15.
You are about to leave the office for a 2-week vacation with your family when you receive a telephone call from a 78-year-old long-time patient. The patient has type 2 diabetes mellitus and has just been discharged from the hospital following debridement of a foot ulcer. She is now having difficulty ambulating because of obesity and an inability to bear weight on the affected foot. She lives alone, and she says she is having difficulty cooking for herself and caring for the wound. She is not scheduled to see the surgeon who performed the debridement for another week. She asks for your help. Which of the following is the most appropriate intervention at this time?
A) Admit the patient to the hospital
B) Advise the patient to see the surgeon sooner
C) Arrange home assessment by a visiting nurse
D) Notify the patient's neighbors of her condition
E) Schedule a home visit when you return from vacation
q15.-
Ans) C
C) Arrange home assessment by a visiting nurse
Good thing I got this Ethic qsn right
I would never find a way to know the right answer for Ethic questions
16.
A 74-year-old woman comes to the office because of three to four 2-minute episodes of dizziness during the past 2 weeks. She says during the episodes she feels like her head and the room are spinning, and she has double vision and numbness of her face. She reports no auditory symptoms or hearing loss. She has never experienced these symptoms before. Medical history is remarkable for hypertension controlled with atenolol. Vital signs are temperature 37.0°C (98.6°F), pulse 72/min and regular, respirations 12/min, and blood pressure 152/90 mm Hg. Physical examination, including neurologic examination, shows no abnormalities. Which of the following is the most likely diagnosis?
A) Acoustic neuroma (vestibular schwannoma)
B) Benign positional vertigo
C) Labyrinthitis
D) Meniere disease
E) Vertebrobasilar ischemia
Q-16
Correct Answer by feedback:
E) Vertebrobasilar ischemia
There is no hearing loss, so we kill A, C and D
There are more symptoms that have to explain her problems than a simple BPV
In Vertebrovasilar Insufficiency there is Transient DIZZINESS, as the mc manifestation of VBI, which increases in prevalence with advancing age. Other common symptoms of VBI include TRANSIENT BLURRED VISION in one or both fields, DYSARTHRIA, UNSTEADINESS OF GAIT, HEADACHES, TINNITUS and sometimes even hearing loss.
Some VBI patients experience drop attacks or syncope. VBI patients have similar outcomes to those of anterior circulation TIA patients in most therapeutic trials of antiplatelet agents, because atherosclerosis is the most common cause of VBI symptoms. The most common risk factors for atherosclerosis are hypertension, cigarette smoking, and high serum cholesterol levels.
17.
A 16-year-old Hispanic boy comes to the health center because of progressively worsening right ear pain for the past 2 days. He swims daily, and he is a lifeguard and instructor for children at a local swimming pool for 24 hours weekly. He has a history of recurrent otitis media as an infant. He states that the pain now is nearly unbearable. Vital signs are temperature 37.2°C (99.0°F), pulse 82/min, respirations 12/min, and blood pressure 118/84 mm Hg. Physical examination discloses a quiet adolescent who is in mild distress. Examination of the right ear discloses tenderness with traction of the pinna. Attempted examination of the tympanic membrane causes severe pain. The canal appears red and swollen with white debris present. Examination of the left tympanic membrane and canal discloses no abnormalities. Throat is not red. There is tender adenopathy in the posterior cervical chain on the right. The most likely cause of this patient's condition is which of the following?
A) Atopic dermatitis
B) Candida albicans
C) Pseudomonas aeruginosa
D) Seborrheic dermatitis
E) Streptococcus pneumonia
18.
A 67-year-old white woman comes to the office for a periodic health evaluation. She has been in excellent health. She takes calcium supplements. She has had a Pap smear and a mammogram within the past year, and she underwent flexible sigmoidoscopy 2 years ago, which showed no abnormalities. She had all appropriate vaccinations as a child. Her last tetanus vaccination was 6 years ago. Today she asks what other vaccines are necessary at this time. Which of the following is the most appropriate vaccination for this patient at this time?
A) Measles (rubeola) booster
B) Hepatitis B vaccine
C) Pneumococcal vaccine
D) Tetanus booster
E) No vaccination
Can someone explain 17 please?
the kid has otitis externa (swimmers ear). Pseudomonas is a common pathogen