Nokea
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.
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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 78-year-old male was recently diagnosed with Alzheimer’s disease. He scored 23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical presentation is consistent with mild disease. Which of the following is NOT a common side effect of donepezil?
- A. Thrombocytopenia
- B. Bradycardia
- C. Vivid dreams
- D. Gastrointestinal distress
Correct Answer: A
Rationale: Thrombocytopenia is not a common side effect of donepezil, while bradycardia, vivid dreams, and gastrointestinal distress are.
Two years later Mr. Hunter reports progression of his urinary symptoms and desires “a pill to make this better.” His current IPSS is 17, with a bother score of 3 indicating moderate voiding symptoms with moderate impact on his quality of life. On review of systems he notes that his vision has worsened, especially in his left eye. His ophthalmologist has recommended cataract surgery. For which of the following medications would initiation of therapy be delayed until after cataract surgery?
- A. Finasteride
- B. Tamsulosin
- C. Tadalafil
- D. Oxybutynin
Correct Answer: B
Rationale: Tamsulosin may cause intraoperative floppy iris syndrome, so it is often delayed until after cataract surgery.
A 17-year-old is diagnosed with mild bronchospasm. Which of the following would provide relief?
- A. Inhaled mometasone (Asmanex)
- B. Inhaled levalbuterol (Xopenex)
- C. Oral montelukast (Singulair)
- D. Oral dextromethorphan/guaifenesin product
Correct Answer: B
Rationale: Levalbuterol is a fast-acting bronchodilator that provides relief from bronchospasm.
A pulsating mass may be an indication of...
- A. Strangulated hernia
- B. Incarcerated hernia
- C. AAA
- D. All of the above
Correct Answer: C
Rationale: A pulsating mass can indicate an abdominal aortic aneurysm (AAA), which is a critical condition.