Nokea
A 78-year-old man has an emergency partial colectomy for lower gastrointestinal bleeding. A localized colonic adenocarcinoma is completely resected. The surgeon did not dissect lymph nodes for metastatic sampling. The patient wants to know if he should have chemotherapy. Should he?
- A. Yes because without knowing his complete staging it would be safer.
- B. No because he can be followed with serial carcinoembryonic antigens and CT scans.
- C. Yes because the severe bleeding indicates advanced disease.
- D. No because he is too old and will not likely have any problems during his lifetime.
Correct Answer: B
Rationale: Follow-up with serial carcinoembryonic antigens and CT scans is appropriate after resection of localized disease.
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Which of the following best describes the components included in a patient's Social History (SH)?
- A. A summary of the patient's medical history and family background
- B. Lifestyle factors, social habits, and living conditions
- C. The patient's current medications and allergies
- D. Details about the patient's physical examination findings
Correct Answer: B
Rationale: Social History (SH) includes lifestyle factors, social habits, and living conditions, which impact overall health.
The most common treatment for Helicobacter pylori is a triple therapy, interpreted as
- A. 2 antibiotics and proton pump inhibitor for 7-14 days
- B. 3 different antibiotics for 7-20 days
- C. 3 rounds of the same antibiotic over 3 weeks
- D. 2 proton pump inhibitors and 1 antibiotic for 7-14 days
Correct Answer: A
Rationale: Triple therapy for H. pylori typically includes 2 antibiotics and a proton pump inhibitor for 7-14 days.
Explain why late inspiratory crackles in the lower third of the chest are indicative of heart failure rather than other respiratory conditions.
- A. They indicate airway obstruction typical of asthma.
- B. They suggest fluid accumulation in the alveoli due to heart failure.
- C. They are a sign of chronic bronchial inflammation.
- D. They are associated with hyperinflation of the lungs in COPD.
Correct Answer: B
Rationale: Late inspiratory crackles indicate fluid in the alveoli, a hallmark of heart failure.
When interpreting a complete blood count (CBC) lab report, which of the following results describes the size of the RBCs?
- A. Hemoglobin
- B. Mean corpuscular volume (MCV)
- C. Red cell distribution width (RDW)
- D. Hematocrit
Correct Answer: B
Rationale: MCV measures the average size of red blood cells.
A 67-year-old woman with a history of A-fib and an ejection fraction of 48% has had normal digoxin levels. Which can cause a decrease in digoxin level?
- A. Decrease creatinine clearance
- B. Weight loss
- C. Increase exercise
- D. Regular use of antacid
Correct Answer: D
Rationale: Regular use of antacids can decrease the absorption of digoxin, potentially lowering its levels.