internal med clinical mastery form 2 help pls!
42) 27 y/o previously healthy man came complaining of fatigue, loss of appetite for 2 weeks. mom has hemochromastosis. exam shows scleral icterus. liver edge smooth, palpebral
totl bili 4.4
alk phos 176
hepatitis b surface antigen negative
anti hepatitis b core antigen positive
anti hepatitis b surface antigen negative
what could have prevented jaundice?
a) abstinence from alcohol
b) hand washing
c) opthalmic screening for kayser flesicher rings
d) transferrin sat testing
e) administration of hepatitis b vaccine
overweight 65 y/o man smokes cigarettes daily. brother died of cva, both parents died in 40s. his bp is 150/102, grade 2 hypertensive retinopathy and pmi impulse 2cm lateral to mcl. as part of inital assessment, which lab assessment?
a) plasma renin acitivity
b) serum aldosterone concentration
c) measurement serum creatinine concentration
d) measurement urine metanephrine concentration
e) urine sodium/creatinine ratio
54 y/o woman w/ dm had sob and ankle swelling 3 weeks. she has nonproductive cough, discomfort when sleeping on fewer than 4 pillows. there is s3 w/ dullness to percussion, dec breath sounds at base right hemithorax. what is finding of pleural fluid?
a) erythrocyte count >15,000mm
b) glucose conc equal to serum glucose concentration
c) ldh > than or equal to 200
d) neutrophilic leuk count greater than 1000
e) protein concentration > or equal to 3
pls give explanations if possible thanks!
1) He probably is in the window period of Hepatitis infection...so e?.
2) Hypertension related complication..how did his parents die...anything mentioned?...i would go with serum creatinine...as renal morbidity is one of the significant for hypertension..?.
3)Definitely CHF...so a transudative PE...rules out c and e( both are for exudative PE)...not d as why there would be so many neutrophils..no fever either..not sure about a ...so i would go with b?..
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