Nokea
Ophthalmoscopic examination of a 40-year-old carpenter reveals a triangular thickening of the bulbar conjunctiva across the outer surface of the cornea. This condition is termed:
- A. Corneal arcus
- B. Corneal scar
- C. Pterygium
- D. Cataract
Correct Answer: C
Rationale: A pterygium is a growth of the conjunctiva over the cornea.
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A pulsating mass may be an indication of...
- A. Strangulated hernia
- B. Incarcerated hernia
- C. AAA
- D. All of the above
Correct Answer: C
Rationale: A pulsating mass can indicate an abdominal aortic aneurysm (AAA), which is a critical condition.
Rh-negative women should receive Rho (D) immunoglobulin at what gestational time?
- A. 6 weeks
- B. 12 weeks
- C. 28 weeks
- D. 35 weeks
Correct Answer: C
Rationale: RhoGAM is administered at 28 weeks for Rh-negative women.
An elderly male with benign prostate hyperplasia (BPH) should be advised to avoid antihistamines. What is the reason for this?
- A. Urinary incontinence
- B. Constipation
- C. Orthostatic hypotension
- D. Urinary retention
Correct Answer: D
Rationale: Antihistamines can cause urinary retention, worsening BPH symptoms.
Risk factors associated with breast cancer include all of the following except:
- A. Personal family history of breast cancer
- B. Use of hormone replacement therapy
- C. Post-menopausal obesity
- D. Low socioeconomic status
Correct Answer: D
Rationale: Low socioeconomic status is not a direct risk factor for breast cancer.
On admission to the hospital, an 85-year-old woman was found to have a fungating mass on her right breast. The mass is 9 cm in diameter, partially ulcerated, and associated with edema of the arm and obvious pain. The patient has no children and had lived alone until recently, when a neighbor became concerned for what appeared to be a progressive loss of memory and neglect of the house. A nephew living in another city eventually came to take care of the situation and arranged for the admission. The patient appears confused and withdrawn; her appearance is disheveled, but she seems to be independent in her ADLs. The medical history is negative for any serious illnesses. She was able to drive her own car until shortly before this admission. The nephew does not wish to authorize hospice “right now.” A positron-emission tomography scan was negative for metastatic disease. In addition to determining the cause of her delirium, which of the following is the best way to address the breast mass?
- A. Tamoxifen should be initiated immediately. If no response is seen in 3 months, the patient should receive chemotherapy.
- B. The mass should be biopsied to study hormone receptor and HER2/neu antigen status.
- C. The patient should undergo surgery as initial treatment.
- D. The initial treatment should be radiation therapy.
Correct Answer: E
Rationale: Given the patient's age and condition, the best approach is to avoid aggressive treatment and focus on symptom management.