gilbert
Forum Junior
Topics: 16
Posts: 45
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13. A 47-year-old woman comes to the physician because of a 2-day history of fever and joint pain. Six days ago, she completed a 10-day course of dicloxacillin for folliculitis. She appears comfortable. Her temperature is 38.6°C (101.5°F), pulse is 72/min and regular, respirations are 16/min, and blood pressure is 120/76 mm Hg. Examination shows an urticarial rash over the trunk and extremities. There is moderate generalized lymphadenopathy and diffuse joint tenderness. The remainder of the examination shows no abnormalities. Which of the following is the most likely cause of these symptoms?
A ) Epstein-Barr virus infection
B ) IgE-mediated allergic reaction
C ) Mycobacterium haemophilum infection
D ) Serum sickness
E ) Staphylococcal sepsis
E?
14. A 43-year-old man comes to the physician for evaluation and management of cardiac risk factors 8 weeks after sustaining a myocardial infarction. He takes aspirin and metoprolol daily, and he does not smoke cigarettes. His father and brother both had myocardial infarctions before the age of 50 years; their serum cholesterol levels are unknown. There is no family history of diabetes mellitus. He weighs 86 kg (190 lb) and is 180 cm (71 in) tall. His blood pressure is 130/70 mm Hg, pulse is 68/min, and respirations are 14/min. Two years ago, his serum cholesterol level was 245 mg/dL. Fasting serum glucose level is 88 mg/dL. Which of the following is the most appropriate next step to evaluate his cardiac risk factors?
A ) Random measurements of serum cholesterol level
B ) Measurement of fasting serum cholesterol level only
C ) Fasting serum lipid studies only
D ) Oral glucose tolerance test and fasting serum lipid studies
E ) Oral glucose tolerance test and measurement of fasting serum cholesterol level
E?
17. Twenty-four hours after hospitalization for fixation of a femoral fracture, a 35-year-old construction worker has nausea, agitation, and insomnia. His blood pressure is 150/100 mm Hg. He is oriented but anxious. Which of the following is the most appropriate next step in diagnosis?
A ) Inquire about recent alcohol intake
B ) Examination of a urine specimen for fat bodies
C ) Leukocyte count with differential
D ) ECG
E ) Pulmonary arteriography
A?
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| sprint123
Forum Guru
Topics: 129
Posts: 870
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13. It is serum sickness-Joint pain, Lymphadenopathy and urticarial rash fits in.
14.I think it is B.Since we don't do oral glucose tolerance test which is indicated only in gestational DM. Fasting serum cholesterol is appropriate!
15.I think it is delirium due to alcohol withdrawal.
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| webjeee
Forum Guru
Topics: 99
Posts: 349
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yes, dba
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| nadiabarati
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D
C
A
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| prathapdoctor
Forum Elite
Topics: 12
Posts: 406
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I would go with
D
C
A
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| Akeen
Forum Newbie
Topics: 0
Posts: 36
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For Question 14, pls what's the difference btw fasting serum lipid and cholesterol?
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| maninder_amc
Forum Junior
Topics: 13
Posts: 63
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i agree with sprint......
d
b
a
---fasting glucose testing is the best method for diagnosis of DM
---as far as difference between lipid and cholesterol levels is concerned.....serum cholesterol levels have a positive correlation to cardiac risk,,,.....ELEVATED LIPID LEVELS HAVE NOT SHOWN TO HAVE ANY SIGNIFICANT ASSOCIATION WITH CARDIAC EVENTS,.though they r related to pancreatitis etc
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| epica
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d c a
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| klimt
Forum Guru
Topics: 27
Posts: 605
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D A A
as far as I know cholesterol level doesn't necessarily have to be determined while fasting
(unlike glucose level)
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| Akeen
Forum Newbie
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Q14 - IS it A, B or C?
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| ram3
Forum Guru
Topics: 47
Posts: 513
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I agree with the first two but not the third the first one is serum sickness a type three hypersensitivity the second one also is fasting serum cholesterol but the third is examination of urine for fat bodies to check for fat embolism which is common after an accident also in the united states usually patients are put on a drug to revent delirium tremens
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| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,241
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14 is C since he has a previous total cholesterol>200. Then treat according to LDL level.
If 17 was PE, the patient would have dyspnea with or without thoracic pain, not only anxiety, in my opinion.
Edited by arlete on 06/19/07 - 07:24 AM
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| Justice
Forum Fanatic
Topics: 101
Posts: 1,972
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(D)
(C)
(A)
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| dr in trouble
Forum Guru
Topics: 60
Posts: 592
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A. --Infectious mononeuclosis , C-- fasting lipid studies, and A--Alcohol withdrawl
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| abc888
Forum Newbie
Topics: 4
Posts: 17
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Q14: D ) Oral glucose tolerance test and fasting serum lipid studies
The USPSTF recommends screening for type 2 DM in adults with HTN or hyperlipidemia. (B recommendation)
DM can be screened by
1. fasting plasma glucose
2. 2-hr post-load plasma glucose
3. HbA1c level
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| tamerbashir
Forum Elite
Topics: 20
Posts: 284
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D
C
A
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| guangyu
Forum Elite
Topics: 29
Posts: 308
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where is the serum sickness coming from? the patient did not use any antibody
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| wywywy2006
Forum Elite
Topics: 43
Posts: 166
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OGTT is not indicated if the fasting plasma glucose level is below 100. It is indicated when fasting plasma glucose is between 110 and 126.
Lipid screening should include total cholesterol and HDL in addition to LDL. So, fasting lipid profile is indicated.
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| Korotkoff
Forum Senior
Topics: 15
Posts: 168
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A,C,A
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| guangyu
Forum Elite
Topics: 29
Posts: 308
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D
A
A
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