APMLE answers - Podiatry and Medical Updated: 2024
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Exam Code: APMLE Podiatry and Medical answers January 2024 by Killexams.com team
APMLE Podiatry and Medical
The Part I examination samples the candidates knowledge in the basic science areas of General Anatomy, including embryology, histology, genetics, and geriatrics; Lower Extremity Anatomy; Biochemistry; Physiology; Microbiology and Immunology; Pathology; and Pharmacology. A separate Candidate Information Bulletin for the Part I test is available online at killexams.com
The Part II written examination samples the candidates knowledge in the clinical areas of Medicine; Radiology; Orthopedics, Biomechanics and Sports Medicine; Anesthesia and Surgery; and Community Health, Jurisprudence, and Research. A separate Candidate Information Bulletin for the Part II written test is available online at killexams.com Performance on the Part II written examination does not impact eligibility for the Part II CSPE.
The Part II Clinical Skills Patient Encounter (Part II CSPE) assesses proficiency in podiatric clinical tasks needed to enter residency. Candidates will be expected to perform a focused physical examination including podiatric and general medicine physical test maneuvers appropriate for each patient presentation. Podiatric and general medical knowledge, verbal and written communication, and interpersonal skills will be assessed in each test form. Performance on the Part II CSPE does not impact eligibility for the Part II written examination.
The Part III examination is designed to determine whether a candidates knowledge and clinical skills are adequate for safe, unsupervised practice. The Part III examination samples the candidates clinical skills in evaluating, diagnosing, and treating patients. Examples of the application of knowledge may be measured through photographs, radiographs and case presentations. A separate Candidate Information Bulletin for the Part III test is available online at killexams.com
Part I and II
Podiatric Medical College Faculty submit questions (with accompanying references) to Prometric.
The pool of questions (items) are reviewed by a panel of practicing podiatric physicians and two podiatric medical school faculty in each content area.
The primary responsibility of the faculty is clarity and a current reference check.
The primary responsibility of the DPM members is what is the relationship between the item and the tasks performed by a DPM in practice?
priority with regard importance in practice.
estimated difficulty-Is it easy, medium or hard?
For Part I, the questions (items) also are reviewed by a content specialist in one of the basic sciences for accuracy and currency. This individual is a medical school faculty member.
Prometric assembles the test from approved questions according to the content specification.
Items are written and reviewed by panels of DPM practitioners who have been trained how to prepare effective test items. A second panel of DPMs reviews each form of the test before it is published.
Post Test Administration
Double Scoring Ensures Accuracy
At the examinee level, each computer-based test undergoes two independent scorings. Each test is first scored at the testing site and subsequently rescored when the data arrive back at Prometric. If scores do not match exactly, the examinees record is held until the results can be reconciled. Irregularities that may have occurred at the testing site are also noted and any examinees who may have experienced irregular testing conditions at the test site (such as hardware or software failures or power interruptions) receive a thorough review of their responses. Scores for these examinees are not released until all irregular conditions are given consideration and resolution processing rules are applied fairly to ensure equity in the test administration process.
Each item is statistically analyzed to determine how many candidates answered correctly and whether the item discriminated between the high and low scoring candidates (the high scoring candidates answered correctly and the low scoring candidates did not). If the item is “flagged”, content experts review each of the flagged items for accuracy.
At the conclusion of the above analyses and after the scores are mailed to the candidates, each dean receives a report, which compares the performance for first time candidates at that school with the national examination data.
Reliability refers to the consistency of test scores, the consistency with which candidates are classified as either passing or failing, and the degree to which test scores are free from errors of measurement. Errors of measurement result from factors not related to the test, factors such as fatigue or heightened attention, personal interests and other characteristics not related to the test. A persons score will not be perfectly consistent from one occasion to the next as a result of measurement error.
Determination of Passing Scores
The National Board and its test consultant, Prometric, use a widely-accepted criterion-referenced approach to determine passing scores known as the Angoff Method. The important feature of criterion-referenced standard setting is that it is based on an expected level of competence regardless of how many candidates in a particular group pass or fail. This is distinguished from a norm-referenced approach in which a set proportion of test takers fall above or below the passing score.
|Podiatry and Medical
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Podiatry and Medical
Signs and symptoms of hemolytic transfusion reactions include:
D. Abnormal bleeding
Signs and symptoms of hemolytic transfusion reactions include abnormal
bleeding. Other symptoms of a hemolytic transfusion reaction include fever,
chills, and pain and heat at the infusion site, as well as respiratory distress,
anxiety, hypotension, and oliguria. During surgery, a hemolytic transfusion
reaction can manifest as abnormal bleeding.
