un	I-Claim	HighQuality	
parto	I-Claim	HighQuality	
cesareo,	I-Claim	HighQuality	
da	I-Claim	HighQuality	
un'isterectomia	I-Claim	HighQuality	
o	I-Claim	HighQuality	
da	I-Claim	HighQuality	
un'operazione	I-Claim	HighQuality	
all'addome	I-Claim	HighQuality	
inferiore.	I-Claim	HighQuality	

Questa	B-Claim	HighQuality	
lesione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
nervo	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
ipoestesia	I-Claim	HighQuality	
e	I-Claim	HighQuality	
debolezza	I-Claim	HighQuality	
lungo	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sua	I-Claim	HighQuality	
distribuzione.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
femoroneuropatia	I-Claim	HighQuality	
si	I-Claim	HighQuality	
manifesta	I-Claim	HighQuality	
con	I-Claim	HighQuality	
la	I-Claim	HighQuality	
paralisi	I-Claim	HighQuality	
(25%	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
casi)	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
muscoli	I-Claim	HighQuality	
quadricipiti,	I-Claim	HighQuality	
l'abolizione	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
riflessi	I-Claim	HighQuality	
rotulei	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'ipoestesia	I-Claim	HighQuality	
della	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
anteriore	I-Claim	HighQuality	
e	I-Claim	HighQuality	
interna	I-Claim	HighQuality	
della	I-Claim	HighQuality	
coscia.	I-Claim	HighQuality	

Pertanto,	B-Claim	HighQuality	
la	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
1	I-Claim	HighQuality	
è	I-Claim	HighQuality	
corretta.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
nervo	I-Claim	HighQuality	
cutaneo	I-Claim	HighQuality	
femorale	I-Claim	HighQuality	
o	I-Claim	HighQuality	
laterale	I-Claim	HighQuality	
(L2,L3)	I-Claim	HighQuality	
è	I-Claim	HighQuality	
solo	I-Claim	HighQuality	
sensibile	I-Claim	HighQuality	
ed	I-Claim	HighQuality	
è	I-Claim	HighQuality	
responsabile	I-Claim	HighQuality	
della	I-Claim	HighQuality	
sensazione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pelle	I-Claim	HighQuality	
della	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
laterale	I-Claim	HighQuality	
e	I-Claim	HighQuality	
anteriore	I-Claim	HighQuality	
della	I-Claim	HighQuality	
coscia	I-Claim	HighQuality	
fino	I-Claim	HighQuality	
al	I-Claim	HighQuality	
ginocchio,	I-Claim	HighQuality	
quindi	O		
non	B-Claim	HighQuality	
spiegherebbe	I-Claim	HighQuality	
il	I-Claim	HighQuality	
problema	I-Claim	HighQuality	
motorio	I-Claim	HighQuality	
della	I-Claim	HighQuality	
deambulazione	I-Claim	HighQuality	
e	O		
il	B-Claim	HighQuality	
punto	I-Claim	HighQuality	
2	I-Claim	HighQuality	
è	I-Claim	HighQuality	
falso.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
nervo	I-Claim	HighQuality	
otturatore	I-Claim	HighQuality	
(L2-L4)	I-Claim	HighQuality	
è	I-Claim	HighQuality	
un	I-Claim	HighQuality	
nervo	I-Claim	HighQuality	
misto.	I-Claim	HighQuality	

A	B-Claim	HighQuality	
livello	I-Claim	HighQuality	
motorio	I-Claim	HighQuality	
investe	I-Claim	HighQuality	
l'otturatore	I-Claim	HighQuality	
esterno,	I-Claim	HighQuality	
il	I-Claim	HighQuality	
pectineus,	I-Claim	HighQuality	
l'approssimatore	I-Claim	HighQuality	
breve,	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
approssimatori	I-Claim	HighQuality	
(adduttori)	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
gracile.	I-Claim	HighQuality	

Livello	B-Claim	HighQuality	
sensoriale	I-Claim	HighQuality	
la	I-Claim	HighQuality	
capsula	I-Claim	HighQuality	
dell'articolazione	I-Claim	HighQuality	
coxofemorale,	I-Claim	HighQuality	
aspetto	I-Claim	HighQuality	
mediale	I-Claim	HighQuality	
della	I-Claim	HighQuality	
coscia	I-Claim	HighQuality	
sopra	I-Claim	HighQuality	
il	I-Claim	HighQuality	
ginocchio.	I-Claim	HighQuality	

Pertanto,	B-Claim	HighQuality	
non	I-Claim	HighQuality	
influisce	I-Claim	HighQuality	
né	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
sensazione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
anteriore	I-Claim	HighQuality	
della	I-Claim	HighQuality	
coscia	I-Claim	HighQuality	
né	I-Claim	HighQuality	
sull'estensione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
ginocchio,	I-Claim	HighQuality	
quindi	I-Claim	HighQuality	
il	I-Claim	HighQuality	
punto	I-Claim	HighQuality	
3	I-Claim	HighQuality	
è	I-Claim	HighQuality	
falso.	I-Claim	HighQuality	

Una	B-Claim	HighQuality	
lesione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
nervo	I-Claim	HighQuality	
sciatico	I-Claim	HighQuality	
a	I-Claim	HighQuality	
livello	I-Claim	HighQuality	
motorio	I-Claim	HighQuality	
colpisce	I-Claim	HighQuality	
la	I-Claim	HighQuality	
flessione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
e	I-Claim	HighQuality	
non	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sua	I-Claim	HighQuality	
estensione	I-Claim	HighQuality	
e	I-Claim	HighQuality	
a	I-Claim	HighQuality	
livello	I-Claim	HighQuality	
distale	I-Claim	HighQuality	
a	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
(non	I-Claim	HighQuality	
contano	I-Claim	HighQuality	
nulla	I-Claim	HighQuality	
della	I-Claim	HighQuality	
clinica	I-Claim	HighQuality	
distale)	I-Claim	HighQuality	
e	I-Claim	HighQuality	
a	I-Claim	HighQuality	
livello	I-Claim	HighQuality	
sensibile	I-Claim	HighQuality	
è	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
distale	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
faccia	I-Claim	HighQuality	
esterna	I-Claim	HighQuality	
della	I-Claim	HighQuality	
gamba	I-Claim	HighQuality	
e	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
piede	I-Claim	HighQuality	
quindi	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
il	I-Claim	HighQuality	
4	I-Claim	HighQuality	
è	I-Claim	HighQuality	
falso.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
CURA	O		
CRITICA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
18	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
arriva	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
dell'ospedale	I-Premise	HighQuality	
trasferito	I-Premise	HighQuality	
da	I-Premise	HighQuality	
un'unità	I-Premise	HighQuality	
di	I-Premise	HighQuality	
supporto	I-Premise	HighQuality	
vitale	I-Premise	HighQuality	
di	I-Premise	HighQuality	
base.	I-Premise	HighQuality	

È	B-Premise	HighQuality	
stato	I-Premise	HighQuality	
investito	I-Premise	HighQuality	
da	I-Premise	HighQuality	
un'auto	I-Premise	HighQuality	
mentre	I-Premise	HighQuality	
era	I-Premise	HighQuality	
in	I-Premise	HighQuality	
bicicletta.	I-Premise	HighQuality	

All'arrivo	B-Premise	HighQuality	
ha	I-Premise	HighQuality	
una	I-Premise	HighQuality	
frequenza	I-Premise	HighQuality	
cardiaca	I-Premise	HighQuality	
di	I-Premise	HighQuality	
115	I-Premise	HighQuality	
bpm,	I-Premise	HighQuality	
una	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
110/75	I-Premise	HighQuality	
mmHg,	I-Premise	HighQuality	
un	I-Premise	HighQuality	
polso	I-Premise	HighQuality	
radiale	I-Premise	HighQuality	
palpabile,	I-Premise	HighQuality	
una	I-Premise	HighQuality	
ricarica	I-Premise	HighQuality	
capillare	I-Premise	HighQuality	
di	I-Premise	HighQuality	
2,5	I-Premise	HighQuality	
secondi	I-Premise	HighQuality	
e	I-Premise	HighQuality	
una	I-Premise	HighQuality	
frequenza	I-Premise	HighQuality	
respiratoria	I-Premise	HighQuality	
di	I-Premise	HighQuality	
25	I-Premise	HighQuality	
rpm.	I-Premise	HighQuality	

Cosa	O		
ci	O		
dicono	O		
questi	O		
dati?	O		

1	O		
-	O		
Il	B-Claim	LowQuality	corrected
paziente	B-Claim	LowQuality	corrected
ha	B-Claim	LowQuality	corrected
perso	I-Claim	LowQuality	
il	I-Claim	LowQuality	
15-30%	I-Claim	LowQuality	
del	I-Claim	LowQuality	
volume	I-Claim	LowQuality	
del	I-Claim	LowQuality	
sangue	I-Claim	LowQuality	
e	I-Claim	LowQuality	
avete	I-Claim	LowQuality	
bisogno	I-Claim	LowQuality	
di	I-Claim	LowQuality	
una	I-Claim	LowQuality	
sostituzione	I-Claim	LowQuality	
del	I-Claim	LowQuality	
volume.	I-Claim	LowQuality	

2-	O		
Perdita	B-Claim	HighQuality	
di	I-Claim	HighQuality	
oltre	I-Claim	HighQuality	
il	I-Claim	HighQuality	
30%	I-Claim	HighQuality	
del	I-Claim	HighQuality	
volume	I-Claim	HighQuality	
ematico	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sostituzione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
volume	I-Claim	HighQuality	
ematico.	I-Claim	HighQuality	

3-	O		
Ha	B-Claim	HighQuality	
perso	I-Claim	HighQuality	
più	I-Claim	HighQuality	
del	I-Claim	HighQuality	
40%	I-Claim	HighQuality	
del	I-Claim	HighQuality	
volume	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sangue	I-Claim	HighQuality	
e	I-Claim	HighQuality	
richiede	I-Claim	HighQuality	
un	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
chirurgico.	I-Claim	HighQuality	

4-	O		
Perdita	B-Claim	HighQuality	
di	I-Claim	HighQuality	
oltre	I-Claim	HighQuality	
il	I-Claim	HighQuality	
50%	I-Claim	HighQuality	
del	I-Claim	HighQuality	
volume	I-Claim	HighQuality	
ematico	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sostituzione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
volume	I-Claim	HighQuality	
ematico.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
1	O		

Tecnicamente,	B-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
ha	I-Claim	HighQuality	
un'emorragia	I-Claim	HighQuality	
di	I-Claim	HighQuality	
grado	I-Claim	HighQuality	
II	I-Claim	HighQuality	
secondo	I-Claim	HighQuality	
la	I-Claim	HighQuality	
classificazione	I-Claim	HighQuality	
ATLS,	I-Claim	HighQuality	
in	B-Claim	HighQuality	
linea	I-Claim	HighQuality	
di	I-Claim	HighQuality	
principio	I-Claim	HighQuality	
ciò	I-Claim	HighQuality	
significa	I-Claim	HighQuality	
una	I-Claim	HighQuality	
perdita	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sangue	I-Claim	HighQuality	
compresa	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
750	I-Claim	HighQuality	
e	I-Claim	HighQuality	
1500mL	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'azione	I-Claim	HighQuality	
indicata	I-Claim	HighQuality	
è	I-Claim	HighQuality	
la	I-Claim	HighQuality	
rianimazione	I-Claim	HighQuality	
con	I-Claim	HighQuality	
cristalloidi;	I-Claim	HighQuality	
tuttavia,	B-Claim	HighQuality	
nelle	I-Claim	HighQuality	
linee	I-Claim	HighQuality	
guida	I-Claim	HighQuality	
per	I-Claim	HighQuality	
l'assistenza	I-Claim	HighQuality	
ai	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
con	I-Claim	HighQuality	
politraumi	I-Claim	HighQuality	
gravi,	I-Claim	HighQuality	
si	I-Claim	HighQuality	
raccomanda	I-Claim	HighQuality	
sempre	I-Claim	HighQuality	
più	I-Claim	HighQuality	
l'uso	I-Claim	HighQuality	
precoce	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
plasmaderivati,	I-Claim	HighQuality	
soprattutto	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
casi	I-Claim	HighQuality	
limite	I-Claim	HighQuality	
come	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
e	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
giovani,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
potrebbero	I-Claim	HighQuality	
non	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
in	I-Claim	HighQuality	
grado	I-Claim	HighQuality	
di	I-Claim	HighQuality	
riconoscere	I-Claim	HighQuality	
la	I-Claim	HighQuality	
gravità	I-Claim	HighQuality	
della	I-Claim	HighQuality	
perdita	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sangue	I-Claim	HighQuality	
finché	I-Claim	HighQuality	
non	I-Claim	HighQuality	
diventa	I-Claim	HighQuality	
molto	I-Claim	HighQuality	
più	I-Claim	HighQuality	
significativa.	I-Claim	HighQuality	

Pertanto,	B-Claim	HighQuality	
esiterei	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
le	I-Claim	HighQuality	
opzioni	I-Claim	HighQuality	
1	I-Claim	HighQuality	
e	I-Claim	HighQuality	
2	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
EMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
di	I-Premise	HighQuality	
18	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un'epistassi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
diversi	I-Premise	HighQuality	
giorni,	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
personale	I-Premise	HighQuality	
o	I-Premise	HighQuality	
familiare	I-Premise	HighQuality	
di	I-Premise	HighQuality	
interesse.	I-Premise	HighQuality	

All'esame	B-Premise	HighQuality	
è	I-Premise	HighQuality	
astemio,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
osservano	I-Premise	HighQuality	
ecchimosi	I-Premise	HighQuality	
multiple,	I-Premise	HighQuality	
non	I-Premise	HighQuality	
è	I-Premise	HighQuality	
palpabile	I-Premise	HighQuality	
alcuna	I-Premise	HighQuality	
splenomegalia.	I-Premise	HighQuality	

Analisi:	B-Premise	HighQuality	
Leucociti	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	
Piastrine	I-Premise	HighQuality	
6,0	I-Premise	HighQuality	
x103/μL.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
trombocitopenia	I-Premise	HighQuality	
è	I-Premise	HighQuality	
confermata	I-Premise	HighQuality	
dallo	I-Premise	HighQuality	
striscio,	I-Premise	HighQuality	
dove	I-Premise	HighQuality	
si	I-Premise	HighQuality	
osserva	I-Premise	HighQuality	
un	I-Premise	HighQuality	
aumento	I-Premise	HighQuality	
delle	I-Premise	HighQuality	
dimensioni	I-Premise	HighQuality	
delle	I-Premise	HighQuality	
piastrine.	I-Premise	HighQuality	

Studi	B-Premise	HighQuality	
normali	I-Premise	HighQuality	
di	I-Premise	HighQuality	
coagulazione	I-Premise	HighQuality	
e	I-Premise	HighQuality	
biochimica.	I-Premise	HighQuality	

Quale	O		
ritiene	O		
sia	O		
la	O		
diagnosi	O		
più	O		
probabile?	O		

1-	O		
Porpora	B-Claim	HighQuality	
trombotica	I-Claim	HighQuality	
trombocitopenica.	I-Claim	HighQuality	

2-	O		
Coagulazione	B-Claim	HighQuality	
intravascolare	I-Claim	HighQuality	
disseminata.	I-Claim	HighQuality	

3-	O		
Trombocitopenia	B-Claim	HighQuality	
indotta	I-Claim	HighQuality	
da	I-Claim	HighQuality	
infezioni.	I-Claim	HighQuality	

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

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
4	O		

Se	B-Claim	HighQuality	
volessero	I-Claim	HighQuality	
rispondere	I-Claim	HighQuality	
che	I-Claim	HighQuality	
si	I-Claim	HighQuality	
tratta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
TTP	I-Claim	HighQuality	
(risposta	I-Claim	HighQuality	
1)	I-Claim	HighQuality	
probabilmente	I-Claim	HighQuality	
assocerebbero	I-Claim	HighQuality	
l'anemia	I-Claim	HighQuality	
e	I-Claim	HighQuality	
sicuramente	I-Claim	HighQuality	
ci	I-Claim	HighQuality	
direbbero	I-Claim	HighQuality	
degli	I-Claim	HighQuality	
schistociti	I-Claim	HighQuality	
nello	I-Claim	HighQuality	
striscio.	I-Claim	HighQuality	

Per	B-Claim	HighQuality	
non	I-Claim	HighQuality	
dire	I-Claim	HighQuality	
che	I-Claim	HighQuality	
probabilmente	I-Claim	HighQuality	
i	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
del	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
andrebbero	I-Claim	HighQuality	
ben	I-Claim	HighQuality	
oltre	I-Claim	HighQuality	
l'epistassi.	I-Claim	HighQuality	

Per	B-Claim	HighQuality	
le	I-Claim	HighQuality	
altre	I-Claim	HighQuality	
due	I-Claim	HighQuality	
risposte	I-Claim	HighQuality	
non	I-Claim	HighQuality	
c'è	I-Claim	HighQuality	
bisogno	I-Claim	HighQuality	
di	I-Claim	HighQuality	
esitare.	I-Claim	HighQuality	

Non	B-Claim	HighQuality	
c'è	I-Claim	HighQuality	
nulla	I-Claim	HighQuality	
che	I-Claim	HighQuality	
lo	I-Claim	HighQuality	
indichi.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PEDIATRIA	O		

