Test 7
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A young man is brought to the Emergency Department in an anxious and agitated state. He informed the doctor that he had taken a "street drug" that he had injected himself with about 12 hours earlier. After an initial episode of contentment and relaxation, he is now experiencing shaking and muscle pain and vomiting. Its symptoms include hyperventilation and hyperthermia. The doctor notices that his pupils are more dilated than normal. What is the most likely cause of these symptoms?

  • Symptoms and signs are suggestive of opioid withdrawal syndrome (correct)
  • The patient has overdosed on an opioid
  • These are early signs of toxicity resulting from contamination of "street heroin"
  • The patient injected himself with dextroamphetamine
  • The patient has hepatitis B
  • A 66-year-old female has develops a rash shortly after being started on sulfamethoxazole. Which of the following medications might cause a similar rash in this patient?

  • Naproxen
  • Celecoxib (correct)
  • Aspirin
  • Indomethacin
  • A 46-year-old man has Cushing's syndrome due to an adrenal tumor. Which of the following drugs can reduce the symptoms of this disease?

  • Ketoconazole (correct)
  • Fludrocortisone
  • Cortisol
  • Betamethasone
  • Triamcinolone
  • A 39-year-old man presented to the healthcare provider with generalized tonic-clonic seizures. He has a history of epilepsy and has been on carbamazepine for the last 15 years without any seizures. His sister said he recently started taking another medication, but she cannot recall the name. Which of the following drug is the patient most likely taking?

    <p>St. John wort</p> Signup and view all the answers

    A patient is prescribed heparin sodium 18 units/kg/h with titration according to protocol. The patient weighs 56 kg. Available with heparin 25,000 units/250 ml (100 units/ml). What is the infusion rate in ml/h?

    <p>10 ml/h</p> Signup and view all the answers

    A 39-year-old woman presents as a new patient for weight loss management. She works as a nursing aide at a long-term care facility. She reports missing several days of work recently due to low back pain flare-ups and is concerned that her coworkers may feel resentful because they are short-staffed on her missed days. She says her weight is "connected" to her low back pain. She informs the clinician that she would like to lose weight. However, she declines a dietician referral, saying, "I've tried lots of different diets, but they never work for me. I gain all of the weight right back." She then asks for additional information regarding weight loss. According to the transtheoretical model of change, this patient is in what stage of change concerning weight loss?

    <p>Contemplation</p> Signup and view all the answers

    The following graph shows the elimination time course obtained after giving a 320 mg dose of a drug by either i.v. or oral routes. From the data shown, the drugs elimination clearance is:

    <p>17.5 L/hr</p> Signup and view all the answers

    A 35-year-old woman presents to the clinic with changes in her bowel habits after being prescribed antibiotics for a urinary tract infection. She states her bowels have been loose and greater than 3 times a day. On physical exam, her abdomen appears normal and is non-tender to palpation, and she currently has hyperactive bowel sounds. Which of the following probiotics would be most appropriate for her condition?

    <p>Lactobacilli</p> Signup and view all the answers

    A 65-year-old man with a past medical history of hypertension, type 2 diabetes, and erectile dysfunction presents to the office for a follow-up. His home medications are metformin and nebivolol. He complains of a dull type of headache that is diffusely present. He denies aura, photophobia, blurry vision, and nasal congestion. He denies any stress at work or in his personal life. His last eye exam was one month ago, and it was completely normal. His vital signs are stable. His physical exam is within normal limits. What is the most likely cause of his headache?

    <p>Drug side effect</p> Signup and view all the answers

    A 26-year-old construction worker is brought to the emergency department after suffering a lacerated and broken right index finger. Prior to cleansing the wound and applying stitches, the EM physician decides to inject a local anesthetic agent to dull the pain. Which of the following would be contraindicated for use in a local anesthetic solution for this patient's condition?

