Test 44

Question 1

Decision making capacity

Answer 1

Patients who lack decision-making capacity and require emergency treatment may be treated under the doctrine of implied consent, which allows treatment that a reasonable person in a similar situation would be excepted to accept.

Question 2

Decision making capacity

Answer 2

Patients typically execute advance directives to avoid prolonged care for terminal illness but usually do not intend to refuse care for temporary conditions. When an incapacitated patient’s proxy decision maker refuses consent for treatment of correctable conditions, the physician should discuss the illness and treatment further to ensure that refusal is truly consistent with the patient’s wishes.

Question 3

Polycystic ovary disease

Answer 3

Patients with polycystic ovarian syndrome and obesity typically have infertility secondary to anovulation. Weight loss in these patients restores ovulation and is first-line therapy in patients pursuing pregnancy. Then ovulation induction with letrozole or gonadotropins then in vitro…

Question 4

Central venous thrombosis

Answer 4

Patients with central venous sinus thrombosis usually develop a gradually worsening headache due to elevated intracranial pressure, and may have focal neurologic deficits or seizure due to cerebral venous congestion. Although focal cerebral hemorrhage may be present on imaging, treatment with heparin or low-molecular-weight heparin is considered safe and the standard of care.

Question 5

Minimal change glomerulopathy

Answer 5

Minimal change disease is the most common cause of nephrotic syndrome in young children and presents with edema secondary to proteinuria and hypoalbuminemia. Diagnosis is clinical in classic cases, and management is empiric corticosteroid therapy.

Question 6

Referrals

Answer 6

The arrangements medical professionals make to sublease medical office space to each other are regulated by federal law. To avoid conflicts of interest and violations of the law, medical professionals should base rental fees on current market rates and never make them dependent on the volume of referrals between medical professionals.

Question 7

Pulmonary arterial HTN

Answer 7

Transthoracic echocardiography allows for an estimation of pulmonary arterial pressure and should be the initial diagnostic evaluation in patients with suspected pulmonary HTN.

Question 8

Study designs

Answer 8

Meta-analysis is conducted by pooling data from several studies to increase statistical power.

Question 9

Pseudoaneurysm

Answer 9

Pseudoaneurysm is a potential complication of arterial access for cardiac catheterization; it occurs when arterial bleeding remains confined within the periarterial connective tissue, resulting in a contained hematoma that communicates with the arterial lumen. Patients typically have a tender, pulsatile mass with a systolic bruit at the puncture site, and the diagnosis is confirmed by ultrasonography.

Question 10

Acute diarrhea

Answer 10

Salmonellosis does not need to be treated with antibiotics in immunocompetent individuals age 12 months or older.