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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Desmopressin acetate (DDAVP) nasal spray has been found to be useful in the management of enuresis in children. In which of the following situations is the drug especially beneficial?
- A. Daytime incontinence
- B. Hypertensive children with enuresis
- C. Secondary enuresis
- D. Sleepovers
Correct Answer: D
Rationale: DDAVP is especially beneficial for primary nocturnal enuresis, and may be used during situations like sleepovers.
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.
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.
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.