Property:Prompt
Jump to navigation
Jump to search
This is a property of type Text.
W
An anesthesiology resident is prepping a patient for open reduction and internal fixation of a radial fracture. He is attempting his first axillary brachial plexus block. He begins by carefully palpating the axillary artery, trying to keep it fixed between two fingers and then inserts a needle slightly above the artery. He then advances the needle and injects 250 mg of bupivacaine. While withdrawing the needle, the resident notices significant bright red blood flowing out of the needle tubing and realizes that he might have accidentally injected the anesthetic intravascularly. Which of the following signs should be expected to occur in this patient? +
A 23-year-old woman is brought to the emergency department after consuming rat poison in a suicide attempt. On arrival, EMS inform the staff of several episode of hematemesis on the way to the hospital. The patient is found to be hypotensive and tachycardic with altered mental status. Which of the following mechanisms is responsible for this patient's presentation? +
A 50 year old female with a history of hypertension for the last 5 years presents to her physician’s office for an annual physical examination. In the history her last menstrual period was 8 months ago, and she shows interest in knowing about menopause and its effects. Further questioning reveals that her father died of Myocardial Infarction at the age of 60 and mother is hypertensive. She says she has been researching about menopause recently and asks “Can I take estrogen replacement to decrease my risk of coronary artery disease”. Administration of estrogen replacement leads to which of the following? +
A 52 year old post menopausal woman develops chest pain immediately after a minor earth quake. Electrocardiogram shows ST segment elevation in V1-V4. Troponin is elevated. Echocardiography shows Ballooning of the apex of the left ventricle. Coronary angiogram shows normal coronary arteries even after Ergonovine provocation test. What is the diagnosis of patient’s condition? +
A 55 year old male presented to the Emergency room with the acute onset of chest pain, shortness of breath and excessive sweating. Electrocardiogram was perfomed, and cardiac enzymes were measured, confirming the diagnosis of myocardial infarction. Angiogram showed a 75% stenosis in the left coronary artery and angioplasty was performed. The patient’s post-angioplasty recovery was unremarkable. While discharging the patient, Atorvastatin was advised as the patient’s Low density lipoprotein level was 115mg/dl.
While the patient is on statins which of the following should be routinely monitored? +
A 65 year old female patient came to the emergency department with severe chest pain for the last one hour associated with excessive sweating and dyspnea. She describes the pain as dull and radiating to her left arm. She has a history of hypertension and diabetes mellitus for the last 20 years .Electrocardiogram shows ST segment elevation in V1 and V2 . What is the most appropriate next step in the management? +
A 55 year old male presented to the emergency room with acute chest pain and diaphoresis . Electrocardiogram revealed ST segment elevation in leads V2 – V4 . Aspirin was administered and the patient was sent for coronary angiography, which revealed a 75% stenosis in the left main coronary artery . Angioplasty was performed immediately thereafter. On the fourth day following angioplasty, the patient began to experience chest pain again .Which of the following would be helpful in diagnosing a reinfarction? +
A 50 year old male presented to the emergency department with severe substernal chest pain for the last 30 minutes. Electrocardiogram reveals ST segment elevation in leads V1 and V2. His past medical history is significant for rheumatoid arthritis and an episode of anaphylaxis when treated with aspirin for his arthritic pain.What is the next best step in managing this patient? +
A 52 year old female presented to urgent care with acute chest pain associated with nausea, and vomiting, which radiated to her left arm for the last 30 minutes. Electrocardiogram reveals ST segment elevation in II, III, aVF . Aspirin was administered. A medical center with a catheterization laboratory was within 30 minutes distance. What is the most appropriate step in the management of this patient? +
A 55 year old female presented to urgent care with acute chest pain associated with nausea, and vomiting, which radiated to her left arm for the last 45 minutes. Electrocardiogram reveals ST segment elevation in II, III, aVF. Aspirin was administered. A medical center with a catheterization laboratory was within 60 minutes distance. What is the most appropriate step in the management of this patient? +
A 55 year old female who underwent total abdominal hysterectomy 10 days ago presented to urgent care with acute chest pain associated with nausea, and vomiting that has radiated to the left arm for 45 minutes. Electrocardiogram reveals ST segment elevation in V2-V4 . Aspirin was given. A medical center with a catheterization laboratory was in one hour distance. What is the most appropriate step in further managing this patient? +
