01-01-2008, 07:16 PM
A healthy 55-year-old man comes for an initial health maintenance examination. His last visit to a physician was over 10 years ago. He does not smoke and drinks only on social occasions. Examination shows no abnormalities. Which of the following immunizations should be administered?
A
) Hepatitis A vaccine
B
) Influenza virus vaccine
C
) Measles-mumps-rubella vaccine
D
) Pneumococcal vaccine
E
) Diphtheria-tetanus toxoid
QS 2 Three days after hospitalization for heparin treatment of deep venous thrombosis of a left superficial femoral vein, a 52-year-old woman has prolonged bleeding from a venipuncture site. She had a pulmonary embolus 2 years ago. Her temperature is 37.5 C (99.5 F). Examination shows multiple ecchymoses at the venipuncture sites with oozing of fresh blood. Laboratory studies show:
Hemoglobin
10.5 g/dL
Platelet count
25,000/mm3
Prothrombin time
14 sec (INR=1.3)
Partial thromboplastin time
65 sec
Plasma fibrinogen
300 mg/dL (N=200“400)
Serum creatinine
1.1 mg/dL
Which of the following is the most likely diagnosis?
A
) Adverse drug reaction
B
) Disseminated intravascular coagulation
C
) Excessive blood loss from anticoagulation
D
) Factor VIII deficiency
E
) Factor IX deficiency
F
) Immune thrombocytopenic purpura
G
) Thrombotic thrombocytopenic purpura
A
) Hepatitis A vaccine
B
) Influenza virus vaccine
C
) Measles-mumps-rubella vaccine
D
) Pneumococcal vaccine
E
) Diphtheria-tetanus toxoid
QS 2 Three days after hospitalization for heparin treatment of deep venous thrombosis of a left superficial femoral vein, a 52-year-old woman has prolonged bleeding from a venipuncture site. She had a pulmonary embolus 2 years ago. Her temperature is 37.5 C (99.5 F). Examination shows multiple ecchymoses at the venipuncture sites with oozing of fresh blood. Laboratory studies show:
Hemoglobin
10.5 g/dL
Platelet count
25,000/mm3
Prothrombin time
14 sec (INR=1.3)
Partial thromboplastin time
65 sec
Plasma fibrinogen
300 mg/dL (N=200“400)
Serum creatinine
1.1 mg/dL
Which of the following is the most likely diagnosis?
A
) Adverse drug reaction
B
) Disseminated intravascular coagulation
C
) Excessive blood loss from anticoagulation
D
) Factor VIII deficiency
E
) Factor IX deficiency
F
) Immune thrombocytopenic purpura
G
) Thrombotic thrombocytopenic purpura