01-01-2009, 07:02 AM
18. An asymptomatic 47-year-old woman comes to the
physician for a follow-up examination. Six blood pressure
readings during the past 3 months have ranged between
140/80 mm Hg and 150/90 mm Hg. She has a 5-year
history of type 2 diabetes mellitus and hyperlipidemia.
Current medications include an oral hypoglycemic agent
and an HMG-CoA reductase inhibitor. Her mother has
hypertension, coronary artery disease, and type 2 diabetes
mellitus. The patient's blood pressure today is
160/90 mm Hg. Examination shows no other abnormalities.
Serum studies show a glucose concentration of 178 mg/dL
and creatinine concentration of 1.5 mg/dL. Urinalysis
shows 1+ protein. Which of the following is the most
appropriate medication to add to this patient's regimen?
(A) ACE inhibitor
(B) β-Adrenergic blocking agent
© Calcium-channel blocking agent
(D) Loop diuretic
(E) No additional pharmacotherapy is indicated at
this time
19. A previously healthy 13-month-old girl is brought to the
physician in January by her mother because she has had
watery, nonbloody diarrhea five times during the past 24
hours. She has had a low-grade fever and two episodes of
vomiting during this period. She attends day care, and other
children have had similar symptoms. She weighs 10 kg
(22 lb), unchanged from 2 weeks ago. Her temperature is
37.7°C (100°F), pulse is 140/min, respirations are 24/min,
and blood pressure is 90/58 mm Hg. Examination shows
moist mucous membranes; the patient cries with tears. The
extremities are warm with normal capillary refill time. The
remainder of the examination shows no abnormalities.
Which of the following is the most likely causal organism?
(A) Campylobacter jejuni
(B) Cryptosporidium parvum
© Giardia lamblia
(D) Rotavirus
(E) Salmonella enteritidis
physician for a follow-up examination. Six blood pressure
readings during the past 3 months have ranged between
140/80 mm Hg and 150/90 mm Hg. She has a 5-year
history of type 2 diabetes mellitus and hyperlipidemia.
Current medications include an oral hypoglycemic agent
and an HMG-CoA reductase inhibitor. Her mother has
hypertension, coronary artery disease, and type 2 diabetes
mellitus. The patient's blood pressure today is
160/90 mm Hg. Examination shows no other abnormalities.
Serum studies show a glucose concentration of 178 mg/dL
and creatinine concentration of 1.5 mg/dL. Urinalysis
shows 1+ protein. Which of the following is the most
appropriate medication to add to this patient's regimen?
(A) ACE inhibitor
(B) β-Adrenergic blocking agent
© Calcium-channel blocking agent
(D) Loop diuretic
(E) No additional pharmacotherapy is indicated at
this time
19. A previously healthy 13-month-old girl is brought to the
physician in January by her mother because she has had
watery, nonbloody diarrhea five times during the past 24
hours. She has had a low-grade fever and two episodes of
vomiting during this period. She attends day care, and other
children have had similar symptoms. She weighs 10 kg
(22 lb), unchanged from 2 weeks ago. Her temperature is
37.7°C (100°F), pulse is 140/min, respirations are 24/min,
and blood pressure is 90/58 mm Hg. Examination shows
moist mucous membranes; the patient cries with tears. The
extremities are warm with normal capillary refill time. The
remainder of the examination shows no abnormalities.
Which of the following is the most likely causal organism?
(A) Campylobacter jejuni
(B) Cryptosporidium parvum
© Giardia lamblia
(D) Rotavirus
(E) Salmonella enteritidis