07-24-2009, 05:15 PM
16. A 1-year study of a new drug to treat hypertension is conducted. One hundred patients with hypertension are enrolled; 50 patients are given the new drug and another 50 patients are given hydrochlorothiazide. All patients completed the trial. One noted unexpected effect is increased growth of scalp hair which occurred in those taking the new drug, a nonstatistically significant difference (p>0.10). This effect has also been reported in studies of other similar drugs in the new therapeutic class. The investigators of the study concluded that the new drug did not cause hair growth. Which of the following features of this study is most likely to affect the validity of this conclusion?
A
) Differential follow-up
B
) Lead time bias
C
) Length of the study
D
) Sample size
E
) Self-selection
17. A 38-year-old woman, gravida 2, para 1, at 38 weeks' gestation has had no fetal movement for 36 hours. Her prenatal course, prenatal tests, and fetal growth have been normal. Fetal heart tones are heard by Doppler. Which of the following is the most appropriate next step in management?
A
) Routine prenatal visit in 1 week
B
) Maternal hydration
C
) Nonstress test
D
) Immediate induction of labor
E
) Amniocentesis
33. A 60-year-old man comes to the physician because of increasing shortness of breath for 1 week; it occurs at rest and is exacerbated by exertion. He has not had chest pain. He has smoked two packs of cigarettes daily for 40 years. Between the ages of 18 and 30 years, he worked in a warehouse with exposed bare insulation; for the past 15 years, he has driven a taxi. Medications include ipratropium bromide and albuterol metered-dose inhalers. His temperature is 37 C (98.6 F), blood pressure is 170/95 mm Hg, pulse is 100/min, and respirations are 24/min. Anterior and posterior diffuse wheezes are heard. Cardiac examination shows no murmurs. There is mild pretibial edema. An x-ray film of the chest shows calcified pleural plaques on the right hemidiaphragm and a 2-cm pleural-based mass. With regard to the findings on the x-ray film, which of the following is most likely to have prevented this patient's condition?
A
) Appropriate immunizations
B
) Different occupation
C
) Different medications
D
) Hypertension screening
E
) Smoking cessation
A
) Differential follow-up
B
) Lead time bias
C
) Length of the study
D
) Sample size
E
) Self-selection
17. A 38-year-old woman, gravida 2, para 1, at 38 weeks' gestation has had no fetal movement for 36 hours. Her prenatal course, prenatal tests, and fetal growth have been normal. Fetal heart tones are heard by Doppler. Which of the following is the most appropriate next step in management?
A
) Routine prenatal visit in 1 week
B
) Maternal hydration
C
) Nonstress test
D
) Immediate induction of labor
E
) Amniocentesis
33. A 60-year-old man comes to the physician because of increasing shortness of breath for 1 week; it occurs at rest and is exacerbated by exertion. He has not had chest pain. He has smoked two packs of cigarettes daily for 40 years. Between the ages of 18 and 30 years, he worked in a warehouse with exposed bare insulation; for the past 15 years, he has driven a taxi. Medications include ipratropium bromide and albuterol metered-dose inhalers. His temperature is 37 C (98.6 F), blood pressure is 170/95 mm Hg, pulse is 100/min, and respirations are 24/min. Anterior and posterior diffuse wheezes are heard. Cardiac examination shows no murmurs. There is mild pretibial edema. An x-ray film of the chest shows calcified pleural plaques on the right hemidiaphragm and a 2-cm pleural-based mass. With regard to the findings on the x-ray film, which of the following is most likely to have prevented this patient's condition?
A
) Appropriate immunizations
B
) Different occupation
C
) Different medications
D
) Hypertension screening
E
) Smoking cessation