Test 7

Question 1

Pregnancy, Childbirth & Puerperium

Answer 1

Patients with preterm prelabor rupture of membranes at <34 weeks gestation are managed conservatively with prophylactic latency abx (ampicillin plus azithromycin) to prolong the interval between membrane rupture and delivery, thereby improving neonatal outcomes.
See chart

Question 2

Bipolar disorder

Answer 2

All antidepressants carry the risk of inducing mania, especially in patients with bipolar disorder. The first step in managing treatment-emergent mania is to discontinue any antidepressants.

Question 3

Aspiration PNA

Answer 3

A frequent complication of PD dx is the development of dysphasia and aspiration, which may be silent. Undetected dysphagia may lead to weight loss and frequent aspiration PNA. The dx is confirmed with a videofluoroscopic swallowing study. A multidisciplinary intervention is required to address nutrition and reduce the risk of recurrent aspiration pneumonia.
See table

Question 4

Scoliosis

Answer 4

Adolescent idiopathic scoliosis is characterized by lateral curvature of the spine in an otherwise healthy adolescent. A thoracic or lumbar prominence on forward bend test is indicative of scoliosis, and a scoliometer angle of rotation greater than or equal to 7 degrees requires additional evaluation with an x-ray of the spine.

Question 5

Atopic dermatitis

Answer 5

Atopic dermatitis typically has an onset before age 5 and follows a chronic course with periodic flares (ie, pruritic, erythematous patches in flexural distribution). It typically resolves by adulthood.
See table

Question 6

P-value and confidence interval

Answer 6

P-values less than or equal to 0.05 suggest statistical significance.

Question 7

Pressure induced injury

Answer 7

Initial management of pressure ulcers included local wound care, repositioning to reduce pressure, pain control, and nutritional support. Shallow ulcers are managed with occlusive or semipermeable dressings to maintain a moist wound environment. Full thickness wounds require more complex care, including debridement of devitalized tissues and specialized wound dressings.
See table

Question 8

Syncope

Answer 8

Cardiac syncope due to ventricular tachycardia is suggested by the presence of underlying structural heart dx and the abrupt onset of syncope without prodrome. Patients with cardiac syncope are at risk of sudden cardiac death and require definitive evaluation and management.
See table

Question 9

Seborrheic dermatitis

Answer 9

Is characterized by erythematous plaques with loose, greasy-looking scales on the scalp (“dandruff”), central face, and ears. Treatment options include topical antifungal agents (eg, ketoconazole, selenium sulfide), keratolytic agents (eg, salicylic acid), coal tar, topical glucocorticoids, and topical calcineurin inhibitors (eg, pimecrolimus, tacrolimus).
A chronic, relapsing condition. Initial tx can provide significant improvement in sx, but patients usually benefit from intermittent re-tx.
See table

Question 10

Prostate cancer

Answer 10

External beam radiation therapy should be used for pain alleviation in patients with single or few focal bone metastatic lesions due to hormone-refractory prostate cancer.

Question 11

Knee trauma

Answer 11

The classic dashboard injury results from a posteriorly directed force on the anterior aspect of the proximal tibia with knee in a flexed position. This results in disruption of the posterior cruciate ligament (PCL).
Unlike patients with ACL injury, these patients do not complain of a typical ‘popping’ sound, and may not have an unstable knee.

Question 12

Coronary artery dx

Answer 12

In pts with diabetes and multivessel coronary artery dx, coronary artery bypass graft (CABG) surgery is preferred over percutaneous coronary intervention due to a lower rate of all-cause mortality and myocardial infarction with CABG.