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Questions and Answers
A patient presents to you complaining of headaches and says that he had his blood pressure
checked in a local shopping centre and the person that did it said that he needed to see his
doctor. After a series of investigations, including blood tests and imaging investigations, he
has surgery to remove a Conns tumour (adenoma of the adrenal gland which produces
aldosterone). One of the blood tests was to measure renin activity and potassium
concentrations. You expect the results to be:
A patient presents to you complaining of headaches and says that he had his blood pressure checked in a local shopping centre and the person that did it said that he needed to see his doctor. After a series of investigations, including blood tests and imaging investigations, he has surgery to remove a Conns tumour (adenoma of the adrenal gland which produces aldosterone). One of the blood tests was to measure renin activity and potassium concentrations. You expect the results to be:
What is the most effective measure to reduce the spread of infections?
What is the most effective measure to reduce the spread of infections?
Oestrogen therapy in postmenopausal women:
Oestrogen therapy in postmenopausal women:
Which of the following statements about the Masters & Johnson model of human sexual
response is the most accurate?
Which of the following statements about the Masters & Johnson model of human sexual response is the most accurate?
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A 25-year-old woman presents with thigh pain approximately monthly. This is most likely
explained by the fact that the ovary is irritating the:
A 25-year-old woman presents with thigh pain approximately monthly. This is most likely explained by the fact that the ovary is irritating the:
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Which of the following compounds decreases thyroid hormone levels by inhibiting the iodination of tyrosine?
Which of the following compounds decreases thyroid hormone levels by inhibiting the iodination of tyrosine?
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The most important ethical problem in performing a focus group on people’s experience of
depression is that:
The most important ethical problem in performing a focus group on people’s experience of depression is that:
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A 50-year-old man complains of decreased libido. On examination he is 178cm tall, weighs
90kg, with a normal distribution of body hair. His right visual field is restricted in the upper,
outer quadrant and he reports frequent headaches. A tumour secreting which of the following hormones most likely explains this situation?
A 50-year-old man complains of decreased libido. On examination he is 178cm tall, weighs 90kg, with a normal distribution of body hair. His right visual field is restricted in the upper, outer quadrant and he reports frequent headaches. A tumour secreting which of the following hormones most likely explains this situation?
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Sam is a 40-year-old teacher who presents to his GP for his annual health check. The GP
takes his blood pressure using the auscultatory method. The following will not affect the
reading taken:
Sam is a 40-year-old teacher who presents to his GP for his annual health check. The GP takes his blood pressure using the auscultatory method. The following will not affect the reading taken:
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Extrapyramidal symptoms (e.g. drug-induced Parkinsonism) caused by antipsychotic drugs like haloperidol and chlorpromazine are due to the blockade of
Extrapyramidal symptoms (e.g. drug-induced Parkinsonism) caused by antipsychotic drugs like haloperidol and chlorpromazine are due to the blockade of
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A girl starts to grow rapidly at the age of 7, and from that time is always the tallest girl in the class at school. Despite being tall she does not develop breasts or pubic hair, and at the age of 21 she is investigated for primary amenorrhoea and delayed puberty. A growth
hormone secreting tumour of her pituitary is identified. The most likely explanation for her delayed puberty is:
A girl starts to grow rapidly at the age of 7, and from that time is always the tallest girl in the class at school. Despite being tall she does not develop breasts or pubic hair, and at the age of 21 she is investigated for primary amenorrhoea and delayed puberty. A growth hormone secreting tumour of her pituitary is identified. The most likely explanation for her delayed puberty is:
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An 18-year-old woman requires a pudendal nerve block during childbirth. The best landmark
to palpate in order to direct the needle close to the nerve is the
An 18-year-old woman requires a pudendal nerve block during childbirth. The best landmark to palpate in order to direct the needle close to the nerve is the
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A 27-year-old male intravenous drug user presented to the emergency department with a cough persisting for 5 weeks and 7kg weight loss. He also complains of night sweats and loss of appetite. For the past 2 days he complained of coughing up blood-tinged sputum. Choose the single most likely organism that caused this.
A 27-year-old male intravenous drug user presented to the emergency department with a cough persisting for 5 weeks and 7kg weight loss. He also complains of night sweats and loss of appetite. For the past 2 days he complained of coughing up blood-tinged sputum. Choose the single most likely organism that caused this.