A patient suspected of having a hemolytic transfusion reaction should be managed
A. Removal of nonessential foreign body irritants, e.g., Foley catheter
B. Fluid restriction
D. Fluids and mannitol
A patient suspected of having a hemolytic transfusion reaction should be managed
with fluids and mannitol. Hemolytic transfusion reactions lead to hypotension and
oliguria. The increased hemoglobin in the plasma will be cleared via the kidneys,
which leads to hemoglobinuria.
Which of the following characteristics in a patient might increase the risk of a
A. History of colon surgery
C. Male sex
D. Receipt of chemotherapy
A characteristic in a patient that might increase the risk of a wound infection is
receipt of chemotherapy. Decreasing the bacterial inoculum and virulence by
limiting the patient"s prehospital stay, clipping the operative site in the operating
room, administering perioperative antibiotics (within a 24-h period surrounding
operation) with an appropriate antimicrobial spectrum, treating remote infections,
avoiding breaks in technique, using closed drainage systems (if needed at all) that
exit the skin away from the surgical incision, and minimizing the duration of the
operation have all been shown to decrease postoperative infection.
Signs and symptoms associated with early sepsis include:
A. Respiratory acidosis
B. Decreased cardiac output
D. Cutaneous vasodilation
Signs and symptoms associated with early sepsis include cutaneous vasodilation.
A changing mental status, tachypnea that leads to respiratory alkalosis, and
flushed skin are often the earliest manifestations of sepsis.
Hypocalcemia is associated with:
B. Shortened QT interval
D. Myocardial irritability
Hypocalcemia is associated with hypomagnesemia. Hypocalcemia is also
associated with a prolonged QT interval and may be aggravated by both
hypomagnesemia and alkalosis.
Which of the following inhalation anesthetics accumulates in air-filled cavities
during general anesthesia?
A. Diethyl ether
B. Nitrous oxide
The inhalation anesthetic that accumulates in air-filled cavities during general
anesthesia is nitrous oxide. Nitrous oxide (N2O) has a low solubility compared
with other inhalation anesthetics. Its blood:gas partition coefficient is 0.47 and it
is 30 times more soluble in blood than is nitrogen (N2).
Dopamine is a frequently used drug in critically ill patients because:
A. At high doses, it increases splanchnic flow
B. At high doses, it increases coronary flow
C. At low doses, it decreases heart rate
D. At low doses, it lowers peripheral resistance
Dopamine is a frequently used drug in critically ill patients because at high doses,
it increases coronary flow. In low doses (1-5 mg/kg/min), dopamine affects
primarily the dopaminergic receptors. Activation of these receptors causes
vasodilation of the renal and mesenteric vasculature and mild vasoconstriction of
the peripheral bed, which thereby redirects blood flow to kidneys and bowel.
During blood transfusion, clotting of transfused blood is associated with:
A. ABO incompatibility
B. Minor blood group incompatibility
C. Rh incompatibility
D. Transfusion through Ringer"s lactate
During blood transfusion, clotting of transfused blood is associated with
transfusion through Ringer"s lactate. Calcium-containing solutions such as
Ringer"s lactate cause clotting within the intravenous line rather than hemolysis
and may lead to pulmonary embolism.
The etiologic factor implicated in the development of pulmonary insufficiency
following major nonthoracic trauma is:
C. Fat embolism syndrome
D. Fluid overload
The etiologic factor implicated in the development of pulmonary insufficiency
following major nonthoracic trauma is fat embolism syndrome. Post-traumatic
pulmonary insufficiency in the absence of significant thoracic trauma has been
attributed to a wide variety of etiologic agents, including aspiration, simple
atelectasis, lung contusion, fat embolism, pneumonia, pneumothorax, pulmonary
edema, and pulmonary thromboembolism.
Signs and symptoms of unsuspected Addison"s disease include:
Signs and symptoms of unsuspected Addison"s disease include hyponatremia.
Other clinical manifestations of adrenocortical insufficiency include
hyperkalemia, hyponatremia, hypoglycemia, fever, weight loss, and dehydration.
Treatment for clostridial myonecrosis (gas gangrene) includes which of the
A. Administration of an antifungal agent
B. Administration of antitoxin
C. Wide debridement
D. Administration of hyperbaric oxygen
Treatment for clostridial myonecrosis (gas gangrene) includes wide debridement.
Necrotizing skin and soft tissue infections may produce insoluble gases
(hydrogen, nitrogen, methane) through anaerobic bacterial metabolism.
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ChatGPT might not be a cure-all for answers to medical questions, a new study suggests.
Researchers at Long Island University posed 39 medication-related queries to the free version of the artificial intelligence chatbot, all of which were braindump questions from the university’s College of Pharmacy drug information service. The software’s answers were then compared with responses written and reviewed by trained pharmacists.
