j*****o
发帖数: 137 | 1 A 30-year-old woman has had progressive fatigue and muscle stiffness over
the past 6 months. She is the primary caretaker for her three children and
her elderly disabled parents and has had difficulty sleeping because of the
needs of her children. She says that she has to stay motivated because of
her responsibilities and has had no difficulty concentrating. She has not
had suicidal ideation. She has had an increased appetite and has had a 14-kg
(30-lb) weight gain over the past year. She has a previous history of binge
-eating and purging by vomiting. She has no history of psychoactive
substance abuse or dependence, cold or heat intolerance, or changes in bowel
or urinary function. Range of motion of the upper extremities is limited by
pain. There is no evidence of muscle atrophy. She has good eye contact. She
describes her mood as down and stressed. Her affect is dysphoric and
intermittently tearful. Which of the following is the most appropriate
pharmacotherapy? A ) Bupropion
B ) Diazepam
C ) Fluoxetine
D ) Imipramine
E ) Phenelzine
what ur Dx and Rx Choice | j*****o
发帖数: 137 | 2 A previously healthy 47-year-old man is brought to the emergency department
after collapsing at work. His coworkers report that he had the sudden onset
of a severe generalized headache before he lost consciousness. On arrival,
he is lethargic and in severe distress. A lumbar puncture is performed.
Cerebrospinal fluid analysis shows xanthochromia and an erythrocyte count of
40,0001mm3 in tubes 1 and 4. His wife and three children are at the
hospital, and his parents are en route. The patient dies, and the physician
informs the wife of her husband's death. When asked to provide consent for
an autopsy, his wife replies, "No. He hated being in the hospital, and I don
't want him to be cut up." Which of the following is the most appropriate
next step?
O A) Ask the parents to consent to the autopsy when they arrive
O B) Ask the wife again and explain the potential benefits of an autopsy
O C) Notify the medical examiner to mandate an autopsy
O D) Perform genetic testing on a postmortem blood sample | j*****o
发帖数: 137 | 3 A 37-year-old man comes to the physician for a routine follow-up
examination. Eight years ago, he had the gradual onset of symptoms of
schizophrenia without any apparent precipitating factors. He lives alone and
is able to care for himself. He has no history of depression. He has had
two brief hospitalizations for medication adjustment. His only medication is
risperidone. Physical examination shows no abnormalities. Mental status
examination shows a mildly constricted affect. He is concerned about his
prognosis. Which of the following historical factors is most predictive of a
good prognosis for this patient?
A) Absence of depression
B) Absence of precipitating factors for symptoms
C) Gradual onset of symptoms
D) Late onset of symptoms
E) Living independently | j*****o
发帖数: 137 | 4 20. A 57-year-old woman comes for a follow-up examination. She has a 15-year
history of type 2 diabetes mellitus and hypertension well controlled with
an angiotensin-converting enzyme (ACE) inhibitor. Examination shows no flank
tenderness. The kidneys are not palpable. Laboratory studies show:
Serum creatinine
1.9 mg/dL
Urine
Protein
1+
WBC
5–7/hpf
Which of the following is the most appropriate next step in management to
minimize progression of her renal disease?
A
) High-phosphate diet
B
) Low-protein diet
C
) Daily corticosteroid therapy
D
) Ibuprofen therapy
E
) Sodium chloride supplementation |
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