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A 33-year-old man was admitted with a 3-day history of high fever, dry cough and generalised malaise. He recently attended a business conference at a hotel in Philadelphia. Chest x-ray showed patchy, diffuse infiltrates. Gram stain of his respiratory specimens showed faintly stained Gram-negative rods that did not grow on routine culture media. Choose the single most likely organism that caused this.
A 33-year-old man was admitted with a 3-day history of high fever, dry cough and generalised malaise. He recently attended a business conference at a hotel in Philadelphia. Chest x-ray showed patchy, diffuse infiltrates. Gram stain of his respiratory specimens showed faintly stained Gram-negative rods that did not grow on routine culture media. Choose the single most likely organism that caused this.
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A female patient presents with a history of amenorrhoea and infertility associated with a lack of the sense of smell (anosmia). What abnormality of the hypothalamus is most likely to be associated with her problems:
A female patient presents with a history of amenorrhoea and infertility associated with a lack of the sense of smell (anosmia). What abnormality of the hypothalamus is most likely to be associated with her problems:
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Sally is a 75-year-old retired clerk who has just returned from a holiday in India. She has come to see her GP following frequent bouts of diarrhoea and vomiting. Which is the least reliable sign in assessing dehydration in Sally?
Sally is a 75-year-old retired clerk who has just returned from a holiday in India. She has come to see her GP following frequent bouts of diarrhoea and vomiting. Which is the least reliable sign in assessing dehydration in Sally?
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Which statement is incorrect regarding epithelioid macrophages in chronic inflammation?
Which statement is incorrect regarding epithelioid macrophages in chronic inflammation?
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A six-year-old boy presents with short stature, low weight, decreased bone age, low growth hormone, TSH, and cortisol. What is the most likely underlying diagnosis?
A six-year-old boy presents with short stature, low weight, decreased bone age, low growth hormone, TSH, and cortisol. What is the most likely underlying diagnosis?
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Which of the following is not one of the accepted criteria used to determine whole brain death?
Which of the following is not one of the accepted criteria used to determine whole brain death?
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Which of the following is correct regarding prevention of birth defects?
Which of the following is correct regarding prevention of birth defects?
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An 80-year-old man presents for regular aspiration of a scrotal hydrocele. Where should the needle be inserted?
An 80-year-old man presents for regular aspiration of a scrotal hydrocele. Where should the needle be inserted?
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An evidence-based review of studies found that the 5-year survival benefit of chemotherapy for the 22 major adult malignancies was approximately:
An evidence-based review of studies found that the 5-year survival benefit of chemotherapy for the 22 major adult malignancies was approximately:
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The mid-cycle surge of luteinizing hormone (LH) in the ovarian cycle is primarily driven by:
The mid-cycle surge of luteinizing hormone (LH) in the ovarian cycle is primarily driven by:
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The obturator artery is normally a branch of which of the following arteries?
The obturator artery is normally a branch of which of the following arteries?
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Borderline Personality Disorder is characterized by:
Borderline Personality Disorder is characterized by:
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The human ovarian cycle has the mid-cycle surge of luteinizing hormone (LH) as a prominent feature that results in ovulation. The major endocrine signal leading to the mid-cycle LH surge is:
The human ovarian cycle has the mid-cycle surge of luteinizing hormone (LH) as a prominent feature that results in ovulation. The major endocrine signal leading to the mid-cycle LH surge is:
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The obturator artery is normally a branch of which of the following arteries?
The obturator artery is normally a branch of which of the following arteries?
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Borderline Personality Disorder is characterized by:
Borderline Personality Disorder is characterized by:
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In pregnancy, delivery of oxygen from mother to fetus is facilitated by increased maternal:
In pregnancy, delivery of oxygen from mother to fetus is facilitated by increased maternal:
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Structure ‘E’ is most likely to be the vertebral body of:
Structure ‘E’ is most likely to be the vertebral body of:
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Spontaneous bleeding into which of the following sites is characteristic of a coagulation factor deficiency?
Spontaneous bleeding into which of the following sites is characteristic of a coagulation factor deficiency?
