please answer - linab

[ArchivalUser]

1. A 77-year-old woman is brought to the physician by her son for a routine health maintenance
examination. She says that she feels well. Her son reports that 1 month ago, she got lost while
driving home from the local supermarket. Two weeks ago, she forgot to turn off the stove after
cooking dinner. She has been wearing bilateral hearing aids since audiometry 2 years ago showed
bilateral high-frequency hearing loss. Her visual acuity corrected with glasses is 20/25 in both eyes.
Neurologic examination shows mild fine tremors of the hands when the arms are outstretched; the
tremor is not present at rest. Muscle strength is 5/5 in all extremities. Deep tendon reflexes are
decreased at the ankles and 2+ elsewhere. Her gait is normal. Sensation to vibration is mildly
decreased over the toes. On mental status examination, she is awake, alert, and conversant. Her
language function is normal. She is oriented to person, place, and time and recalls one out of three
objects after 10 minutes. Which of the following findings in this patient warrants further evaluation?
A
) Decreased deep tendon reflexes at the ankles
B
) Decreased sensation to vibration over the toes
C
) High-frequency hearing loss
D
) Memory loss
E
) Tremor of the outstretched hands

[ArchivalUser]

44. A 28-year-old woman is hospitalized after taking a massive overdose of acetaminophen tablets
in a suicide attempt. She has type 1 diabetes mellitus and major depressive disorder refractory to
tricyclic antidepressant therapy. Despite appropriate therapy, she develops rapidly progressive
hepatic failure and becomes progressively encephalopathic. On the 6th day of hospitalization, she is
comatose. A CT scan of the brain shows mild diffuse swelling. An appropriately crossmatched, sizeappropriate
donor liver is available. Which of the following is the most appropriate course of action
regarding transplantation?
A
) Do not proceed with the transplantation because diabetes mellitus is a contraindication
B
) Do not proceed with the transplantation because hepatic function is likely to return over the next
week
C
) Do not proceed with the transplantation because major depressive disorder places the patient at
risk for another suicide attempt
D
) Do not proceed with the transplantation because the onset of encephalopathy and CT findings
suggest bacterial meningitis
E
) Proceed with the transplantation

[ArchivalUser]

please help with answers...anybody please

[ArchivalUser]

1 is D bcoz need to find the underlying cause such as thyroid cause or vit defi

44 is not sure. i read in this forum discussion in the past.
some say C and some E
i prefer E

[ArchivalUser]

me too , 1 seems like D and 44 seems like E.....

[ArchivalUser]

1.ans D.[she forgot to turn off the stove.]Rest of the choices r normal in elderly.
44 ans C.

[ArchivalUser]

please explain 44 is C, jija
i also confuse. if don't do liver transplant, the patient is sure to die, h/o of MDD and suicide is contraindication for transplant? Is it ethical?

[ArchivalUser]

its


b and
e

[ArchivalUser]

thanks

[ArchivalUser]

b and e.