01-25-2008, 05:25 PM
18. A 6-year-old boy with cystic fibrosis is
brought to the
physician by his mother because his skin has been cool
and clammy for 30
minutes. Earlier in the day, he had been playing
outdoors, and the
temperature was 99 F. When returning indoors, he was
thirsty and restless. His
blood pressure is 70/40 mm Hg, and pulse is 120/min.
Examination shows
dry mucous membranes. Serum sodium level is 128
mEq/L, and serum
chloride level is 87 mEq/L. Which of the following is
the most likely
explanation for these findings?
A
) Excessive sweat electrolyte level
B
) Excessive sweat volume
C
) Excessive urinary output
D
) Excessive vasopressor secretion
E
) Inadequate sweat production
19.
A 27-year-old primigravid woman at 29 weeks' gestation
comes to the
emergency department because of a 24-hour history of
increasingly severe
right-sided abdominal pain and no appetite. She has
vomited twice over
the past 4 hours. She has not had vaginal bleeding.
Her temperature
is 38.2 C (100.8 F). Examination shows exquisite
tenderness of the
right lateral flank and the fundus. There are no
peritoneal signs. Bowel
sounds are absent. The fetal heart rate is 144/min.
Laboratory
studies show:
Hematocrit 37%
Leukocyte count 16,000/mm3
Serum
Total bilirubin 1.1 mg/dL
Amylase 32 U/L
Lactate dehydrogenase 110 U/L
Urine WBC 3“5/hpf
Which of the following is the most likely diagnosis?
A
) Abruptio placentae
B
) Appendicitis
C
) Cholelithiasis
D
) Colitis
E
) Pyelonephritis
20. A 32-year-old woman has had a lump in her neck
for 6 months.
She has a 1.2-cm solitary left thyroid nodule.
Fine-needle aspiration
cytology of the mass is consistent with a low-grade
papillary malignancy.
Which of the following is the most appropriate next
step in management?
A
) Thyroid scan
B
) 131I therapy
C
) Propylthiouracil therapy
D
) Thyroxine therapy
E
) Left thyroid lobectomy
brought to the
physician by his mother because his skin has been cool
and clammy for 30
minutes. Earlier in the day, he had been playing
outdoors, and the
temperature was 99 F. When returning indoors, he was
thirsty and restless. His
blood pressure is 70/40 mm Hg, and pulse is 120/min.
Examination shows
dry mucous membranes. Serum sodium level is 128
mEq/L, and serum
chloride level is 87 mEq/L. Which of the following is
the most likely
explanation for these findings?
A
) Excessive sweat electrolyte level
B
) Excessive sweat volume
C
) Excessive urinary output
D
) Excessive vasopressor secretion
E
) Inadequate sweat production
19.
A 27-year-old primigravid woman at 29 weeks' gestation
comes to the
emergency department because of a 24-hour history of
increasingly severe
right-sided abdominal pain and no appetite. She has
vomited twice over
the past 4 hours. She has not had vaginal bleeding.
Her temperature
is 38.2 C (100.8 F). Examination shows exquisite
tenderness of the
right lateral flank and the fundus. There are no
peritoneal signs. Bowel
sounds are absent. The fetal heart rate is 144/min.
Laboratory
studies show:
Hematocrit 37%
Leukocyte count 16,000/mm3
Serum
Total bilirubin 1.1 mg/dL
Amylase 32 U/L
Lactate dehydrogenase 110 U/L
Urine WBC 3“5/hpf
Which of the following is the most likely diagnosis?
A
) Abruptio placentae
B
) Appendicitis
C
) Cholelithiasis
D
) Colitis
E
) Pyelonephritis
20. A 32-year-old woman has had a lump in her neck
for 6 months.
She has a 1.2-cm solitary left thyroid nodule.
Fine-needle aspiration
cytology of the mass is consistent with a low-grade
papillary malignancy.
Which of the following is the most appropriate next
step in management?
A
) Thyroid scan
B
) 131I therapy
C
) Propylthiouracil therapy
D
) Thyroxine therapy
E
) Left thyroid lobectomy