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3,531 questions
You are evaluating a journal article describing a test for the diagnosis of congestive heart failure (CHF). In the study described, 250 consecutive patients were given the test. Of the 250 subjects, 106 tested positive for CHF and 144 tested negative. All 250 subjects were then evaluated by expert cardiologists who were blinded to the results of the experimental test. These cardiologists determined that of the 106 persons who tested positive, 95 actually had CHF. Further, the cardiologists found that of the 144 who tested negative, 2 truly had CHF. What is the sensitivity of this test for the diagnosis of CHF?
With reference to the above patient, you tell her that her expected delivery date (EDD) is which of the following? May 18
A 58-year-old man is establishing care with you because his insurance changed. His old records have not yet arrived, but he is complaining of palpitations and lightheadedness, so you order the ECG shown in Figure What is the underlying abnormality?
A recent study compared two drugs--exemestane and tamoxifen--for the treatment of estrogenreceptor positive breast cancer in postmenopausal women. At the end of the study, 91.5% of the women treated with the drug exemestane and 86.8% of the women treated with tamoxifen were disease free (P < 0.001). What is the number needed to treat (NNT) with exemestane compared to tamoxifen to prevent one breast cancer recurrence?
A 30-year-old woman who has been human immunodeficiency virus (HIV) positive for 4 years was recently diagnosed with AIDS. Which of the following meets the criteria for the case definition?
A recent study compared two drugs--exemestane and tamoxifen--for the treatment of estrogenreceptor positive breast cancer in postmenopausal women. At the end of the study, 91.5% of the women treated with the drug exemestane and 86.8% of the women treated with tamoxifen were disease free (P < 0.001). What is the absolute risk reduction (ARR) for the development of recurrent breast cancer for women taking exemestane compared to women taking tamoxifen?
A54-year-old woman with diabetes is noted to have BP in the range of 140/90 mmHg on several occasions. Which of the following is the best next step in management? initiate antihypertensive therapy
A recent study compared two drugs--exemestane and tamoxifen--for the treatment of estrogenreceptor positive breast cancer in postmenopausal women. At the end of the study, 91.5% of the women treated with the drug exemestane and 86.8% of the women treated with tamoxifen were disease free (P < 0.001). What is the relative risk reduction for the development of recurrent breast cancer for women taking exemestane compared to women taking tamoxifen?
While examining a 46-year-old woman, you hear a diastolic murmur that is increased when the patient is in the left lateral decubitus position. You ask her to run in place for 3 minutes, and the murmur is found to be accentuated as well by exercise. What is the most likely valvular defect?
A recent study compared two drugs--exemestane and tamoxifen--for the treatment of estrogenreceptor positive breast cancer in postmenopausal women. At the end of the study, 91.5% of the women treated with the drug exemestane and 86.8% of the women treated with tamoxifen were disease free (P < 0.001). What is the relative risk of developing recurrent breast cancer in a woman treated with exemestane compared to a woman treated with tamoxifen?
A 75-year-old man who developed diabetes within the last 6 months was found to be jaundiced. He has remained asymptomatic, except for weight loss of about 10 lbs in 6 months. On physical examination, he is found to have a nontender, globular, right upper quadrant mass that moves with respiration. A CT scan shows enlargement of the head of the pancreas, with no filling defects in the liver. What is the most likely cause of his painless jaundice?
A42-year-old male presents to the office for a refill of the nasal steroid medication that he uses every spring to control his allergies. You notice on the vital signs taken by the nurse that his blood pressure is 150/95. Except for some sneezing and nasal congestion, the patient has no symptoms. He has no other medical history and his only medication is a nasal steroid. He does not smoke cigarettes, does not drink alcohol, and does not exercise. His body mass index is 24 kg/m2. Of the options listed, which would be the most appropriate management at this point?
A22-year-old man complains of low back pain and stiffness that is worse on arising and improves with exercise. On examination, he is found to have limited mobility of the sacroiliac joints and lumbar spine. A serum test for histocompatibility antigen HLA-B27 is positive. What is the most common extraskeletal manifestation of this disease?
A42-year-old male presents to the office for a refill of the nasal steroid medication that he uses every spring to control his allergies. You notice on the vital signs taken by the nurse that his blood pressure is 150/95. Except for some sneezing and nasal congestion, the patient has no symptoms. He has no other medical history and his only medication is a nasal steroid. He does not smoke cigarettes, does not drink alcohol, and does not exercise. His body mass index is 24 kg/m2.
Which of the following is a degenerative disease of the central nervous system (CNS) caused by infectious proteins called prions?
A 57-year-old man complains of worsening headache, nausea, and vomiting for 2 months. On examination, he is lethargic, confused, and has right-sided weakness. While waiting for a computed tomography (CT) scan, he develops status epilepticus, suffers cardiorespiratory arrest, and dies. His brain at autopsy is shown in the figure below. Which of the following is the most likely diagnosis? glioma
A dentist asks you to evaluate a 42-year-old woman before tooth extraction. In patients who are not intravenous (IV) drug users and who do not have prosthetic valves, which of the following organisms is the most common cause of bacterial endocarditis?
A 40-year-old male comes to your office as a new patient to get established for care, as he recently moved into your city from another state. He has been on medical therapy for type 2 diabetes mellitus for 3 years and has had good glycemic control. He takes metformin 500 mg bid and reports having fasting glucose levels of less than 100 on home monitoring. He has records from his previous physician that show that he had a dilated eye examination 6 months ago that was normal and a hemoglobin A1C (HgbA1C) level of 6.2 that was taken 3 months ago. He has no known history of coronary artery disease. His last fasting lipid measurement was 14 months ago. You order a fasting lipid panel today and get the following results: Total cholesterol: 235 mg/dL Triglycerides: 210 mg/dL HDL cholesterol: 45mg/dL LDL cholesterol: 162 mg/dL He states that he has not had any immunizations in "longer than I can remember." Which of the following would be recommended for him?
A 47-year-old man with diabetes and hypertension travels with his family to Mexico. The next morning after eating out at a local restaurant and despite drinking bottled water, he develops severe crampy abdominal pain and watery, frequent diarrhea. Which of the following is the best approach for his care?
A 40-year-old male comes to your office as a new patient to get established for care, as he recently moved into your city from another state. He has been on medical therapy for type 2 diabetes mellitus for 3 years and has had good glycemic control. He takes metformin 500 mg bid and reports having fasting glucose levels of less than 100 on home monitoring. He has records from his previous physician that show that he had a dilated eye examination 6 months ago that was normal and a hemoglobin A1C (HgbA1C) level of 6.2 that was taken 3 months ago. He has no known history of coronary artery disease. His last fasting lipid measurement was 14 months ago. You order a fasting lipid panel today and get the following results: Total cholesterol: 235 mg/dL Triglycerides: 210 mg/dL HDL cholesterol: 45mg/dL LDL cholesterol: 162 mg/dL The patient follows up in 2 months and has been compliant with your recommendations. Results of a repeat fasting lipid panel are as follows: Total cholesterol: 160 mg/dL Triglycerides: 140 mg/dL HDL cholesterol: 48 mg/dL LDL cholesterol: 98 mg/dL Your recommendations for today include which of the following?