The study found that ChatGPT provided accurate responses to only about 10 of the questions, or about a quarter of the total. For the other 29 prompts, the answers were incomplete or inaccurate, or they did not address the questions.
The findings were presented Tuesday at the annual meeting of the American Society for Health-Systems Pharmacists in Anaheim, California.
ChatGPT, OpenAI’s experimental AI chatbot, was released in November 2022 and became the fastest-growing consumer application in history, with nearly 100 million people registering within two months.
Given that popularity, the researchers’ interest was sparked by concern that their students, other pharmacists and ordinary consumers would turn to resources like ChatGPT to explore questions about their health and medication plans, said Sara Grossman, an associate professor of pharmacy practice at Long Island University and one of the study’s authors.
Those queries, they found, often yielded inaccurate – or even dangerous – responses.
In one question, for example, researchers asked ChatGPT whether the Covid-19 antiviral medication Paxlovid and the blood-pressure lowering medication verapamil would react with each other in the body. ChatGPT responded that taking the two medications together would yield no adverse effects.
In reality, people who take both medications might have a large drop in blood pressure, which can cause dizziness and fainting. For patients taking both, clinicians often create patient-specific plans, including lowering the dose of verapamil or cautioning the person to get up slowly from a sitting position, Grossman said.
ChatGPT’s guidance, she added, would have put people in harm’s way.
“Using ChatGPT to address this question would put a patient at risk for an unwanted and preventable drug interaction,” Grossman wrote in an email to CNN.
When the researchers asked the chatbot for scientific references to support each of its responses, they found that the software could provide them for only eight of the questions they asked. And in each case, they were surprised to find that ChatGPT was fabricating references.
At first glance, the citations looked legitimate: They were often formatted appropriately, provided URLs and were listed under legitimate scientific journals. But when the team attempted to find the referenced articles, they realized that ChatGPT had given them fictional citations.
In one case, the researchers asked ChatGPT how to convert spinal injection doses of the muscle spasm medication baclofen to corresponding oral doses. Grossman’s team could not find a scientifically established dose conversion ratio, but ChatGPT put forth a single conversion rate and cited two medical organizations’ guidance, she said.
However, neither organization provides any official guidance on the dose conversion rate. In fact, the conversion factor that ChatGPT suggested had never been scientifically established. The software also provided an example calculation for the dose conversion but with a critical mistake: It mixed up units when calculating the oral dose, throwing off the dose recommendation by a factor of 1,000.
If that guidance was followed by a health care professional, Grossman said, they might provide a patient an oral baclofen dose 1,000 times lower than required, which could cause withdrawal symptoms like hallucinations and seizures.
“There were numerous errors and “problems’ with this response and ultimately, it could have a profound impact on patient care,” she wrote.
The Long Island University study is not the first to raise concerns about ChatGPT’s fictional citations. Previous research has also documented that, when asked medical questions, ChatGPT can create deceptive forgeries of scientific references, even listing the names of real authors with previous publications in scientific journals.
Grossman, who had worked little with the software before the study, was surprised by how confidently ChatGPT was able to synthesize information nearly instantaneously, answers that would take trained professionals hours to compile.
“The responses were phrased in a very professional and sophisticated manner, and it just seemed it can contribute to a sense of confidence in the accuracy of the tool,” she said. “A user, a consumer, or others that may not be able to discern can be swayed by the appearance of authority.”
A spokesperson for OpenAI, the organization that develops ChatGPT, said it advises users not to rely on responses as a substitute for professional medical advice or treatment.
The spokesperson pointed to ChatGPT’s usage policies, which indicate that “OpenAI’s models are not fine-tuned to provide medical information.” The policy also states that the models should never be used to provide “diagnostic or treatment services for serious medical conditions.”
Although Grossman was unsure of how many people use ChatGPT to address medication questions, she raised concerns that they could use the chatbot like they would search for medical advice on search engines like Google.
“People are always looking for instantaneous responses when they have this at their fingertips,” Grossman said. “I think that this is just another approach of using ‘Dr. Google’ and other seemingly easy methods of obtaining information.”
For online medical information, she recommended that consumers use governmental websites that provide reputable information, like the National Institutes of Health’s MedlinePlus page.
Still, Grossman doesn’t believe that online answers can replace the advice of a health care professional.
“[Websites are] maybe one starting point, but they can take their providers out of the picture when looking for information about medications that are directly applicable to them,” she said. “But it may not be applicable to the patients themselves because of their personal case, and every patient is different. So the authority here should not be removed from the picture: the healthcare professional, the prescriber, the patient’s physicians.”
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