Nokea
Even though older adults are less likely to get counseled for smoking cessation, they have which one of the following?
- A. The same quit rates as younger individuals
- B. Approximately 50% better quit rates than younger individuals
- C. Approximately 25% better quit rates than younger individuals
- D. Much lower quit rates than younger individuals
Correct Answer: C
Rationale: The correct answer is C: Approximately 25% better quit rates than younger individuals. Older adults tend to have higher quit rates compared to younger individuals due to factors like increased motivation, life experience, and health concerns. Older adults often have more resources and support systems in place to help them quit smoking successfully. Choice A is incorrect because older adults do not necessarily have the same quit rates as younger individuals. Choice B is also incorrect as the difference in quit rates is not as high as 50%. Choice D is incorrect as older adults do not generally have much lower quit rates than younger individuals.
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You are conducting a pupillary examination on a 34-year-old man. You note that both pupils dilate slightly. Both are noted to constrict briskly when the light is placed on the right eye. What is the most likely problem?
- A. Optic nerve damage on the right
- B. Optic nerve damage on the left
- C. Efferent nerve damage on the right
- D. Efferent nerve damage on the left
Correct Answer: C
Rationale: The correct answer is C: Efferent nerve damage on the right. When both pupils dilate but only the right pupil constricts briskly in response to light, it indicates a problem with the efferent pathway controlling the right eye's pupillary constriction. This suggests damage to the parasympathetic fibers of the oculomotor nerve (CN III) that innervate the pupillary sphincter muscle. Choices A and B (optic nerve damage) do not involve pupil constriction. Choice D (efferent nerve damage on the left) would not explain the brisk constriction in the right eye.
What clinical finding in a funduscopic examination is indicative of increased intracranial pressure?
- A. Pulsating veins
- B. Indistinct disk edge
- C. Clear disk edge
- D. Normal retinal appearance
Correct Answer: B
Rationale: The correct answer is B: Indistinct disk edge. Increased intracranial pressure causes papilledema, resulting in swelling and elevation of the optic disk. This leads to a blurred or indistinct disk edge. Pulsating veins (choice A) are seen in conditions like arteriovenous malformations, not specifically indicative of increased intracranial pressure. Clear disk edge (choice C) and normal retinal appearance (choice D) are not consistent with the findings associated with increased intracranial pressure.
Where should the uterine fundus be palpable at 12 weeks?
- A. At the level of the umbilicus
- B. At the level of the symphysis pubis
- C. Midway between the symphysis and umbilicus
- D. Below the symphysis pubis
Correct Answer: B
Rationale: At 12 weeks of gestation, the uterine fundus should be palpable at the level of the symphysis pubis. This is because the uterus rises approximately 1 cm above the symphysis pubis each week during the first trimester. By 12 weeks, it should be palpable at this level.
Choice A (At the level of the umbilicus) is incorrect because the fundus is not expected to reach the level of the umbilicus until around 20 weeks.
Choice C (Midway between the symphysis and umbilicus) is incorrect as this would typically occur around 16-18 weeks.
Choice D (Below the symphysis pubis) is also incorrect because by 12 weeks, the fundus should have risen above the symphysis pubis.
You want to start pharmacologic treatment for depression in an older patient who is taking numerous medications. Which of the following antidepressants is the least likely to cause drug-drug interactions?
- A. Citalopram
- B. Fluoxetine
- C. Paroxetine
- D. Venlafaxine
Correct Answer: E
Rationale: I believe you made a typo in listing the correct answer as "E" while there is no "E" option in the choices provided. Could you please confirm the correct answer choice so I can provide you with a detailed explanation and summary of why the correct answer is correct and why the other choices are incorrect?
The addition of benzoyl peroxide to erythromycin for the topical treatment of acne:
- A. Improve the efficacy of erythromycin
- B. Decrease the risk of desquamation
- C. Decreases the risk of resistance to erythromycin
- D. Increases the time the patient can be exposed to sunlight
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct:
1. Benzoyl peroxide has antibacterial properties.
2. Combining benzoyl peroxide with erythromycin reduces bacterial resistance.
3. This combination therapy prevents the development of resistance to erythromycin.
4. Therefore, the risk of resistance to erythromycin is decreased.
Summary:
- Choice A is incorrect as benzoyl peroxide does not directly improve the efficacy of erythromycin.
- Choice B is incorrect as desquamation is not directly affected by the addition of benzoyl peroxide.
- Choice D is incorrect as there is no evidence to suggest that benzoyl peroxide increases the time a patient can be exposed to sunlight.