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Depression is a greater cause of DALYs (Disability-Adjusted Life Years) than severe dementia, despite dementia being a more severe form of disability, because of all but one of the following reasons:
Depression is a greater cause of DALYs (Disability-Adjusted Life Years) than severe dementia, despite dementia being a more severe form of disability, because of all but one of the following reasons:
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A patient being treated for depression is advised to avoid tyramine-containing foods (e.g., cheese, broad beans, preserved meat) if he is prescribed:
A patient being treated for depression is advised to avoid tyramine-containing foods (e.g., cheese, broad beans, preserved meat) if he is prescribed:
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Niki, a 60-year-old lady who is staying in residential care, has attended her GP due to fatigue in the last 3 months. Which of the following does not put her at risk of poor nutrition?
Niki, a 60-year-old lady who is staying in residential care, has attended her GP due to fatigue in the last 3 months. Which of the following does not put her at risk of poor nutrition?
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A woman is taking a third-generation, ultra-low dose monophasic combined oral contraceptive pill. She takes active pills from day 6 to 26 of her cycle, and her period commences on day 1. She forgets to take two pills. From the point of view of becoming pregnant, which of the following combinations of days of missing the pill most increases her risk?
A woman is taking a third-generation, ultra-low dose monophasic combined oral contraceptive pill. She takes active pills from day 6 to 26 of her cycle, and her period commences on day 1. She forgets to take two pills. From the point of view of becoming pregnant, which of the following combinations of days of missing the pill most increases her risk?
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Ross is a young, fit 20-year-old student who has been sitting in a lecture theatre for 2 hours. Which of the following is the major source of energy used by his skeletal muscles?
Ross is a young, fit 20-year-old student who has been sitting in a lecture theatre for 2 hours. Which of the following is the major source of energy used by his skeletal muscles?
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A 40-year-old man is in the hospital with terminal prostatic carcinoma. He has numerous metastases in his lumbar spine. This is because the prostatic venous plexus communicates with the internal vertebral venous plexus most likely via the:
A 40-year-old man is in the hospital with terminal prostatic carcinoma. He has numerous metastases in his lumbar spine. This is because the prostatic venous plexus communicates with the internal vertebral venous plexus most likely via the:
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Insulin is :
Insulin is :
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A man has a selective increase in inhibin production and secretion. What abnormalities of hypothalamic and pituitary hormone secretion would you expect to see?
A man has a selective increase in inhibin production and secretion. What abnormalities of hypothalamic and pituitary hormone secretion would you expect to see?
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A carcinoma originating in the breast:
A carcinoma originating in the breast:
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A 26-year-old woman presents with a six-month history of increasing agitation, sweating, weight loss, oligomenorrhea, and heat intolerance. Which of the following combination of hormone assay results are most likely, if the cause of her problems is at the anterior pituitary, rather than the thyroid gland?
A 26-year-old woman presents with a six-month history of increasing agitation, sweating, weight loss, oligomenorrhea, and heat intolerance. Which of the following combination of hormone assay results are most likely, if the cause of her problems is at the anterior pituitary, rather than the thyroid gland?
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With regard to systematic desensitization, the most appropriate target group for this program would be patients who:
With regard to systematic desensitization, the most appropriate target group for this program would be patients who:
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A child with cerebral palsy will always have:
A child with cerebral palsy will always have:
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A woman has a regular 28-day menstrual cycle, and she wishes to find out if she is ovulating. Which of the following would you advise as the most reliable method to determine if she has ovulated?
A woman has a regular 28-day menstrual cycle, and she wishes to find out if she is ovulating. Which of the following would you advise as the most reliable method to determine if she has ovulated?
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A week following a total thyroidectomy, a 32-year-old female notes marked numbness and tingling in her feet and hands. On examination, both Trousseau’s and Chvostek’s signs are positive. Which of the following is most likely to be the cause of this problem?
A week following a total thyroidectomy, a 32-year-old female notes marked numbness and tingling in her feet and hands. On examination, both Trousseau’s and Chvostek’s signs are positive. Which of the following is most likely to be the cause of this problem?
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Which statement is incorrect regarding “The Lyon Heart Diet Study”?
Which statement is incorrect regarding “The Lyon Heart Diet Study”?
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Which of the following statements on viral hepatitis is incorrect?
Which of the following statements on viral hepatitis is incorrect?
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A 60-year-old female patient presents with total fecal incontinence. She has given birth to 7 children. Pathology of which one of the following structures is most likely to be the cause of her symptoms?
A 60-year-old female patient presents with total fecal incontinence. She has given birth to 7 children. Pathology of which one of the following structures is most likely to be the cause of her symptoms?
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Which is true of atherosclerosis?
Which is true of atherosclerosis?