    <p>epinephrine</p> Signup and view all the answers

    A 45-year old man who suffered a serious injury to his forearm requires surgery. The patient has a history of poorly controlled hypertension, type 2 diabetes, and angina, which makes the use of general anesthesics unacceptably risky. The anesthesiologist therefore decides to produce a regional block of the axillary brachial plexus with a local anesthetic prior to surgery. However, the patient's medical history indicates a severe allergy to ester-type anesthetics. Which of the following would be the best choice for use in this patient's procedure?

    <p>lidocaine</p> Signup and view all the answers

    A young patient with bipolar disorder is prescribed risperidone. About which side effect the patient should be informed

    <p>Frequent urination</p> Signup and view all the answers

    Recently widowed 76-year-old woman was treated with benzodiazepines for several weeks after the death of her husband, but did not like the daytime sedation she received even with low doses. She lives independently and has no significant illnesses, but appears frail for her age and has poor eyesight. Since her depressive symptoms are not abating, you decide to prescribe an antidepressant. Which of the following medications is most appropriate for this patient?

    <p>Citalopram</p> Signup and view all the answers

    A 33-year-old woman tried to induce an abortion by taking ergotamine. She was admitted to the Emergency Department with severe pain in both legs. On examination, her legs are cold and pale, and there is no arterial pulse. Which of the following is an antidote that can reverse the vasospastic effect of ergotamine?

    <p>Nitroprusside</p> Signup and view all the answers

    A 16-year-old boy with a seizure disorder presents to the hospital with a history of severe joint pain, fever, and fatigue. On examination, he has a low-grade fever, and his vitals are blood pressure 135/85 mmHg, heart rate 89 bpm, and respiratory rate 19 breaths/min. His seizures have been controlled with phenytoin for the past few years. The autoimmune assay is positive for ssDNA, anti-histones, and ANA. What is the most likely diagnosis?

    <p>Drug-induced lupus erythematosus</p> Signup and view all the answers

    A patient begins treatment with an antiepileptic drug for idiopathic epilepsy and asks how long he will have to take the drug. Which answer is most appropriate?

    <p>You will need to take anti-epileptic medicine for the rest of your life</p> Signup and view all the answers

    Clarithromycin 0.25 g orally twice a day was prescribed. Clarithromycin oral suspension 125 mg/5 ml is available. How many milliliters should be administered after the medicine is dissolved according to the directions given in the patient leaflet.

    <p>10 ml</p> Signup and view all the answers

    A researcher wants to evaluate the development of infants with cerebral palsy born to diabetic mothers. The researcher will use the world health organization (WHO) growth standards for boys and girls by collecting information on weight, height, age, and sex. The children will be observed from birth to the age of 5 years. What kind of study is this?

    <p>Cohort study</p> Signup and view all the answers

    This graph illustrates the dose-response relationship for the effect of the beta agonist isoproterenol on an isolated perfused heart, both alone and in the presence of different fixed concentrations of Drug X. Based upon the data shown, Drug X is most likely a(n):

    <p>competitive antagonist</p> Signup and view all the answers

    A 28-year-old man presents to his primary care provider for a wellness visit. He states that he is healthy in general and has no complaints. He occasionally drinks 1 or 2 beers and has smoked 10 cigarettes daily for 6 years. He has tried quitting a few times; however, he was unsuccessful. His vitals are temperature 98.0 °F (36.7 °C), blood pressure 124/83 mmHg, heart rate 84 bpm, respirations 11 breaths/min, and oxygen saturation 97% on room air. Physical examination reveals a healthy man with no abnormal findings. The patient asks for help quitting smoking cigarettes, and the provider prescribes a ganglionic cholinergic-receptor agonist in the form of gum to aid the patient in cessation. Which of the following recommendations should be given to this patient regarding medication use?

    <p>Discard the gum after 30 minutes and avoid drinking acidic beverages for 1 to 2 hours before chewing the gum.</p> Signup and view all the answers

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