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What are the signs of thyroid crisis resulting from Graves' disease?
- A. Constipation with gastric distension.
- B. Bradycardia and bradypnea.
- C. Hyperthermia and tachycardia.
- D. Constipation and lethargy.
Correct Answer: C
Rationale: In a thyroid crisis resulting from Graves' disease, the patient typically experiences symptoms such as hyperthermia (elevated body temperature) and tachycardia (rapid heart rate). These symptoms are indicative of the hypermetabolic state seen in thyroid storm. Choices A and D are incorrect as constipation and lethargy are not typical signs of a thyroid crisis; instead, patients with hyperthyroidism often experience diarrhea and agitation. Choice B is incorrect because bradycardia (slow heart rate) and bradypnea (slow breathing rate) are more commonly associated with hypothyroidism rather than a thyroid crisis in Graves' disease.
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A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strange and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:
- A. Alzheimer's disease.
- B. Vascular dementia.
- C. Dementia with Lewy bodies.
- D. Frontotemporal dementia.
Correct Answer: C
Rationale: The symptoms described in the scenario, such as visual hallucinations, fluctuations in cognition, and parkinsonism (bradykinesia and limb rigidity), are classic features of dementia with Lewy bodies (DLB). DLB is characterized by the presence of Lewy bodies in the brain, which are abnormal protein deposits. Alzheimer's disease (Choice A) typically presents with memory loss as a predominant symptom, which is not a major concern in this case. Vascular dementia (Choice B) is associated with a history of cerebrovascular disease and is not supported by the symptoms described. Frontotemporal dementia (Choice D) usually presents with changes in behavior and personality, rather than the symptoms described in the scenario.
Which of the following is a clinical manifestation in a patient with renal impairment associated with polycystic kidney disease?
- A. Suprapubic pain
- B. Periorbital edema
- C. Low serum creatinine level
- D. Palpable kidneys
Correct Answer: D
Rationale: Palpable kidneys are a common clinical manifestation in patients with polycystic kidney disease due to the enlarged kidneys with multiple cysts. Suprapubic pain is not typically associated with this condition. Periorbital edema is more commonly seen in conditions like nephrotic syndrome. A low serum creatinine level is not a typical finding in renal impairment, as impaired kidneys usually lead to an elevated serum creatinine level.
Which of the following patients are at higher risk for developing oral cancer?
- A. A female who has taken oral contraceptives for the last 4 years
- B. Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe
- C. An adult female who eats spicy foods regularly
- D. An older adult female who chews gum frequently
Correct Answer: B
Rationale: The correct answer is 'Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe.' Alcohol consumption and tobacco use, such as smoking a pipe, are well-known risk factors for developing oral cancer. These two factors significantly increase the likelihood of developing oral cancer compared to the other choices. Taking oral contraceptives, eating spicy foods regularly, and chewing gum frequently are not established risk factors for oral cancer, making them less likely to lead to the development of this type of cancer.
Macular degeneration occurs as a result of:
- A. loss of lens accommodation
- B. detachment of the retina
- C. increased intraocular pressure
- D. impaired blood supply leading to cellular waste accumulation and ischemia
Correct Answer: D
Rationale: Macular degeneration is a condition that affects the macula, a part of the retina responsible for central vision. It is primarily caused by impaired blood supply to the macula, leading to cellular waste accumulation and ischemia. This results in the death of photoreceptor cells and ultimately vision loss. Choices A, B, and C are incorrect because macular degeneration is not related to the loss of lens accommodation, detachment of the retina, or increased intraocular pressure. The correct answer directly addresses the underlying pathophysiology of macular degeneration.
In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:
- A. eosinophils
- B. neutrophils
- C. monocytes
- D. cells
Correct Answer: B
Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.