12-24-2011, 04:18 PM
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12-24-2011, 04:24 PM
35. A 17-year-old boy is brought to the emergency department by his parents because of bizarre behavior for 6 hours. Last night he was out with friends, and since returning, he has been confused and has "trashed" his room. His blood pressure is 165/95 mm Hg. He is hypervigilant, has little spontaneous speech, and is disoriented to place and time. He appears catatonic but abruptly becomes assaultive two times and needs to be restrained. Which of the following is the most likely substance taken?
A
) Cocaine
B
) Ecstasy
C
) LSD
D
) Methaqualone
E
) PCP
A
) Cocaine
B
) Ecstasy
C
) LSD
D
) Methaqualone
E
) PCP
12-24-2011, 04:32 PM
DEGENERARIVE DISC DIS=RUPTURE SO CLEAR...........IF STRAIN NEED HISTORY OF HEAVY LIFTING
12-24-2011, 04:36 PM
A and E CLOSED ANSWERs BUT mostly .....AA... due to high bp
12-24-2011, 04:39 PM
for 35 its E because of restrain word
12-24-2011, 04:40 PM
The response options for the next two items are the same. You will be required to select one answer for each item in the set.
For each patient with back pain, select the most likely diagnosis.
A
) Herniated disc
B
) Lumbar spinal stenosis
C
) Metastatic cancer
D
) Muscle strain
E
) Osteoporotic compression fracture
F
) Sacroiliitis
G
) Spinal epidural abscess
H
) Spondylolisthesis
36. A 57-year-old woman is brought to the physician 2 days after the sudden onset of severe low back pain; the pain does not radiate to the lower extremities. The pain began when she was lifting her grandson. She does not have weakness or sensory loss in the legs and has had no urinary incontinence. She has a 10-year history of rheumatoid arthritis treated with prednisone. Her temperature is 37 C (98.6 F), blood pressure is 130/60 mm Hg, and pulse is 64/min. Examination shows deformities of the interphalangeal joints of the hands and exquisite tenderness to percussion over the lumbar spine. Bilateral straight-leg raising to 80 degrees does not increase the pain. Muscle strength and sensation are intact in the lower extremities. Deep tendon reflexes are 2+ bilaterally. Babinski's sign is absent bilaterally.
For each patient with back pain, select the most likely diagnosis.
A
) Herniated disc
B
) Lumbar spinal stenosis
C
) Metastatic cancer
D
) Muscle strain
E
) Osteoporotic compression fracture
F
) Sacroiliitis
G
) Spinal epidural abscess
H
) Spondylolisthesis
For each patient with back pain, select the most likely diagnosis.
A
) Herniated disc
B
) Lumbar spinal stenosis
C
) Metastatic cancer
D
) Muscle strain
E
) Osteoporotic compression fracture
F
) Sacroiliitis
G
) Spinal epidural abscess
H
) Spondylolisthesis
36. A 57-year-old woman is brought to the physician 2 days after the sudden onset of severe low back pain; the pain does not radiate to the lower extremities. The pain began when she was lifting her grandson. She does not have weakness or sensory loss in the legs and has had no urinary incontinence. She has a 10-year history of rheumatoid arthritis treated with prednisone. Her temperature is 37 C (98.6 F), blood pressure is 130/60 mm Hg, and pulse is 64/min. Examination shows deformities of the interphalangeal joints of the hands and exquisite tenderness to percussion over the lumbar spine. Bilateral straight-leg raising to 80 degrees does not increase the pain. Muscle strength and sensation are intact in the lower extremities. Deep tendon reflexes are 2+ bilaterally. Babinski's sign is absent bilaterally.
For each patient with back pain, select the most likely diagnosis.
A
) Herniated disc
B
) Lumbar spinal stenosis
C
) Metastatic cancer
D
) Muscle strain
E
) Osteoporotic compression fracture
F
) Sacroiliitis
G
) Spinal epidural abscess
H
) Spondylolisthesis
12-24-2011, 04:42 PM
37. A previously healthy 32-year-old plumber comes to the physician because of a 3-week history of constant, dull, low back pain that does not radiate to the extremities. The pain began after he unloaded heavy equipment from his van. It increases with activity and is temporarily relieved by bed rest and ibuprofen. Examination shows tenderness to palpation over the lumbar paraspinal region bilaterally. The pain increases with forward or lateral movements of the spine. Muscle strength and sensation are intact in the lower extremities. Bilateral straight-leg raising to 80 degrees does not increase the pain. Deep tendon reflexes are 2+ bilaterally. Babinski's sign is absent bilaterally.
12-24-2011, 04:51 PM
36-10 yr prednisolone.............EE
37DD
37DD
12-24-2011, 06:02 PM
38. A 72-year-old man comes to the physician because of a 2-month history of urination twice nightly and occasional urinary frequency and urgency. He has a 15-year history of type 2 diabetes mellitus now moderately well controlled with glyburide. His father was diagnosed with prostate cancer at the age of 70 years, and his sister died of complications from systemic lupus erythematosus. His blood pressure is 135/86 mm Hg. Cardiopulmonary examination shows no abnormalities. Abdominal examination shows no suprapubic fullness or tenderness. There is mild enlargement of the prostate with no palpable nodules. His postvoid residual volume is 10 mL. Serum studies show a urea nitrogen (BUN) level of 45 mg/dL and creatinine level of 3.8 mg/dL. Urine dipstick shows 3+ protein. Which of the following is most likely to have prevented progression of this patient's renal disease?
A
) Intermittent Foley catheterization
B
) Intravenous mannitol therapy
C
) Oral cyclophosphamide and prednisone therapy
D
) Oral enalapril therapy
E
) Oral finasteride therapy
F
) Oral prednisone therapy only
G
) Oral terazosin therapy
A
) Intermittent Foley catheterization
B
) Intravenous mannitol therapy
C
) Oral cyclophosphamide and prednisone therapy
D
) Oral enalapril therapy
E
) Oral finasteride therapy
F
) Oral prednisone therapy only
G
) Oral terazosin therapy
12-24-2011, 06:11 PM
dd