Kamsi
Forum Guru
Topics: 103
Posts: 347
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30. One month after undergoing an uneventful renal transplant for chronic renal failure secondary to glomerulonephritis, a 38-year-old woman is hospitalized because of increased serum urea nitrogen (BUN) and creatinine levels. Prior to transplantation, she had been receiving hemodialysis for 3 years. Current medications include cyclosporine and prednisone. Examination shows no abnormalities. Over the past 48 hours, urine output has remained stable. Both renal biopsy and a radionuclide scan confirm the diagnosis of acute rejection. Which of the following is the most effective treatment?
A
) Immediate discontinuation of cyclosporine
B
) Increased dosage of corticosteroids
C
) Diuresis and alkalinization of the urine
D
) Renal dialysis for 1•2 weeks
E
) Transplant nephrectomy
32. A 77-year-old woman comes to the physician because of a 2-day history of cramping abdominal pain and distention accompanied by nausea and vomiting. She is otherwise healthy and has no history of abdominal operations. Her temperature is 37.4 C (99.4 F), blood pressure is 110/86 mm Hg, pulse is 112/min, and respirations are 24/min. Cardiopulmonary examination shows no abnormalities. Examination of the abdomen shows distention and mild diffuse tenderness; bowel sounds are high-pitched. An x-ray film of the abdomen shows air-fluid levels throughout the small bowel and air in the liver; there is no gas in the colon or free air. Which of the following is the most likely diagnosis?
A
) Adhesive small-bowel obstruction
B
) Cecal cancer
C
) Gallstone ileus
D
) Intussusception
E
) Mesenteric infarction
F
) Ruptured appendicitis
G
) Small bowel lymphoma
44. A 28-year-old woman is hospitalized after taking a massive overdose of acetaminophen tablets in a suicide attempt. She has type 1 diabetes mellitus and major depressive disorder refractory to tricyclic antidepressant therapy. Despite appropriate therapy, she develops rapidly progressive hepatic failure and becomes progressively encephalopathic. On the 6th day of hospitalization, she is comatose. A CT scan of the brain shows mild diffuse swelling. An appropriately crossmatched, size-appropriate donor liver is available. Which of the following is the most appropriate course of action regarding transplantation?
A
) Do not proceed with the transplantation because diabetes mellitus is a contraindication
B
) Do not proceed with the transplantation because hepatic function is likely to return over the next week
C
) Do not proceed with the transplantation because major depressive disorder places the patient at risk for another suicide attempt
D
) Do not proceed with the transplantation because the onset of encephalopathy and CT findings suggest bacterial meningitis
E
) Proceed with the transplantation
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| dermatology
Forum Elite
Topics: 30
Posts: 293
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B ????? not sure
C galll stone ileus
E .... ?????
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| Kamsi
Forum Guru
Topics: 103
Posts: 347
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What do U think about renal dialysis since it is an acute rejection in the 1st Q
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| aaroho
Forum Junior
Topics: 8
Posts: 75
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B
C
E
___________________
Life is wonderful when doctors all around
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| Dr.D
Forum Senior
Topics: 22
Posts: 191
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B
C
B?
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| spmvj
Forum Newbie
Topics: 3
Posts: 36
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1.B.If there is acute rejection short course of high dose steroids can be given
2.C
3.E.>5 days-liver transplant
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| tamerbashir
Forum Elite
Topics: 20
Posts: 284
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B
C
E
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| Ivonne
Forum Guru
Topics: 55
Posts: 1,452
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B
C
E
___________________
If you beleive you can do it then you WILL DO IT!! (by Mymeghhi)
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| Korotkoff
Forum Senior
Topics: 15
Posts: 168
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got the BCE
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| drshvetasm
Forum Elite
Topics: 22
Posts: 282
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BCE
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