59 yo woman presents with onset of tingling in her toes. Her reflexes are depressed with downgoing toes. The finding that suggests most strongly that this is Guillain-Barré syndrome and not a spinal cord problem is:

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100 Questions on the Cardiovascular System Questions

Question 1 of 5

59 yo woman presents with onset of tingling in her toes. Her reflexes are depressed with downgoing toes. The finding that suggests most strongly that this is Guillain-Barré syndrome and not a spinal cord problem is:

Correct Answer: D

Rationale: Lack of incontinence strongly favors Guillain-Barré (peripheral neuropathy) over spinal cord lesions, which often affect bowel/bladder control.

Question 2 of 5

If aseptic meningitis due to HSV is suspected, empiric therapy with which antimicrobial is indicated?

Correct Answer: B

Rationale: Acyclovir is the antiviral of choice for herpes simplex virus (HSV) meningitis because it effectively inhibits viral replication in this context.

Question 3 of 5

You are treating a 66-year-old man with stable angina with a statin, a b-blocker, a diuretic, and an ACE inhibitor. His BP is 130/82 mmHg and his heart rate is 64 beats/min. He generally feels fine; however, he has started to play golf since his retirement 4 months ago and his knee osteoarthritis is more apparent now. Which ONE of the following treatment recommendations would you suggest for this patient?

Correct Answer: B

Rationale: Acetaminophen is safer in patients with cardiovascular risk factors and does not exacerbate hypertension or renal dysfunction compared to NSAIDs.

Question 4 of 5

Group II synovial fluid is typical of which condition?

Correct Answer: D

Rationale: Group II synovial fluid is inflammatory and typically seen in conditions like rheumatoid arthritis or other inflammatory arthritides, making 'Inflammatory arthritis' the correct choice.

Question 5 of 5

A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n)

Correct Answer: A

Rationale: Heart failure with normal ejection fraction is particularly likely to develop in the elderly, in women, and in those without a history of MI. A middle-aged man with a previous history of MI may have heart failure, but the older woman fits the criteria of heart failure with normal ejection fraction. A young female athlete with cardiomegaly may experience heart failure, but is not the normal patient profile for this condition. A young sedentary male with a high-stress job may experience heart failure, but this patient does not fit the normal profile for this condition.

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