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The secretion of AVP from the posterior pituitary gland is regulated by blood volume (as detected by changes in blood pressure) and plasma osmolality. Which of the following scenarios is likely to be associated with the highest plasma arginine vasopressin concentrations?
The secretion of AVP from the posterior pituitary gland is regulated by blood volume (as detected by changes in blood pressure) and plasma osmolality. Which of the following scenarios is likely to be associated with the highest plasma arginine vasopressin concentrations?
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The most appropriate outcome measure to evaluate whether a law limiting junk-food advertising to children on television had been successful would be:
The most appropriate outcome measure to evaluate whether a law limiting junk-food advertising to children on television had been successful would be:
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The diagnosis of lower urinary tract infections is usually confirmed by:
The diagnosis of lower urinary tract infections is usually confirmed by:
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Which of the following statements about human pregnancy and parturition is most accurate?
Which of the following statements about human pregnancy and parturition is most accurate?
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Which of the following is the most valuable test to confirm (or exclude) a diagnosis of hypothyroidism?
Which of the following is the most valuable test to confirm (or exclude) a diagnosis of hypothyroidism?
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Which of the following is true in diabetic ketoacidosis?
Which of the following is true in diabetic ketoacidosis?
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The mechanism of action of bisphosphonates (e.g. alendronate) in the treatment of osteoporosis relates to their ability to:
The mechanism of action of bisphosphonates (e.g. alendronate) in the treatment of osteoporosis relates to their ability to:
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There have been many reported benefits for women taking hormone therapy after menopause. The currently accepted health benefits of hormone therapy include which one of the following:
There have been many reported benefits for women taking hormone therapy after menopause. The currently accepted health benefits of hormone therapy include which one of the following:
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An 8-year-old boy is brought in for surgical correction of ectopic testis (a testicle that has migrated away from the normal pathway of descent). The surgeon may find the ectopic testicle in the:
An 8-year-old boy is brought in for surgical correction of ectopic testis (a testicle that has migrated away from the normal pathway of descent). The surgeon may find the ectopic testicle in the:
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The human menstrual cycle is characterised by a proliferative phase followed by a secretory phase. The secretory phase of the human menstrual cycle is dependent upon:
The human menstrual cycle is characterised by a proliferative phase followed by a secretory phase. The secretory phase of the human menstrual cycle is dependent upon:
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Benzodiazepines produce the following effects except:
Benzodiazepines produce the following effects except:
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All clinically significant developmental disabilities:
All clinically significant developmental disabilities:
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Women are advised that if they miss taking the combined, low-dose, oral contraceptive pill for one or more days, they may get pregnant (and that the seven-day rule for alternative contraception should be applied). Why don’t they get pregnant when they stop taking the pill for the 7 days after each 21-day pill-taking cycle?
Women are advised that if they miss taking the combined, low-dose, oral contraceptive pill for one or more days, they may get pregnant (and that the seven-day rule for alternative contraception should be applied). Why don’t they get pregnant when they stop taking the pill for the 7 days after each 21-day pill-taking cycle?
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Sulphonylurea drugs (e.g. glibenclamide) promote insulin release from the pancreas by:
Sulphonylurea drugs (e.g. glibenclamide) promote insulin release from the pancreas by:
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Neuropeptide Y:
Neuropeptide Y:
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All of the following factors affect the rate of induction/recovery of anaesthesia with an inhaled anaesthetic agent except:
All of the following factors affect the rate of induction/recovery of anaesthesia with an inhaled anaesthetic agent except:
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A 70-year-old man presented with loss of weight, increasing lethargy, and a history of
drinking 2 bottles of wine and smoking 40 cigarettes daily for "many years". Preliminary
investigations show that he is hypercalcaemic and hypophosphataemic. This is most likely
to be due to:
A 70-year-old man presented with loss of weight, increasing lethargy, and a history of drinking 2 bottles of wine and smoking 40 cigarettes daily for "many years". Preliminary investigations show that he is hypercalcaemic and hypophosphataemic. This is most likely to be due to:
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With regard to Treponema pallidum infection:
With regard to Treponema pallidum infection:
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Which of the following is true about depression in old age?
