04-16-2015, 02:32 PM
5. A 32-year-old woman at 38 weeks' gestation comes for a routine prenatal visit. During routine screening at 28 weeks' gestation, she tested positive for hepatitis B surface antigen. Her pregnancy has been otherwise uncomplicated. Examination shows a uterus consistent in size with a 38-week gestation. Which of the following measures is most likely to decrease the risk for hepatitis B infection in her newborn?
A) Recommendation of bottle-feeding rather than breast-feeding
B) Maternal administration of hepatitis B immune globulin (HBIG) now
C) Neonatal administration of HBIG after delivery and hepatitis B vaccine at 3 months of age
D) Neonatal administration of HBIG and hepatitis B vaccine immediately after delivery
E) Cesarean delivery
26. A 19-year-old man comes to the physician because of frequent nosebleeds over the past 3 weeks. He has bipolar disorder currently well controlled with lithium carbonate, bupropion, and valproic acid. Physical examination shows no abnormalities except for dried blood in the nares. Mental status examination shows an anxious mood and slight motor restlessness. Serum studies show a lithium carbonate level of 1.3 mEq/L (therapeutic range=0.6–1.2), and valproic acid level of 77 μg/mL (therapeutic range=40–100). Which of the following is the most appropriate next step in management?
A) Measurement of serum aspartate aminotransferase (AST, GOT) activity
B) Measurement of serum bupropion level
C) Platelet count
D) Discontinuation of lithium carbonate therapy
E) Discontinuation of valproic acid therapy
32. A previously healthy 24-year-old woman comes to the physician because of a low-grade fever and a nonproductive cough for 7 days. She has been able to continue her daily activities. Her temperature is 37.7 C (99.9 F). A few scattered inspiratory crackles are heard in the thorax. An x-ray film of the chest shows patchy infiltrates in both lungs. Which of the following is the most appropriate initial pharmacotherapy?
A) Amoxicillin
B) Cefaclor
C) Ciprofloxacin
D) Erythromycin
E) Trimethoprim-sulfamethoxazole
A) Recommendation of bottle-feeding rather than breast-feeding
B) Maternal administration of hepatitis B immune globulin (HBIG) now
C) Neonatal administration of HBIG after delivery and hepatitis B vaccine at 3 months of age
D) Neonatal administration of HBIG and hepatitis B vaccine immediately after delivery
E) Cesarean delivery
26. A 19-year-old man comes to the physician because of frequent nosebleeds over the past 3 weeks. He has bipolar disorder currently well controlled with lithium carbonate, bupropion, and valproic acid. Physical examination shows no abnormalities except for dried blood in the nares. Mental status examination shows an anxious mood and slight motor restlessness. Serum studies show a lithium carbonate level of 1.3 mEq/L (therapeutic range=0.6–1.2), and valproic acid level of 77 μg/mL (therapeutic range=40–100). Which of the following is the most appropriate next step in management?
A) Measurement of serum aspartate aminotransferase (AST, GOT) activity
B) Measurement of serum bupropion level
C) Platelet count
D) Discontinuation of lithium carbonate therapy
E) Discontinuation of valproic acid therapy
32. A previously healthy 24-year-old woman comes to the physician because of a low-grade fever and a nonproductive cough for 7 days. She has been able to continue her daily activities. Her temperature is 37.7 C (99.9 F). A few scattered inspiratory crackles are heard in the thorax. An x-ray film of the chest shows patchy infiltrates in both lungs. Which of the following is the most appropriate initial pharmacotherapy?
A) Amoxicillin
B) Cefaclor
C) Ciprofloxacin
D) Erythromycin
E) Trimethoprim-sulfamethoxazole