CLINICAL	O		
CASE:	O		

Il	B-Premise	HighQuality	
disturbo	I-Premise	HighQuality	
ossessivo-compulsivo	I-Premise	HighQuality	
(DOC)	I-Premise	HighQuality	
a	I-Premise	HighQuality	
esordio	I-Premise	HighQuality	
improvviso	I-Premise	HighQuality	
in	I-Premise	HighQuality	
un	I-Premise	HighQuality	
bambino	I-Premise	HighQuality	
di	I-Premise	HighQuality	
9	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
tic	I-Premise	HighQuality	
e	I-Premise	HighQuality	
corea	I-Premise	HighQuality	
come	I-Premise	HighQuality	
manifestazioni	I-Premise	HighQuality	
neurologiche	I-Premise	HighQuality	
deve	O		
essere	O		
escluso:	O		

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

2-	O		
Streptococco	B-Claim	HighQuality	
alfa-emolitico.	I-Claim	HighQuality	

3-	O		
Streptococco	B-Claim	HighQuality	
beta-emolitico,	I-Claim	HighQuality	
gruppo	I-Claim	HighQuality	
A.	I-Claim	HighQuality	

4-	O		
Enterococco.	B-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Viene	B-Claim	HighQuality	
presentato	I-Claim	HighQuality	
un	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sindrome	I-Claim	HighQuality	
PANDAS,	I-Claim	HighQuality	
una	I-Claim	HighQuality	
rara	I-Claim	HighQuality	
complicanza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un'infezione	I-Claim	HighQuality	
causata	I-Claim	HighQuality	
da	I-Claim	HighQuality	
streptococco	I-Claim	HighQuality	
beta-emolitico	I-Claim	HighQuality	
di	I-Claim	HighQuality	
gruppo	I-Claim	HighQuality	
A.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PEDIATRIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
bambina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
5	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
completamente	I-Premise	HighQuality	
asintomatica,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
si	I-Premise	HighQuality	
reca	I-Premise	HighQuality	
al	I-Premise	HighQuality	
controllo	I-Premise	HighQuality	
periodico	I-Premise	HighQuality	
del	I-Premise	HighQuality	
pediatra.	I-Premise	HighQuality	

Si	O		
consulta	O		
perché	O		
sua	B-Premise	HighQuality	
madre	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
operata	I-Premise	HighQuality	
per	I-Premise	HighQuality	
un	I-Premise	HighQuality	
tumore	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
tiroide	I-Premise	HighQuality	
e	I-Premise	HighQuality	
una	I-Premise	HighQuality	
nonna	I-Premise	HighQuality	
è	I-Premise	HighQuality	
morta	I-Premise	HighQuality	
10	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
fa	I-Premise	HighQuality	
per	I-Premise	HighQuality	
un	I-Premise	HighQuality	
feocromocitoma.	I-Premise	HighQuality	

L'approccio	O		
terapeutico	O		
prioritario	O		
che	O		
adotteremo	O		
sarà:	O		

1-	O		
Esame	B-Claim	HighQuality	
fisico	I-Claim	HighQuality	
approfondito	I-Claim	HighQuality	
con	I-Claim	HighQuality	
controllo	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
arteriosa	I-Claim	HighQuality	
per	I-Claim	HighQuality	
valutare	I-Claim	HighQuality	
se	I-Claim	HighQuality	
il	I-Claim	HighQuality	
bambino	I-Claim	HighQuality	
può	I-Claim	HighQuality	
avere	I-Claim	HighQuality	
una	I-Claim	HighQuality	
malattia	I-Claim	HighQuality	
familiare.	I-Claim	HighQuality	

2-	O		
Analisi	B-Claim	HighQuality	
biochimica	I-Claim	HighQuality	
con	I-Claim	HighQuality	
calcitonina.	I-Claim	HighQuality	
Se	I-Claim	HighQuality	
la	I-Claim	HighQuality	
calcitonina	I-Claim	HighQuality	
è	I-Claim	HighQuality	
normale,	I-Claim	HighQuality	
a	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
età	I-Claim	HighQuality	
non	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
necessari	I-Claim	HighQuality	
ulteriori	I-Claim	HighQuality	
controlli.	I-Claim	HighQuality	

3-	O		
Monitoraggio	B-Claim	HighQuality	
annuale	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
livelli	I-Claim	HighQuality	
di	I-Claim	HighQuality	
calcitonina	I-Claim	HighQuality	
con	I-Claim	HighQuality	
stimolazione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
pentagastrina	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
se	I-Claim	HighQuality	
elevati,	I-Claim	HighQuality	
indicazione	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
tiroidectomia	I-Claim	HighQuality	
profilattica.	I-Claim	HighQuality	

4-	O		
Studio	B-Claim	HighQuality	
genetico	I-Claim	HighQuality	
della	I-Claim	HighQuality	
mutazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
proto-oncogene	I-Claim	HighQuality	
RET	I-Claim	HighQuality	
c634	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
positività,	I-Claim	HighQuality	
tiroidectomia	I-Claim	HighQuality	
radicale	I-Claim	HighQuality	
profilattica	I-Claim	HighQuality	
a	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
età.	I-Claim	HighQuality	

5-	O		
Studio	B-Claim	HighQuality	
genetico	I-Claim	HighQuality	
della	I-Claim	HighQuality	
mutazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
proto-oncogene	I-Claim	HighQuality	
RET	I-Claim	HighQuality	
c634,	I-Claim	HighQuality	
livelli	I-Claim	HighQuality	
di	I-Claim	HighQuality	
calcitonina	I-Claim	HighQuality	
e	I-Claim	HighQuality	
FNA	I-Claim	HighQuality	
(aspirazione	I-Claim	HighQuality	
con	I-Claim	HighQuality	
ago	I-Claim	HighQuality	
sottile)	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
se	I-Claim	HighQuality	
positivo,	I-Claim	HighQuality	
tiroidectomia	I-Claim	HighQuality	
radicale.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
4	O		

La	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
4	I-Claim	HighQuality	

Mi	O		
sembra	O		
più	O		
una	O		
domanda	O		
da	O		
endocrinologo	O		
che	O		
da	O		
pediatra.	O		

I	B-Claim	HighQuality	
portatori	I-Claim	HighQuality	
del	I-Claim	HighQuality	
proto-oncogene	I-Claim	HighQuality	
presentano	I-Claim	HighQuality	
spesso	I-Claim	HighQuality	
tumori	I-Claim	HighQuality	
tiroidei	I-Claim	HighQuality	
precoci	I-Claim	HighQuality	
e	O		
la	B-Claim	HighQuality	
tiroidectomia	I-Claim	HighQuality	
radicale	I-Claim	HighQuality	
è	I-Claim	HighQuality	
spesso	I-Claim	HighQuality	
raccomandata	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
5	I-Claim	HighQuality	
anni	I-Claim	HighQuality	
di	I-Claim	HighQuality	
età.	I-Claim	HighQuality	

Ovviamente	O		
ho	O		
dovuto	O		
informarmi...	O		
non	O		
è	O		
molto	O		
comune	O		
nella	O		
nostra	O		
pratica	O		
abituale.	O		

QUESTION	O		
TYPE:	O		
DIGESTIVO	O		

CLINICAL	O		
CASE:	O		

Paziente	B-Premise	HighQuality	
con	I-Premise	HighQuality	
diagnosi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
diverticolite	I-Premise	HighQuality	
acuta,	I-Premise	HighQuality	
trattato	I-Premise	HighQuality	
con	I-Premise	HighQuality	
amoxicillina/acido	I-Premise	HighQuality	
clavulanico.	I-Premise	HighQuality	

Dopo	B-Premise	HighQuality	
5	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
inizia	I-Premise	HighQuality	
a	I-Premise	HighQuality	
presentare	I-Premise	HighQuality	
febbre	I-Premise	HighQuality	
e	I-Premise	HighQuality	
diarrea.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
diagnosticata	I-Premise	HighQuality	
una	I-Premise	HighQuality	
colite	I-Premise	HighQuality	
da	I-Premise	HighQuality	
Clostridium	I-Premise	HighQuality	
difficile,	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
sospesa	I-Premise	HighQuality	
l'amoxicillina/acido	I-Premise	HighQuality	
clavulanico	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stato	I-Premise	HighQuality	
prescritto	I-Premise	HighQuality	
il	I-Premise	HighQuality	
metronidazolo.	I-Premise	HighQuality	

A	B-Premise	HighQuality	
4	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
non	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
risposto	I-Premise	HighQuality	
al	I-Premise	HighQuality	
metronidazolo,	I-Premise	HighQuality	
ma	I-Premise	HighQuality	
è	I-Premise	HighQuality	
clinicamente	I-Premise	HighQuality	
stabile.	I-Premise	HighQuality	

La	O		
fase	O		
successiva	O		
del	O		
trattamento	O		
è:	O		

1-	O		
Passare	B-Claim	HighQuality	
dal	I-Claim	HighQuality	
metronidazolo	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
vancomicina	I-Claim	HighQuality	
orale	I-Claim	HighQuality	
(125	I-Claim	HighQuality	
mg,	I-Claim	HighQuality	
quattro	I-Claim	HighQuality	
volte	I-Claim	HighQuality	
al	I-Claim	HighQuality	
giorno	I-Claim	HighQuality	
per	I-Claim	HighQuality	
10	I-Claim	HighQuality	
giorni).	I-Claim	HighQuality	

2-	O		
Passare	B-Claim	HighQuality	
dal	I-Claim	HighQuality	
metronidazolo	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
piperacillina/tazobactam	I-Claim	HighQuality	
(4	I-Claim	HighQuality	
g	I-Claim	HighQuality	
di	I-Claim	HighQuality	
piperacillina/0,5	I-Claim	HighQuality	
g	I-Claim	HighQuality	
di	I-Claim	HighQuality	
tazobactam	I-Claim	HighQuality	
ogni	I-Claim	HighQuality	
8	I-Claim	HighQuality	
ore).	I-Claim	HighQuality	

3-	O		
Indicare	B-Claim	HighQuality	
una	I-Claim	HighQuality	
colectomia	I-Claim	HighQuality	
subtotale.	I-Claim	HighQuality	

4-	O		
Eseguire	B-Claim	HighQuality	
un'ileostomia	I-Claim	HighQuality	
ad	I-Claim	HighQuality	
ansa	I-Claim	HighQuality	
con	I-Claim	HighQuality	
lavaggio	I-Claim	HighQuality	
anterogrado	I-Claim	HighQuality	
con	I-Claim	HighQuality	
polietilenglicole.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
1	O		

Il	B-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
di	I-Claim	HighQuality	
scelta	I-Claim	HighQuality	
per	I-Claim	HighQuality	
l'infezione	I-Claim	HighQuality	
da	I-Claim	HighQuality	
Clostridioides	I-Claim	HighQuality	
difficile	I-Claim	HighQuality	
è	I-Claim	HighQuality	
la	I-Claim	HighQuality	
vancomicina	I-Claim	HighQuality	
per	I-Claim	HighQuality	
via	I-Claim	HighQuality	
orale	I-Claim	HighQuality	
125mg/6h	I-Claim	HighQuality	
per	I-Claim	HighQuality	
10	I-Claim	HighQuality	
giorni.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
metronidazolo	I-Claim	HighQuality	
è	I-Claim	HighQuality	
stato	I-Claim	HighQuality	
relegato	I-Claim	HighQuality	
alle	I-Claim	HighQuality	
situazioni	I-Claim	HighQuality	
in	I-Claim	HighQuality	
cui	I-Claim	HighQuality	
la	I-Claim	HighQuality	
vancomicina	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
disponibile.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
PSICHIATRIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
di	I-Premise	HighQuality	
36	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
proveniente	I-Premise	HighQuality	
da	I-Premise	HighQuality	
un'altra	I-Premise	HighQuality	
cultura	I-Premise	HighQuality	
e	I-Premise	HighQuality	
residente	I-Premise	HighQuality	
in	I-Premise	HighQuality	
Spagna	I-Premise	HighQuality	
da	I-Premise	HighQuality	
4	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
in	I-Premise	HighQuality	
una	I-Premise	HighQuality	
clinica	I-Premise	HighQuality	
del	I-Premise	HighQuality	
Servizio	I-Premise	HighQuality	
Sanitario	I-Premise	HighQuality	
Nazionale.	I-Premise	HighQuality	

Riferisce	B-Premise	HighQuality	
di	I-Premise	HighQuality	
aver	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
sintomi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
ansia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
umore	I-Premise	HighQuality	
depressivo	I-Premise	HighQuality	
negli	I-Premise	HighQuality	
ultimi	I-Premise	HighQuality	
10	I-Premise	HighQuality	
mesi.	I-Premise	HighQuality	

Questa	O		
condizione	O		
interferisce	O		
moderatamente	O		
con	O		
le	O		
loro	O		
attività	O		
quotidiane.	O		

Nessun	B-Premise	HighQuality	
precedente	I-Premise	HighQuality	
psichiatrico.	I-Premise	HighQuality	

Questa	O		
situazione	O		
si	O		
è	O		
creata	O		
dopo	O		
la	O		
morte	O		
in	O		
un	O		
incidente	O		
stradale	O		
di	O		
un	O		
fratello	O		
maggiore	O		
a	O		
cui	O		
era	O		
molto	O		
legato.	O		

Quale	O		
delle	O		
seguenti	O		
diagnosi	O		
è	O		
appropriata?	O		

1-	O		
Depressione	B-Claim	HighQuality	
maggiore.	I-Claim	HighQuality	

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

3-	O		
Disturbo	B-Claim	HighQuality	
di	I-Claim	HighQuality	
adattamento.	I-Claim	HighQuality	

4-	O		
Distimia.	B-Claim	HighQuality	

5-	O		
Ciclotimia.	B-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
3	O		

La	B-Claim	HighQuality	
relativa	I-Claim	HighQuality	
mitezza	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
sintomi,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
non	I-Claim	HighQuality	
interferiscono	I-Claim	HighQuality	
seriamente	I-Claim	HighQuality	
con	I-Claim	HighQuality	
le	I-Claim	HighQuality	
attività	I-Claim	HighQuality	
quotidiane,	I-Claim	HighQuality	
esclude	I-Claim	HighQuality	
in	I-Claim	HighQuality	
linea	I-Claim	HighQuality	
di	I-Claim	HighQuality	
principio	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
depressione	I-Claim	HighQuality	
maggiore.	I-Claim	HighQuality	

Non	B-Claim	HighQuality	
ci	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
prove	I-Claim	HighQuality	
di	I-Claim	HighQuality	
fasi	I-Claim	HighQuality	
ipomaniacali	I-Claim	HighQuality	
che	I-Claim	HighQuality	
giustifichino	I-Claim	HighQuality	
un	I-Claim	HighQuality	
disturbo	I-Claim	HighQuality	
bipolare	I-Claim	HighQuality	
II.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
distimia	I-Claim	HighQuality	
richiede	I-Claim	HighQuality	
una	I-Claim	HighQuality	
durata	I-Claim	HighQuality	
di	I-Claim	HighQuality	
almeno	I-Claim	HighQuality	
due	I-Claim	HighQuality	
anni.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
ciclotimia	I-Claim	HighQuality	
è	I-Claim	HighQuality	
una	I-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
molto	I-Claim	HighQuality	
rara	I-Claim	HighQuality	
al	I-Claim	HighQuality	
giorno	I-Claim	HighQuality	
d'oggi	I-Claim	HighQuality	
(perché,	O		
come	O		
ha	O		
detto	O		
Castilla	O		
del	O		
Pino	O		
in	O		
un'intervista,	O		
quelli	B-Claim	HighQuality	
che	I-Claim	HighQuality	
un	I-Claim	HighQuality	
tempo	I-Claim	HighQuality	
erano	I-Claim	HighQuality	
ciclotimici	I-Claim	HighQuality	
ora	I-Claim	HighQuality	
vengono	I-Claim	HighQuality	
chiamati	I-Claim	HighQuality	
bipolari,	I-Claim	HighQuality	
contribuendo	I-Claim	HighQuality	
a	I-Claim	HighQuality	
una	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
molteplici	I-Claim	HighQuality	
epidemie	I-Claim	HighQuality	
psichiatriche	I-Claim	HighQuality	
del	I-Claim	HighQuality	
nostro	I-Claim	HighQuality	
tempo),	I-Claim	HighQuality	
che	B-Claim	HighQuality	
consiste	I-Claim	HighQuality	
in	I-Claim	HighQuality	
oscillazioni	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
il	I-Claim	HighQuality	
polo	I-Claim	HighQuality	
depressivo	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
polo	I-Claim	HighQuality	
lievemente	I-Claim	HighQuality	
depressivo.	I-Claim	HighQuality	

Ma	B-Premise	HighQuality	
non	I-Premise	HighQuality	
ci	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
dati	I-Premise	HighQuality	
su	I-Premise	HighQuality	
queste	I-Premise	HighQuality	
oscillazioni.	I-Premise	HighQuality	