A 48 year old male presented to the emergency room with chest pain and diaphoresis . Electrocardiogram showed ST segment elevation in leads II, III, aVF. Angiogram revealed 75% stenosis in the right coronary artery and angioplasty was performed. While in the Intensive care unit the patient suddenly complains of dizziness , and dyspnea . Electrocardiogram on the monitor displays uncoordinated P waves and QRS complexes with an atrial rate of 90 beats per minute and ventricular rate of 45 beats per minute. What is the most likely diagnosis? +
A 52 year old male with hypertension and Diabetes presents to the emergency department with severe crushing chest pain that developed when he was watching his favorite show on TV. Electrocardiogram shows ST segment depression in V2-V4.Oxygen, Morphine and nitrates are administered along with aspirin. Heparin and Abciximab are administered thereafter. Patient continues to be in pain and electrocardiogram now shows ventricular tachycardia.What is the next best step in managing this patient? +
A 60 year old male who developed sudden chest pain associated with excessive sweating while having his lunch is brought to the emergency department . Electrocardiogram shows ST segment depression in leads V2-V4. Aspirin, Oxygen, Morphine and nitrates are given.Which of the following therapeutics are associated with a major mortality benefit in this patient? +
A 56 year old male presented to his physician’s office for his regular physical check up.He was discharged from the hospital one month prior after undergoing angioplasty for Unstable angina. Now he is on Clopidogrel, atenolol, Lipitor , Lisinopril and Nitrates.Today he asks whether he can resume his sexual activity and how long he should wait between taking his Nitrates and Sildenafil. What is your response? +
A 55-year-old woman comes to the clinic for a routine Check up. She is an actress and is wearing a very tight red dress. Her hair is long and has highlights. She complaints she likes a man at work who he does not pay enough attention to her. The physician perceives that she is staring at him in a non-professional manner. She says to the doctor “you are very handsome, are you married?” and touches his tie. The physician steps back a feet away from her and continues interviewing her. She then says: “you don’t want me either, you are just like all other men, I thought you were my special doctor”. She then bursts into tears complaining that people should recognize her more when she walks in the streets because she is on television. She has been married 4 times, and has had 3 boyfriends over the last year. Upon her first divorce she cut her wrists trying to commit suicide. Which of the following is the most appropriate statement about her diagnosis? +
A research group is studying the effects of a short course of concentrated coffee bean extract on weight loss among healthy volunteers. The group designs a randomized double-blinded controlled trial and recruits 154 subjects. Subjects are then randomized into 2 groups, one receiving 3 daily doses of coffee bean extract and the other receiving 3 daily doses of placebo. At the end of the two-month period, the biostatistician wants to compare the mean change in body weight from baseline among the 2 groups. Which of the following tests should the biostatistician use in order to obtain a valid comparison? +
A 20-year-old man presents to the neurology clinic for left foot weakness and gradual loss sensation in the both lower extremities. His symptoms have been progressive over the past 2 years. On physical examination, the physician notes significant pes cavus with left foot drop, lower extremity weakness and muscle wasting giving the legs an inverted champagne bottle appearance. The patient explains that several of his family members have had the same condition. A mutation in which of the following gene is likely to be responsible for this patient's condition? +
A research lab develops a new knock-in mouse model with a chimeric mouse/human exon containing 140 CAG repeats inserted into a gene on the short arm of chromosome 4. The mice are grown and observed for a total 18 months. All mice develop increased locomotor activity and abnormal posturing at approximately 1 month of age, followed by hypoactivity at 4 months and gait abnormalities at 1 year. Which of the following neurochemical changes is associated with this syndrome? +
47 y/o African American male patient comes to the emergency department with severe chest pain radiating to his left jaw for 45 minutes. He describes his pain as constant, and dull in nature. It is accompanied by diaphoresis and nausea. He admits to smoking 2 packs of cigarettes per day. His Blood pressure is 145/92, Pulse is 103, RR 18, and temperature is 96.7. He received oxygen, aspirin and IV morphine upon arrival. His EKG only shows ST segment depression in leads 2,3,AVF. His cardiac markers are normal. What is the most appropriate next step in management. +