Kamsi
Forum Guru
Topics: 103
Posts: 347
|
A 45-year-old woman comes to the emergency department because of shortness of breath, chest pain, dizziness, and mild numbness and tingling around the lips for 2 hours. She says that she feels like she is going to die. She had three similar episodes last week when she was vacationing at the Grand Canyon; the first episode occurred while crossing a narrow bridge on a donkey. She takes a hypoglycemic drug for type 2 diabetes mellitus, verapamil for hypertension, and sumatriptan as needed for migraine. She is mildly diaphoretic and appears pale. Her blood pressure is 130/90 mm Hg, pulse is 120/min, and respirations are 28/min. Serum glucose level is 120 mg/dL. An ECG shows sinus tachycardia. Sublingual nitroglycerin therapy does not relieve her symptoms and gives her a headache. The most appropriate next step in management is administration of which of the following?
A
) Haloperidol
B
) Lorazepam
C
) Oxygen
D
) Sumatriptan
E
) Verapamil
20. A 67-year-old woman has been intubated for 1 week after undergoing a left lobectomy for lung cancer. She has chronic obstructive pulmonary disease. Her preoperative functional vital capacity was 40% of predicted. She is awake and alert. Her blood pressure is 130/75 mm Hg, and pulse is 72/min. The ventilator settings are a synchronized intermittent mandatory ventilation of 8/min, FIO2 of 40%, and positive-end expiratory pressure of 5 cm H2O. Arterial blood gas analysis shows:
pH 7.42
PCO2 47 mm Hg
PO2 90 mm Hg
O2 saturation 96%
Which of the following is the most appropriate next step in management?
A
) Antibiotic therapy
B
) Bronchodilator therapy
C
) Chest physiotherapy
D
) Decrease inotropes
E
) Diuretic therapy
F
) Fiberoptic bronchoscopy
G
) Heparin therapy
H
) Incentive spirometry
I
) Increase FIO2
J
) Increase inotropes
K
) Increase respiratory rate
L
) Placement of thoracostomy tube
M
) Tracheostomy
N
) Wean from the ventilator
19For each patient with papilledema, select the most likely diagnosis.
A
) Bacterial meningitis
B
) Cerebral infarction
C
) Cryptococcal meningitis
D
) Glioblastoma multiforme
E
) Herpes simplex encephalitis
F
) Hypertensive encephalopathy
G
) Idiopathic intracranial hypertension
H
) Intracerebral hemorrhage
I
) St. Louis encephalitis
. A 25-year-old man with a history of intravenous drug use comes to the emergency department because of a progressive diffuse headache, generalized malaise, and low-grade fever for 2 months. During this period, he has had a poor appetite resulting in a 6.8-kg (15-lb) weight loss. His temperature is 38 C (100.4 F). Examination shows ¬¬neck stiffness. Mental status examination shows no abnormalities. Cranial nerve examination shows weakness of the lateral rectus muscle on the right and bilateral papilledema. A CT scan of the head with and without contrast shows moderate ventricular enlargement. Examination of cerebrospinal fluid shows:
Opening pressure 220 mm H2O
Glucose 35 mg/dL
Protein 150 mg/dL
WBC 100/mm3
Lymphocytes 100%
RBC 1/mm
|
| dermatology
Forum Elite
Topics: 30
Posts: 293
|
1. B
2. ???????
3. E
|
| Kamsi
Forum Guru
Topics: 103
Posts: 347
|
What's ur diagnosis in the Ist Q
|
| aaroho
Forum Junior
Topics: 8
Posts: 75
|
1 B
2 c
3 E
___________________
Life is wonderful when doctors all around
|
| elitoki
Forum Guru
Topics: 54
Posts: 508
|
1. B
2. K
3. E?
|
| Dr.D
Forum Senior
Topics: 22
Posts: 191
|
C May be Anxiety disorder
K
E
Kamsi, plz let us know the 1 Q's answer.
|
| Dr.D
Forum Senior
Topics: 22
Posts: 191
|
sorry anxiety attack
|
| docfor99
Forum Senior
Topics: 9
Posts: 104
|
1 B....3.... i? COZ HERPES SIMPLEX will cause a bloody csf right? can anyone explain the concept in 2? fio2 concept is lost on me  panic attacks i think for 1 one.....
|
| Dr.D
Forum Senior
Topics: 22
Posts: 191
|
Kamsi, what are the answers?
|
| Kamsi
Forum Guru
Topics: 103
Posts: 347
|
I'm not sure of the answers
1 C
2 i/k??
3 i/c??
2nd and 3rd had varying answers that's why I posted them
|
| donjuan
Forum Junior
Topics: 9
Posts: 68
|
regarding the last question the csf is kind of typical for crypto. meningitis and there can also be vent enlargement on the ct if there is some sort of obstruction.
|
| tamerbashir
Forum Elite
Topics: 20
Posts: 284
|
B
K
C
|
| Korotkoff
Forum Senior
Topics: 15
Posts: 168
|
C
N?
C
|
| dr_arc
Forum Senior
Topics: 5
Posts: 156
|
1. panic attacks- lorazepam
2. pt probably fighting the ventillator,spontaneous breathing clashing with the synchronised ones so maybe retaining co2, why is the pH up with co2 retention? well maybe attempt to wean off the ventilator???????????????
3.IV drug abuse, low grade fever for mnths, focal findings, lymphos on csf- cryptococcal
|
| farnsworth
Forum Newbie
Topics: 0
Posts: 165
|
B
N
C
|
| RX 135
tormenta
Topics: 23
Posts: 522
|
c.n.g
___________________
“People don't change. For example, I'm gonna keep on repeating 'people don't change.' ”
|
| guangyu
Forum Elite
Topics: 29
Posts: 308
|
B
N
C
|
|
| |
| | | | | | | | | | | | | | | | | |