La	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
probabilmente	I-Claim	HighQuality	
la	I-Claim	HighQuality	
3	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
disturbo	I-Claim	HighQuality	
adattivo	I-Claim	HighQuality	
compare	I-Claim	HighQuality	
entro	I-Claim	HighQuality	
3	I-Claim	HighQuality	
mesi	I-Claim	HighQuality	
dall'evento	I-Claim	HighQuality	
stressante	I-Claim	HighQuality	
e	I-Claim	HighQuality	
non	I-Claim	HighQuality	
dura	I-Claim	HighQuality	
più	I-Claim	HighQuality	
di	I-Claim	HighQuality	
6	I-Claim	HighQuality	
mesi	I-Claim	HighQuality	
se	I-Claim	HighQuality	
l'evento	I-Claim	HighQuality	
stressante	I-Claim	HighQuality	
o	I-Claim	HighQuality	
le	I-Claim	HighQuality	
sue	I-Claim	HighQuality	
conseguenze	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
cessate	I-Claim	HighQuality	
(il	I-Claim	HighQuality	
che	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
il	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
perché	I-Claim	HighQuality	
il	I-Claim	HighQuality	
fratello	I-Claim	HighQuality	
del	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
immaginario	I-Claim	HighQuality	
è	I-Claim	HighQuality	
ancora	I-Claim	HighQuality	
morto).	I-Claim	HighQuality	

I	O		
sintomi	O		
ansioso-depressivi	O		
lievi	O		
si	O		
adattano	O		
a	O		
tale	O		
diagnosi.	O		

Un	O		
altro	O		
esempio	O		
di	O		
come	O		
si	O		
possano	O		
concettualizzare	O		
come	O		
malattia	O		
quelli	O		
che	O		
sono	O		
fatti	O		
della	O		
vita	O		
(anche	O		
se	O		
dolorosi).	O		

Sono	O		
sicuro	O		
che	O		
il	O		
paziente	O		
immaginario	O		
prende	O		
qualche	O		
antidepressivo	O		
perché	O		
forse	O		
qualcosa	O		
aiuta	O		
(1).	O		

QUESTION	O		
TYPE:	O		
ONCOLOGIA	O		

CLINICAL	O		
CASE:	O		

In	B-Premise	HighQuality	
un	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
che	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
una	I-Premise	HighQuality	
lesione	I-Premise	HighQuality	
ulcerativa	I-Premise	HighQuality	
sulla	I-Premise	HighQuality	
gengiva	I-Premise	HighQuality	
mandibolare	I-Premise	HighQuality	
a	I-Premise	HighQuality	
livello	I-Premise	HighQuality	
della	I-Premise	HighQuality	
regione	I-Premise	HighQuality	
molare	I-Premise	HighQuality	
di	I-Premise	HighQuality	
5	I-Premise	HighQuality	
mesi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
evoluzione,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
deve	I-Premise	HighQuality	
escludere	I-Premise	HighQuality	
la	I-Premise	HighQuality	
comparsa	I-Premise	HighQuality	
di	I-Premise	HighQuality	
ipoestesia	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
regione	I-Premise	HighQuality	
del	I-Premise	HighQuality	
mento:	I-Premise	HighQuality	

1-	O		
Una	B-Claim	HighQuality	
neuropatia	I-Claim	HighQuality	
paraneoplastica.	I-Claim	HighQuality	

2-	O		
La	B-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sarcoidosi	I-Claim	HighQuality	
con	I-Claim	HighQuality	
paralisi	I-Claim	HighQuality	
facciale	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
bilancia.	I-Claim	HighQuality	

3-	O		
Infezione	B-Claim	HighQuality	
da	I-Claim	HighQuality	
Herpes	I-Claim	HighQuality	
virus	I-Claim	HighQuality	
in	I-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
immunocompromessi.	I-Claim	HighQuality	

4-	O		
Diagnosi	B-Claim	HighQuality	
di	I-Claim	HighQuality	
carcinoma	I-Claim	HighQuality	
con	I-Claim	HighQuality	
infiltrazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
canale	I-Claim	HighQuality	
mandibolare.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
4	O		

Le	B-Claim	HighQuality	
parestesie	I-Claim	HighQuality	
mentoniere	I-Claim	HighQuality	
(segno	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Roger)	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
associate	I-Claim	HighQuality	
a	I-Claim	HighQuality	
metastasi	I-Claim	HighQuality	
ossee	I-Claim	HighQuality	
(non	B-Claim	HighQuality	
paraneoplastiche	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
con	I-Claim	HighQuality	
infiltrazione	I-Claim	HighQuality	
diretta).	I-Claim	HighQuality	

In	B-Claim	HighQuality	
questo	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
si	I-Claim	HighQuality	
tratta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un	I-Claim	HighQuality	
tumore	I-Claim	HighQuality	
orale	I-Claim	HighQuality	
che	I-Claim	HighQuality	
cresce	I-Claim	HighQuality	
localmente	I-Claim	HighQuality	
e	I-Claim	HighQuality	
si	I-Claim	HighQuality	
infiltra	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
canale	I-Claim	HighQuality	
mandibolare.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
ENDOCRINOLOGIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
55	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
diabete	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tipo	I-Premise	HighQuality	
1	I-Premise	HighQuality	
diagnosticato	I-Premise	HighQuality	
all'età	I-Premise	HighQuality	
di	I-Premise	HighQuality	
15	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
lamenta	I-Premise	HighQuality	
nausea	I-Premise	HighQuality	
e	I-Premise	HighQuality	
gonfiore,	I-Premise	HighQuality	
soprattutto	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
i	I-Premise	HighQuality	
pasti.	I-Premise	HighQuality	

La	B-Premise	HighQuality	
valutazione	I-Premise	HighQuality	
è	I-Premise	HighQuality	
compatibile	I-Premise	HighQuality	
con	I-Premise	HighQuality	
la	I-Premise	HighQuality	
gastroparesi	I-Premise	HighQuality	
diabetica.	I-Premise	HighQuality	

Quale	O		
dei	O		
seguenti	O		
farmaci	O		
sarebbe	O		
il	O		
trattamento	O		
più	O		
appropriato	O		
per	O		
migliorare	O		
i	O		
suoi	O		
sintomi?	O		

1-	O		
Lansoprazolo.	B-Claim	HighQuality	

2-	O		
Ondansetron.	B-Claim	HighQuality	

3-	O		
Loperamida.	B-Claim	HighQuality	

4-	O		
Metoclopramide.	B-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
4	O		

È	B-Claim	HighQuality	
stato	I-Claim	HighQuality	
approvato	I-Claim	HighQuality	
come	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
per	I-Claim	HighQuality	
la	I-Claim	HighQuality	
gastroparesi	I-Claim	HighQuality	
dalla	I-Claim	HighQuality	
Food	I-Claim	HighQuality	
and	I-Claim	HighQuality	
Drug	I-Claim	HighQuality	
Administration	I-Claim	HighQuality	
(FDA)	I-Claim	HighQuality	
statunitense	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
1979	I-Claim	HighQuality	
e	I-Claim	HighQuality	
rimane	I-Claim	HighQuality	
il	I-Claim	HighQuality	
farmaco	I-Claim	HighQuality	
di	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
linea.	I-Claim	HighQuality	

Agisce	B-Claim	HighQuality	
come	I-Claim	HighQuality	
procinetico	I-Claim	HighQuality	
attraverso	I-Claim	HighQuality	
il	I-Claim	HighQuality	
suo	I-Claim	HighQuality	
effetto	I-Claim	HighQuality	
antagonista	I-Claim	HighQuality	
sul	I-Claim	HighQuality	
recettore	I-Claim	HighQuality	
della	I-Claim	HighQuality	
dopamina	I-Claim	HighQuality	
2	I-Claim	HighQuality	
(D2)	I-Claim	HighQuality	
favorendo	I-Claim	HighQuality	
lo	I-Claim	HighQuality	
svuotamento	I-Claim	HighQuality	
gastrico	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
inoltre,	I-Claim	HighQuality	
si	I-Claim	HighQuality	
lega	I-Claim	HighQuality	
al	I-Claim	HighQuality	
recettore	I-Claim	HighQuality	
della	I-Claim	HighQuality	
5-idrossitriptamina	I-Claim	HighQuality	
4	I-Claim	HighQuality	
(serotonina	I-Claim	HighQuality	
5-HT4)	I-Claim	HighQuality	
per	I-Claim	HighQuality	
stimolare	I-Claim	HighQuality	
le	I-Claim	HighQuality	
vie	I-Claim	HighQuality	
nervose	I-Claim	HighQuality	
colinergiche	I-Claim	HighQuality	
nello	I-Claim	HighQuality	
stomaco.	I-Claim	HighQuality	

Fisiologicamente,	B-Claim	HighQuality	
accelera	I-Claim	HighQuality	
il	I-Claim	HighQuality	
transito	I-Claim	HighQuality	
intestinale	I-Claim	HighQuality	
aumentando	I-Claim	HighQuality	
il	I-Claim	HighQuality	
tono	I-Claim	HighQuality	
e	I-Claim	HighQuality	
l'ampiezza	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
contrazioni	I-Claim	HighQuality	
gastriche,	I-Claim	HighQuality	
aumenta	I-Claim	HighQuality	
la	I-Claim	HighQuality	
pressione	I-Claim	HighQuality	
dello	I-Claim	HighQuality	
sfintere	I-Claim	HighQuality	
esofageo	I-Claim	HighQuality	
inferiore	I-Claim	HighQuality	
e	I-Claim	HighQuality	
migliora	I-Claim	HighQuality	
la	I-Claim	HighQuality	
coordinazione	I-Claim	HighQuality	
antropiloroduodenale.	I-Claim	HighQuality	

Inoltre,	B-Claim	HighQuality	
questo	I-Claim	HighQuality	
agente	I-Claim	HighQuality	
antiemetico	I-Claim	HighQuality	
fornisce	I-Claim	HighQuality	
sollievo	I-Claim	HighQuality	
attraverso	I-Claim	HighQuality	
l'antagonismo	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
recettori	I-Claim	HighQuality	
centrali	I-Claim	HighQuality	
e	I-Claim	HighQuality	
periferici	I-Claim	HighQuality	
della	I-Claim	HighQuality	
dopamina.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
NEFROLOGIA	O		

CLINICAL	O		
CASE:	O		

Donna	B-Premise	HighQuality	
di	I-Premise	HighQuality	
67	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
malattia	I-Premise	HighQuality	
renale	I-Premise	HighQuality	
cronica	I-Premise	HighQuality	
secondaria	I-Premise	HighQuality	
a	I-Premise	HighQuality	
nefropatia	I-Premise	HighQuality	
diabetica.	I-Premise	HighQuality	

Attualmente	B-Premise	HighQuality	
ha	I-Premise	HighQuality	
una	I-Premise	HighQuality	
creatinina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
3,2	I-Premise	HighQuality	
mg/dl	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
velocità	I-Premise	HighQuality	
di	I-Premise	HighQuality	
filtrazione	I-Premise	HighQuality	
glomerulare	I-Premise	HighQuality	
stimata	I-Premise	HighQuality	
(CKD-EPI)	I-Premise	HighQuality	
di	I-Premise	HighQuality	
14	I-Premise	HighQuality	
ml/min.	I-Premise	HighQuality	

Quale	O		
delle	O		
seguenti	O		
affermazioni	O		
è	O		
vera?	O		

1-	O		
Ha	B-Claim	HighQuality	
una	I-Claim	HighQuality	
malattia	I-Claim	HighQuality	
renale	I-Claim	HighQuality	
cronica	I-Claim	HighQuality	
di	I-Claim	HighQuality	
stadio	I-Claim	HighQuality	
3	I-Claim	HighQuality	
e	I-Claim	HighQuality	
deve	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
sottoposto	I-Claim	HighQuality	
a	I-Claim	HighQuality	
chelanti	I-Claim	HighQuality	
del	I-Claim	HighQuality	
fosforo.	I-Claim	HighQuality	

2-	O		
Ha	B-Claim	HighQuality	
una	I-Claim	HighQuality	
malattia	I-Claim	HighQuality	
renale	I-Claim	HighQuality	
cronica	I-Claim	HighQuality	
allo	I-Claim	HighQuality	
stadio	I-Claim	HighQuality	
5	I-Claim	HighQuality	
e	I-Claim	HighQuality	
deve	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
presa	I-Claim	HighQuality	
in	I-Claim	HighQuality	
considerazione	I-Claim	HighQuality	
la	I-Claim	HighQuality	
terapia	I-Claim	HighQuality	
renale	I-Claim	HighQuality	
sostitutiva.	I-Claim	HighQuality	

3-	O		
Un	B-Claim	HighQuality	
buon	I-Claim	HighQuality	
controllo	I-Claim	HighQuality	
glicemico	I-Claim	HighQuality	
può	I-Claim	HighQuality	
far	I-Claim	HighQuality	
regredire	I-Claim	HighQuality	
l'insufficienza	I-Claim	HighQuality	
renale.	I-Claim	HighQuality	

4-	O		
È	B-Claim	HighQuality	
improbabile	I-Claim	HighQuality	
che	I-Claim	HighQuality	
la	I-Claim	HighQuality	
proteinuria	I-Claim	HighQuality	
superi	I-Claim	HighQuality	
i	I-Claim	HighQuality	
500	I-Claim	HighQuality	
mg/24h.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
2	O		

Una	B-Claim	HighQuality	
velocità	I-Claim	HighQuality	
di	I-Claim	HighQuality	
filtrazione	I-Claim	HighQuality	
glomerulare	I-Claim	HighQuality	
inferiore	I-Claim	HighQuality	
a	I-Claim	HighQuality	
15	I-Claim	HighQuality	
ml/min	I-Claim	HighQuality	
è	I-Claim	HighQuality	
classificata	I-Claim	HighQuality	
come	I-Claim	HighQuality	
stadio	I-Claim	HighQuality	
5	I-Claim	HighQuality	
(G5),	I-Claim	HighQuality	
indicando	O		
che	O		
la	B-Claim	HighQuality	
malattia	I-Claim	HighQuality	
renale	I-Claim	HighQuality	
è	I-Claim	HighQuality	
in	I-Claim	HighQuality	
fase	I-Claim	HighQuality	
terminale	I-Claim	HighQuality	
e	O		
che	O		
si	B-Claim	HighQuality	
deve	I-Claim	HighQuality	
prendere	I-Claim	HighQuality	
in	I-Claim	HighQuality	
considerazione	I-Claim	HighQuality	
l'inizio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
terapia	I-Claim	HighQuality	
sostitutiva	I-Claim	HighQuality	
(opzione	B-Claim	HighQuality	
2	I-Claim	HighQuality	
vera,	I-Claim	HighQuality	
opzione	B-Claim	HighQuality	
1	I-Claim	HighQuality	
falsa).	I-Claim	HighQuality	

In	B-Claim	HighQuality	
questa	I-Claim	HighQuality	
situazione,	I-Claim	HighQuality	
un	I-Claim	HighQuality	
buon	I-Claim	HighQuality	
controllo	I-Claim	HighQuality	
glicemico	I-Claim	HighQuality	
non	I-Claim	HighQuality	
può	I-Claim	HighQuality	
invertire	I-Claim	HighQuality	
il	I-Claim	HighQuality	
danno	I-Claim	HighQuality	
renale,	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
se	I-Claim	HighQuality	
può	I-Claim	HighQuality	
contribuire	I-Claim	HighQuality	
a	I-Claim	HighQuality	
ritardarne	I-Claim	HighQuality	
la	I-Claim	HighQuality	
progressione	I-Claim	HighQuality	
(falsa	B-Claim	HighQuality	
scelta	I-Claim	HighQuality	
3).	I-Claim	HighQuality	

Questi	B-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
presentano	I-Claim	HighQuality	
solitamente	I-Claim	HighQuality	
un'albuminuria	I-Claim	HighQuality	
di	I-Claim	HighQuality	
stadio	I-Claim	HighQuality	
A3	I-Claim	HighQuality	
(superiore	I-Claim	HighQuality	
a	I-Claim	HighQuality	
300	I-Claim	HighQuality	
mg/24	I-Claim	HighQuality	
h)	I-Claim	HighQuality	
e	I-Claim	HighQuality	
possono	I-Claim	HighQuality	
raggiungere	I-Claim	HighQuality	
il	I-Claim	HighQuality	
range	I-Claim	HighQuality	
nefrosico	I-Claim	HighQuality	
(falsa	B-Claim	HighQuality	
scelta	I-Claim	HighQuality	
4).	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
NEFROLOGIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
75	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
in	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
con	I-Premise	HighQuality	
sertralina	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
presentata	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
disturbo	I-Premise	HighQuality	
confusionale.	I-Premise	HighQuality	

Non	B-Premise	HighQuality	
è	I-Premise	HighQuality	
evidente	I-Premise	HighQuality	
alcun	I-Premise	HighQuality	
edema	I-Premise	HighQuality	
e	I-Premise	HighQuality	
la	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
è	I-Premise	HighQuality	
di	I-Premise	HighQuality	
130/70.	I-Premise	HighQuality	

Le	B-Premise	HighQuality	
analisi	I-Premise	HighQuality	
del	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
Na	I-Premise	HighQuality	
126	I-Premise	HighQuality	
mEq/l	I-Premise	HighQuality	
e	I-Premise	HighQuality	
K	I-Premise	HighQuality	
4	I-Premise	HighQuality	
mEq/l,	I-Premise	HighQuality	
la	I-Premise	HighQuality	
natriuria	I-Premise	HighQuality	
era	I-Premise	HighQuality	
di	I-Premise	HighQuality	
45	I-Premise	HighQuality	
mEq/l	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stata	I-Premise	HighQuality	
esclusa	I-Premise	HighQuality	
l'assunzione	I-Premise	HighQuality	
di	I-Premise	HighQuality	
diuretici.	I-Premise	HighQuality	

