Answer 50

50.  Choice C is the correct answer.  Pulmonary Stenosis is usually congenital and sometimes caused by rheumatic fever.  It has a systolic murmur.  Pulmonic regurgitation is caused by pulmonary hypertension not pulmonic stenosis.

Question 50

50.  Which of the following is not true about pulmonic stenosis?

A.  Systolic murmur
B.  Usually congenital
C.  Caused from pulmonary hypertension
D.  Rheumatic fever sometimes causes pulmonic stenosis

Answer 49

49.  Choice B is the correct answer.  Temporal arteritis presents in older patients usually with unilateral headache, vision disturbance and elevated ESR.  Definitive diagnosis is made with temporal artery biopsy.  Temporal arteritis is treated with corticosteroids.  Migraine headache would not give you an elevated ESR.  Some patients get vision changes with their migraines.  It is concerning if this is a new type of headache.  Pseudotumor Cerebri gives more of a diffuse headache and vision changes are on both sides because of edema around the optic nerve.  

Question 49

49.  Your patient is a 58 year old female that presents with right sided headache and blurry vision out of right eye.  Her CT scan of her head is normal.  CBC is normal.  ESR is 105.  Which of the following is the most likely diagnosis?

A.  Migraine Headache
B.  Temporal Arteritis
C.  Multiple Sclerosis
D.  Pseudotumor Cerebri

Answer 48

48.  Choice C is the correct answer.  Restrictive cardiomyopathy is a diastolic problem with small ventricles.  It can involve one or both ventricles.  Sometime presents with right heart failure.  The most common cause is amyloidosis.  A key characteristic is that the systolic function is normal.  Will see elevated right heart pressures.

Question 48

48.  Your patient is a 54 year old male with shortness of breath with exertion and orthopnea.  His ejection fraction is 35%.  His physical exam reveals JVD.  His lungs are clear.  His ECHO reveals elevated ventricular filling pressure, diastolic impairment but normal systolic function.  Which of the following is the correct diagnosis?

A.  Dilated Cardiomyopathy
B.  Hypertrophic Cardiomyopathy
C.  Restrictive Cardiomyopathy
D.  None of the above

Answer 47

47.  Choice C is the correct answer.  Alcohol is not considered a risk factor for DVT.  Lupus anticoagulant, central venous catheters, malignancy, pregnancy, surgery, immobility, trauma, and lupus anticoagulant are considered some of the risk factors for DVT.

Question 47

47.  Which of the following is not consider a risk factor for DVT?

A.  Lupus anticoagulant
B.  Central venous catheters
C.  Malignancy
D.  Alcohol

Answer 46

46.  Choice B is the correct answer.   Superficial thrombophlebitis is treated with NSAIDs.  They help with the inflammation of the vein and help with pain.  Coumadin is not necessary because the clot is in the superficial vein and there is valve to keep it from moving.  The body's endogenous TPA helps redissolve the clot.  Plavix is really for arterial problems and not venous.  Keflex is used is there is an associated infection suspected.

Question 46

46.  Your patient is a 46 year old male that present with pain in RLE.  Physical exam reveals a firm tender cord at affected vein.  Doppler of right lower extremity confirms superficial thrombophlebitis or that affected vein.  Which of the following is the best management option?

A.  Start Coumadin
B.  Start Naprosyn
C.  Start Plavix
D.  Start Keflex