Items 395396

A 35-year-old woman develops an itchy rash over her back, legs, and trunk several hours after swimming in a lake. Erythematous, edematous papules are noted. The wheals vary in size. There are no mucosal lesions and no swelling of the lips (see photo). The most likely diagnosis is 396. The treatment of choice for this patient is c. Antihistamines and avoidance of offending agent 397. A 30-year-old black female has had a history of cough, and a chest x-ray shows bilateral hilar...

Questions

DIRECTIONS Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 452. A 20-year-old female develops urticaria that lasts for 6 weeks and then resolves spontaneously. She gives no history of weight loss, fever, rash, or tremulousness. Physical exam shows no abnormalities. The most likely cause of the urticaria is 453. A 20-year-old male is found to have weight loss and generalized lymph-adenopathy. He has...

Is Livergen Suitable For Three Months Pregnancies

The answer is d. (Braunwald, 15 e, pp 21-25, 501.) A lipid profile is recommended every 5 years for patients 20 years of age or older. With this patient's family history of early coronary artery disease, which suggests a possible dyslipidemia, a lipid profile is warranted. There is no indication in the history that screening liver function tests are required. A chest x-ray is not indicated for screening even if the patient is a tobacco user. Screening mammography is recommended for the...

Items 376378

Match each symptom or sign with the appropriate diagnosis. g. Temporomandibular joint dysfunction 376. Bilateral, bandlike sensation around head dull, steady pain that may last days, weeks possible occipital or nuchal soreness (SELECT 1 DIAGNOSIS) 377. Unilateral, nonthrobbing headache more common in men nasal stuffiness and lacrimation (SELECT 1 DIAGNOSIS) 378. Unilateral headache with localized scalp tenderness in older patient may have transient visual loss (SELECT 1 DIAGNOSIS) 379. A...

Items 495497

A 21-year-old female presents with complaints of dysuria for the past 48 h. She denies elevated temperature, chills, or nausea vomiting. She states she is having some difficulty sleeping at night. She is 28 weeks pregnant with her first child. You note she is wearing long sleeves in warm weather and she has bruising on her forearms and left lateral thoracic area. An appropriate way to explore your concerns with the patient would be to ask which of the following questions a. Do you know how...

Answers

The answer is c. (Braunwald, 15 e, pp 662-664.) The patient has a microcytic anemia. A low serum iron, low ferritin, and high iron-binding capacity all suggest iron-deficiency anemia. Most iron-deficiency anemia is explained by blood loss. The patient's symptoms of constipation point to blood loss from the lower GI tract. Colonoscopy would be the highest-yield procedure. Barium enema misses 50 of polyps and a significant minority of colon cancers. Even patients without a history of GI...

Items 398399

An elderly homeless male is evaluated for anemia. On exam, he has purpura and ecchymoses of the legs. Perifollicular papules and perifollicular hemorrhages are also noted. There is swelling and bleeding of gums around the patient's teeth as well as tenderness around a hematoma of the calf. The most likely diagnosis is 399. The best approach to the management of this patient is a. Obtain platelet ascorbic acid level and give ascorbic acid while in hospital b. Discharge with dietary consult...

Infectious Disease

DIRECTIONS Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 1. A 30-year-old male patient complains of fever and sore throat for several days. The patient presents to you today with additional complaints of hoarseness, difficulty breathing, and drooling. On examination, the patient is febrile and has inspiratory stridor. Which of the following is the best course of action a. Begin outpatient treatment...

Items 8384

A 65-year-old male develops the sudden onset of severe knee pain. The knee is red, swollen, and tender. He has a history of diabetes mellitus and cardiomyopathy. An x-ray of the knee shows linear calcification. Definitive diagnosis is best made by c. Arthrocentesis and identification of positively birefringent rhomboid crystals 84. Further workup in this patient should include evaluation for 85. A 35-year-old woman complains of aching all over. She says she sleeps poorly and all her joints...