Nokea
A 67-year-old female with a history of congestive heart failure and myocardial infarction is admitted to the hospital because of increasing altered mental status and decreased arousal over the last week. Which one of the following features best distinguishes delirium from depression or dementia?
- A. Irritability
- B. Inattention
- C. Paranoia
- D. Aggressiveness
Correct Answer: B
Rationale: Inattention and waxing and waning of alertness are key features distinguishing delirium from depression or dementia.
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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.
George Hall is a 91-year-old man. If the physician agrees with his daughter and does not inform George of bad news, which ethical principle might this violate?
- A. Paternalism
- B. Autonomy
- C. Authenticity
- D. None of the above
Correct Answer: B
Rationale: Autonomy is violated when the patient is not informed about his medical condition.
A 32-year-old woman presents with dull puffiness of the eyes, pronounced non-pitting periorbital edema. This finding is suggestive of:
- A. Nephrotic syndrome
- B. Myxedema
- C. Cushing syndrome
- D. Sinusitis
Correct Answer: B
Rationale: Myxedema, associated with hypothyroidism, causes puffiness and edema around the eyes.
How many chains of lymph nodes should be assessed during a clinical examination?
- A. Five chains
- B. Seven chains
- C. Nine chains
- D. Eleven chains
Correct Answer: B
Rationale: Seven chains of lymph nodes are typically assessed during a clinical examination, including cervical, axillary, and inguinal regions.
A 27-year-old male patient presents with a painless chancre on the shaft of his penis and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial treatment is:
- A. Ceftriaxone (Rocephin)
- B. Clindamycin (Cleocin)
- C. Metronidazole (Flagyl)
- D. Benzathine penicillin G (Bicillin L.A)
Correct Answer: D
Rationale: Benzathine penicillin G is the first-line treatment for primary syphilis.