Barkley questions Flashcards
32 y/o female complains of chronic cough that is “phlegmy” also stating that the littles physical activity causes her to be out of breath. Exam indicates normal chest percussion and edema to BLE. Vitals are 118/79, RR 21 HR 69 and T 98.2 What is most likely the cause of patients s/s
A. chronic bronchitis
B. sarcoidosis
C. emphysema
D. chronic venous insufficiency
A
sarcoidosis tends to have fever and anorexia
emphysema has underweight and hyperresonatn chest on percussion
Pt with history of bleeding ulcers comes to ED with abdominal pain and nausea He says pin is worse after he eats Vitals are T 98.4, HR 88, BP 110/62. If his s/s are due to bleeding ulcer which of these findings might be seen
A. melena
B. board-like abdomen
C. frank, red bleeding from rectum
D. coffee-like emesis
D
35 y/o female returns to hospital 2 weeks after gastric resection surgery to treat gastric cancer She reprots for past week has been experiencing persistent vomiting What electrolyte disturbance do you expect
A. metabolic alkalosis and hyperkalemia
B. metabolic alkalosis and hypokalemia
C. metabolic acidosis and hypokalemia
D. metabolic acidosis and hyperkalemia
B
vomiting cause bicarb elevation resulting in alkalosis and hypokalemia
A pt with HIV presents with fatigue, SOB and night sweats A purified protein derivative was administered with a 7mm induration as a result Once dx is confirmed what treatment do you expect
A. repetition of TB test
B. four drug therapy
C. Two drug therapy
D. mono therapy
B
four drug therapy due to HIB and TB
a 36 y/o patient presents with complaints of moderate SOB and chronic phlegmy cough a physical exam indicates obesity, normal anteroposterior chest diameter, and normal percussion. Which of the following chest Xray findings would be most consistent with the most likely condition
A. air pockets
B. lung infilatrates
C. pleural effusion
D. hyper inflated lungs
D
Which of the following factors is an explicit part of the PICOT framework for clinical based questions
A Control
B Observation
C Time
D Indication
C
P-patient/population
I-intervention
C-comparision
O-outcome
T- time
which of the following is best treatment for euvolemic hypernatremia
A. Sodium bicarbonate solution
B. 0.9 NS
c. %5 dextrose in water
D. loop diuretic
C
0.9 NS for hypovolemic hypernatremia
loop diuretic used in supplement with overload
sodium card add with severe acidosis
38 y/o female with type 1 DM is in ED after car accident She says she started feeling tired being the wheel and lost control As your assessment goes on she becomes disoriented and you smell fruity breath with observed hypotension and tachycardia
Which of the following results on lab panel would indication the most likely condition
A. decreased potassium
B decreased BUN
c glycosuria
D. increased serum bicarbonate
C
glycosuria is classic finding of DKA
A patient presents with number of abdominal s/s including nausea vomtng and diarrhea you also note fever you suspect peritonitis which abdominal findings would be most consistent with suspected diagnosis
a. hypoactive bowel sounds and rigidity
b. hyperactive bowel sounds and percussion tenderness
c. hypoactive bowel sounds and percussion tenderness
d. hyperactive bowel sounds and rigidity
A
due to contraction of abdominal walls you get hypoatice bowel sounds and rigidity
hyperactive bowel sounds are associated with gastroenteritis
ambulance brings 57 y/o pt to ED after head hit steering wheel during car accident. She was dazed at the scene but able to answer questions during ride to hospital. Assessment reveals patient is confused and complains of dizziness and vague frontal headache. Moments after you complete assessment pt becomes unconscious and has a seizure. What should you consider most likely diagnosis
A. brain infarct
B. intracebral hemorrhage
c. subdural hematoma
d intraventricular bleed
C
subdural presents with confusion, headache and LOC
intracerebral
which of the following profiles best reflects anaphylactic shock
a. CO 3.5; CVP 1; PCWP 4; SVR 700
b. CO 3.5; CVP 1; PCWP 14; SVR 1300
c. CO 8.5; CVP 9; PCWP 4 ; SVR 700
d. CO 3.5; CVP 1; PCWP 12; SVR 1300
a
anaphylactic shock is indicated by low CO, low CVOP, low PCWP low SVR and low SVO2
66 y/o presents with SOB, fever and persistent , productive cough. Pt has hx of DM2 and high cholesterol. Xray reveals lung infiltrates. Blood culture positive for Strep. pneumonia. Which of the following drugs should be used as monotherpay to treat patients most likely condition
A. moxifloxacin
B. azithromycin
C. doxycycline
d. clarithromycin
A
tx of CAP with comorbidites should be fluoroquinolone
your patient has serum osmolality of 268 and serum sodium of 120 his urine Na is less than 10 . which is the most likely explanation for these findings
a. vomiting
b. liver disease
c. diuretic
d. mineralocorticoid deficiency
a
a 19 year old male comes to your office complaining of number of painful, itching sores that have appeared on his pensi. He says the sores presented shortly after he came down with fever that was accompanied by headache, malaise, and joint pain. Based on these findings what is the most appropriate medication for treatment
a. azithromycin
b. Penicillin G
c. ceftriaxone
d. acyclovir
d
treats HSV-2
which of the following is true regarding sentinel events
a. sentinel event is synonymous with medial erro
b. sentinel event applies if no harm occurs, but eh same circumstances could result in harm in the future
c. sentinel event are investigated by joint commission
d. sentinel events cover only physical harm
b
