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Complications of deep venous thrombosis include:
- A. Moist gangrene, secondary postpartum hemorrhage
- B. Pulmonary embolism, varicosity
- C. Hydronephrosis, hematoma formation
- D. Prolonged labor, disseminated intravascular coagulopathy
Correct Answer: B
Rationale: Pulmonary embolism and varicosity are significant complications of deep venous thrombosis.
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K. W. is a 50-year-old woman who presents for surgical resection of the liver for treatment of metastatic colon cancer. Preoperatively, the surgeon tells her that he is planning to remove 50 to 75 of her liver. The patient is concerned that she will not be able to recover normal liver function with that much removed. The AGACNP counsels her that
- A. Such a high-volume resection is utilized only in people with markedly compromised hepatic function
- B. Major regeneration occurs within 10 days, and the process is complete by 5 weeks
- C. Liver function will probably recover to 50% baseline, but that is enough for normal function
- D. Up to 95% of the liver can be removed without any apparent consequence to the patient
Correct Answer: B
Rationale: The liver is known for its remarkable ability to regenerate. Major regeneration can occur within 10 days after partial hepatectomy (liver resection) as a compensatory mechanism. The process is typically complete within 5 weeks. This regenerative capacity allows for safe removal of a significant portion of the liver for procedures such as liver resection for cancer. The remaining liver tissue is able to rapidly proliferate and restore normal liver function. The patient should be reassured that even with 50 to 75% of her liver being removed, she can expect a significant amount of liver function recovery postoperatively.
Complications of deep venous thrombosis include:
- A. Pulmonary embolism, varicosity
- B. Moist gangrene, secondary postpartum hemorrhage
- C. Hydronephrosis, hematoma formation
- D. Prolonged labor, disseminated intravascular coagulopathy
Correct Answer: A
Rationale: Pulmonary embolism and varicosity are common complications of deep venous thrombosis.
What is the role of folic acid in pregnancy?
- A. Prevents gestational hypertension
- B. Supports placenta growth
- C. Prevents neural tube defects
- D. Reduces anemia
Correct Answer: C
Rationale: Folic acid is crucial for preventing neural tube defects.
Achalasia is a risk factor for
- A. Squamous cell carcinoma
- B. Gastroesophageal reflux disease
- C. Esophageal atrophy
- D. Malabsorption syndromes
Correct Answer: A
Rationale: Achalasia is a motility disorder characterized by the inability of the lower esophageal sphincter to relax, resulting in difficulty swallowing and impaired movement of food from the esophagus into the stomach. Patients with achalasia have an increased risk of developing squamous cell carcinoma of the esophagus. This risk is due to chronic inflammation, stasis of food in the esophagus, and increased exposure of esophageal mucosa to irritants, all of which can contribute to the development of cancer over time. Gastroesophageal reflux disease (Choice B) is less likely to be associated with achalasia because the impaired esophageal motility in achalasia results in decreased, rather than increased, reflux of stomach contents into the esophagus. Esophageal atrophy (Choice C) and malabsorption syndromes (Choice D) are not directly related to achalasia.
The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
- A. Alpha-adrenergic antagonists
- B. Beta-adrenergic antagonists
- C. Intravenous vasodilators
- D. Arteriolar dilators
Correct Answer: C
Rationale: Surgical manipulation of the adrenal medulla during resection of a pheochromocytoma can result in the release of catecholamines leading to a hypertensive crisis. Alpha-adrenergic antagonists, such as phenoxybenzamine or prazosin, are the drugs of choice for managing hypertensive crisis in this situation. These medications block the alpha-adrenergic receptors, leading to vasodilation and lowering of blood pressure. Beta-adrenergic antagonists are contraindicated in this scenario due to the risk of unopposed alpha-adrenergic stimulation that could worsen the hypertension. Intravenous vasodilators and arteriolar dilators may be used as adjunctive therapy but alpha-adrenergic antagonists are the primary agents for managing hypertensive crisis in this context.