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9-bb

10-AA.....postural hypotension

15. For 8 weeks, a 52-year-old man with a 5-year history of type 2 diabetes mellitus has had deep burning pain in the ball of his right foot and big toe when the foot is raised above chest level. He also has cramping in his right calf when he walks more than 50 feet. He has smoked two packs of cigarettes daily for 30 years. Femoral pulses are palpable; pedal pulses are absent. Which of the following is the most likely diagnosis?

A
) Aortoiliac stenosis

B
) Femoral popliteal stenosis

C
) Mononeuropathy

D
) Vasculitis

E
) Venous stasis

16. A 1-year study of a new drug to treat hypertension is conducted. One hundred patients with hypertension are enrolled; 50 patients are given the new drug and another 50 patients are given hydrochlorothiazide. All patients completed the trial. One noted unexpected effect is increased growth of scalp hair which occurred in those taking the new drug, a nonstatistically significant difference (p>0.10). This effect has also been reported in studies of other similar drugs in the new therapeutic class. The investigators of the study concluded that the new drug did not cause hair growth. Which of the following features of this study is most likely to affect the validity of this conclusion?

A
) Differential follow-up

B
) Lead time bias

C
) Length of the study

D
) Sample size

E
) Self-selection

15 B

16 E?

17. A 38-year-old woman, gravida 2, para 1, at 38 weeks' gestation has had no fetal movement for 36 hours. Her prenatal course, prenatal tests, and fetal growth have been normal. Fetal heart tones are heard by Doppler. Which of the following is the most appropriate next step in management?

A
) Routine prenatal visit in 1 week

B
) Maternal hydration

C
) Nonstress test

D
) Immediate induction of labor

E
) Amniocentesis

18. A healthy 7-year-old boy is brought to the physician 1 week after he was exposed for several hours to a child with chickenpox. The patient and his healthy sister have not had chickenpox. They have not received varicella vaccine. Which of the following is the most appropriate management for the patient and his sister at this time?

A
) Administer acyclovir as prophylaxis

B
) Administer immune globulin, intravenously

C
) Administer aspirin therapy if vesicles appear

D
) Advise the parents to keep the siblings home from school to prevent exposing their classmates

E
) Inform the parents that a vesicular rash may appear at any time over the next 2 weeks

17. C

18. E

17-C..................can you explain why it is C ...........................
18-E..................do they need vaccine at the time being.........

17.this women was pretty much normal all through her pregnancy, no fetal movement for 36 hours, even though foetal cardiac activity was heard by doppler and she is at 38 weeks gestation, that means fetal lungs mature. u can go for induction of labor and u have to do that after u make sure that fetus is not in any distress, to find it out first u do nonstress test. she is 38 weeks pregnant, no point waiting another week when fetus is in jeopardy.

18. this q i am not sure, the child was exposed to varicella virus, as it spread through inhalation so several hours was enough to be infected. now what i think its no harm administering IVIG even though it may not work. but E is also approprite response, so i am pretty much torn between B and E. what do u think about D? they r really big on prevention, so D could be the answer too.

19. A 6-year-old boy is brought to the physician by his mother because of progressive visual loss over the past year. Over the past 2 years, he has had deterioration of his hearing, speech, writing, and intellectual performance. His maternal uncle had similar symptoms. Visual acuity is 20/200 bilaterally. Funduscopic examination shows optic atrophy. His hearing is markedly impaired. There is weakness and spasticity of all extremities. Deep tendon reflexes are extremely hyperactive. Babinski's sign is present bilaterally. On mental status examination, he is not oriented to place, year, month, or the names of his siblings. An MRI of the brain shows marked symmetric white matter disease involving all lobes. Diagnostic studies are most likely to show which of the following?

A
) Abnormally decreased serum cholesterol level

B
) Acanthocytes on blood smear

C
) An excess of very long chain fatty acids

D
) Normal nerve conduction studies

E
) Vitamin E deficiency

20. A 22-year-old primigravid woman at 16 weeks' gestation is brought to the emergency department because of progressive shortness of breath over the past 48 hours. Her temperature is 37 C (98.6 F), blood pressure is 120/70 mm Hg, pulse is 100/min, and respirations are 24/min. Scattered wheezes are heard. Pelvic examination shows a uterus that extends to the umbilicus. Fetal heart tones are absent. Her hematocrit is 32%, leukocyte count is 11,000/mm3, and serum β-hCG level is 300,000 mIU/mL. Pulse oximetry on room air shows an oxygen saturation of 92%. An x-ray film of the chest shows multiple round densities throughout all lung fields. Which of the following is the most likely diagnosis?

A
) Bacterial pneumonia

B
) Choriocarcinoma

C
) Pulmonary embolism

D
) Tuberculosis

E
) Viral pneumonia

19. C, I hate biochem

20.B