Nokea
What is the most common cause of erectile dysfunction in older men?
- A. Psychological stress
- B. Adverse drug reaction
- C. Atherosclerosis
- D. Autonomic neuropathy
Correct Answer: C
Rationale: The correct answer is C: Atherosclerosis. Atherosclerosis is the most common cause of erectile dysfunction in older men as it leads to reduced blood flow to the penis, affecting the ability to achieve and maintain an erection. Psychological stress (A) can contribute to erectile dysfunction but is not the primary cause. Adverse drug reactions (B) can also lead to erectile dysfunction, but it is not as common as atherosclerosis. Autonomic neuropathy (D) can affect nerve impulses in the penis but is not as prevalent as atherosclerosis in causing erectile dysfunction in older men.
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An 81-year-old transgender female with a history of depression and hyperlipidemia presents to your clinic for routine care. She endorses a history of smoking, currently smoking 1 pack per day, and occasionally drinks a glass of wine, although she denies illicit drug use. She reports she takes atorvastatin 20 mg and subcutaneous estrogen therapy.
- A. Counseling on starting aspirin
- B. Counseling on alcohol cessation
- C. Counseling on smoking cessation
- D. Counseling on mammogram
Correct Answer: C
Rationale: The correct answer is C: Counseling on smoking cessation. Smoking is a major risk factor for numerous health issues such as cardiovascular disease, respiratory problems, and cancer. Given the patient's age, history of smoking, and other risk factors like depression and hyperlipidemia, counseling on smoking cessation is crucial to improve her overall health and reduce the risk of future complications.
Choice A: Counseling on starting aspirin may be appropriate for some individuals based on their cardiovascular risk profile, but in this case, smoking cessation is a more urgent priority due to the direct impact of smoking on health.
Choice B: Counseling on alcohol cessation is important, but in this scenario, smoking cessation takes precedence due to the immediate and significant health risks associated with smoking.
Choice D: Counseling on mammogram is important for breast cancer screening, but addressing smoking cessation should be the primary focus given the patient's current health risks.
In summary, counseling on smoking cessation is the most critical intervention for this patient to improve her overall health
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?
Racial disparities have been a part of US healthcare for many decades. How might this impact the expectations of older Black Americans?
- A. Reluctance to participate in medical research because of unethical studies in the past
- B. Underrepresentation of Black physicians in the geriatric workforce
- C. Cumulative effects of differences in access to healthcare providers
- D. All of these
Correct Answer: D
Rationale: The correct answer is D because each of the choices addresses a different aspect of how racial disparities in healthcare can impact the expectations of older Black Americans. A is correct because unethical studies in the past can lead to reluctance to participate in medical research. B is correct because the underrepresentation of Black physicians may affect the quality of care older Black Americans receive. C is correct because differences in access to healthcare providers can result in cumulative negative effects on health outcomes for older Black Americans. Therefore, the combination of these factors can significantly impact the expectations and experiences of older Black Americans in healthcare.
When applying the SAMPLE mnemonic, which of the following statements from the patient would be classified under the letter 'M' for medications?
- A. I have been taking aspirin for my headaches.
- B. I am allergic to penicillin.
- C. I recently had surgery on my knee.
- D. I take Metformin for my diabetes.
Correct Answer: D
Rationale: Step 1: The 'M' in the SAMPLE mnemonic stands for Medications, which focuses on the current and past medications the patient is taking.
Step 2: Choice D, "I take Metformin for my diabetes," directly provides information about a medication the patient is currently taking.
Step 3: This statement is relevant to the patient's medical history and helps in understanding their current health condition.
Summary: Choice D is correct as it specifically addresses the patient's medication (Metformin for diabetes), while the other choices provide information related to headaches (A), allergies (B), and surgical history (C), which do not fall under the 'M' category for medications.
Which of the following anatomic landmark associations is correct?
- A. 2nd intercostal space for needle insertion in tension pneumothorax
- B. T6 for lower margin of endotracheal tube
- C. Sternal angle marks the 4th rib
- D. 5th intercostal space for chest tube insertion
Correct Answer: D
Rationale: The correct answer is D because the 5th intercostal space is the recommended location for chest tube insertion to drain the pleural space effectively. This space is ideal as it allows for adequate drainage without causing injury to vital structures.
A: The 2nd intercostal space is actually used for needle decompression in tension pneumothorax.
B: T6 is the level at which the tip of the endotracheal tube should ideally lie to ensure proper placement and ventilation.
C: The sternal angle corresponds to the 2nd rib, not the 4th rib, making this association incorrect.
In summary, choice D is correct as it aligns with the standard practice for chest tube insertion, while choices A, B, and C are incorrect due to their association with different anatomic landmarks and procedures.