Quale	O		
dei	O		
seguenti	O		
è	O		
l'atteggiamento	O		
più	O		
corretto?	O		

1-	O		
Si	B-Claim	HighQuality	
tratta	I-Claim	HighQuality	
del	I-Claim	HighQuality	
morbo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Addison	I-Claim	HighQuality	
e	I-Claim	HighQuality	
i	I-Claim	HighQuality	
corticosteroidi	I-Claim	HighQuality	
devono	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
somministrati	I-Claim	HighQuality	
immediatamente.	I-Claim	HighQuality	

2-	O		
Somministrare	B-Claim	HighQuality	
una	I-Claim	HighQuality	
soluzione	I-Claim	HighQuality	
salina	I-Claim	HighQuality	
ipertonica	I-Claim	HighQuality	
per	I-Claim	HighQuality	
ripristinare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
natremia	I-Claim	HighQuality	
il	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
possibile.	I-Claim	HighQuality	

3-	O		
Indicare	B-Claim	HighQuality	
la	I-Claim	HighQuality	
restrizione	I-Claim	HighQuality	
idrica	I-Claim	HighQuality	
e,	I-Claim	HighQuality	
se	I-Claim	HighQuality	
la	I-Claim	HighQuality	
natremia	I-Claim	HighQuality	
non	I-Claim	HighQuality	
aumenta,	I-Claim	HighQuality	
passare	I-Claim	HighQuality	
all'infusione	I-Claim	HighQuality	
lenta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
soluzione	I-Claim	HighQuality	
fisiologica.	I-Claim	HighQuality	

4-	O		
Ordinare	B-Claim	HighQuality	
una	I-Claim	HighQuality	
risonanza	I-Claim	HighQuality	
magnetica	I-Claim	HighQuality	
dell'encefalo,	I-Claim	HighQuality	
poiché	I-Claim	HighQuality	
è	I-Claim	HighQuality	
probabile	I-Claim	HighQuality	
che	I-Claim	HighQuality	
si	I-Claim	HighQuality	
tratti	I-Claim	HighQuality	
di	I-Claim	HighQuality	
diabete	I-Claim	HighQuality	
insipido.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Ci	B-Claim	HighQuality	
viene	I-Claim	HighQuality	
presentato	I-Claim	HighQuality	
un	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
con	I-Claim	HighQuality	
moderata	I-Claim	HighQuality	
iponatriemia	I-Claim	HighQuality	
euvolaemica,	I-Claim	HighQuality	
che	I-Claim	HighQuality	
suggerisce	I-Claim	HighQuality	
una	I-Claim	HighQuality	
sindrome	I-Claim	HighQuality	
da	I-Claim	HighQuality	
antidiuresi	I-Claim	HighQuality	
inadeguata	I-Claim	HighQuality	
(SIAD)	I-Claim	HighQuality	
secondaria	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
sertralina,	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
se	I-Claim	HighQuality	
l'osmolalità	I-Claim	HighQuality	
urinaria	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
necessaria	I-Claim	HighQuality	
per	I-Claim	HighQuality	
confermarlo.	I-Claim	HighQuality	

L'insufficienza	B-Claim	HighQuality	
surrenalica	I-Claim	HighQuality	
primaria	I-Claim	HighQuality	
porta	I-Claim	HighQuality	
all'iponatriemia	I-Claim	HighQuality	
ipovolemica	I-Claim	HighQuality	
(opzione	B-Claim	HighQuality	
1	I-Claim	HighQuality	
errata).	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
diabete	I-Claim	HighQuality	
insipido	I-Claim	HighQuality	
è	I-Claim	HighQuality	
l'opposto	I-Claim	HighQuality	
di	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
condizione	I-Claim	HighQuality	
e	I-Claim	HighQuality	
di	I-Claim	HighQuality	
solito	I-Claim	HighQuality	
si	I-Claim	HighQuality	
presenta	I-Claim	HighQuality	
con	I-Claim	HighQuality	
ipernatremia	I-Claim	HighQuality	
(opzione	B-Claim	HighQuality	
4	I-Claim	HighQuality	
non	I-Claim	HighQuality	
corretta).	I-Claim	HighQuality	

Resta	B-Claim	HighQuality	
da	I-Claim	HighQuality	
decidere	I-Claim	HighQuality	
se	I-Claim	HighQuality	
trattare	I-Claim	HighQuality	
in	I-Claim	HighQuality	
modo	I-Claim	HighQuality	
aggressivo	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
soluzione	I-Claim	HighQuality	
salina	I-Claim	HighQuality	
ipertonica	I-Claim	HighQuality	
o	I-Claim	HighQuality	
se	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
più	I-Claim	HighQuality	
conservativi	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
restrizione	I-Claim	HighQuality	
idrica.	I-Claim	HighQuality	

Con	B-Claim	HighQuality	
natremie	I-Claim	HighQuality	
superiori	I-Claim	HighQuality	
a	I-Claim	HighQuality	
125	I-Claim	HighQuality	
mmol/l,	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
con	I-Claim	HighQuality	
HSS	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
indicato	I-Claim	HighQuality	
a	I-Claim	HighQuality	
meno	I-Claim	HighQuality	
che	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
non	I-Claim	HighQuality	
presenti	I-Claim	HighQuality	
gravi	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
neurologici,	I-Claim	HighQuality	
cosa	I-Claim	HighQuality	
che	I-Claim	HighQuality	
non	I-Claim	HighQuality	
sembra	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
il	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
(il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
descrive	I-Premise	HighQuality	
un	I-Premise	HighQuality	
quadro	I-Premise	HighQuality	
confusionale	I-Premise	HighQuality	
che	B-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
un'encefalopatia	I-Claim	HighQuality	
iponatremica	I-Claim	HighQuality	
moderata),	I-Claim	HighQuality	
né	O		
è	B-Claim	HighQuality	
indicato	I-Claim	HighQuality	
ripristinare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
natremia	I-Claim	HighQuality	
il	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
possibile	I-Claim	HighQuality	
(a	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
del	I-Claim	HighQuality	
rischio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sindrome	I-Claim	HighQuality	
da	I-Claim	HighQuality	
demielinizzazione	I-Claim	HighQuality	
osmotica).	I-Claim	HighQuality	

Pertanto,	B-Claim	HighQuality	
la	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
3	I-Claim	HighQuality	

Quello	B-Claim	HighQuality	
che	I-Claim	HighQuality	
non	I-Claim	HighQuality	
mi	I-Claim	HighQuality	
piace	I-Claim	HighQuality	
di	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
che	I-Claim	HighQuality	
la	I-Claim	HighQuality	
seconda	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
(se	I-Claim	HighQuality	
la	I-Claim	HighQuality	
natremia	I-Claim	HighQuality	
non	I-Claim	HighQuality	
sale,	I-Claim	HighQuality	
passare	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un'infusione	I-Claim	HighQuality	
lenta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
soluzione	I-Claim	HighQuality	
fisiologica)	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
corretta,	I-Claim	HighQuality	
in	B-Claim	HighQuality	
quanto	I-Claim	HighQuality	
in	I-Claim	HighQuality	
questo	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
si	I-Claim	HighQuality	
dovrebbe	I-Claim	HighQuality	
considerare	I-Claim	HighQuality	
l'uso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
furosemide,	I-Claim	HighQuality	
tolvaptan	I-Claim	HighQuality	
o	I-Claim	HighQuality	
urea,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
di	I-Claim	HighQuality	
soluzione	I-Claim	HighQuality	
fisiologica	I-Claim	HighQuality	
(e	B-Claim	HighQuality	
non	I-Claim	HighQuality	
indica	I-Claim	HighQuality	
nemmeno	I-Claim	HighQuality	
la	I-Claim	HighQuality	
tonicità,	I-Claim	HighQuality	
in	I-Claim	HighQuality	
quanto	I-Claim	HighQuality	
isotonico	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
uguale	I-Claim	HighQuality	
a	I-Claim	HighQuality	
ipertonico).	I-Claim	HighQuality	

In	B-Claim	HighQuality	
ogni	I-Claim	HighQuality	
caso,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
mi	I-Claim	HighQuality	
sembra	I-Claim	HighQuality	
molto	I-Claim	HighQuality	
probabile	I-Claim	HighQuality	
che	I-Claim	HighQuality	
venga	I-Claim	HighQuality	
annullata.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
NEUROLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
30	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
consultato	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
cefalea	I-Premise	HighQuality	
perioculare	I-Premise	HighQuality	
unilaterale	I-Premise	HighQuality	
che	I-Premise	HighQuality	
è	I-Premise	HighQuality	
rapidamente	I-Premise	HighQuality	
progredita	I-Premise	HighQuality	
fino	I-Premise	HighQuality	
a	I-Premise	HighQuality	
diventare	I-Premise	HighQuality	
molto	I-Premise	HighQuality	
intensa.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
attacchi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
durano	I-Premise	HighQuality	
30-60	I-Premise	HighQuality	
minuti,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
verificano	I-Premise	HighQuality	
2-3	I-Premise	HighQuality	
volte	I-Premise	HighQuality	
al	I-Premise	HighQuality	
giorno	I-Premise	HighQuality	
e	I-Premise	HighQuality	
sono	I-Premise	HighQuality	
accompagnati	I-Premise	HighQuality	
da	I-Premise	HighQuality	
lacrimazione	I-Premise	HighQuality	
dell'occhio	I-Premise	HighQuality	
dolente	I-Premise	HighQuality	
e	I-Premise	HighQuality	
rinorrea	I-Premise	HighQuality	
unilaterale.	I-Premise	HighQuality	

Qual	O		
è	O		
il	O		
trattamento	O		
preventivo	O		
più	O		
appropriato?	O		

1-	O		
Prednisone	B-Claim	HighQuality	
orale	I-Claim	HighQuality	
con	I-Claim	HighQuality	
sospensione	I-Claim	HighQuality	
in	I-Claim	HighQuality	
2-3	I-Claim	HighQuality	
mesi.	I-Claim	HighQuality	

2-	O		
Prednisone	B-Claim	HighQuality	
orale	I-Claim	HighQuality	
con	I-Claim	HighQuality	
sospensione	I-Claim	HighQuality	
in	I-Claim	HighQuality	
un	I-Claim	HighQuality	
mese,	I-Claim	HighQuality	
associato	I-Claim	HighQuality	
a	I-Claim	HighQuality	
verapamil	I-Claim	HighQuality	
orale	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
dose	I-Claim	HighQuality	
di	I-Claim	HighQuality	
80-180	I-Claim	HighQuality	
mg	I-Claim	HighQuality	
ogni	I-Claim	HighQuality	
8	I-Claim	HighQuality	
ore.	I-Claim	HighQuality	

3-	O		
Carbamazepina	B-Claim	HighQuality	
alla	I-Claim	HighQuality	
dose	I-Claim	HighQuality	
di	I-Claim	HighQuality	
600-1200	I-Claim	HighQuality	
mg	I-Claim	HighQuality	
al	I-Claim	HighQuality	
giorno.	I-Claim	HighQuality	

4-	O		
Indometacina	B-Claim	HighQuality	
alla	I-Claim	HighQuality	
dose	I-Claim	HighQuality	
di	I-Claim	HighQuality	
50	I-Claim	HighQuality	
mg	I-Claim	HighQuality	
ogni	I-Claim	HighQuality	
8	I-Claim	HighQuality	
ore	I-Claim	HighQuality	
per	I-Claim	HighQuality	
un	I-Claim	HighQuality	
mese.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
2	O		

Descrivono	B-Claim	HighQuality	
un	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
caratteristico	I-Claim	HighQuality	
di	I-Claim	HighQuality	
cefalea	I-Claim	HighQuality	
a	I-Claim	HighQuality	
grappolo.	I-Claim	HighQuality	

È	B-Claim	HighQuality	
più	I-Claim	HighQuality	
frequente	I-Claim	HighQuality	
nei	I-Claim	HighQuality	
maschi,	I-Claim	HighQuality	
il	B-Claim	HighQuality	
dolore	I-Claim	HighQuality	
è	I-Claim	HighQuality	
caratteristicamente	I-Claim	HighQuality	
unilaterale	I-Claim	HighQuality	
perioculare	I-Claim	HighQuality	
di	I-Claim	HighQuality	
grande	I-Claim	HighQuality	
intensità,	I-Claim	HighQuality	
di	I-Claim	HighQuality	
durata	I-Claim	HighQuality	
variabile,	I-Claim	HighQuality	
generalmente	I-Claim	HighQuality	
di	I-Claim	HighQuality	
pochi	I-Claim	HighQuality	
minuti	I-Claim	HighQuality	
e	I-Claim	HighQuality	
associato	I-Claim	HighQuality	
a	I-Claim	HighQuality	
segni	I-Claim	HighQuality	
trigeminoautonomici	I-Claim	HighQuality	
come	I-Claim	HighQuality	
rinorrea	I-Claim	HighQuality	
e	I-Claim	HighQuality	
iniezione	I-Claim	HighQuality	
congiuntivale	I-Claim	HighQuality	
unilaterale.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
preventivo	I-Claim	HighQuality	
per	I-Claim	HighQuality	
eccellenza	I-Claim	HighQuality	
è	I-Claim	HighQuality	
il	I-Claim	HighQuality	
verapamil,	I-Claim	HighQuality	
associato	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un	I-Claim	HighQuality	
regime	I-Claim	HighQuality	
di	I-Claim	HighQuality	
corticosteroidi	I-Claim	HighQuality	
a	I-Claim	HighQuality	
basso	I-Claim	HighQuality	
dosaggio,	I-Claim	HighQuality	
come	I-Claim	HighQuality	
descritto	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
2	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
NEUROLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
45	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
è	I-Premise	HighQuality	
stato	I-Premise	HighQuality	
portato	I-Premise	HighQuality	
in	I-Premise	HighQuality	
clinica	I-Premise	HighQuality	
dai	I-Premise	HighQuality	
suoi	I-Premise	HighQuality	
parenti	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
storia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
perdita	I-Premise	HighQuality	
di	I-Premise	HighQuality	
memoria	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
anno,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
era	I-Premise	HighQuality	
progredita	I-Premise	HighQuality	
al	I-Premise	HighQuality	
punto	I-Premise	HighQuality	
da	I-Premise	HighQuality	
richiedere	I-Premise	HighQuality	
aiuto	I-Premise	HighQuality	
per	I-Premise	HighQuality	
alcune	I-Premise	HighQuality	
attività	I-Premise	HighQuality	
della	I-Premise	HighQuality	
vita	I-Premise	HighQuality	
quotidiana.	I-Premise	HighQuality	

Ha	B-Premise	HighQuality	
un'anamnesi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
emicrania	I-Premise	HighQuality	
e	I-Premise	HighQuality	
alcuni	I-Premise	HighQuality	
episodi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
focalità	I-Premise	HighQuality	
neurologica	I-Premise	HighQuality	
autolimitata	I-Premise	HighQuality	
per	I-Premise	HighQuality	
i	I-Premise	HighQuality	
quali	I-Premise	HighQuality	
non	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
mai	I-Premise	HighQuality	
consultata.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
neuropsicologico	I-Premise	HighQuality	
è	I-Premise	HighQuality	
compatibile	I-Premise	HighQuality	
con	I-Premise	HighQuality	
una	I-Premise	HighQuality	
demenza	I-Premise	HighQuality	
iniziale	I-Premise	HighQuality	
e	I-Premise	HighQuality	
la	I-Premise	HighQuality	
RMN	I-Premise	HighQuality	
cerebrale	I-Premise	HighQuality	
mostra	I-Premise	HighQuality	
una	I-Premise	HighQuality	
grave	I-Premise	HighQuality	
leucoencefalopatia.	I-Premise	HighQuality	

Quali	O		
prove	O		
devono	O		
essere	O		
richieste?	O		

1-	O		
Puntura	B-Claim	HighQuality	
lombare	I-Claim	HighQuality	
per	I-Claim	HighQuality	
analizzare	I-Claim	HighQuality	
le	I-Claim	HighQuality	
proteine	I-Claim	HighQuality	
amiloidi	I-Claim	HighQuality	
e	I-Claim	HighQuality	
tau	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
liquor.	I-Claim	HighQuality	

2-	O		
Studio	B-Claim	HighQuality	
genetico	I-Claim	HighQuality	
della	I-Claim	HighQuality	
presenilina	I-Claim	HighQuality	
1	I-Claim	HighQuality	
(PSEN1).	I-Claim	HighQuality	

3-	O		
Studio	B-Claim	HighQuality	
genetico	I-Claim	HighQuality	
per	I-Claim	HighQuality	
NOTCH3.	I-Claim	HighQuality	

4-	O		
Studio	B-Claim	HighQuality	
genetico	I-Claim	HighQuality	
per	I-Claim	HighQuality	
la	I-Claim	HighQuality	
progranulina.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
3	O		

Descriviamo	B-Claim	HighQuality	
un	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
caratteristico	I-Claim	HighQuality	
di	I-Claim	HighQuality	
CADASIL	I-Claim	HighQuality	
(Arteriopatia	I-Claim	HighQuality	
Cerebrale	I-Claim	HighQuality	
Autosomica	I-Claim	HighQuality	
Dominante	I-Claim	HighQuality	
con	I-Claim	HighQuality	
Infarti	I-Claim	HighQuality	
Sottocorticali	I-Claim	HighQuality	
e	I-Claim	HighQuality	
Leucoencefalopatia).	I-Claim	HighQuality	

È	B-Claim	HighQuality	
una	I-Claim	HighQuality	
malattia	I-Claim	HighQuality	
genetica,	I-Claim	HighQuality	
ereditata	I-Claim	HighQuality	
in	I-Claim	HighQuality	
modo	I-Claim	HighQuality	
autosomico	I-Claim	HighQuality	
dominante	I-Claim	HighQuality	
per	I-Claim	HighQuality	
mutazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
gene	I-Claim	HighQuality	
NOTCH3.	I-Claim	HighQuality	

