|
| |
| * Medicine question 28 |
| | #531210 |
|
| |
| |
| |
A 55 y/o woman with history of well controlled DM Type II presents for her regular follow-up visit. She has no new complaints. She has been well controlled on Metformin alone with a hemoglobin A1c of 6.5. The patient is afebrile with a B.P 96/72, HR 88, RR 16. Physical examination is benign except for decreased sensation in her bilateral lower extremities consistent with diabetic neuropathy and bilater lower extremity edema. Her last urinary microalbumin about one year ago was negative. A repeat dipstick test now is positive for protein and blood but negative for leucoesterase and nitrite. Subsequent urine microscopy reveals 4 dysmorphic RBCs/HPF and red cell casts. Labs reveal elevated serum creatinine at 1.4 as opposed to her baseline creatinine of 0.8 6 months ago. The next important step in approaching this patient’s Renal Insufficiency is:
A) Obtain CPK level
B) 24 hour urine for microalbumin
C) Start ACE inhibitor
D) Repeat urinalysis in 3 months
E) Referral to Nephrologist and Renal biopsy
F) Start emperic antibiotic therapy for UTI
|
|
| Report Abuse |
|
| * Re:Medicine question 28 |
| #2315619 |
| |
| |
hi mystikal. I completed my exam last week.
A little nervous about the multiple choice qs but my CCS was good. All cases ended smoothly.
What i observed was that most CCS cases end faster than the real time so, we will have enough real time. We have to be good at taking quick decisions at early simulated time in ER ccs cases, they end fast so if we order all imp things quickly in early simulated time, we can get more score.
mcq is difficult to say because i do not know the correct answers myself. Many closely resembling choices. But I made sure that I finished the block completely. Sometimes, if we think a little longer for few qs, we will not have enough time for easy qs at the end. So, skip the nasty qs with guess work , mark them and finish the block. If you have time, revise the answers of these nasty qs at the end of the block.
do not spend too much time on nasty qs because we wont have enough time for easy ones that may come up in the end. |
|
| Report Abuse |
|
|
|
