p2
Forum Senior
Topics: 58
Posts: 75
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1] An asymptomatic 57-year-old man comes to the physician before beginning a jogging program. He has a sedentary lifestyle and has smoked two packs of cigarettes daily for 30 years. His blood pressure is 150188 mm Hg. Examination shows no other abnormalities. An ECG shows normal findings. His serum cholesterol level is 250 mgfdL. Which of the following is the most appropriate next step in management?
O A) Referral to a supervised exercise program
O B) Ambulatory blood pressure monitoring
O C) Ambulatory ECG monitoring
O D) Exercise stress test
0 E) Echocardiograph
ansAAAAAAA
2]]47-year-old man comes to the physician because of swelling of his feet for 1 month. He is otherwise asymptomatic. His last visit to a physician was 30 years ago. He has smoked two packs of cigarettes daily for 30 years and drinks three to four beers each night. He weighs 82 kg (180 lb) and is 185 cm (73 in) tall. His temperature is 37.2°C (99°F), blood pressure is 152192 mm Hg, pulse is 80/min,
and respirations are 121min. Examination shows no other abnormalities except for 2+ pedal edema and decreased sensation to light touch over the distal lower extremities. Serum studies show a glucose level of 240 mg1dL, creatinine level of 2.7 mgldL, and total cholesterol level of 252 mg/dL. Urine dipstick shows 3+ protein. Which of the following is most likely to have prevented this condition?
O A) Abstinence from alcohol
O B) Lowering of serum cholesterol level
O C) Low-protein diet
OD) Tight glycemic control
0 E) Weight loss
D/C?
3] A 2-month-old infant is brought to the emergency department by paramedics after his mother found him not breathing in his crib. He is apneic and cyanotic; no pulses are palpable, but he is warm. After manually stabilizing his neck and positioning the airway, which of the following is the most appropriate next step in management?
O A) Positive pressure ventilation and oxygenation
O B) Two chest thrusts followed by chest compressions
O C) Establishing vascular access
O D) Administration of epinephrine
0 E) Electrical defibrillation
ANS:AAAAAAAAAA
4] A 77-year-old man comes to the physician because of a 3-month history of fatigue and decreased appetite resulting in a 4.5-kg (10-Ib) weight loss. He also has had depressed mood and decreased concentration. He is no longer interested in participating in his weekly golf outing and rarely attempts to visit with friends. He is no longer motivated to clean his house and keep up with his bills. He says he
can hear his wife, who has been dead for 4 years, telling him that his loss of appetite is due to cancer and that he should end his life before he goes through the same painful death that she did. Physical examination shows no abnormalities. Mental status examination shows a depressed mood. He is able to recall two of three objects after 5 minutes. There is no evidence of suicidal ideation. Which of the following is the most likely diagnosis?
O A) Adjustment disorder with depressed mood
O B) Dysthymic disorder
O C) Major depressive disorder with psychotic features
O D) Pathological bereavement
0 E) Schizoaffective disorder
ans:A/C?
6] One hour ago, a 33-year-old man had the sudden onset of a shaking chill and fever. Two weeks ago, he was diagnosed with acute myelogenous leukemia and was hospitalized for initiation of chemotherapy. He is pale and has rigors. His temperature is 38.6°C (101.5°F), blood pressure is 120/76 mm Hg, pulse is 110/min, and respirations are 32/min. There are multiple petechiae over his antecubital fossae. Physical examination is otherwise normal. Laboratory studies show:
Hematocrit 24%
Leukocyte count 4001mm3
Segmented neutrophils 1%
Lymphocytes 98%
Monocytes 1%
Platelet count 15,000/mm3
Blood is drawn for culture. Which of the following should be administered intravenously?
O A) Clindamycin and cefazolin
O B) Ticarcillin and tobramycin
O C) Vancomycin
O D) High-dose penicillin
O E) High-dose trimethoprim-sulfamethoxazole
Should be BBBBBBBBBBBB [pseudomonas]
7] Seven days after sustaining partial- and full-thickness burns in a house fire, a 7-year-old boy has brain asphyxia, acute respiratory distress syndrome, multiorgan system failure, and sepsis. He is being mechanically ventilated. After consultation with his parents, a do-not-resuscitate order is written, and the boy is removed from the ventilator. Twenty minutes later, his blood pressure is bp86/42 mm Hg, pulse is 130 min. and respirations are 8/min. He periodically moans in pain. His current pain medication is intravenous morphine (20 mg/h). Which of the following is the most appropriate next step in pain management?
O A) Decrease the morphine until the patient's respirations are greater than 12/min
O B) Increase the morphine
O C) Administer midazolam
O D) Administer naloxone
0 E) Administer pancuronium
CCCCC ???????
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| Fred33
Forum Guru
Topics: 103
Posts: 755
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1 D this comes up in another qs. answer pretty sure
2 D at a guess.
3 A for first step in ABC
4 C No reason because I never try to reason with psychiatry
5 no 5
6 no idea. But what are 98% lymphocytes doing with AML?
7 was answered recently. I think answer was increase morphine. Mine was anesthetize (E)
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| kauraabhimanyu
Forum Junior
Topics: 9
Posts: 49
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3)For Q 3 you do ABC. Since you have already positioned the airway next look if the patient is breathing or not. since baby has apnea you treat it with positive pressure ventilation and oxygen. Next we come to C you look for pulses and start chest compressions if they are abscent.
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| kauraabhimanyu
Forum Junior
Topics: 9
Posts: 49
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Q1 man has hypercholesteremia and hypertension we have to confirm after taking 3 readings. So we just ask him to exercise. Exercise stress test is used only in people who have moderate risk for getting MI but I dont know if he is moderate risk or low risk??? So I'll go with A.
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| kauraabhimanyu
Forum Junior
Topics: 9
Posts: 49
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Q7 morphine is considered to be the best agent to reduce pain. dont be afraid to use it. I think midazolam would also cause resp depression.
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