Quiz 11

Question 1

CURB-65 score

Answer 1

respiratory rate,

blood pressure, uremia, confusion, and age.

Question 2

community-acquired pneumonia

Answer 2

Patients who have only mild symptoms can be treated with azithromycin on an outpatient basis if there is
a low level of macrolide resistance in the community.

If there is a high level of resistance in the
community, if the patient has comorbidities such as diabetes mellitus or COPD, or if there is a history of
use of an immunosuppressing drug or recent use of an antibiotic, the patient can still be treated as an
outpatient but should be treated with levofloxacin.

Patients with more severe symptoms, such as an
elevated pulse rate or respiratory rate, should be treated on an inpatient basis with ceftriaxone or
azithromycin.

Patients who have more severe symptoms along with bronchiectasis should be treated with
piperacillin/tazobactam plus levofloxacin.

Patients with the most severe symptoms, including hypotension, a more elevated pulse rate, low oxygen
saturation, and confusion, should be treated in the intensive-care unit with levofloxacin and vancomycin.

Question 3

Neck Mass

Answer 3

three categories: developmental, inflammatory/reactive,
or neoplastic. The history and physical examination can help narrow the diagnosis, with location of the
mass being particularly helpful.

Branchial cleft cysts make up approximately 20% of neck masses in children. They commonly present in
late childhood or adulthood, when a previously unrecognized cyst becomes infected. They are most
frequently found anterior to the sternocleidomastoid muscle, but can also be preauricular.
Thyroglossal duct cysts are located in the midline over the hyoid bone. Frequently, they elevate when the
patient swallows. Dermoid cysts are usually mobile, moving with the overlying skin. They can be located
in the submental or midline region. Thyroid tumors are also usually located in the midline. Malignant
masses are usually hard, irregular, nontender, and fixed.

Question 4

Treatment of rhabdomyolysis

Answer 4

The treatment of rhabdomyolysis includes rapid large infusions of isotonic saline to prevent and treat acute
kidney injury,

Question 5

pet groomer
A. A wound size >2 cm 
 B. The presence of wound gaping 
 C. A bite involving the hand 
 D. The patient’s occupation 
Which one of the following is an indication for antibiotics in this patient?

Answer 5

Factors associated with a high risk include
a bite on an extremity with underlying venous and/or lymphatic compromise, a bite involving the hand,
a bite near or in a prosthetic joint, cat bites, crush injuries, delayed presentation, puncture wounds,
underlying diabetes mellitus, and immunosuppression.

Question 6

autosomal dominant polycystic kidney disease tx of htn

Answer 6

ACE inhibitors such as lisinopril are first-line agents because they have renal protective benefits in addition
to their effects on blood pressure

Question 7

Which one of the following would be best for making a diagnosis of fibromyalgia?

Answer 7

diagnostic criteria for fibromyalgia based on the

patient’s symptoms (SOR A). Previously, tender points on examination WERE the diagnostic criterion.

Question 8

Sympathomimetic agents

Answer 8

Sympathomimetic agents can elevate blood pressure and intraocular pressure, may worsen existing urinary
obstruction, and adversely interact with β-blockers, methyldopa, tricyclic antidepressants, oral
hypoglycemic agents, and MAOIs. They also speed up the heart rate. First-generation nonprescription
antihistamines can enhance the anticholinergic and sedative effects of other medications.

Question 9

Which one of the following would you suggest for improving iron absorption

Answer 9

Taking oral iron with vitamin C or a meal high in meat protein increases iron absorption. Calcium and
coffee both decrease iron absorption, but not as much as tea, which can reduce absorption of oral iron by
as much as 90%.

Question 10

Which one of the following conditions can affect hemoglobin A1c levels

Answer 10

The hemoglobin A1c (HbA1c) blood test provides information regarding average glucose levels over the past
3 months. Any condition that shortens erythrocyte survival or decreases mean erythrocyte age, such as
recent acute blood loss or hemolytic anemia, will falsely lower HbA1c levels. Hemoglobin variants and iron
deficiency, kidney failure, and liver disease can also affect HbA1c results. Heart failure, COPD, and
hypothyroidism do not influence HbA1c values.