Questa	B-Claim	HighQuality	
mutazione	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
un	I-Claim	HighQuality	
coinvolgimento	I-Claim	HighQuality	
vascolare	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
piccoli	I-Claim	HighQuality	
vasi	I-Claim	HighQuality	
che	I-Claim	HighQuality	
porta	I-Claim	HighQuality	
a	I-Claim	HighQuality	
una	I-Claim	HighQuality	
grave	I-Claim	HighQuality	
leucoencefalopatia	I-Claim	HighQuality	
precoce,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
serie	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sintomi.	I-Claim	HighQuality	

Spiccano	B-Claim	HighQuality	
le	I-Claim	HighQuality	
emicranie,	I-Claim	HighQuality	
le	I-Claim	HighQuality	
malattie	I-Claim	HighQuality	
cerebrovascolari	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
deterioramento	I-Claim	HighQuality	
cognitivo	I-Claim	HighQuality	
in	I-Claim	HighQuality	
età	I-Claim	HighQuality	
precoce,	I-Claim	HighQuality	
come	I-Claim	HighQuality	
mostrato	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
caso	I-Claim	HighQuality	
clinico	I-Claim	HighQuality	
della	I-Claim	HighQuality	
domanda.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
REUMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
26	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
diagnosi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
lupus	I-Premise	HighQuality	
eritematoso	I-Premise	HighQuality	
sistemico,	I-Premise	HighQuality	
in	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
con	I-Premise	HighQuality	
idrossiclorochina,	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
consultato	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
sensazione	I-Premise	HighQuality	
di	I-Premise	HighQuality	
debolezza	I-Premise	HighQuality	
generalizzata	I-Premise	HighQuality	
che	I-Premise	HighQuality	
si	I-Premise	HighQuality	
è	I-Premise	HighQuality	
sviluppata	I-Premise	HighQuality	
progressivamente	I-Premise	HighQuality	
negli	I-Premise	HighQuality	
ultimi	I-Premise	HighQuality	
15	I-Premise	HighQuality	
giorni.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
fisico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
pallore	I-Premise	HighQuality	
cutaneo	I-Premise	HighQuality	
e	I-Premise	HighQuality	
gli	I-Premise	HighQuality	
esami	I-Premise	HighQuality	
del	I-Premise	HighQuality	
sangue	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
Hb	I-Premise	HighQuality	
7,4	I-Premise	HighQuality	
g/dL,	I-Premise	HighQuality	
Hct	I-Premise	HighQuality	
31%,	I-Premise	HighQuality	
MCV	I-Premise	HighQuality	
108	I-Premise	HighQuality	

Quale	O		
delle	O		
seguenti	O		
determinazioni	O		
sarà	O		
più	O		
utile	O		
per	O		
decidere	O		
l'azione	O		
da	O		
intraprendere?	O		

1-	O		
Aptoglobina.	B-Claim	HighQuality	

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

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

4-	O		
Anticorpi	B-Claim	HighQuality	
antinucleari.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
2	O		

In	B-Claim	HighQuality	
questa	I-Claim	HighQuality	
domanda	I-Claim	HighQuality	
ci	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
presentato	I-Claim	HighQuality	
un	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
con	I-Claim	HighQuality	
lupus	I-Claim	HighQuality	
eritematoso	I-Claim	HighQuality	
sistemico	I-Claim	HighQuality	
che	I-Claim	HighQuality	
presenta	I-Claim	HighQuality	
un'anemia	I-Claim	HighQuality	
emolitica	I-Claim	HighQuality	
autoimmune.	I-Claim	HighQuality	

Per	B-Claim	HighQuality	
questo,	I-Claim	HighQuality	
l'opzione	I-Claim	HighQuality	
migliore	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
quella	I-Claim	HighQuality	
di	I-Claim	HighQuality	
chiedere	I-Claim	HighQuality	
i	I-Claim	HighQuality	
reticolociti,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
poiché	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
le	I-Claim	HighQuality	
opzioni,	I-Claim	HighQuality	
dovremmo	I-Claim	HighQuality	
chiedere	I-Claim	HighQuality	
un	I-Claim	HighQuality	
test	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Coombs,	I-Claim	HighQuality	
quindi	O		
la	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
2	I-Claim	HighQuality	

Sebbene	B-Premise	HighQuality	
vogliano	I-Premise	HighQuality	
confonderci	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un	I-Premise	HighQuality	
MCV	I-Premise	HighQuality	
108,	I-Premise	HighQuality	
in	B-Claim	HighQuality	
modo	I-Claim	HighQuality	
da	I-Claim	HighQuality	
farci	I-Claim	HighQuality	
pensare	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un'anemia	I-Claim	HighQuality	
megaloblastica,	I-Claim	HighQuality	
l'MCV	B-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
eccessivamente	I-Claim	HighQuality	
alto,	I-Claim	HighQuality	
l'insorgenza	I-Claim	HighQuality	
dell'anemia	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
nostro	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
è	I-Claim	HighQuality	
stata	I-Claim	HighQuality	
rapida	I-Claim	HighQuality	
e	I-Claim	HighQuality	
non	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
compatibile	I-Claim	HighQuality	
con	I-Claim	HighQuality	
il	I-Claim	HighQuality	
LES	I-Claim	HighQuality	
o	I-Claim	HighQuality	
la	I-Claim	HighQuality	
forma	I-Claim	HighQuality	
di	I-Claim	HighQuality	
presentazione.	I-Claim	HighQuality	

Gli	B-Claim	HighQuality	
anticorpi	I-Claim	HighQuality	
antinucleari	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
utilizzati	I-Claim	HighQuality	
per	I-Claim	HighQuality	
la	I-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
non	I-Claim	HighQuality	
per	I-Claim	HighQuality	
il	I-Claim	HighQuality	
monitoraggio	I-Claim	HighQuality	
del	I-Claim	HighQuality	
LES.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
TRAUMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
41	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
consultato	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
gonalgia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
diversi	I-Premise	HighQuality	
giorni.	I-Premise	HighQuality	

All'esame,	B-Premise	HighQuality	
il	I-Premise	HighQuality	
test	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Thessaly	I-Premise	HighQuality	
(dolore	I-Premise	HighQuality	
con	I-Premise	HighQuality	
movimenti	I-Premise	HighQuality	
di	I-Premise	HighQuality	
rotazione	I-Premise	HighQuality	
interna	I-Premise	HighQuality	
ed	I-Premise	HighQuality	
esterna	I-Premise	HighQuality	
con	I-Premise	HighQuality	
il	I-Premise	HighQuality	
ginocchio	I-Premise	HighQuality	
flesso)	I-Premise	HighQuality	
era	I-Premise	HighQuality	
positivo.	I-Premise	HighQuality	

Quale	O		
delle	O		
seguenti	O		
lesioni	O		
è	O		
più	O		
probabile	O		
che	O		
si	O		
verifichi?	O		

1-	O		
Lesione	B-Claim	HighQuality	
meniscale.	I-Claim	HighQuality	

2-	O		
Rottura	B-Claim	HighQuality	
del	I-Claim	HighQuality	
legamento	I-Claim	HighQuality	
crociato	I-Claim	HighQuality	
anteriore.	I-Claim	HighQuality	

3-	O		
Rottura	B-Claim	HighQuality	
del	I-Claim	HighQuality	
legamento	I-Claim	HighQuality	
crociato	I-Claim	HighQuality	
posteriore.	I-Claim	HighQuality	

4-	O		
Lesione	B-Claim	HighQuality	
dovuta	I-Claim	HighQuality	
ad	I-Claim	HighQuality	
artropatia	I-Claim	HighQuality	
degenerativa.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
1	O		

Risposta	B-Claim	HighQuality	
corretta	I-Claim	HighQuality	
1:	I-Claim	HighQuality	
Il	B-Claim	HighQuality	
test	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Tessaglia	I-Claim	HighQuality	
è	I-Claim	HighQuality	
una	I-Claim	HighQuality	
manovra	I-Claim	HighQuality	
di	I-Claim	HighQuality	
screening	I-Claim	HighQuality	
meniscale.	I-Claim	HighQuality	

La	B-Premise	HighQuality	
dichiarazione	I-Premise	HighQuality	
si	I-Premise	HighQuality	
concentra	I-Premise	HighQuality	
esclusivamente	I-Premise	HighQuality	
su	I-Premise	HighQuality	
questa	I-Premise	HighQuality	
parte	I-Premise	HighQuality	
dell'esame	I-Premise	HighQuality	
e	I-Premise	HighQuality	
spiega	I-Premise	HighQuality	
anche	I-Premise	HighQuality	
che	I-Premise	HighQuality	
è	I-Premise	HighQuality	
effettivamente	I-Premise	HighQuality	
positiva,	I-Premise	HighQuality	
il	B-Claim	HighQuality	
che	I-Claim	HighQuality	
porta	I-Claim	HighQuality	
a	I-Claim	HighQuality	
sospettare	I-Claim	HighQuality	
una	I-Claim	HighQuality	
lesione	I-Claim	HighQuality	
meniscale.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
test	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Tessaglia	I-Claim	HighQuality	
è	I-Claim	HighQuality	
una	I-Claim	HighQuality	
riproduzione	I-Claim	HighQuality	
dinamica	I-Claim	HighQuality	
della	I-Claim	HighQuality	
trasmissione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
carico	I-Claim	HighQuality	
nell'articolazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
e	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
eseguito	I-Claim	HighQuality	
a	I-Claim	HighQuality	
5°	I-Claim	HighQuality	
e	I-Claim	HighQuality	
20°	I-Claim	HighQuality	
di	I-Claim	HighQuality	
flessione.	I-Claim	HighQuality	

L'esaminatore	B-Claim	HighQuality	
sostiene	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
tenendo	I-Claim	HighQuality	
le	I-Claim	HighQuality	
mani	I-Claim	HighQuality	
tese	I-Claim	HighQuality	
mentre	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
è	I-Claim	HighQuality	
in	I-Claim	HighQuality	
piedi	I-Claim	HighQuality	
sul	I-Claim	HighQuality	
pavimento.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
paziente	I-Claim	HighQuality	
ruota	I-Claim	HighQuality	
quindi	I-Claim	HighQuality	
il	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
corpo,	I-Claim	HighQuality	
internamente	I-Claim	HighQuality	
ed	I-Claim	HighQuality	
esternamente,	I-Claim	HighQuality	
per	I-Claim	HighQuality	
tre	I-Claim	HighQuality	
volte,	I-Claim	HighQuality	
mantenendo	I-Claim	HighQuality	
il	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
in	I-Claim	HighQuality	
leggera	I-Claim	HighQuality	
flessione	I-Claim	HighQuality	
(5°).	I-Claim	HighQuality	

Poi	B-Claim	HighQuality	
si	I-Claim	HighQuality	
esegue	I-Claim	HighQuality	
la	I-Claim	HighQuality	
stessa	I-Claim	HighQuality	
procedura	I-Claim	HighQuality	
con	I-Claim	HighQuality	
il	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
flesso	I-Claim	HighQuality	
a	I-Claim	HighQuality	
20°.	I-Claim	HighQuality	

I	B-Claim	HighQuality	
pazienti	I-Claim	HighQuality	
con	I-Claim	HighQuality	
sospetta	I-Claim	HighQuality	
lacerazione	I-Claim	HighQuality	
meniscale	I-Claim	HighQuality	
avvertono	I-Claim	HighQuality	
un	I-Claim	HighQuality	
fastidio	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
linea	I-Claim	HighQuality	
articolare	I-Claim	HighQuality	
mediale	I-Claim	HighQuality	
o	I-Claim	HighQuality	
laterale	I-Claim	HighQuality	
e	I-Claim	HighQuality	
possono	I-Claim	HighQuality	
avere	I-Claim	HighQuality	
un	I-Claim	HighQuality	
senso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
blocco	I-Claim	HighQuality	
o	I-Claim	HighQuality	
di	I-Claim	HighQuality	
impigliamento.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
teoria	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
base	I-Claim	HighQuality	
del	I-Claim	HighQuality	
test	I-Claim	HighQuality	
è	I-Claim	HighQuality	
che,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
manovra,	I-Claim	HighQuality	
il	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
lacerazione	I-Claim	HighQuality	
meniscale	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
sottoposto	I-Claim	HighQuality	
a	I-Claim	HighQuality	
condizioni	I-Claim	HighQuality	
di	I-Claim	HighQuality	
carico	I-Claim	HighQuality	
eccessivo	I-Claim	HighQuality	
e	I-Claim	HighQuality	
quasi	I-Claim	HighQuality	
certamente	I-Claim	HighQuality	
presenterà	I-Claim	HighQuality	
gli	I-Claim	HighQuality	
stessi	I-Claim	HighQuality	
sintomi	I-Claim	HighQuality	
riferiti	I-Claim	HighQuality	
dal	I-Claim	HighQuality	
paziente.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
test	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
sempre	I-Claim	HighQuality	
eseguito	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
sul	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
normale	I-Claim	HighQuality	
in	I-Claim	HighQuality	
modo	I-Claim	HighQuality	
che	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
possa	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
istruito,	I-Claim	HighQuality	
soprattutto	I-Claim	HighQuality	
per	I-Claim	HighQuality	
quanto	I-Claim	HighQuality	
riguarda	I-Claim	HighQuality	
il	I-Claim	HighQuality	
modo	I-Claim	HighQuality	
in	I-Claim	HighQuality	
cui	I-Claim	HighQuality	
mantenere	I-Claim	HighQuality	
il	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
a	I-Claim	HighQuality	
5°	I-Claim	HighQuality	
e	I-Claim	HighQuality	
poi	I-Claim	HighQuality	
a	I-Claim	HighQuality	
20°	I-Claim	HighQuality	
di	I-Claim	HighQuality	
flessione	I-Claim	HighQuality	
e	I-Claim	HighQuality	
come	I-Claim	HighQuality	
riconoscere,	I-Claim	HighQuality	
per	I-Claim	HighQuality	
confronto,	I-Claim	HighQuality	
un	I-Claim	HighQuality	
eventuale	I-Claim	HighQuality	
risultato	I-Claim	HighQuality	
positivo	I-Claim	HighQuality	
nel	I-Claim	HighQuality	
ginocchio	I-Claim	HighQuality	
sintomatico.	I-Claim	HighQuality	
Risposta	B-Claim	HighQuality	
2	I-Claim	HighQuality	
errata:	I-Claim	HighQuality	
Non	B-Premise	HighQuality	
si	I-Premise	HighQuality	
descrivono	I-Premise	HighQuality	
in	I-Premise	HighQuality	
nessun	I-Premise	HighQuality	
momento	I-Premise	HighQuality	
le	I-Premise	HighQuality	
manovre	I-Premise	HighQuality	
di	I-Premise	HighQuality	
esplorazione	I-Premise	HighQuality	
del	I-Premise	HighQuality	
legamento	I-Premise	HighQuality	
crociato	I-Premise	HighQuality	
anteriore,	I-Premise	HighQuality	
né	I-Premise	HighQuality	
si	I-Premise	HighQuality	
parla	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
trauma	I-Premise	HighQuality	
che	I-Premise	HighQuality	
lo	I-Premise	HighQuality	
abbia	I-Premise	HighQuality	
potuto	I-Premise	HighQuality	
lesionare.	I-Premise	HighQuality	

Risposta	B-Claim	HighQuality	
errata	I-Claim	HighQuality	
3:	I-Claim	HighQuality	
non	B-Premise	HighQuality	
viene	I-Premise	HighQuality	
descritta	I-Premise	HighQuality	
alcuna	I-Premise	HighQuality	
manovra	I-Premise	HighQuality	
esplorativa	I-Premise	HighQuality	
del	I-Premise	HighQuality	
legamento	I-Premise	HighQuality	
crociato	I-Premise	HighQuality	
posteriore,	I-Premise	HighQuality	
né	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
menzionato	I-Premise	HighQuality	
alcun	I-Premise	HighQuality	
trauma	I-Premise	HighQuality	
che	I-Premise	HighQuality	
possa	I-Premise	HighQuality	
averlo	I-Premise	HighQuality	
lesionato.	I-Premise	HighQuality	

Risposta	B-Claim	HighQuality	
errata	I-Claim	HighQuality	
4:	I-Claim	HighQuality	
Sebbene	B-Claim	HighQuality	
possa	I-Claim	HighQuality	
verificarsi,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
prevedibile	I-Claim	HighQuality	
in	I-Claim	HighQuality	
un	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
di	I-Claim	HighQuality	
41	I-Claim	HighQuality	
anni	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
condizione	I-Claim	HighQuality	
clinica	I-Claim	HighQuality	
acuta.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
TRAUMATOLOGIA	O		

