Nbme 3 block 3 Q8 - yeastmito

[ArchivalUser]

8. A previously healthy 47-year-old man is brought to the emergency department after collapsing at work. His coworkers report that he had the sudden onset of a severe generalized headache before he lost consciousness. On arrival, he is lethargic and in severe distress. A lumbar puncture is performed. Cerebrospinal fluid analysis shows xanthochromia and an erythrocyte count of 40,0001mm3 in tubes 1 and 4. His wife and three children are at the hospital, and his parents are en route. The patient dies, and the physician informs the wife of her husband's death. When asked to provide consent for an autopsy, his wife replies, "No. He hated being in the hospital, and I don't want him to be cut up." Which of the following is the most appropriate next step?

O A) Ask the parents to consent to the autopsy when they arrive
O B) Ask the wife again and explain the potential benefits of an autopsy
O C) Notify the medical examiner to mandate an autopsy
O D) Perform genetic testing on a postmortem blood sample

[ArchivalUser]

Nbme 3 blcok 3 Q27
27. Five days after undergoing an emergency appendectomy for a perforated appendicitis, a 47-year-old woman has abdominal pain, nausea, and vomiting. She is pale and diaphoretic. Her temperature is 39°C (102.2°F), blood pressure is 82144 mmHg, pulse is 115Imin, and respirations are 181min. There is nojugularvenous distention. The lungs are clear to auscultation. Abdominal
examination shows mild distention and tenderness in the right lower quadrant. The upper and lower extremities are warm. Rectal examination shows a tender mass in the right pelvis extrinsic to the rectum. Which of the following is the most likely set of hemodynamic findings in this patient?
Preload Cardiac Contractility Afterload
O A) D D D
O B) D I D
O C) D I I
O D) I D I
O E) I I D
O F) I I I

[ArchivalUser]

O B) Ask the wife again and explain the potential benefits of an autopsy
O B) D I D ( early sepsis hyperdynamic phase).

[ArchivalUser]

?ccc for the 1st q....SAH....young patient, chance of foul play (head trauma).
PKD association is 2nd MC cause.

[ArchivalUser]

agree for SAH but would would you like to notify this to med examiner?

[ArchivalUser]

Wild guess.....As her wife has already clearly refused?

[ArchivalUser]

Screening for aneurysms is not performed on a population level; because they are relatively rare, it would not be cost-effective. If someone has two or more first-degree relatives who have suffered an aneurysmal subarachnoid hemorrhage, screening may be worthwhile.[1][47]

Autosomal dominant polycystic kidney disease (ADPKD), a hereditary kidney condition, is known to be associated with cerebral aneurysms in 8% of cases, but most such aneurysms are small and therefore unlikely to rupture. As a result, screening is only recommended in families with ADPKD where one family member has suffered a ruptured aneurysm.[48

http://en.wikipedia.org/wiki/Subarachnoid_hemorrhage

I think it should be D...

O D) Perform genetic testing on a postmortem blood sample

[ArchivalUser]

ddimer in this case it is not screening " in general population" it is a different case, autopsy could be justified in this case may be for best preventing and or screening his childs, but still think that the first thing to do here is starting by explain this to his wife...
in general options that include " encourage, discuss, explain" are always true...

[ArchivalUser]

There are three main types of autopsies:

Forensic: This is done for medical-legal purposes, and is the one that is normally seen on television or in the news. This type depict an extensive methodology and tends to be complete and comprehensive. No family permission is required to complete this type of autopsy[citation needed].
Clinical/academic: This is usually performed in hospitals for research and study purposes. Prior to the start, of a clinical autopsy, a cause of death must have already been established, and a death certificate completed. This usually is as comprehensive as it needs to be adequate. To complete this type of autopsy, permission from the deceased's legal next of kin is required.
Coroner's: In Great Britain this type of autopsy encompasses cases where no medical cause of death is readily available. Cause, manner and mechanism of death are in question. Eventually, the prosectors will identify whether the cases deserve comprehensive forensic autopsy or a routine postmortem. In the United States, each state has a set of guidelines defining a "coroner's case" for autopsy, for example: hospital deaths occurring within 24 hours of admission or within 24 hours of a major surgical procedure, with any history (current or remote) of illegal drug or alcohol abuse by the deceased, patients with certain communicable diseases (HIV, hepatitis C virus, etc.), patients with any previous history of violent injury (e.g., gunshot wound many years before death). These cases may or may not be also considered "forensic" in nature. They may be done by the hospital pathologist with the legal permission of the coroner or medical examiner for that county/parish and do not require permission from the deceased's legal next of kin.


This case looks like a clinical/academic autopsy, this is the only condition where concent is required...

please correct me if I'm wrong

[ArchivalUser]

Is it B or D as other options are eliminated?