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Which of the following clinical findings in a 51-year-old woman is consistent with Graves disease?
- A. Thin hair, exophthalmos, hyperreflexia, and pretibial edema.
- B. Thin hair, exophthalmos, weight gain, and constipation.
- C. Thick hair, bradycardia, weight loss, and dry skin.
- D. Thick hair, bradycardia, weight gain, and constipation.
Correct Answer: A
Rationale: The clinical findings of thin hair, exophthalmos (bulging eyes), hyperreflexia, and pretibial edema are classic manifestations of Graves disease, an autoimmune condition that results in hyperthyroidism. Choice B is incorrect because weight gain and constipation are more indicative of hypothyroidism, not hyperthyroidism seen in Graves disease. Choice C is incorrect as the symptoms described are more characteristic of hypothyroidism, not hyperthyroidism. Choice D is also incorrect as the symptoms listed are not consistent with Graves disease but rather suggest hypothyroidism.
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Which of the following tests is recommended for lung cancer screening?
- A. Chest X-ray
- B. Pulmonary function test
- C. Computed tomography (CT) scan
- D. Magnetic resonance imaging
Correct Answer: C
Rationale: The correct answer is Computed tomography (CT) scan. When screening for lung cancer, CT scans are recommended over chest X-rays due to their higher sensitivity in detecting lung nodules and early-stage cancers. Pulmonary function tests are not used for screening lung cancer but rather to assess lung function. Magnetic resonance imaging is not the preferred imaging modality for routine lung cancer screening, as CT scans are more commonly used.
A 65-year-old man is admitted to the intensive care unit from the operating room after a triple coronary artery bypass graft. He is intubated and on a ventilator. Lactic acid levels were normal postoperatively, but now they are rising. The increased level could be an indication of:
- A. excessive sedation
- B. bowel ischemia
- C. excessive volume infusion in the operating room
- D. mild hypothermia postoperatively
Correct Answer: B
Rationale: In this scenario, the rising lactic acid levels in a 65-year-old man after a coronary artery bypass graft could indicate bowel ischemia. Bowel ischemia can lead to anaerobic metabolism, causing an increase in lactic acid levels. Excessive sedation may cause respiratory depression but would not directly lead to rising lactic acid levels. Excessive volume infusion in the operating room might cause fluid overload but would not typically result in rising lactic acid levels. Mild hypothermia postoperatively could lead to shivering and increased oxygen consumption, but it is less likely to be the primary cause of rising lactic acid levels in this context.
Anemia of chronic inflammation is generally classified as:
- A. Hypochromic and microcytic.
- B. Hypochromic and macrocytic.
- C. Normochromic and microcytic.
- D. Normochromic and normocytic.
Correct Answer: D
Rationale: Anemia of chronic inflammation is typically characterized by normochromic (normal hemoglobin content) and normocytic (normal cell size) red blood cells. Choice A, hypochromic and microcytic, is incorrect because hypochromic refers to reduced hemoglobin content and microcytic refers to smaller than normal red blood cells, which are not typically seen in anemia of chronic inflammation. Choice B, hypochromic and macrocytic, is also incorrect as macrocytic refers to larger than normal red blood cells. Choice C, normochromic and microcytic, is incorrect because microcytic red blood cells are smaller than normal. Therefore, the correct classification for anemia of chronic inflammation is normochromic and normocytic.
In nephritic syndrome compared to nephrotic syndrome, there is:
- A. higher amounts of albuminuria.
- B. negligible hematuria or absence of hematuria.
- C. presence of red blood cell casts in the urine.
- D. hypoalbuminemia
Correct Answer: C
Rationale: In nephritic syndrome, the presence of red blood cell casts in the urine is a characteristic finding, reflecting glomerular inflammation and damage. This differentiates it from nephrotic syndrome, where red blood cell casts are typically absent. Choice A is incorrect because nephritic syndrome usually presents with less albuminuria compared to nephrotic syndrome. Choice B is incorrect as hematuria is a common feature of nephritic syndrome. Choice D is incorrect as hypoalbuminemia is more commonly associated with nephrotic syndrome.
Which of the following eye disorders manifests with red eye, pain, and visual acuity changes?
- A. Bacterial conjunctivitis
- B. Acute closed-angle glaucoma
- C. Chronic open-angle glaucoma
- D. Blepharitis
Correct Answer: B
Rationale: Acute closed-angle glaucoma presents with symptoms such as a red eye, severe pain, and rapid visual acuity changes due to increased intraocular pressure. This condition is considered an ophthalmologic emergency. Bacterial conjunctivitis typically presents with redness, discharge, and irritation but is not associated with severe pain or visual changes. Chronic open-angle glaucoma is usually asymptomatic until advanced stages and does not typically present with acute pain. Blepharitis involves inflammation of the eyelid margins and is characterized by redness and irritation, but it does not cause severe pain or acute visual changes.