Quiz 44 Flashcards
spirolactone
antiandrogen effects, use to tx hirsuitism in lubal ligation.
A 67-year-old white female has a DXA scan with a resulting T-score of –2.7
Calcitonin nasal spray is an antiresorptive spray that decreases the incidence of vertebral compression fractures. Teriparatide is a recombinant human parathyroid hormone with potent bone anabolic activity, effective against vertebral and nonvertebral fractures. Hormone replacement therapy is recommended for osteoporosis only in women with moderate or severe vasomotor symptoms.
For breast cancer risk factors give Raloxifene
A 50-year-old white female comes to you because she has found a breast mass. Your examination reveals a firm, fixed, nontender, 2-cm mass. No axillary nodes are palpable, nor is there any nipple discharge. You send her for a mammogram, and fine-needle aspiration is performed to obtain cells for cytologic examination. The mammogram is read as “suspicious” and the fine-needle cytology report reads, “a few benign ductal epithelioid cells and adipose tissue.”
Which one of the following would be the most appropriate next step? (check one)
An excisional biopsy of the mass
Clinical information is critical for interpreting the results of fine-needle aspiration, especially given the fact that the tissue sample is more limited than with a tissue biopsy.
Although the report from the mammogram and the biopsy are not ominous in this patient, they do not explain the clinical findings. Immediate repeat fine-needle aspiration or, preferably, a tissue biopsy is indicated.
A 67-year-old female comes to your office because she noticed flashing lights in her left eye 2 hours ago, and since then has had decreased vision in the lateral aspect of that eye. On examination she has a blind spot in the lateral visual field of her left eye. Her fundus is difficult to examine because of an early cataract.
Which one of the following is the most likely diagnosis? (check one)
A. Posterior vitreous detachment
B. Vitreous hemorrhage
C. Macular degeneration
D. Ocular migraine
E. Retinal detachment
In a patient complaining of flashes of light and a visual field defect, retinal detachment is the most likely diagnosis. Many cases of vitreous detachment are asymptomatic, and it does not cause sudden visual field defects in the absence of a retinal detachment. A vitreous hemorrhage would cause more blurring of vision in the entire field of vision. Ocular migraine causes binocular symptoms.
You are evaluating a 68-year-old male with obstructive urinary symptoms. Which one of the following medications may lead to falsely depressed levels of prostate-specific antigen (PSA)? (check one) A. Terazosin (Hytrin) B. Finasteride (Proscar) C. Tamsulosin (Flomax) D. Doxazosin (Cardura) E. Lycopene
Finasteride has considerable efficacy in treating obstructive symptoms, but it unfortunately falsely depresses PSA levels.
Subacute sclerosing panencephalitis
Subacute sclerosing panencephalitis usually occurs in children and young adults between the ages of 4 and 20 years and is characterized by deterioration in behavior and work. The most characteristic neurologic sign is mild clonus.
1 yo w/ microcytic, hypochromic anemia
can be caused by iron deficiency, thalassemia, sideroblastic anemia, and lead poisoning.
Hypothyroidism, vitamin B12 deficiency, and folate deficiency result in macrocytic anemias.
Which one of the following classes of medications for the treatment of diabetes mellitus
is most likely to lead to weight loss? (check one)
A. GLP-1 receptor agonists such as exenatide (Byetta)
B. Meglitinides such as repaglinide (Prandin)
C. Sulfonylureas such as glipizide (Glucotrol)
D. Thiazolidinediones such as pioglitazone (Actos)
E. Insulin
GLP-1 receptor agonists are the most likely of these medications to lead to weight loss.
Other diabetes
medications that may promote weight loss include metformin, amylin mimetics, and SGLT-2
inhibitors.
A 42-year-old white male develops respiratory distress 12 hours after he sustained a closed head injury and a femur fracture. A physical examination reveals a respiratory rate of 40/min. He has a pO2 of 45 mm Hg (N 75–100), a pCO2 of 25 mm Hg (N 35–45), and a blood pH of 7.46 (N 2 2 7.35–7.45). His hematocrit is 30.0% (N 37.0–49.0).
Of the following, the most likely diagnosis is:
This has led to the theory that the lung has a limited number of ways of reacting to injury and that several different types of acute, diffuse lung injury result in a similar pathophysiologic response. The common denominator of this response appears to be injury at the alveolar-capillary interface, with resulting leakage of proteinaceous fluid from the intravascular space into the interstitium and subsequently into alveolar spaces. It has become acceptable to describe this entire spectrum of acute diffuse injury as adult respiratory distress syndrome (ARDS).
PCWP and LV func to distinguish from CHF.
Decrease TV and increase RR for CO2
PEEP for oxygen. Keeps alveoli open.
