This endocrine disorder is a severe form of hypothyroidism characterized by an accumulation of mucopolysaccharide in subcutaneous and other interstitial tissues

Correct Answer: A

Rationale: Myxedema is a severe form of hypothyroidism that is characterized by the accumulation of mucopolysaccharides in subcutaneous and other interstitial tissues. This condition leads to puffiness, swelling, and thickening of the skin, giving it a waxy appearance. Other symptoms of myxedema include fatigue, weight gain, cold intolerance, and hair loss. It is important to recognize and treat myxedema promptly as it can lead to serious complications such as myxedema coma, which is a life-threatening condition requiring immediate medical attention.

Correct Answer: A

Rationale: The presentation of sudden-onset unilateral facial droop, arm weakness, and slurred speech that partially resolved within 30 minutes is more consistent with a transient ischemic attack (TIA) rather than an ischemic or hemorrhagic stroke. TIAs are caused by temporary decreases in blood flow to a specific area of the brain, leading to transient neurological deficits that typically last for less than 24 hours. In this case, the symptoms partially resolving suggest a temporary and reversible ischemic event, characteristic of a TIA. Ischemic strokes involve more prolonged or permanent impairment due to blockage of a blood vessel supplying the brain, while hemorrhagic strokes involve bleeding within the brain tissue or the surrounding membranes.

Correct Answer: C

Rationale: The member of the health team responsible for preparing pre-operative orders for a patient undergoing surgery, such as a coronary arterial bypass graft (CABG), is typically the anesthesiologist. Anesthesiologists are specialized physicians who are trained to administer anesthesia and manage the patient's well-being during surgery. They are responsible for assessing the patient's medical history, determining the appropriate anesthesia plan, and prescribing pre-operative medications. Cardiologists focus on diagnosing and treating heart conditions, surgeons perform the actual surgical procedure, and medical internists specialize in the diagnosis and non-surgical treatment of internal diseases. The anesthesiologist plays a crucial role in ensuring the safety and comfort of the patient before, during, and after surgery.

Correct Answer: A

Rationale: The most significant contributory factor to the development of lung cancer is being a cigarette smoker. Cigarette smoking is directly linked to approximately 85% of lung cancer cases. The harmful substances in tobacco smoke, such as carcinogens, damage the cells in the lungs, leading to the development of cancer over time. Smokers are at a significantly higher risk of developing lung cancer compared to non-smokers. Therefore, being a cigarette smoker is the primary and most influential risk factor for developing lung cancer.

Correct Answer: C

Rationale: Cryptosporidium parvum is a protozoan parasite that commonly causes waterborne illness characterized by watery diarrhea, abdominal cramps, and nausea. This parasite is often transmitted through contaminated water sources such as streams or lakes. Laboratory tests identifying oocysts in the stool sample are indicative of Cryptosporidium infection. Giardia lamblia can also cause similar symptoms, but the presence of oocysts points more towards Cryptosporidium in this case. Entamoeba histolytica causes amoebic dysentery with bloody diarrhea and is usually associated with fecal-oral transmission through contaminated food or water. Cyclospora cayetanensis typically causes prolonged watery diarrhea and is associated with the ingestion of contaminated food or water.

Correct Answer: A

Rationale: The presentation described indicates a candidal infection, which commonly occurs in warm, moist body areas like inguinal folds and gluteal cleft. The pruritic, erythematous rash with scaly plaques and satellite papules and pustules is characteristic of cutaneous candidiasis. The recent antibiotic use for urinary tract infection likely disrupted the normal skin flora, predisposing the patient to a Candida overgrowth. Tinea cruris (jock itch) can also present similarly, but the presence of satellite papules and pustules is more indicative of candidiasis. Erythrasma typically presents as well-defined brown-red patches without satellite lesions, and intertrigo is a more generic term referring to inflammation of skin folds that can have various causes, including candidiasis.

Correct Answer: B

Rationale: Negligence refers to the failure to act or perform duties according to the standard of care expected from a reasonable person in similar circumstances. In this case, Nurse Lina administering a penicillin injection that was ordered for another patient is a clear instance of negligence. It involves a breach of duty by not verifying the correct patient and medication before administration. While malpractice can also encompass negligence, it typically involves a broader scope of professional misconduct or harm caused by a healthcare provider. Assault and battery involve intentional harmful acts, which are not applicable in this situation.

Correct Answer: A

Rationale: The clinical presentation of recurrent episodes of epistaxis, gum bleeding, and easy bruising, along with laboratory findings of prolonged bleeding time, normal platelet count, and normal coagulation studies (PT and aPTT) are highly suggestive of Von Willebrand disease. Von Willebrand disease is the most common inherited bleeding disorder and is characterized by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a key role in platelet adhesion and aggregation. The prolonged bleeding time is due to impaired platelet adhesion to the damaged vessel wall in the absence of functional vWF. Normal platelet count and normal PT/aPTT help differentiate Von Willebrand disease from other bleeding disorders such as hemophilia and platelet function disorders like Glanzmann thrombasthenia and Bernard-Soulier syndrome.

Correct Answer: C

Rationale: The symptoms described in the scenario - chest pain, dyspnea, and cyanosis - are indicative of a potential air embolism. Air embolism occurs when air enters the bloodstream, leading to blockages in blood vessels and impeding oxygen delivery to tissues. In patients receiving Total Parenteral Nutrition (TPN) through intravenous lines, the risk of air embolism exists during line manipulations, disconnections, or improper priming of the tubing. The sudden onset of symptoms like chest pain and cyanosis in a patient on TPN should raise suspicion for an air embolism, as it requires immediate intervention to prevent further complications such as cardiac arrest or stroke.