CLINICAL	O		
CASE:	O		

Donna	B-Premise	HighQuality	
di	I-Premise	HighQuality	
13	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
precedenti	I-Premise	HighQuality	
rilevanti,	I-Premise	HighQuality	
con	I-Premise	HighQuality	
menarca	I-Premise	HighQuality	
da	I-Premise	HighQuality	
3	I-Premise	HighQuality	
mesi,	I-Premise	HighQuality	
seguita	I-Premise	HighQuality	
dall'età	I-Premise	HighQuality	
di	I-Premise	HighQuality	
10	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
per	I-Premise	HighQuality	
una	I-Premise	HighQuality	
scoliosi	I-Premise	HighQuality	
idiopatica	I-Premise	HighQuality	
che	I-Premise	HighQuality	
è	I-Premise	HighQuality	
peggiorata.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
fisico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
evidenziato	I-Premise	HighQuality	
un	I-Premise	HighQuality	
gibbo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
7	I-Premise	HighQuality	
gradi	I-Premise	HighQuality	
nel	I-Premise	HighQuality	
test	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Adams	I-Premise	HighQuality	
e	I-Premise	HighQuality	
nello	I-Premise	HighQuality	
scoliogramma	I-Premise	HighQuality	
una	I-Premise	HighQuality	
curva	I-Premise	HighQuality	
toracolombare	I-Premise	HighQuality	
T4-L1	I-Premise	HighQuality	
di	I-Premise	HighQuality	
35	I-Premise	HighQuality	
gradi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Cobb	I-Premise	HighQuality	
e	I-Premise	HighQuality	
una	I-Premise	HighQuality	
curva	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Risser	I-Premise	HighQuality	
di	I-Premise	HighQuality	
0	I-Premise	HighQuality	
gradi.	I-Premise	HighQuality	

1-	O		
Raccomandare	B-Claim	HighQuality	
il	I-Claim	HighQuality	
nuoto	I-Claim	HighQuality	
e	I-Claim	HighQuality	
rivederlo	I-Claim	HighQuality	
tra	I-Claim	HighQuality	
tre	I-Claim	HighQuality	
mesi.	I-Claim	HighQuality	

2-	O		
Prescrivere	B-Claim	HighQuality	
un'ortesi	I-Claim	HighQuality	
di	I-Claim	HighQuality	
tipo	I-Claim	HighQuality	
corsetto.	I-Claim	HighQuality	

3-	O		
Rivolgersi	B-Claim	HighQuality	
alla	I-Claim	HighQuality	
fisioterapia	I-Claim	HighQuality	
per	I-Claim	HighQuality	
l'elasticizzazione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
colonna	I-Claim	HighQuality	
vertebrale.	I-Claim	HighQuality	

4-	O		
Revisione	B-Claim	HighQuality	
tra	I-Claim	HighQuality	
6	I-Claim	HighQuality	
mesi	I-Claim	HighQuality	
con	I-Claim	HighQuality	
una	I-Claim	HighQuality	
nuova	I-Claim	HighQuality	
radiografia.	I-Claim	HighQuality	

5-	O		
nan	O		

RISPOSTA	O		
CORRETTA:	O		
2	O		

Ci	B-Premise	HighQuality	
viene	I-Premise	HighQuality	
presentato	I-Premise	HighQuality	
il	I-Premise	HighQuality	
caso	I-Premise	HighQuality	
di	I-Premise	HighQuality	
una	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
femmina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
13	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
con	I-Premise	HighQuality	
menarca	I-Premise	HighQuality	
da	I-Premise	HighQuality	
3	I-Premise	HighQuality	
mesi,	I-Premise	HighQuality	
una	I-Premise	HighQuality	
curva	I-Premise	HighQuality	
toracolombare	I-Premise	HighQuality	
T4-L1	I-Premise	HighQuality	
di	I-Premise	HighQuality	
35º	I-Premise	HighQuality	
e	I-Premise	HighQuality	
una	I-Premise	HighQuality	
Risser	I-Premise	HighQuality	
0	I-Premise	HighQuality	

Come	B-Claim	HighQuality	
regola	I-Claim	HighQuality	
generale	I-Claim	HighQuality	
possiamo	I-Claim	HighQuality	
dire	I-Claim	HighQuality	
che	I-Claim	HighQuality	
al	I-Claim	HighQuality	
di	I-Claim	HighQuality	
sotto	I-Claim	HighQuality	
dei	I-Claim	HighQuality	
50°	I-Claim	HighQuality	
il	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
è	I-Claim	HighQuality	
solitamente	I-Claim	HighQuality	
conservativo,	I-Claim	HighQuality	
con	I-Claim	HighQuality	
due	I-Claim	HighQuality	
opzioni:	I-Claim	HighQuality	
l'osservazione	I-Claim	HighQuality	
o	I-Claim	HighQuality	
l'uso	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un	I-Claim	HighQuality	
corsetto	I-Claim	HighQuality	
per	I-Claim	HighQuality	
rallentare	I-Claim	HighQuality	
l'evoluzione.	I-Claim	HighQuality	

In	B-Claim	HighQuality	
questo	I-Claim	HighQuality	
caso,	I-Claim	HighQuality	
tenendo	I-Claim	HighQuality	
conto	I-Claim	HighQuality	
della	I-Claim	HighQuality	
crescita	I-Claim	HighQuality	
residua	I-Claim	HighQuality	
(menarca	I-Claim	HighQuality	
3	I-Claim	HighQuality	
mesi	I-Claim	HighQuality	
fa	I-Claim	HighQuality	
e	I-Claim	HighQuality	
Risser	I-Claim	HighQuality	
0)	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
meglio	I-Claim	HighQuality	
utilizzare	I-Claim	HighQuality	
un	I-Claim	HighQuality	
corsetto	I-Claim	HighQuality	
(risposta	B-Claim	HighQuality	
2	I-Claim	HighQuality	
corretta).	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
ANESTESIOLOGIA	O		
E	O		
CURE	O		
CRITICHE	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
30	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
cade	I-Premise	HighQuality	
in	I-Premise	HighQuality	
piedi	I-Premise	HighQuality	
da	I-Premise	HighQuality	
un'altezza	I-Premise	HighQuality	
di	I-Premise	HighQuality	
2	I-Premise	HighQuality	
metri.	I-Premise	HighQuality	

All'arrivo	B-Claim	HighQuality	
al	I-Claim	HighQuality	
Pronto	I-Claim	HighQuality	
Soccorso,	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
sottoposto	I-Claim	HighQuality	
a	I-Claim	HighQuality	
coltura	I-Claim	HighQuality	
e	I-Claim	HighQuality	
cateterizzato	I-Claim	HighQuality	
con	I-Claim	HighQuality	
urine	I-Claim	HighQuality	
chiare.	I-Claim	HighQuality	

Presenta	B-Premise	HighQuality	
gonfiore	I-Premise	HighQuality	
al	I-Premise	HighQuality	
tallone	I-Premise	HighQuality	
sinistro	I-Premise	HighQuality	
e	I-Premise	HighQuality	
un	I-Premise	HighQuality	
leggero	I-Premise	HighQuality	
formicolio	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
parte	I-Premise	HighQuality	
anteriore	I-Premise	HighQuality	
della	I-Premise	HighQuality	
coscia	I-Premise	HighQuality	
destra	I-Premise	HighQuality	
e	I-Premise	HighQuality	
dello	I-Premise	HighQuality	
scroto,	I-Premise	HighQuality	
oltre	I-Premise	HighQuality	
a	I-Premise	HighQuality	
disestesia	I-Premise	HighQuality	
in	I-Premise	HighQuality	
entrambi	I-Premise	HighQuality	
i	I-Premise	HighQuality	
piedi.	I-Premise	HighQuality	

Il	O		
paziente	O		
saluta	O		
il	O		
barelliere	O		
con	O		
una	O		
stretta	O		
di	O		
mano	O		
e	O		
una	O		
contemporanea	O		
pacca	O		
sulla	O		
spalla.	O		

La	B-Premise	HighQuality	
rotazione	I-Premise	HighQuality	
degli	I-Premise	HighQuality	
arti	I-Premise	HighQuality	
inferiori	I-Premise	HighQuality	
sulla	I-Premise	HighQuality	
barella	I-Premise	HighQuality	
per	I-Premise	HighQuality	
le	I-Premise	HighQuality	
caviglie	I-Premise	HighQuality	
è	I-Premise	HighQuality	
indolore	I-Premise	HighQuality	
e	O		
la	B-Premise	HighQuality	
compressione	I-Premise	HighQuality	
del	I-Premise	HighQuality	
bacino	I-Premise	HighQuality	
è	I-Premise	HighQuality	
asintomatica.	I-Premise	HighQuality	

Il	O		
prossimo:	O		

1-	O		
Il	B-Claim	HighQuality	
paziente	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
fatto	I-Claim	HighQuality	
sedere	I-Claim	HighQuality	
sulla	I-Claim	HighQuality	
barella	I-Claim	HighQuality	
in	I-Claim	HighQuality	
modo	I-Claim	HighQuality	
da	I-Claim	HighQuality	
poter	I-Claim	HighQuality	
esplorare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
rachide	I-Claim	HighQuality	
cervicale.	I-Claim	HighQuality	

2-	O		
Fare	B-Claim	HighQuality	
riferimento	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
Rx	I-Claim	HighQuality	
per	I-Claim	HighQuality	
lo	I-Claim	HighQuality	
studio	I-Claim	HighQuality	
degli	I-Claim	HighQuality	
arti	I-Claim	HighQuality	
inferiori.	I-Claim	HighQuality	

3-	O		
Palpare	B-Claim	HighQuality	
l'addome	I-Claim	HighQuality	
e	I-Claim	HighQuality	
ruotarlo	I-Claim	HighQuality	
in	I-Claim	HighQuality	
blocco	I-Claim	HighQuality	
per	I-Claim	HighQuality	
palpare	I-Claim	HighQuality	
la	I-Claim	HighQuality	
colonna	I-Claim	HighQuality	
vertebrale	I-Claim	HighQuality	
toraco-lombare.	I-Claim	HighQuality	

4-	O		
Verrà	B-Claim	HighQuality	
applicato	I-Claim	HighQuality	
un	I-Claim	HighQuality	
collare	I-Claim	HighQuality	
cervicale	I-Claim	HighQuality	
e	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente	I-Claim	HighQuality	
verrà	I-Claim	HighQuality	
indirizzato	I-Claim	HighQuality	
in	I-Claim	HighQuality	
radiologia	I-Claim	HighQuality	
per	I-Claim	HighQuality	
uno	I-Claim	HighQuality	
studio	I-Claim	HighQuality	
di	I-Claim	HighQuality	
imaging	I-Claim	HighQuality	
del	I-Claim	HighQuality	
rachide	I-Claim	HighQuality	
cervicale	I-Claim	HighQuality	
e	I-Claim	HighQuality	
degli	I-Claim	HighQuality	
arti	I-Claim	HighQuality	
inferiori.	I-Claim	HighQuality	

5-	O		
Chiederemo	B-Claim	HighQuality	
un'ecografia	I-Claim	HighQuality	
addominale.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
3	O		

Dai	B-Premise	HighQuality	
sintomi	I-Premise	HighQuality	
riportati,	I-Premise	HighQuality	
formicolio	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
parte	I-Premise	HighQuality	
anteriore	I-Premise	HighQuality	
della	I-Premise	HighQuality	
coscia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
nello	I-Premise	HighQuality	
scroto	I-Premise	HighQuality	
e	I-Premise	HighQuality	
disestesia	I-Premise	HighQuality	
ai	I-Premise	HighQuality	
piedi,	I-Premise	HighQuality	
sembra	B-Claim	HighQuality	
esserci	I-Claim	HighQuality	
un	I-Claim	HighQuality	
coinvolgimento	I-Claim	HighQuality	
vertebrale	I-Claim	HighQuality	
a	I-Claim	HighQuality	
livello	I-Claim	HighQuality	
di	I-Claim	HighQuality	
L2-3	I-Claim	HighQuality	
e	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
radici	I-Claim	HighQuality	
sacrali,	I-Claim	HighQuality	
per	O		
cui	O		
la	B-Claim	HighQuality	
cosa	I-Claim	HighQuality	
più	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
da	I-Claim	HighQuality	
fare	I-Claim	HighQuality	
sarebbe	I-Claim	HighQuality	
eseguire	I-Claim	HighQuality	
un	I-Claim	HighQuality	
esame	I-Claim	HighQuality	
radiologico	I-Claim	HighQuality	
senza	I-Claim	HighQuality	
mobilizzare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
paziente.	I-Claim	HighQuality	

Ma	B-Claim	HighQuality	
è	I-Claim	HighQuality	
necessario	I-Claim	HighQuality	
mobilitarsi	I-Claim	HighQuality	
per	I-Claim	HighQuality	
esplorarla,	I-Claim	HighQuality	
ovviamente	I-Claim	HighQuality	
in	I-Claim	HighQuality	
blocco.	I-Claim	HighQuality	

La	B-Claim	HighQuality	
colonna	I-Claim	HighQuality	
vertebrale	I-Claim	HighQuality	
cervicale	I-Claim	HighQuality	
non	I-Claim	HighQuality	
sembra	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
danneggiata	I-Claim	HighQuality	
perché	O		
il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
mobilizza	I-Premise	HighQuality	
adeguatamente	I-Premise	HighQuality	
entrambe	I-Premise	HighQuality	
le	I-Premise	HighQuality	
braccia,	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
parestesia.	I-Premise	HighQuality	

QUESTION	O		
TYPE:	O		
ANATOMIA	O		
PATOLOGICA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
uomo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
56	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
diabetico	I-Premise	HighQuality	
e	I-Premise	HighQuality	
in	I-Premise	HighQuality	
moderato	I-Premise	HighQuality	
sovrappeso,	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
un'epatomegalia	I-Premise	HighQuality	
discreta.	I-Premise	HighQuality	

Il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
indica	I-Premise	HighQuality	
che	I-Premise	HighQuality	
non	I-Premise	HighQuality	
è	I-Premise	HighQuality	
un	I-Premise	HighQuality	
bevitore	I-Premise	HighQuality	
abituale,	I-Premise	HighQuality	
solo	O		
eccezionalmente	O		
beve	O		
del	O		
vino.	O		

Una	B-Premise	HighQuality	
biopsia	I-Premise	HighQuality	
epatica	I-Premise	HighQuality	
mostra	I-Premise	HighQuality	
accumuli	I-Premise	HighQuality	
di	I-Premise	HighQuality	
vacuoli	I-Premise	HighQuality	
citoplasmatici	I-Premise	HighQuality	
chiari	I-Premise	HighQuality	
nel	I-Premise	HighQuality	
50%	I-Premise	HighQuality	
degli	I-Premise	HighQuality	
epatociti.	I-Premise	HighQuality	

Focolai	B-Premise	HighQuality	
infiammatori	I-Premise	HighQuality	
multipli	I-Premise	HighQuality	
con	I-Premise	HighQuality	
neutrofili,	I-Premise	HighQuality	
degenerazione	I-Premise	HighQuality	
ialina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Mallory	I-Premise	HighQuality	
e	I-Premise	HighQuality	
fibrosi	I-Premise	HighQuality	
intorno	I-Premise	HighQuality	
alle	I-Premise	HighQuality	
venule	I-Premise	HighQuality	
epatiche	I-Premise	HighQuality	
terminali.	I-Premise	HighQuality	

Segnare	O		
la	O		
risposta	O		
corretta	O		
in	O		
questo	O		
caso:	O		

1-	O		
La	B-Claim	HighQuality	
biopsia	I-Claim	HighQuality	
deve	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
ripetuta	I-Claim	HighQuality	
per	I-Claim	HighQuality	
vedere	I-Claim	HighQuality	
se	I-Claim	HighQuality	
i	I-Claim	HighQuality	
cambiamenti	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
diffusi.	I-Claim	HighQuality	

2-	O		
La	B-Claim	HighQuality	
diagnosi	I-Claim	HighQuality	
è	I-Claim	HighQuality	
glicogenosi	I-Claim	HighQuality	
epatica	I-Claim	HighQuality	
associata	I-Claim	HighQuality	
a	I-Claim	HighQuality	
diabete.	I-Claim	HighQuality	

3-	O		
Le	B-Claim	HighQuality	
alterazioni	I-Claim	HighQuality	
istologiche	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
irreversibili	I-Claim	HighQuality	
e	I-Claim	HighQuality	
finiscono	I-Claim	HighQuality	
per	I-Claim	HighQuality	
portare	I-Claim	HighQuality	
alla	I-Claim	HighQuality	
cirrosi.	I-Claim	HighQuality	

4-	O		
La	B-Claim	HighQuality	
lesione	I-Claim	HighQuality	
è	I-Claim	HighQuality	
chiaramente	I-Claim	HighQuality	
causata	I-Claim	HighQuality	
dall'alcol,	I-Claim	HighQuality	
nonostante	I-Claim	HighQuality	
la	I-Claim	HighQuality	
negazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
paziente.	I-Claim	HighQuality	

5-	O		
È	B-Claim	HighQuality	
importante	I-Claim	HighQuality	
ridurre	I-Claim	HighQuality	
il	I-Claim	HighQuality	
peso	I-Claim	HighQuality	
e	I-Claim	HighQuality	
controllare	I-Claim	HighQuality	
adeguatamente	I-Claim	HighQuality	
il	I-Claim	HighQuality	
diabete	I-Claim	HighQuality	
per	I-Claim	HighQuality	
evitare	I-Claim	HighQuality	
il	I-Claim	HighQuality	
possibile	I-Claim	HighQuality	
sviluppo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
cirrosi.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
5	O		

I	B-Claim	HighQuality	
cambiamenti	I-Claim	HighQuality	
descritti	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
domanda	I-Claim	HighQuality	
corrispondono	I-Claim	HighQuality	
a	I-Claim	HighQuality	
una	I-Claim	HighQuality	
situazione	I-Claim	HighQuality	
pre-cirrotica	I-Claim	HighQuality	
precoce.	I-Claim	HighQuality	

