Nokea
On examination, a patient is noted to have a "mask-like" face with decreased blinking and a characteristic stare. These features may be characteristic of:
- A. Nephrotic syndrome
- B. Myxedema
- C. Cushing’s syndrome
- D. Parkinson disease
Correct Answer: D
Rationale: A "mask-like" face is a classic feature of Parkinson’s disease.
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Papilledema is a cause for concern because it is suggestive of:
- A. Optic atrophy
- B. Microaneurysms
- C. Increased intracranial pressure
- D. Retinal hemorrhage
Correct Answer: C
Rationale: Papilledema is caused by increased intracranial pressure, leading to swelling of the optic disc.
What is an appropriate step in the initial management of the seven patients receiving atypical antipsychotics?
- A. No action is necessary, because one potential indication for atypical antipsychotic use is refractory behavioral disturbance in persons with significant dementia.
- B. Taper to discontinue the atypical antipsychotic; after a 2-week washout, begin therapy with zolpidem.
- C. Taper to discontinue the atypical antipsychotic, and create day programs that allow patients to develop a sleep deficit/need through the morning/afternoon/early evening.
- D. Start modafinil or a similar short-acting stimulant to minimize daytime sleepiness.
Correct Answer: C
Rationale: Creating day programs that help establish a sleep deficit and discontinuing antipsychotics is appropriate for managing the patients’ sleep issues.
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.
A patient presents with an elongated head with bony prominence of the forehead, nose, and lower jaw. These facial features could be suggestive of:
- A. Nephrotic syndrome
- B. Acromegaly
- C. Cushing’s syndrome
- D. Parkinson’s disease
Correct Answer: B
Rationale: Acromegaly is characterized by enlargement of bones and soft tissues, leading to features like a prominent jaw and forehead.
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.