Kamsi
Forum Guru
Topics: 103
Posts: 347
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1) Ten days after undergoing liver transplantation, a patient's levels of gamma-glutamyl transferase (GGT), alkaline phosphatase, and bilirubin begin to rise. Which of the following is the most appropriate next step in diagnosis?
A. Measurement of preformed antibody levels
B. Ultrasound of biliary tract and Doppler studies of the anastomosed vessels
C. Liver biopsy and determination of portal pressures
D. Liver biopsy and more detailed liver function tests
E. Liver biopsy and trial of steroid boluses
20) A 54-year-old woman has a severe ureteral colic. An intravenous pyelogram shows a 7-mm ureteral stone at the ureteropelvic junction. She has a normal coagulation profile. Which of the following would most likely be the best therapy in this case?
A. Plenty of fluids and analgesics and await spontaneous passage
B. Extracorporeal shock wave lithotripsy (ESWL)
C. Endoscopic retrograde basket extraction
D. Endoscopic retrograde laser vaporization of the stone
E. Open surgical removal
22) A 31-year-old woman smashes her car against a bridge abutment. She sustains multiple injuries, including upper and lower extremity fractures. She is fully awake and alert, and she reports that she was not wearing a seat belt and distinctly remembers hitting her abdomen against the steering wheel. Her blood pressure is 135/75 mm Hg, and her pulse is 88/min. Physical examination shows that she has a rigid, tender abdomen, with guarding and rebound in all four quadrants. She has no bowel sounds. Which of the following would be the most appropriate step in evaluating potential intraabdominal injuries?
A. Continued clinical observation
B. CT scan of the abdomen
C. Sonogram of the abdomen
D. Diagnostic peritoneal lavage
E. Exploratory laparotomy
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| Doc750
transfer:step 3 prison
Topics: 52
Posts: 636
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B, B, B
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Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
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B. Ultrasound of biliary tract and Doppler studies of the anastomosed vessels
B. Extracorporeal shock wave lithotripsy (ESWL)
B. CT scan of the abdomen
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"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
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| MAGY17
Forum Elite
Topics: 30
Posts: 234
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1= E I`M COFUSED BECAUSE THIS IS ACUTE REJECTION. CITOTOXIC T LYMPHOCYTES REACT AGAINTS FOREIGN MHCs,
MAY BE BIOPSY AND STEROID
2=B
3=B
repley about # 1 qs please
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| Kamsi
Forum Guru
Topics: 103
Posts: 347
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1B. In all other solid organ transplants, deterioration of function 10 days out would suggest an acute rejection episode, and appropriate biopsies would be done to confirm the diagnosis. In the case of the liver, however, antigenic reactions are less common, whereas technical problems with the biliary and vascular anastomosis are the most common cause of early functional deterioration. They are, therefore, the first anomalies to be sought.
20 B
22 E Pt has acute abd as shown by rigid tender abd with guarding n rebound in all 4 quadrants
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| MAGY17
Forum Elite
Topics: 30
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GJ KANSI THANKS
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| doyoudig
Forum Guru
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Posts: 613
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1.?
2.B (any stone > 5 mm at junction) --open surgery for struvite stones
3. Even tough she is Stable, she has Peritoneal Sigsn which needs -- E. Exploratory laparotomy
Blunt Trauns + Unstable -- Fast Focused US 1st (if unavailbale or Inconclusive then DPL)
-- a + US --> Exploratomy Lapa comes next
Blunt Trauma + Stable -- CT Scan 1st which will guide the next Rx -- i.e. Laparotomy or observation
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