| Author | 9 Posts |
dr_jojo
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12…………….A 37-year-old man comes to the physician 6 months prior to traveling to sub-Saharan Africa for 1 year. He has no history of hepatitis and has no high-risk behavior for hepatitis B. Which of the following is the most appropriate recommendation to prevent hepatitis during and after his trip?
A) Immune globulin
B) Hepatitis B immune globulin (HBIG) only
C) Hepatitis B vaccine series only
D) Hepatitis B vaccine series and HBIG
E) Hepatitis B vaccine series and hepatitis A vaccine
13……………..A 67-year-old man comes to the physician because of a 2-month history of progressive shortness of breath. He has had a 4.5-kg (10-lb) weight loss over the past 4 months. He has not had chest pain. He has congestive heart failure treated with furosemide, digoxin, and enalapril. He has smoked two packs of cigarettes daily for 30 years.He appears alert and is in no acute distress. His temperature is 37.2 C (99 F), blood pressure is 140/85 mm Hg, pulse is 84/min, and respirations are 18/min.
Examination shows no jugular venous distention. There is dullness to percussion, and breath sounds are decreased at the left base. Cardiac examination shows a laterally displaced point of maximal impulse, normal S1 and S2, and an S3 at the apex. There is 1+ edema over the extremities. An x-ray film of the chest shows an enlarged cardiac silhouette, left hilar fullness, and a moderate-sized left pleural effusion. Thoracentesis yields straw-colored fluid. Laboratory studies show:
Serum Glucose 90 mg/dL
Protein 7 g/dL
Lactate dehydrogenase 300 U/L
Pleural fluid
pH 7.25
Glucose 75 mg/dL
Protein 4.5 g/dL
Lactate dehydrogenase 280 U/L
Leukocyte count 2000/mm3
Segmented neutrophils 15%
Lymphocytes 85%
A Gram's stain and acid-fast stains are negative for any organisms.
Which of the following is the most likely cause of this patient's pleural effusion?
A) Bacterial pneumonia
B) Collagen vascular disease
C) Congestive heart failure
D) Malignancy
E) Pulmonary embolus with infarction
F) Viral pleuritis
14………….. A 13-year-old boy is brought to the physician by his mother because of frequent headaches over the past 5 weeks. He describes the headaches as dull pain across his forehead; they occur four to five times weekly. Acetaminophen does not relieve the pain. His mother states that occasionally he has nausea without vomiting. He has schizophrenia well controlled with risperidone. Physical examination shows no abnormalities. An MRI of the brain is most likely to show which of the following?
A) Bilateral increased caudate nuclei
B) Decreased cerebellar volume
C) Hippocampal symmetry
D) Increased lateral ventricle size
E) Multiple white-matter hyperintensities
Edited by new_n_lost on 03/30/07 - 10:45 PM
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| vanshita
Forum Guru
Topics: 25
Posts: 866
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E
D
D
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| rn
Forum Senior
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E
D
D
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| krsna
Forum Senior
Topics: 1
Posts: 211
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agree with E D and D....wat r the correct ans?
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| raghavesh_p
Forum Newbie
Topics: 6
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yeah,even my choices the same EDD
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| gilbert
Forum Junior
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EDD
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| Justice
Forum Fanatic
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EDD
___________________
Don't live in a town where there are no doctors
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| webjeee
Forum Guru
Topics: 99
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what is E) Multiple white-matter hyperintensities referred to?
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| usmle12
Forum Senior
Topics: 19
Posts: 194
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EFD
its not chf induced pleural effusion ...its viral pleritis withldh ratio more than .6 and also low ph and plus lymphocytes
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