Sebbene	B-Claim	HighQuality	
l'alcol	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
la	I-Claim	HighQuality	
sostanza	I-Claim	HighQuality	
tossica	I-Claim	HighQuality	
più	I-Claim	HighQuality	
comune	I-Claim	HighQuality	
che	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
questa	I-Claim	HighQuality	
condizione,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
l'unica	I-Claim	HighQuality	
causa.	I-Claim	HighQuality	

Il	B-Claim	HighQuality	
diabete	I-Claim	HighQuality	
mellito	I-Claim	HighQuality	
provoca	I-Claim	HighQuality	
alterazioni	I-Claim	HighQuality	
epatiche	I-Claim	HighQuality	
simili:	I-Claim	HighQuality	
accumulo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
grasso	I-Claim	HighQuality	
negli	I-Claim	HighQuality	
epatociti,	I-Claim	HighQuality	
fibrosi	I-Claim	HighQuality	
centroacinare,	I-Claim	HighQuality	
infiltrato	I-Claim	HighQuality	
infiammatorio	I-Claim	HighQuality	
da	I-Claim	HighQuality	
parte	I-Claim	HighQuality	
di	I-Claim	HighQuality	
neutrofili	I-Claim	HighQuality	
polimorfonucleati	I-Claim	HighQuality	
e	I-Claim	HighQuality	
degenerazione	I-Claim	HighQuality	
ialina	I-Claim	HighQuality	
del	I-Claim	HighQuality	
mallorio	I-Claim	HighQuality	
perinucleare.	I-Claim	HighQuality	

Tenendo	O		
conto	O		
di	O		
ciò,	O		
possiamo	B-Claim	HighQuality	
escludere	I-Claim	HighQuality	
la	I-Claim	HighQuality	
seconda	I-Claim	HighQuality	
domanda	I-Claim	HighQuality	
(si	I-Claim	HighQuality	
tratta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
accumuli	I-Claim	HighQuality	
di	I-Claim	HighQuality	
grasso	I-Claim	HighQuality	
intracellulare,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
di	I-Claim	HighQuality	
glicogeno)	I-Claim	HighQuality	
e	I-Claim	HighQuality	
la	I-Claim	HighQuality	
quarta	I-Claim	HighQuality	
(se	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
il	I-Claim	HighQuality	
diabete	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
una	I-Claim	HighQuality	
situazione	I-Claim	HighQuality	
del	I-Claim	HighQuality	
genere,	I-Claim	HighQuality	
non	I-Claim	HighQuality	
c'è	I-Claim	HighQuality	
motivo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
diffidare	I-Claim	HighQuality	
del	I-Claim	HighQuality	
paziente).	I-Claim	HighQuality	

In	B-Premise	HighQuality	
base	I-Premise	HighQuality	
al	I-Premise	HighQuality	
primum	I-Premise	HighQuality	
non	I-Premise	HighQuality	
nocere	I-Premise	HighQuality	
e	I-Premise	HighQuality	
al	I-Premise	HighQuality	
fatto	I-Premise	HighQuality	
che	I-Premise	HighQuality	
non	I-Premise	HighQuality	
è	I-Premise	HighQuality	
di	I-Premise	HighQuality	
particolare	I-Premise	HighQuality	
rilevanza	I-Premise	HighQuality	
per	I-Premise	HighQuality	
il	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
se	I-Premise	HighQuality	
si	I-Premise	HighQuality	
tratta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
una	I-Premise	HighQuality	
malattia	I-Premise	HighQuality	
focale	I-Premise	HighQuality	
o	I-Premise	HighQuality	
generalizzata,	I-Premise	HighQuality	
non	B-Claim	HighQuality	
è	I-Claim	HighQuality	
necessario	I-Claim	HighQuality	
ripetere	I-Claim	HighQuality	
una	I-Claim	HighQuality	
biopsia	I-Claim	HighQuality	
epatica	I-Claim	HighQuality	
che	I-Claim	HighQuality	
non	I-Claim	HighQuality	
fornirebbe	I-Claim	HighQuality	
ulteriori	I-Claim	HighQuality	
informazioni,	I-Claim	HighQuality	
escludendo	I-Claim	HighQuality	
la	I-Claim	HighQuality	
prima	I-Claim	HighQuality	
domanda.	I-Claim	HighQuality	

Fortunatamente	B-Claim	HighQuality	
per	I-Claim	HighQuality	
l'ipotetico	I-Claim	HighQuality	
paziente,	I-Claim	HighQuality	
nella	I-Claim	HighQuality	
fase	I-Claim	HighQuality	
iniziale	I-Claim	HighQuality	
queste	I-Claim	HighQuality	
alterazioni	I-Claim	HighQuality	
sono	I-Claim	HighQuality	
reversibili	I-Claim	HighQuality	
quando	I-Claim	HighQuality	
la	I-Claim	HighQuality	
noxa	I-Claim	HighQuality	
scompare,	I-Claim	HighQuality	
per	O		
cui	O		
ci	B-Claim	HighQuality	
rimane	I-Claim	HighQuality	
la	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
n.	I-Claim	HighQuality	
5	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
ANESTESIOLOGIA,	O		
CURE	O		
CRITICHE	O		
ED	O		
EMERGENZE	O		

CLINICAL	O		
CASE:	O		

Una	B-Premise	HighQuality	
donna	I-Premise	HighQuality	
di	I-Premise	HighQuality	
67	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
un'anamnesi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
insufficienza	I-Premise	HighQuality	
cardiaca	I-Premise	HighQuality	
congestizia	I-Premise	HighQuality	
(in	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
con	I-Premise	HighQuality	
ramipril	I-Premise	HighQuality	
e	I-Premise	HighQuality	
furosemide)	I-Premise	HighQuality	
e	I-Premise	HighQuality	
diabete	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tipo	I-Premise	HighQuality	
2	I-Premise	HighQuality	
(in	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
con	I-Premise	HighQuality	
insulina)	I-Premise	HighQuality	
è	I-Premise	HighQuality	
giunta	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
per	I-Premise	HighQuality	
dispnea.	I-Premise	HighQuality	

I	B-Premise	HighQuality	
gas	I-Premise	HighQuality	
ematici	I-Premise	HighQuality	
misurati	I-Premise	HighQuality	
in	I-Premise	HighQuality	
aria	I-Premise	HighQuality	
ambiente	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
mostrato	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	

Quale	O		
alterazione	O		
gastrica	O		
presenta	O		
il	O		
paziente?	O		

1-	O		
Insufficienza	B-Claim	HighQuality	
respiratoria	I-Claim	HighQuality	
ipossiemica	I-Claim	HighQuality	
con	I-Claim	HighQuality	
alcalosi	I-Claim	HighQuality	
respiratoria	I-Claim	HighQuality	
compensata.	I-Claim	HighQuality	

2-	O		
Alcalosi	B-Claim	HighQuality	
metabolica	I-Claim	HighQuality	
acuta	I-Claim	HighQuality	
con	I-Claim	HighQuality	
insufficienza	I-Claim	HighQuality	
respiratoria	I-Claim	HighQuality	
ipossiemica	I-Claim	HighQuality	
e	I-Claim	HighQuality	
ipocapnica.	I-Claim	HighQuality	

3-	O		
Insufficienza	B-Claim	HighQuality	
respiratoria	I-Claim	HighQuality	
cronica	I-Claim	HighQuality	
normocapnica,	I-Claim	HighQuality	
senza	I-Claim	HighQuality	
alterazione	I-Claim	HighQuality	
dell'equilibrio	I-Claim	HighQuality	
acido-base.	I-Claim	HighQuality	

4-	O		
Insufficienza	B-Claim	HighQuality	
respiratoria	I-Claim	HighQuality	
cronica	I-Claim	HighQuality	
ipossiemica	I-Claim	HighQuality	
con	I-Claim	HighQuality	
acidosi	I-Claim	HighQuality	
metabolica	I-Claim	HighQuality	
compensata.	I-Claim	HighQuality	

5-	O		
Insufficienza	B-Claim	HighQuality	
respiratoria	I-Claim	HighQuality	
ipossiemica	I-Claim	HighQuality	
con	I-Claim	HighQuality	
alcalosi	I-Claim	HighQuality	
mista	I-Claim	HighQuality	
compensata.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
1	O		

Ho	O		
trovato	O		
questa	O		
domanda	O		
complicata.	O		

I	B-Premise	HighQuality	
risultati	I-Premise	HighQuality	
separati	I-Premise	HighQuality	
sono:	I-Premise	HighQuality	
pH	I-Premise	HighQuality	
normale	I-Premise	HighQuality	
ma	I-Premise	HighQuality	
con	I-Premise	HighQuality	
tendenza	I-Premise	HighQuality	
all'alcalosi,	I-Premise	HighQuality	
insufficienza	I-Premise	HighQuality	
respiratoria	I-Premise	HighQuality	
acuta,	I-Premise	HighQuality	
ipocapnia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
bicarbonato	I-Premise	HighQuality	
normale.	I-Premise	HighQuality	

La	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
più	I-Claim	HighQuality	
appropriata	I-Claim	HighQuality	
mi	I-Claim	HighQuality	
sembra	I-Claim	HighQuality	
1,	I-Claim	HighQuality	
poiché	O		
il	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
non	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
alcalosi	I-Premise	HighQuality	
metabolica	I-Premise	HighQuality	
(il	I-Premise	HighQuality	
bicarbonato	I-Premise	HighQuality	
sarebbe	I-Premise	HighQuality	
più	I-Premise	HighQuality	
alto),	I-Premise	HighQuality	
né	I-Premise	HighQuality	
tantomeno	I-Premise	HighQuality	
acidosi	I-Premise	HighQuality	
(il	I-Premise	HighQuality	
bicarbonato	I-Premise	HighQuality	
sarebbe	I-Premise	HighQuality	
più	I-Premise	HighQuality	
basso).	I-Premise	HighQuality	

Anche	B-Claim	HighQuality	
l'alcalosi	I-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
mista,	I-Claim	HighQuality	
ma	I-Claim	HighQuality	
principalmente	I-Claim	HighQuality	
respiratoria.	I-Claim	HighQuality	

La	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
sta	I-Premise	HighQuality	
probabilmente	I-Premise	HighQuality	
iperventilando	I-Premise	HighQuality	
a	I-Premise	HighQuality	
causa	I-Premise	HighQuality	
dell'insufficienza	I-Premise	HighQuality	
respiratoria	I-Premise	HighQuality	
e	O		
il	B-Premise	HighQuality	
rene,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
compensa	I-Premise	HighQuality	
sempre	I-Premise	HighQuality	
in	I-Premise	HighQuality	
ritardo,	I-Premise	HighQuality	
sta	I-Premise	HighQuality	
iniziando	I-Premise	HighQuality	
a	I-Premise	HighQuality	
trattenere	I-Premise	HighQuality	
HCO3	I-Premise	HighQuality	
per	I-Premise	HighQuality	
compensare	I-Premise	HighQuality	
e	I-Premise	HighQuality	
mantenere	I-Premise	HighQuality	
il	I-Premise	HighQuality	
pH.	I-Premise	HighQuality	

Ritengo	B-Claim	HighQuality	
pertanto	I-Claim	HighQuality	
che	I-Claim	HighQuality	
la	I-Claim	HighQuality	
risposta	I-Claim	HighQuality	
corretta	I-Claim	HighQuality	
sia	I-Claim	HighQuality	
1	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
ANESTESIOLOGIA,	O		
CURE	O		
CRITICHE	O		
ED	O		
EMERGENZE	O		

CLINICAL	O		
CASE:	O		

Donna	B-Premise	HighQuality	
di	I-Premise	HighQuality	
76	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
con	I-Premise	HighQuality	
obesità	I-Premise	HighQuality	
e	I-Premise	HighQuality	
diabete	I-Premise	HighQuality	
mellito	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tipo	I-Premise	HighQuality	
2	I-Premise	HighQuality	
in	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
con	I-Premise	HighQuality	
metformina.	I-Premise	HighQuality	

È	B-Premise	HighQuality	
arrivata	I-Premise	HighQuality	
al	I-Premise	HighQuality	
pronto	I-Premise	HighQuality	
soccorso	I-Premise	HighQuality	
perché	I-Premise	HighQuality	
da	I-Premise	HighQuality	
3	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
presentava	I-Premise	HighQuality	
febbre	I-Premise	HighQuality	
a	I-Premise	HighQuality	
38	I-Premise	HighQuality	
ºC,	I-Premise	HighQuality	
poliuria,	I-Premise	HighQuality	
disuria,	I-Premise	HighQuality	
sete	I-Premise	HighQuality	
intensa	I-Premise	HighQuality	
e	I-Premise	HighQuality	
una	I-Premise	HighQuality	
progressiva	I-Premise	HighQuality	
diminuzione	I-Premise	HighQuality	
del	I-Premise	HighQuality	
livello	I-Premise	HighQuality	
di	I-Premise	HighQuality	
coscienza.	I-Premise	HighQuality	

L'esame	B-Premise	HighQuality	
fisico	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
segni	I-Premise	HighQuality	
di	I-Premise	HighQuality	
disidratazione,	I-Premise	HighQuality	
pressione	I-Premise	HighQuality	
arteriosa	I-Premise	HighQuality	
95/54	I-Premise	HighQuality	
mm	I-Premise	HighQuality	
Hg	I-Premise	HighQuality	
e	I-Premise	HighQuality	
nessun	I-Premise	HighQuality	
segno	I-Premise	HighQuality	
di	I-Premise	HighQuality	
localizzazione	I-Premise	HighQuality	
neurologica.	I-Premise	HighQuality	

Gli	B-Premise	HighQuality	
esami	I-Premise	HighQuality	
di	I-Premise	HighQuality	
laboratorio	I-Premise	HighQuality	
hanno	I-Premise	HighQuality	
evidenziato	I-Premise	HighQuality	
leucocitosi,	I-Premise	HighQuality	
creatinina	I-Premise	HighQuality	
di	I-Premise	HighQuality	
1,8	I-Premise	HighQuality	
mg/dL	I-Premise	HighQuality	
e	I-Premise	HighQuality	
glicemia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
855	I-Premise	HighQuality	
mg/dL.	I-Premise	HighQuality	

Qual	O		
è	O		
la	O		
diagnosi	O		
più	O		
probabile?	O		

1-	O		
Coma	B-Claim	HighQuality	
iperglicemico	I-Claim	HighQuality	
iperosmolare	I-Claim	HighQuality	
non	I-Claim	HighQuality	
chetotico.	I-Claim	HighQuality	

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

3-	O		
Ematoma	B-Claim	HighQuality	
subdurale.	I-Claim	HighQuality	

4-	O		
Insufficienza	B-Claim	HighQuality	
renale	I-Claim	HighQuality	
ostruttiva.	I-Claim	HighQuality	

5-	O		
Chetoacidosi	B-Claim	HighQuality	
diabetica	I-Claim	HighQuality	
con	I-Claim	HighQuality	
coma.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
1	O		

La	B-Premise	HighQuality	
domanda	I-Premise	HighQuality	
riguarda	I-Premise	HighQuality	
il	I-Premise	HighQuality	
caso	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un	I-Premise	HighQuality	
paziente	I-Premise	HighQuality	
diabetico	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tipo	I-Premise	HighQuality	
2	I-Premise	HighQuality	
con	I-Premise	HighQuality	
iperglicemia	I-Premise	HighQuality	
e	I-Premise	HighQuality	
diminuzione	I-Premise	HighQuality	
del	I-Premise	HighQuality	
livello	I-Premise	HighQuality	
di	I-Premise	HighQuality	
coscienza	I-Premise	HighQuality	
senza	I-Premise	HighQuality	
focalità	I-Premise	HighQuality	
neurologica	I-Premise	HighQuality	
nel	I-Premise	HighQuality	
contesto	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un'infezione	I-Premise	HighQuality	
delle	I-Premise	HighQuality	
vie	I-Premise	HighQuality	
urinarie	I-Premise	HighQuality	
e	I-Premise	HighQuality	
che	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
sviluppato	I-Premise	HighQuality	
un'insufficienza	I-Premise	HighQuality	
renale	I-Premise	HighQuality	
acuta	I-Premise	HighQuality	
di	I-Premise	HighQuality	
probabile	I-Premise	HighQuality	
origine	I-Premise	HighQuality	
pre-renale.	I-Premise	HighQuality	

L'opzione	B-Claim	HighQuality	
2	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
immediatamente	I-Claim	HighQuality	
esclusa	I-Claim	HighQuality	
in	O		
quanto	O		
il	B-Premise	HighQuality	
quadro	I-Premise	HighQuality	
clinico	I-Premise	HighQuality	
non	I-Premise	HighQuality	
è	I-Premise	HighQuality	
quello	I-Premise	HighQuality	
di	I-Premise	HighQuality	
un'insufficienza	I-Premise	HighQuality	
cardiaca.	I-Premise	HighQuality	

Anche	B-Premise	HighQuality	
l'opzione	I-Premise	HighQuality	
3	I-Premise	HighQuality	
viene	I-Premise	HighQuality	
scartata	I-Premise	HighQuality	
perché	O		
non	B-Premise	HighQuality	
corrisponde	I-Premise	HighQuality	
al	I-Premise	HighQuality	
quadro	I-Premise	HighQuality	
clinico	I-Premise	HighQuality	
e	O		
inoltre	O		
l'HSD	O		
darebbe	O		
sintomi	O		
neurologici	O		
con	O		
localizzazione.	O		

