Patient has cardiac arrest. Nonischemic heart dise

Question 1 of 5

Patient has cardiac arrest. Nonischemic heart disease, no MI. What should be done?

A. Patient needs further electrical monitoring with beta blocker treatment B. Patient should have ICD implanted, a class I indication C. Patient instructed to have further follow up with primary physician with global risk reduction D. Patient requires echocardiogram to further assess his need for ICD implant

Correct Answer: B

Rationale: For nonischemic cardiac arrest without MI, an ICD is a class I indication to prevent future sudden cardiac death due to arrhythmias.

Question 2 of 5

For which of the following circumstances would anastrozole be best indicated?

A. A 25 year-old woman with a 2 cm, lymph node negative, ER- tumor B. A 37 year-old woman with a 0.2 cm, lymph node negative ER+ tumor C. A 69 year-old woman with a 3 cm, lymph node negative, ER+ tumor D. A 31 year-old woman with a 2.8 cm, lymph node positive, ER+, Her2+ tumor

Correct Answer: C

Rationale: Anastrozole is effective for postmenopausal women with ER+ breast cancer; thus, a 69-year-old woman with these characteristics would benefit from it.

Question 3 of 5

Your patient with a recently placed prosthetic aortic valve is about to undergo dental extraction. She reports anaphylaxis to amoxicillin. Which of the following should be offered:

A. Cephalexin 500 mg x 1 prior to procedure B. Clindamycin 300 mg x 1 prior to, then 3 additional doses q 8 hrs following the procedure C. Doxcycline 200mg x 1 prior to procedure D. Clindamycin 600 mg x 1 prior to procedure

Correct Answer: D

Rationale: Clindamycin 600 mg x 1 prior to procedure is appropriate for patients allergic to penicillin.

Question 4 of 5

You are seeing a 61 yo African-American male for back pain, the follow lab is obtained: creatinine 1.9 mg/dl, Hb 8.8, uric acid 10.1mg/dl, Ca 11.8 mg/dl, anion gap is 5 and urine dip is negative for protein. What would be your next diagnostic test?

A. Bone scan B. Renal ultrasound C. ANA D. Serum protein electrophoresis

Correct Answer: D

Rationale: The patient's presentation with elevated calcium levels and renal insufficiency suggests multiple myeloma as a potential diagnosis. Serum protein electrophoresis is essential in detecting monoclonal proteins, which are commonly found in multiple myeloma.

Question 5 of 5

72-y female with a 40-pack year smoking history presents to the hospital with a 4-week history of hemoptysis and progressive dyspnea. She reports lower extremity weakness while climbing stairs. Vital signs are notable for HR 104 bpm and pulse oximetry 91% on room air. Physical exam identifies symmetric proximal muscle weakness in both upper and lower extremities. Lungs are clear. CT chest shows a 4 cm right hilar mass with bilateral mediastinal lymphadenopathy. What is the most likely diagnosis?

A. Thymoma B. Small cell carcinoma C. Squamous cell carcinoma D. Atypical carcinoid

Correct Answer: B

Rationale: Small cell lung cancer (SCLC) is associated with paraneoplastic syndromes like Lambert-Eaton myasthenic syndrome (proximal weakness) and is common in heavy smokers. The hilar mass and rapid symptom onset align with SCLC's aggressive nature.

Patient has cardiac arrest. Nonischemic heart disease, no MI. What should be done?

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