docdoc9
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34. Two days after admission to the hospital
because of a 3-day
history of slurred speech, double vision, and
dysphagia, a 24-year-old
woman becomes quadriplegic and requires intubation and
mechanical
ventilation. Her medical history is unremarkable.
One week ago, she attended a
family picnic; several of her family members have had
abdominal cramps
and diarrhea since the picnic. Her temperature is 37
C (98.6 F), blood
pressure is 120/80 mm Hg, and pulse is 120/min.
Examination shows dry
mucous membranes, large unreactive pupils,
ophthalmoplegia, and
profound facial weakness. There is areflexia,
quadriplegia, and no movement
of the palate and tongue. Sensation is normal.
Babinski's sign is
absent. Which of the following is the most
appropriate pharmacotherapy?
A
) Antitoxin
B
) Azathioprine
C
) Interferon
D
) Pyridostigmine
E
) Riluzole
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| docdoc9
Forum Guru
Topics: 63
Posts: 513
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35. A 2325-g (5 lb 2 oz) male newborn is delivered
at 33 weeks'
gestation; Apgar scores are 7 and 8 at 1 and 5
minutes, respectively. The
13-year-old mother had no prenatal care and did not
know how much
weight she gained. During the pregnancy, the mother
smoked marijuana and
took over-the-counter vitamins occasionally; she did
not drink alcohol
and had no illness except for an upper respiratory
tract infection 4
months ago. She did not know she was pregnant until 2
weeks ago; her
family is unaware of her condition. She has had one
sexual partner. During
the hospital stay, the newborn and his mother have no
complications.
The newborn is at greatest risk for morbidity and
mortality from which
of the following?
A
) Child abuse
B
) Congenital syphilis
C
) Hypocalcemia
D
) Lead poisoning
E
) Seizures
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| docdoc9
Forum Guru
Topics: 63
Posts: 513
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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
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| nightflight1945
banned
Topics: 32
Posts: 920
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A ) Antitoxin
Botulism
A ) Child abuse
more probable than seizure
D ) Malignancy
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| docdoc9
Forum Guru
Topics: 63
Posts: 513
|
Thanks nightflight, wanted to confirm the answers
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| nightflight1945
banned
Topics: 32
Posts: 920
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