L'opzione	B-Claim	HighQuality	
4	I-Claim	HighQuality	
viene	I-Claim	HighQuality	
scartata	I-Claim	HighQuality	
perché	O		
l'insufficienza	B-Premise	HighQuality	
renale	I-Premise	HighQuality	
ostruttiva	I-Premise	HighQuality	
non	I-Premise	HighQuality	
dà	I-Premise	HighQuality	
poliuria,	I-Premise	HighQuality	
disuria	I-Premise	HighQuality	
o	I-Premise	HighQuality	
il	I-Premise	HighQuality	
resto	I-Premise	HighQuality	
del	I-Premise	HighQuality	
quadro	I-Premise	HighQuality	
clinico.	I-Premise	HighQuality	

L'opzione	B-Claim	HighQuality	
5	I-Claim	HighQuality	
è	I-Claim	HighQuality	
meno	I-Claim	HighQuality	
probabile	I-Claim	HighQuality	
perché	O		
la	B-Premise	HighQuality	
chetoacidosi	I-Premise	HighQuality	
diabetica	I-Premise	HighQuality	
è	I-Premise	HighQuality	
più	I-Premise	HighQuality	
tipica	I-Premise	HighQuality	
del	I-Premise	HighQuality	
DM	I-Premise	HighQuality	
di	I-Premise	HighQuality	
tipo	I-Premise	HighQuality	
1	I-Premise	HighQuality	

Pertanto	O		
l'opzione	B-Claim	HighQuality	
corretta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
la	I-Claim	HighQuality	
1	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
CARDIOLOGIA	O		
E	O		
CHIRURGIA	O		
VASCOLARE	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
paziente	I-Premise	HighQuality	
di	I-Premise	HighQuality	
81	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
si	I-Premise	HighQuality	
consulta	I-Premise	HighQuality	
per	I-Premise	HighQuality	
un	I-Premise	HighQuality	
episodio	I-Premise	HighQuality	
di	I-Premise	HighQuality	
sincope.	I-Premise	HighQuality	

Da	B-Premise	HighQuality	
un	I-Premise	HighQuality	
anno	I-Premise	HighQuality	
lamenta	I-Premise	HighQuality	
dispnea	I-Premise	HighQuality	
da	I-Premise	HighQuality	
sforzo.	I-Premise	HighQuality	

L'auscultazione	B-Premise	HighQuality	
cardiaca	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
rivelato	I-Premise	HighQuality	
un	I-Premise	HighQuality	
soffio	I-Premise	HighQuality	
sistolico	I-Premise	HighQuality	
3/6	I-Premise	HighQuality	
al	I-Premise	HighQuality	
bordo	I-Premise	HighQuality	
sternale	I-Premise	HighQuality	
sinistro	I-Premise	HighQuality	
che	I-Premise	HighQuality	
si	I-Premise	HighQuality	
irradia	I-Premise	HighQuality	
alle	I-Premise	HighQuality	
carotidi	I-Premise	HighQuality	
e	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
punta.	I-Premise	HighQuality	

Quale	O		
patologia	O		
ritiene	O		
più	O		
probabile?	O		

1-	O		
Blocco	B-Claim	HighQuality	
atrioventricolare	I-Claim	HighQuality	
di	I-Claim	HighQuality	
terzo	I-Claim	HighQuality	
grado.	I-Claim	HighQuality	

2-	O		
Stenosi	B-Claim	HighQuality	
aortica	I-Claim	HighQuality	
degenerativa.	I-Claim	HighQuality	

3-	O		
Insufficienza	B-Claim	HighQuality	
della	I-Claim	HighQuality	
valvola	I-Claim	HighQuality	
mitrale.	I-Claim	HighQuality	

4-	O		
Cardiomiopatia	B-Claim	HighQuality	
ipertrofica.	I-Claim	HighQuality	

5-	O		
Cardiomiopatia	B-Claim	HighQuality	
dilatativa.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
2	O		

Domanda	O		
molto	O		
semplice.	O		

Descrivono	B-Claim	HighQuality	
il	I-Claim	HighQuality	
ritratto	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
stenosi	I-Claim	HighQuality	
aortica	I-Claim	HighQuality	
degenerativa...	I-Claim	HighQuality	

Paziente	B-Premise	HighQuality	
anziano	I-Premise	HighQuality	
con	I-Premise	HighQuality	
sintomi	I-Premise	HighQuality	
di	I-Premise	HighQuality	
dispnea	I-Premise	HighQuality	
e	I-Premise	HighQuality	
sincope,	I-Premise	HighQuality	
e	I-Premise	HighQuality	
soffio	I-Premise	HighQuality	
sistolico	I-Premise	HighQuality	
che	I-Premise	HighQuality	
si	I-Premise	HighQuality	
irradia	I-Premise	HighQuality	
alle	I-Premise	HighQuality	
arterie	I-Premise	HighQuality	
carotidi	I-Premise	HighQuality	
e	I-Premise	HighQuality	
alla	I-Premise	HighQuality	
punta,	I-Premise	HighQuality	
tutti	I-Premise	HighQuality	
tipici	I-Premise	HighQuality	
di	I-Premise	HighQuality	
questa	I-Premise	HighQuality	
malattia.	I-Premise	HighQuality	

QUESTION	O		
TYPE:	O		
CHIRURGIA	O		
GENERALE	O		

CLINICAL	O		
CASE:	O		

Donna	B-Premise	HighQuality	
di	I-Premise	HighQuality	
26	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
che	I-Premise	HighQuality	
presenta	I-Premise	HighQuality	
incontinenza	I-Premise	HighQuality	
fecale	I-Premise	HighQuality	
dopo	I-Premise	HighQuality	
un	I-Premise	HighQuality	
parto	I-Premise	HighQuality	
strumentale	I-Premise	HighQuality	
prolungato.	I-Premise	HighQuality	

È	B-Premise	HighQuality	
stata	I-Premise	HighQuality	
eseguita	I-Premise	HighQuality	
un'ecografia	I-Premise	HighQuality	
endoanale,	I-Premise	HighQuality	
che	I-Premise	HighQuality	
ha	I-Premise	HighQuality	
mostrato	I-Premise	HighQuality	
una	I-Premise	HighQuality	
sezione	I-Premise	HighQuality	
dello	I-Premise	HighQuality	
sfintere	I-Premise	HighQuality	
anale	I-Premise	HighQuality	
esterno	I-Premise	HighQuality	
di	I-Premise	HighQuality	
30°	I-Premise	HighQuality	
di	I-Premise	HighQuality	
ampiezza.	I-Premise	HighQuality	

Lo	B-Premise	HighQuality	
studio	I-Premise	HighQuality	
elettrofisiologico	I-Premise	HighQuality	
mostra	I-Premise	HighQuality	
un'innervazione	I-Premise	HighQuality	
normale.	I-Premise	HighQuality	

Qual	O		
è	O		
il	O		
trattamento	O		
più	O		
appropriato?	O		

1-	O		
Trattamento	B-Claim	HighQuality	
medico	I-Claim	HighQuality	
con	I-Claim	HighQuality	
regole	I-Claim	HighQuality	
igieniche	I-Claim	HighQuality	
e	I-Claim	HighQuality	
dietetiche.	I-Claim	HighQuality	

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

3-	O		
Sfinteroplastica	B-Claim	HighQuality	
chirurgica.	I-Claim	HighQuality	

4-	O		
Riparazione	B-Claim	HighQuality	
chirurgica	I-Claim	HighQuality	
del	I-Claim	HighQuality	
pavimento	I-Claim	HighQuality	
pelvico.	I-Claim	HighQuality	

5-	O		
Sfintere	B-Claim	HighQuality	
anale	I-Claim	HighQuality	
artificiale.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
3	O		

La	B-Claim	HighQuality	
risposta	I-Claim	HighQuality	
è	I-Claim	HighQuality	
3	I-Claim	HighQuality	
sfinteroplastica	I-Claim	HighQuality	
chirurgica.	I-Claim	HighQuality	

1	B-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
efficace,	I-Claim	HighQuality	
2	B-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
efficace	I-Claim	HighQuality	
per	I-Claim	HighQuality	
una	I-Claim	HighQuality	
lesione	I-Claim	HighQuality	
organica	I-Claim	HighQuality	
con	I-Claim	HighQuality	
elettromiografia	I-Claim	HighQuality	
normale,	I-Claim	HighQuality	
4	B-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
necessario	I-Claim	HighQuality	
perché	B-Premise	HighQuality	
la	I-Premise	HighQuality	
lesione	I-Premise	HighQuality	
è	I-Premise	HighQuality	
solo	I-Premise	HighQuality	
dello	I-Premise	HighQuality	
sfintere	I-Premise	HighQuality	
esterno,	I-Premise	HighQuality	
5	B-Claim	HighQuality	
non	I-Claim	HighQuality	
è	I-Claim	HighQuality	
indicato	I-Claim	HighQuality	
in	I-Claim	HighQuality	
una	I-Claim	HighQuality	
lesione	I-Claim	HighQuality	
che	I-Claim	HighQuality	
può	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
riparata	I-Claim	HighQuality	
con	I-Claim	HighQuality	
la	I-Claim	HighQuality	
chirurgia	I-Claim	HighQuality	
con	I-Claim	HighQuality	
buoni	I-Claim	HighQuality	
risultati.	I-Claim	HighQuality	

QUESTION	O		
TYPE:	O		
DERMATOLOGIA,	O		
VENEREOLOGIA	O		
E	O		
CHIRURGIA	O		
PLASTICA	O		

CLINICAL	O		
CASE:	O		

Un	B-Premise	HighQuality	
ragazzo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
17	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
affetto	I-Premise	HighQuality	
da	I-Premise	HighQuality	
malattia	I-Premise	HighQuality	
di	I-Premise	HighQuality	
Crohn	I-Premise	HighQuality	
con	I-Premise	HighQuality	
interessamento	I-Premise	HighQuality	
del	I-Premise	HighQuality	
colon	I-Premise	HighQuality	
da	I-Premise	HighQuality	
2	I-Premise	HighQuality	
anni,	I-Premise	HighQuality	
in	I-Premise	HighQuality	
trattamento	I-Premise	HighQuality	
di	I-Premise	HighQuality	
mantenimento	I-Premise	HighQuality	
con	I-Premise	HighQuality	
azatioprina,	I-Premise	HighQuality	
si	I-Premise	HighQuality	
rivolge	I-Premise	HighQuality	
per	I-Premise	HighQuality	
la	I-Premise	HighQuality	
comparsa	I-Premise	HighQuality	
negli	I-Premise	HighQuality	
ultimi	I-Premise	HighQuality	
5	I-Premise	HighQuality	
giorni	I-Premise	HighQuality	
di	I-Premise	HighQuality	
noduli	I-Premise	HighQuality	
sottocutanei	I-Premise	HighQuality	
bilaterali	I-Premise	HighQuality	
rosso-violacei,	I-Premise	HighQuality	
caldi	I-Premise	HighQuality	
e	I-Premise	HighQuality	
dolorosi	I-Premise	HighQuality	
nella	I-Premise	HighQuality	
regione	I-Premise	HighQuality	
pretibiale,	I-Premise	HighQuality	
associati	I-Premise	HighQuality	
a	I-Premise	HighQuality	
un	I-Premise	HighQuality	
aumento	I-Premise	HighQuality	
del	I-Premise	HighQuality	
numero	I-Premise	HighQuality	
di	I-Premise	HighQuality	
feci	I-Premise	HighQuality	
e	I-Premise	HighQuality	
a	I-Premise	HighQuality	
dolore	I-Premise	HighQuality	
addominale.	I-Premise	HighQuality	

L'atteggiamento	O		
più	O		
appropriato	O		
in	O		
questo	O		
caso	O		
è:	O		

1-	O		
Consigliare	B-Claim	HighQuality	
un	I-Claim	HighQuality	
riposo	I-Claim	HighQuality	
relativo	I-Claim	HighQuality	
e	I-Claim	HighQuality	
impacchi	I-Claim	HighQuality	
caldi	I-Claim	HighQuality	
su	I-Claim	HighQuality	
entrambe	I-Claim	HighQuality	
le	I-Claim	HighQuality	
gambe	I-Claim	HighQuality	
e	I-Claim	HighQuality	
aggiungere	I-Claim	HighQuality	
un	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
antidepressivo.	I-Claim	HighQuality	

2-	O		
Biopsia	B-Claim	HighQuality	
di	I-Claim	HighQuality	
aree	I-Claim	HighQuality	
cutanee	I-Claim	HighQuality	
lontane	I-Claim	HighQuality	
dalle	I-Claim	HighQuality	
aree	I-Claim	HighQuality	
lese	I-Claim	HighQuality	
e	I-Claim	HighQuality	
prescrizione	I-Claim	HighQuality	
di	I-Claim	HighQuality	
analgesici	I-Claim	HighQuality	
oppioidi	I-Claim	HighQuality	
all'inizio.	I-Claim	HighQuality	

3-	O		
Sospettare	B-Claim	HighQuality	
l'esistenza	I-Claim	HighQuality	
di	I-Claim	HighQuality	
una	I-Claim	HighQuality	
lesione	I-Claim	HighQuality	
tumorale	I-Claim	HighQuality	
intestinale	I-Claim	HighQuality	
maligna	I-Claim	HighQuality	
come	I-Claim	HighQuality	
causa	I-Claim	HighQuality	
scatenante	I-Claim	HighQuality	
del	I-Claim	HighQuality	
processo	I-Claim	HighQuality	
cutaneo.	I-Claim	HighQuality	

4-	O		
Sospetto	B-Claim	HighQuality	
di	I-Claim	HighQuality	
ischemia	I-Claim	HighQuality	
bilaterale	I-Claim	HighQuality	
degli	I-Claim	HighQuality	
arti	I-Claim	HighQuality	
inferiori	I-Claim	HighQuality	
di	I-Claim	HighQuality	
origine	I-Claim	HighQuality	
farmacologica.	I-Claim	HighQuality	

5-	O		
Adattamento	B-Claim	HighQuality	
del	I-Claim	HighQuality	
trattamento	I-Claim	HighQuality	
delle	I-Claim	HighQuality	
malattie	I-Claim	HighQuality	
intestinali.	I-Claim	HighQuality	

RISPOSTA	O		
CORRETTA:	O		
5	O		

2	B-Claim	HighQuality	
e	I-Claim	HighQuality	
4	I-Claim	HighQuality	
vengono	I-Claim	HighQuality	
scartati	I-Claim	HighQuality	
da	I-Claim	HighQuality	
soli.	I-Claim	HighQuality	

Si	B-Claim	HighQuality	
tratta	I-Claim	HighQuality	
di	I-Claim	HighQuality	
un	I-Claim	HighQuality	
eritema	I-Claim	HighQuality	
nodoso,	I-Claim	HighQuality	
per	O		
cui	O		
si	B-Claim	HighQuality	
consiglia	I-Claim	HighQuality	
un	I-Claim	HighQuality	
riposo	I-Claim	HighQuality	
relativo	I-Claim	HighQuality	
(ma	O		
gli	B-Claim	HighQuality	
antidepressivi	I-Claim	HighQuality	
non	I-Claim	HighQuality	
hanno	I-Claim	HighQuality	
senso,	I-Claim	HighQuality	
per	B-Claim	HighQuality	
cui	I-Claim	HighQuality	
si	I-Claim	HighQuality	
esclude	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
il	I-Claim	HighQuality	
punto	I-Claim	HighQuality	
1)).	I-Claim	HighQuality	

Sebbene	B-Claim	HighQuality	
l'eritema	I-Claim	HighQuality	
nodoso	I-Claim	HighQuality	
possa	I-Claim	HighQuality	
essere	I-Claim	HighQuality	
secondario	I-Claim	HighQuality	
a	I-Claim	HighQuality	
un	I-Claim	HighQuality	
processo	I-Claim	HighQuality	
maligno,	I-Claim	HighQuality	
è	I-Claim	HighQuality	
più	I-Claim	HighQuality	
spesso	I-Claim	HighQuality	
dovuto	I-Claim	HighQuality	
al	I-Claim	HighQuality	
morbo	I-Claim	HighQuality	
di	I-Claim	HighQuality	
Crohn	I-Claim	HighQuality	
stesso	I-Claim	HighQuality	
(e	O		
in	B-Premise	HighQuality	
un	I-Premise	HighQuality	
ragazzo	I-Premise	HighQuality	
di	I-Premise	HighQuality	
17	I-Premise	HighQuality	
anni	I-Premise	HighQuality	
questo	I-Premise	HighQuality	
sarebbe	I-Premise	HighQuality	
estremamente	I-Premise	HighQuality	
raro),	I-Premise	HighQuality	
quindi	O		
se	B-Claim	HighQuality	
la	I-Claim	HighQuality	
condizione	I-Claim	HighQuality	
è	I-Claim	HighQuality	
accompagnata	I-Claim	HighQuality	
anche	I-Claim	HighQuality	
da	I-Claim	HighQuality	
una	I-Claim	HighQuality	
riacutizzazione	I-Claim	HighQuality	
della	I-Claim	HighQuality	
malattia	I-Claim	HighQuality	
infiammatoria	I-Claim	HighQuality	
intestinale,	I-Claim	HighQuality	
l'ultima	I-Claim	HighQuality	
opzione	I-Claim	HighQuality	
(5)	I-Claim	HighQuality	
sembra	I-Claim	HighQuality	
la	I-Claim	HighQuality	
più	I-Claim	HighQuality	
corretta.	I-Claim	HighQuality