Test 35

Question 1

Androgen insensitivity syndromes

Answer 1

Androgen insensitivity syndrome presents in phenotypical females with primary amenorrhea and absent pubic/axillary hair but normal breast development. Diagnostic features include an absent uterus but intact testes, a (46, XY) karyotype, and serum testosterone levels in the normal adult male range.

Question 2

Prenatal care

Answer 2

Healthy women with uncomplicated pregnancies are recommended to perform 30 minutes of moderately intense exercise on most days of the week. Scuba diving, exercise associated with a high risk of falling, and contact sports are not recommended during pregnancy.

Question 3

Validity and reliability

Answer 3

External validity answers the question, “How generalizable are the results of a study to other populations?” For example, a study in middle-aged women would not be necessarily generalizable to elderly men.

Question 4

Stimulants

Answer 4

Stimulant toxicity is characterized by anxiety, agitation, insomnia, and loss of appetite. Physical findings include tachycardia, HTN, diaphoresis, and mydriasis. Psychosis and seizures can also occur.

Question 5

Chronic diarrhea

Answer 5

The evaluation and management of chronic diarrhea involves a comprehensive history (clear description of stool characteristics, duration and timing of sx), basic serum analysis, and importantly, stool analysis.

Question 6

Sinusitis

Answer 6

Exposure to cigarette smoke and air pollution causes recurrent or chronic sinusitis by damaging the cilia responsible for moving mucus through the sinuses. Other common causes of chronic or recurrent sinusitis include inadequately treated acute sinusitis, structural abnormalities of the nasal septum or palate, and allergic rhinitis.

Question 7

Dumping syndrome

Answer 7

Dumping syndrome is a common complication of gastrectomy. Treatment is aimed at decreasing the speed of passage of fluids and food into the small gut. A high-protein and low-carbohydrate diet is advised, as well as smaller but more frequent meals throughout the day.

Question 8

Adverse event

Answer 8

Preventable adverse events occur from failure to follow evidence-based best practice guidelines. Non-preventable adverse events are complications that cannot be prevented given the current state of medical knowledge and occur despite appropriate medical practice.

Question 9

Preeclampsia

Answer 9

Patients who have preeclampsia with severe features require stabilization with blood pressure control (hydralazine, labetalol) and magnesium sulfate for seizure prophylaxis. At greater than or equal to 34 weeks gestation, delivery is initiated after maternal stabilization is established.

Question 10

SLE

Answer 10

A kidney biopsy is indicated prior to tx initiation to guide therapy in all patients with SLE with significant renal involvement (proteinuria, active urinary sediment, declining renal function).

Question 11

SLE

Answer 11

Anti-double stranded DNA and complement levels can be used to monitor for active renal involvement in patients with SLE. Antinuclear antibody titers do not correlate with renal disease activity.

Question 12

Venous thromboembolism

Answer 12

IVC filters are an option for patients with acute deep venous thrombosis (DVT) who have contraindications to anticoagulation. Long-term complications of IVC filter placement include recurrent DVTs and IVC thrombosis. IVC filters do not appear to affect overall mortality significantly.