A 56 year-old male presents to the office with a history of abdominal aortic aneurysm.
He was told that he will need On going evaluation to assess whether the aneurysm is
expanding. What is the recommended study to utilize in this situation?
A. plain film of the abdomen
B. serial abdominal exam
C. ultrasound of the abdomen
D. angiography of the abdominal aorta - ANSWER C. An abdominal ultrasound can
outline the transverse and longitudinal dimensions of an abdominal aortic aneurysm and
may identify mural thrombus. Abdominal ultrasound is best utilized to screen patients at
risk for the development of this condition.
Which of the following is a proven risk factor for the development of abdominal aortic
aneurysm?
A. Infective endocarditis
B. Diabetes mellitus
C. Cigarette smoking
D. Alcohol abuse - ANSWER C. Cigarette smoking is the major risk factor in the
development of aortic aneurysms.
The postmenopausal patient is discovered to have stage I breast cancer. The tumor is
0.7 cm in size,
estrogen-receptor positive, and axillary nodes are negative. After a lumpectomy, for
which one of the
following adjuvant therapy is this patient candidate?
A. chemotherapy
B. tamoxifen
C. ovarian ablation
,d. bisphosphonate therapy -ANSWER B. Tamoxifen represents the adjuvant therapy of
choice in post menopausal estrogen receptor positive axillary
node negative breast cancer.
A 28 year-old female with diabetes mellitus type 2 sustains a partial thickness burn to
her left upper arm and her chest when hot grease spilled on her at home. The burn to
her arm is circumferential and the estimated total body surface burned is 18%. She has
no allergies. The most appropriate treatment of this patient would include
A. outpatient application of silver sulfadiazine.
B. debridement of all intact blisters.
C. IV cefazolin (Ancef, Kefzol).
D. transfer to a burn center. - ANSWER D. Indications for transfer to a burn center
include a partial thickness burn involving >10% of total body surface area. Also any
burns in patients with pre-existing medical conditions such as diabetes that could
complicate their management, prolong recovery or affect their outcome is an indication
to be transferred to a burn center.
A 72-year-old female is being seen for repeated renal calculi. PE shows no abnormal
findings. Laboratory shows an increased calcium and low phosphate. Which of the
following is the most likely diagnosis?
A. Pheochromocytoma
B. Adrenal insufficiency
C. Hyperparathyroidism
D. Breast cancer - ANSWER C. Most patients with hyperparathyroidism are
asymptomatic. Recurring nephrolithiasis is one of the various presentations of primary
hyperparathyroidism. The measurement of parathyroid levels would be the first
laboratory examination to investigate hypercalcemia.
A 56 year-old female four days post myocardial infarction presents with a new murmur.
On examination the murmur is a grade 3/6 pansystolic murmur radiating to the axilla.
She is dyspenic at rest and has rales throughout all her lung fields. Blood pressure is
108/68 mmHg, pulse 70 bpm. Which of the following would be the definitive clinical
intervention?
A. Intra-aortic balloon counterpulsation
,B. Mitral valve replacement
C. Coronary artery bypass surgery
D. Immediate fluid bolus - ANSWER B. MVR is the definitive intervention to correct MR
caused by papillary muscle rupture.
Case: A 28-year-old male presents to the emergency department with burns sustained
from hot grease splashed onto his left hand earlier this afternoon. The burn extends
from his palm to the volar aspect of his wrist and has an erythematous base covered by
an intact blister. There are a few small scattered blisters over the dorsum of the left
hand. Which of the following is the initial intervention of choice?
A. Tetanus prophylaxis
B. Burn unit admission
C. Administration of intravenous fluids
D. Debridement of blisters - ANSWER A. All burn patients should initially be considered
for tetanus prophylaxis.
Which of the following patients with hyperthyroidism is the ideal candidate for
radioiodine therapy?
A. A 30-year-old patient with toxic adenoma.
B. A 50-year-old male patient with subacute thyroiditis.
C. A patient over age 65 with Grave's disease.
D. A pregnant woman with Hashimoto's thyroiditis. - ANSWER C. Radioactive iodine is
the indicated treatment for overactive thyroid tissue in patients who do not have risk for
subsequent thyroid cancer, leukemia, or other malignancies.
A 40-year-old male is struck in the face with a baseball. There is nasal deformity with
bleeding. The most appropriate initial management is to
A. treat the hematoma with I&D and antibiotics.
B. consult an ENT for immediate reconstructive nasal surgery.
C. reduce septal defect using open technique.
D. maintain nasal patency and nasal cosmesis. - ANSWER D. Maintain nasal patency
, until closed reduction can be attempted in 1 week.
Which of the following is the preferred method for venous thromboembolism prophylaxis
in a 38-year-old male undergoing an inguinal hernia repair?
A. early ambulation
B. elastic stockings
C. intermittent pneumatic compression
D. low-molecular weight heparin - ANWER A. Early ambulation is indicated for the
prophylaxis of venous thromboembolism in low-risk, minor procedures if the patient is
less than 40 years old and has no clinical risk factors.
A 16-year-old male presents with increasing pain and swelling of his right scrotum.
Upon examination, the right testicle is exquisitely tender to palpation. A Doppler
ultrasound shows reduced blood flow. Which one of the following is the best course of
action?
A. oral doxycycline
B. emergent surgery
C. incision and drainage
D. scrotal elevation and ice packs - ANSWER B. Once a diagnosis of testicular torsion is
suspected, emergent surgery is indicated to have the bestpossible chance of salvaging
the testicle (85-97% chance if less than 6 hours). Any other treatment measures delay
the definitive treatment and increase the risk of testicular ischemia and infarction.
Which of the following is the most appropriate intervention for a stage I testicular
seminoma?
A. Watchful waiting
B. Chemotherapy initially
C. Orchiectomy and radiation
D. Orchiectomy and chemotherapy - ANSWER C. Inguinal orchiectomy followed by
retroperitoneal radiation therapy cures about 98% of patients with stage I seminoma.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Easton. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.