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A patient presents with recurrent episodes of severe headache associated with ipsilateral lacrimation, rhinorrhea, and ptosis. Symptoms are often triggered by alcohol consumption. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Migraine headache
- B. Cluster headache
- C. Tension-type headache
- D. Trigeminal neuralgia
Correct Answer: B
Rationale: The patient is presenting with symptoms consistent with cluster headache. Cluster headaches are characterized by recurrent episodes of severe unilateral (ipsilateral) headache accompanied by lacrimation (tearing from the eyes), rhinorrhea (runny nose), and ptosis (drooping of the eyelid). These headaches often occur in clusters over a period of weeks to months, hence the name "cluster headache."
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A patient presents with recurrent episodes of sudden, severe vertigo lasting hours, accompanied by nausea, vomiting, and nystagmus. Vestibular function tests demonstrate unilateral weakness. Which of the following conditions is most likely responsible for this presentation?
- A. Vestibular neuritis
- B. Benign paroxysmal positional vertigo (BPPV)
- C. Ménière's disease
- D. Acoustic neuroma Ophthalmology
Correct Answer: A
Rationale: The patient's presentation of recurrent episodes of sudden, severe vertigo lasting hours with nausea, vomiting, and nystagmus, along with unilateral weakness on vestibular function tests, is most consistent with vestibular neuritis. Vestibular neuritis is characterized by inflammation of the vestibular nerve leading to sudden onset vertigo that can last for hours to days. It is often associated with nausea, vomiting, and nystagmus. Unilateral weakness on vestibular function tests indicates dysfunction of one vestibular system. Differential diagnosis for this type of presentation includes other conditions such as Meniere's disease, BPPV, and acoustic neuroma. However, the combination of symptoms and unilateral vestibular weakness makes vestibular neuritis the most likely diagnosis in this case.
In response to chronic hypoxia, which physiological adaptation occurs in the body to increase oxygen delivery to tissues?
- A. Decreased erythropoietin production
- B. Decreased red blood cell production
- C. Increased cardiac output
- D. Decreased ventilation rate
Correct Answer: C
Rationale: In response to chronic hypoxia, the body adapts to increase oxygen delivery to tissues by increasing cardiac output. This is achieved by increasing the heart rate and stroke volume, allowing more oxygenated blood to be pumped to the tissues. The increased cardiac output helps compensate for the lower oxygen levels in the blood, ensuring that tissues receive an adequate supply of oxygen despite the hypoxic conditions. This physiological adaptation is essential for maintaining tissue oxygenation and supporting overall cellular function in the presence of chronic hypoxia.
A patient presents with fever, malaise, and a skin lesion resembling a "bull's eye" rash at the site of a tick bite. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: C
Rationale: The most likely causative agent in this scenario is Borrelia burgdorferi, which is the bacterium responsible for causing Lyme disease. The classic presentation of Lyme disease includes fever, malaise, and a skin lesion resembling a "bull's eye" rash, known as erythema migrans. This rash typically appears at the site of a tick bite. If left untreated, Lyme disease can progress to involve multiple organ systems and lead to more severe complications. Plasmodium falciparum is the causative agent of malaria, which typically presents with symptoms such as fever, chills, and fatigue, but it does not cause a "bull's eye" rash. Trypanosoma cruzi is the parasite responsible for Chagas disease, which presents with symptoms such as fever, swelling at the site of entry (typically the bite wound), and enlarged lymph nodes, but it does not
A patient presents with recurrent episodes of epistaxis, gum bleeding, and easy bruising. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?
- A. Von Willebrand disease
- B. Glanzmann thrombasthenia
- C. Hemophilia A
- D. Bernard-Soulier syndrome
Correct Answer: A
Rationale: The clinical presentation of recurrent episodes of epistaxis, gum bleeding, and easy bruising, along with laboratory findings of prolonged bleeding time, normal platelet count, and normal coagulation studies (PT and aPTT) are highly suggestive of Von Willebrand disease. Von Willebrand disease is the most common inherited bleeding disorder and is characterized by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a key role in platelet adhesion and aggregation. The prolonged bleeding time is due to impaired platelet adhesion to the damaged vessel wall in the absence of functional vWF. Normal platelet count and normal PT/aPTT help differentiate Von Willebrand disease from other bleeding disorders such as hemophilia and platelet function disorders like Glanzmann thrombasthenia and Bernard-Soulier syndrome.
The BEST reason why Nurse Nilda opted to review Erikson's psychosocial theory is, which of the following statements?
- A. Completion of task results in a sense of competence and a healthy personality.
- B. Failure to master these tasks leads to feelings of inadequacy
- C. . Helps children grow into successful, contributing members of society.
- D. We are motivated by the need to achieve competence in certain areas of our 1ives.
Correct Answer: A
Rationale: Nurse Nilda likely opted to review Erikson's psychosocial theory because completion of each developmental task in the theory results in a sense of competence and contributes to the development of a healthy personality. Erikson's theory outlines different stages of psychosocial development that individuals go through, with each stage presenting a specific conflict or challenge to be resolved. Successfully navigating and resolving these challenges at each stage leads to the development of essential strengths and virtues. For example, in Erikson's stage of industry versus inferiority (ages 6 to 11 years), successfully completing tasks related to school, sports, and social interactions can lead to a sense of competence and accomplishment. Conversely, failure to master these tasks can lead to feelings of inadequacy and inferiority. By understanding and applying Erikson's theory, Nurse Nilda can better support individuals in their development and help promote positive outcomes.