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1.You are asked to see a 63-year-old woman who is in the hospital after undergoing an operation 4 days ago for a displaced tibia-fibula fracture. The operation was uncomplicated. Preoperative chest x-ray film was normal. She has a transurethral urinary catheter, which was placed during the operation 4 days ago. Today she has a temperature of 37.9°C (100.2°F). Laboratory studies disclose mild leukocytosis. Urinalysis shows greater than 100 WBC/hpf and many bacteria. You suspect that she has a urinary tract infection.
Which of the following would have been the most appropriate method of preventing a urinary tract infection in this patient?
A) Cleaning the perineum twice daily with povidone-iodine
B) Irrigating the bladder every 8 hours
C) Removing the catheter immediately post-operation
D) Treating the patient with prophylactic antibiotics
E) Using only silver-coated urinary catheters
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D) Treating the patient with prophylactic antibiotics
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ok here is another one...
1. A 52-year-old woman is brought to the office by her husband for evaluation of increasing tearfulness, restlessness, difficulty sleeping and weight loss for 1 month. During the visit, the patient appears restless and upset. She acknowledges her husband's account of her symptoms, but she does not volunteer any additional information. They have been married for 15 years and have a good relationship. Both the patient and her husband are teachers and they have a healthy 13-year-old son. She was previously healthy. Physical examination today is normal. The most appropriate initial management of her symptoms is to do which of the following?
A) Prescribe haloperidol
B) Prescribe lithium
C) Prescribe lorazepam
D) Prescribe sertraline
E) Refer them for couples therapy
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2. A 7-year-old white boy is brought to the health center by his mother because of stomach pain for the past 3 months. The mother says that the pain typically comes on soon after waking and is not relieved by antacids. She says his symptoms never occur late in the day, but only in the mornings. There has been no vomiting, diarrhea or weight loss. The child has been generally healthy and is up-to-date with vaccinations. He lives with both parents. His height and weight are at the 75th percentile. Physical examination, including developmental assessment, is normal. Specific additional history should be obtained regarding which of the following?
A) Days of the week in which the patient is most symptomatic
B) Family history of milk allergy
C) Quantity of food intake
D) Recent travel history
E) The source of water at home
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E) Refer them for couples therapy
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A) Days of the week in which the patient is most symptomatic
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pat123 why do you think its A)Days of the week in which the patient is most symptomatic
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It looks like separation anxity disorder
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C) Prescribe lorazepam
E) The source of water at home
