Quiz 10

Question 1

tamoxifen

raloxifene

Answer 1

offered to women at high risk for breast cancer
selective estrogen receptor modulators
Potential harms include an increase of 4–7 events of venous thromboembolism per 1000 women
Tamoxifen also reduces bone fractures but
increases the incidence of endometrial cancer, leg cramps, bladder control issues, vasomotor symptoms,
and vaginal dryness, itching, and discharge.

Question 2

pleural fluid protein to serum protein ratio of 0.7 and a pleural fluid LDH to serum
LDH ratio of 0.8.

Answer 2

Light’s criteria (pleural fluid protein to serum protein ratio >0.5,
pleural fluid LDH to serum LDH ratio >0.6, and/or pleural LDH >0.67 times the upper limit of normal
for serum LDH) are 99.5% sensitive for diagnosing exudative effusions

Question 3

Exudative vs transudative dx.

Answer 3

Cirrhosis
Heart Failure
Nephrotic syndrome
Superior vena cava obstruction

Exudative: Pulmonary Embolism

Question 4

two main classes

of IUDs: the copper T 380A IUD and the levonorgestrel-releasing IUD

Answer 4

severe cirrhosis or liver cancer should not use the levonorgestrel-releasing IUD, and the
copper T is preferred.
Breast
cancer is another contraindication to use of the levonorgestrel-releasing IUD, and the copper T would be
preferred.
Hormonal contraceptives in general should be avoided in women with severe liver
disease, as there is a known association between oral contraceptive use and the growth of hepatocellular
adenoma,

Question 5

Kid with cough at night

Answer 5

A teaspoon of honey, given alone or in a noncaffeinated liquid before bed, has been shown to reduce the
severity and frequency of coughing.

Question 6

Which one of the following is an effect of long-term treatment for narcotic addiction with
methadone and buprenorphine?

Answer 6

Long-term medication-assisted treatment for narcotic addiction is more successful than detoxification
programs (SOR A).

Question 7

Baby will only eat junk food

Answer 7

Provide healthy foods for all meals and snacks, and end the meal if the child refuses to eat

Question 8

lateral hip pain over the outer thigh
 begun a walking program to lose weight
 increased pain
when she lies on that side at night. 
she is
overweight and has tenderness over the greater trochanter. 
no pain with internal and
external rotation of the hip. A radiograph reveals minimal osteoarthritic changes

Answer 8

Trochanteric bursitis develops insidiously after repetitive use, and the patient may report morning stiffness
and pain when lying on the affected side. Palpation of the greater trochanter elicits tenderness, and
occasionally swelling may be noted as well. Early injection with a corticosteroid usually produces a
satisfactory response.

Question 9

Hypertension requiring four
or five drugs to control, abdominal bruits, and development of hyperkalemia or renal insufficiency after
initiating therapy with an ACE inhibitor can all point toward

Answer 9

renal artery stenosis as a diagnosis.

patients with renal artery stenosis who have good control, no testing is necessary other than monitoring
renal function, particularly if an ACE inhibitor or ARB is part of the regimen.

Screening tests
recommended by clinical guidelines include duplex ultrasonography, CT angiography, or MR cystography

Question 10

Which one of the following screening practices is recommended for the adolescent population
by the U.S. Preventive Services Task Force

Answer 10

Chlamydia infection in all sexually
active, nonpregnant young women under the age of 25 (grade B recommendation). Papanicolaou testing
is recommended starting at 21 years of age. Testicular cancer screening, whether by self-examination or
as part of the physical examination, is not recommended. Scoliosis screening for asymptomatic adolescents
is also not recommended. There is insufficient evidence to recommend for or against lipid screening.