A. It cannot be managed with psychosocial treatment alone
B. It has a strong biological aetiology compared with depression earlier in life
C. It is adequately detected in the community
D. It exacerbates comorbid medical conditions
E. It occurs less often in those who have experienced depression previously
Which of the following is true about depression in old age? A. It cannot be managed with psychosocial treatment alone B. It has a strong biological aetiology compared with depression earlier in life C. It is adequately detected in the community D. It exacerbates comorbid medical conditions E. It occurs less often in those who have experienced depression previously
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Which of the following side effects / drug pairings is not an example of a chemotoxic
(predictable) adverse drug reaction?
A. Liver toxicity / paracetamol
B. Excessive bleeding / heparin
C. Hypotension / prazosin
D. Cough / ACE inhibitor
E. Hypoglycaemia / insulin
Which of the following side effects / drug pairings is not an example of a chemotoxic (predictable) adverse drug reaction? A. Liver toxicity / paracetamol B. Excessive bleeding / heparin C. Hypotension / prazosin D. Cough / ACE inhibitor E. Hypoglycaemia / insulin
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Study Notes
Conns Syndrome
- Low renin activity
- Elevated potassium concentrations
Infection Control
- Hand hygiene is the most effective measure to reduce the spread of infections
Oestrogen Therapy
- Oestrogen therapy can increase the risk of breast cancer in postmenopausal women
Masters & Johnson Model
- The model describes four phases of the human sexual response cycle: excitement, plateau, orgasm, and resolution
Thigh Pain
- The ovary can irritate the round ligament of the uterus, causing thigh pain
Thyroid Hormone Inhibition
- Propylthiouracil (PTU) inhibits the iodination of tyrosine, thereby decreasing thyroid hormone levels
Focus Group Ethics
- The most important ethical problem in conducting a focus group on depression is the potential for harm to participants, especially if they are not adequately screened or supported
Decreased Libido and Visual Disturbances
- A pituitary tumor secreting prolactin is the most likely explanation for decreased libido, restricted upper outer quadrant visual field, and headaches
Blood Pressure Measurement
- The auscultatory method of blood pressure measurement is not affected by the presence of a stethoscope
Extrapyramidal Symptoms
- Extrapyramidal symptoms caused by antipsychotic drugs like haloperidol and chlorpromazine are caused by the blockade of dopamine receptors
Delayed Puberty
- Delayed puberty in a girl with a growth hormone-secreting pituitary tumor is likely due to the tumor's suppression of gonadotropin-releasing hormone (GnRH) production
Pudendal Nerve Block
- The ischial spine is the best landmark to palpate when performing a pudendal nerve block
Cough and Weight Loss
- Mycobacterium tuberculosis is the most likely organism causing cough, weight loss, night sweats, loss of appetite, and blood-tinged sputum in an intravenous drug user
Fever, Dry Cough, and Malaise
- Legionella pneumophila is the most likely organism causing fever, dry cough, malaise, and patchy, diffuse infiltrates on chest x-ray in a patient who recently attended a conference at a hotel in Philadelphia
Amenorrhea, Infertility, and Anosmia
- Kallmann syndrome, characterized by anosmia and hypothalamic hypogonadism, is the most likely cause of the patient's problems
Dehydration Assessment
- Skin turgor is the least reliable sign of dehydration in older adults
Epithelioid Macrophages
- Epithelioid macrophages are not multinucleated
Short Stature
- Growth hormone deficiency is the most likely underlying diagnosis in a six-year-old boy with short stature, low weight, decreased bone age, low growth hormone, TSH, and cortisol
Whole Brain Death
- Fixed and dilated pupils are not an accepted criterion for determining whole brain death
Birth Defects
- Folic acid supplementation can prevent neural tube defects
Scrotal Hydrocele Aspiration
- The needle should be inserted into the superior aspect of the hydrocele, avoiding the spermatic cord
Chemotherapy Survival Benefit
- The 5-year survival benefit of chemotherapy for the 22 major adult malignancies is about 2%
LH Surge
- The mid-cycle surge of luteinizing hormone (LH) is primarily driven by positive feedback from estradiol
Obturator Artery
- The obturator artery is normally a branch of the internal iliac artery
Borderline Personality Disorder
- Borderline Personality Disorder is characterized by instability in interpersonal relationships, self-image, and emotions, as well as impulsivity, self-harm, and intense fear of abandonment
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Description
This quiz covers a clinical scenario involving a patient with headache due to hypertension, ultimately diagnosed with Conn's tumor. It evaluates understanding of renin activity, aldosterone production, and potassium levels in blood tests. Dive deep into the endocrine system's role in this case.
