Test 41

Question 1

Turner syndrome

Answer 1

Characteristic features of Turner syndrome include a webbed neck and congenital lymphedema. Normal intelligence is expected, but patients should be monitored for increased risk of learning disabilities.

Question 2

Turner syndrome

Answer 2

Turner syndrome is typically due to a random error in cell division, resulting in loss of an X chromosome. No increase recurrence risk is present after giving birth to an infant with Turner syndrome, and unlike other chromosomal nondisjunctions, the risk of 45,X does not increase with maternal age.

Question 3

Decision making capacity

Answer 3

Informed consent is required prior to any surgical procedure. If a patient does not have decision-making capacity (due to acute delirium), consent falls to a designated proxy, decision maker, or the next of kin.

Question 4

Acute respiratory failure

Answer 4

Laryngeal edema typically presents with post-extubation stridor; reintubation should be considered early to secure the airway in all patients with signs of impending respiratory failure.

Question 5

Ischemic stroke

Answer 5

Patients with cryptogenic strike (ischemic stroke without an obvious source on initial evaluation) should have additional workup to look for a source. Because most cryptogenic strokes are embolic, this workup typically includes advanced cardiac imaging to better visualize a cardiac source (left ventricular thrombus) and prolonged ambulatory cardiac monitoring to detect paroxysmal arrhythmia (atrial fibrillation).

Question 6

Psychosis

Answer 6

Assessment of new-onset psychosis requires ruling out substance-induced and medical etiologies. If substances are identified as a possible factor, monitoring the patient off the substances is an appropriate initial strategy. Physicians should inform the patient and family of the diagnostic possibilities while avoiding a premature diagnosis or false reassurance.

Question 7

Multiple sclerosis

Answer 7

Beta-interferon or glatiramer can decrease the frequency of exacerbations and reduce the development of brain lesions in patients with relapsing-remitting multiple sclerosis.

Question 8

Alzheimer disease

Answer 8

Is a progressive illness characterized by memory loss and functional decline across several cognitive domains. Medications may slow progression, but there is no cure.