EXAM 1-Smarty Pance

Question 1

Tularemia

Answer 1

in acute infection that is transmitted by handling the flesh of infected animals, by the bites of insect vectors and by inoculation of conjunctiva-forms an ulcer at site of inoculation

Question 2

uteroplacental insufficiency.

Answer 2

Late decelerations are from uteroplacental insufficiency. The decelerations have a smooth, gradual symmetrical decrease in FHR beginning at or after the peak of the contraction.

Question 3

A 60 year-old female injured her right wrist when she slipped and fell onto her outstretched hand. Radiographs show a fracture through the metaphysis of the distal radius with dorsal displacement and angulation. Which of the following splints is the best method of temporary immobilization?

Answer 3

The volar forearm splint is best for temporary immobilization of forearm, wrist and hand fractures and is the splint of choice for Colles’ fracture.

Question 4

Aortic dissection

Answer 4

sudden onset of severe chest pain that radiates to back and arms; Elevated bp ex 180/80; high pitched decrescendo diastolic murmur is heard along the left mid-sternal border;ECG shows sinus tachycardia with left ventricular hypertrophy

Question 5

erythrasma

Answer 5

The diagnosis of this condition is made by demonstration of a coral red fluorescence.
People living in warm, tropical climate, people wearing occlusive clothing or shoes, obese patients, and those with hyperhidrosis are at increased risk for erythrasma

Question 6

term for blue discoloration about the umbilicus

Answer 6

Cullen’s sign is a blue discoloration about the umbilicus and can occur in hemorrhagic pancreatitis and results from hemoperitoneum.

Question 7

Which of the following types of pleural effusion result from increased production of fluid due to underlying inflammatory conditions?

Answer 7

Increased production of fluid due to inflammatory or malignant processes results in an EXUDATIVE PLEURAL EFFUSION.

Question 8

abdominal aortic aneurysm presents with ?

Answer 8

pulsatile upper abdominal mass

Question 9

A 16 year-old G0P0 patient presents complaining of lower pelvic pain that alternates from right to left side of her pelvis. She states that it is related to her cycle and occurs most commonly midcycle. She denies sexual activity. She reports that she has taken ibuprofen at the time of the discomfort with some relief. Her pelvic examination is unremarkable. Which of the following is the most likely diagnosis?

Answer 9

MITTELSCHMERZ

Women may experience pain at the time of ovulation, may alternate side to side.

Question 10

medications decreases the exchange of hydrogen for potassium by inhibiting hydrogen, potassium-ATPase?

Answer 10

PPI

proton pump inhibitor, works by inhibiting hydrogen, potassium-ATPase

Question 11

evaluation of the synovial fluid reveals only leukocytosis with a low glucose

Answer 11

Leukocytosis and a low synovial glucose are indicative of SEPTIC ARTHRITIS

Question 12

patient states that he has been camping in the mountains of North Carolina for the past two weeks. He presents to the clinic complaining of “flu-like” symptoms for the past 10-14 days however he notes that he started to develop a slight rash on his wrist and ankles about seven days ago. Which of the following tests would provide a confirmatory diagnosis?

Answer 12

IMMUNOFLUORESCENT ASSAY ; confirm antibodies to Rickettsia

Question 13

ho is most likely to require subacute bacterial endocarditis (SBE) prophylaxis prior to a dental procedure?

Answer 13

he AHA recommends that patients with prosthetic heart valves receive antibiotic prophylaxis. As should cardiac transplant recipients with valve disease, unrepaired cyanotic CHD, repaired CHD with prosthetic material or device during the first six months of the procedure and repaired CHD with residual defects at site of patch or prosthetic device

Question 14

When evaluating jugular venous pulsations a prominent a wave represents which of the following?

Answer 14

The a wave corresponds to right atrial contraction

Question 15

Bipolar disorder

Answer 15

haracterized by episodic mood shifts from depression to manic type moods which is often rapid with depression lasting longer than manic episodes. Bipolar disorder may initially present with a manic episode.

Question 16

A 27-year-old patient presents with crush injuries to both lower extremities after being involved in an automobile accident. Within six hours of the accident, urine output has decreased to less than 10 cc per hour. Within 24 hours the serum creatinine increased from 0.9 mg/dl to 2.9 mg/dl and serum CPK is now 12,000 U/L. In addition to a fluid challenge with normal saline, which of the following is the most appropriate treatment as this time?

Answer 16

Treatment of acute renal failure due to rhabdomyolysis is best accomplished with IV fluids and forced alkaline diuresis.

Question 17

n 18 year-old male high school basketball player comes to clinic for a routine physical exam. His height is 193 cm (76 in.); arm span is 201 cm (79 in.). He has long fingers and toes. Blood pressure is 146/62 mmHg and pulse is 64/min. Which of the following exam findings is most consistent with the diagnosis?

Answer 17

murmur is most consistent with AORTIC REGURGITATION WHICH can be present in patients with Marfans syndrome and a dilated aortic root. Also MVP

Question 18

patient presents to the office with worsening fatigue, weight loss, and weakness. She notes that she is having recurrent bouts of abdominal pain and has been losing her pubic hair. Patient is found to have orthostatic hypotension. Which of the following conditions is most likely

Answer 18

Patients with Addison’s disease have ADDISON’S DZ: PRIMARY adrenal failure from an autoimmune problem in the adrenal gland or due to hemorrhage into the adrenal gland. These patients are not able to make glucocorticoids, mineralocorticoids, or sex hormones which result in hypotension, hyperpigmentation (from an increase in the ACTH and MSH hormones) and are hyponatremic

Question 19

n 18 year-old female comes to the clinic with the complaint of increased vaginal discharge and vaginal odor. She also complains of urinary frequency. On physical examination there is evidence of thin, gray, frothy discharge in the vagina. The cervix appears erythematous and the vaginal pH is 6. Which of the following is the most likely diagnosis?

Answer 19

Signs of TRICHOMONAS include: thin frothy or bubbly, pale yellow-green to gray adherent vaginal discharge, can have erythema of vulva and vagina, may have petechiae on the cervix, amine odor may be present, may also complain of dysuria and dyspareunia, pH 5 to 6.5 (basic).

Question 20

Acute glaucoma

Answer 20

cular emergency that presents as an acutely painful eye and elevated intraocular pressure. Patients typically complain of acute eye pain associated with unilateral headache, nausea/vomiting, cloudy vision, and colored rings around lights. On exam the pupil is fixed and mid dilated with prominent ciliary flush.

Question 21

Anti-HBs

Answer 21

e circulating antibody that develops to surface antigen in response to either past Hepatitis B infection or to Hepatitis B immunization. It represents immunity to the Hepatitis B virus in otherwise immunocompetent patients.