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3,531 questions
Identify the following personality disorders with the symptoms listed below. Chronic feelings of emptiness, fear of abandonment; unstable self-image antisocial avoidant borderline dependent histrionic
A 50-year-old slaughterhouse worker complains of intermittent episodes of fever, malaise, weakness, and weight loss over the past several months. Several of his coworkers have experienced flu-like symptoms since last winter. Which of the following statements about his illness is correct?
You participate in the global effort to eradicate poliomyelitis. A poliomyelitis outbreak has been identified in a community in Africa. You advise your outbreak investigation team that they must focus on transmission from which one of the following sources?
A27-year-old female whose father had a colon resection for adenocarcinoma undergoes her first colonoscopy. Over 100 small polyps are seen distributed mainly in her sigmoid and rectum. Multiple polyps are removed and histologic review reveals tubular adenomas with no evidence of atypia or dysplasia. The most appropriate next step in her management is which of the following?
A 24-year-old White (G1P1001) female presents to your office 6 weeks after a normal spontaneous vaginal delivery at term. She reports that she has been unable to breast-feed her baby despite helpfrom her pediatrician and a lactation consultant. On further questioning, you elicit that she has also experienced nausea, weakness, and weight loss. In addition, she reports dizziness when getting out of bed in the morning. On your examination, she has a waxy texture to her skin and periorbital edema. You also note decreased axillary and pubic hair, which she reports is a change for her. This condition is most commonly associated with which of the following?
A 12-year-old girl has had a sore throat over 2 days. She now has a fever of 39.5°C and has difficulty opening her mouth, swallowing, or speaking. Her throat can be visualized with difficulty, the right tonsil is significantly more enlarged than the left, and the uvula is displaced to the left side. Which of the following is the most likely diagnosis?
A 58-year-old woman with a history of chronic paranoid schizophrenia, who has been continuously treated with antipsychotics for the past 20 years, lives in a community-based residential facility. She has recently suffered an increase in auditory hallucinations, and her haloperidol dose has been increased from 2.5 to 10 mg/day. Four days later, she is brought by a visiting nurse to the emergency room, where she presents with confusion, marked flexor and extensor rigidity in her legs and arms, and a temperature of 103.5°F. Her bl ood pressure is160/120 mmHg, her pulse is 120/min and irregular. Which of the following is the most likely diagnosis that best describes this woman's current condition? neuroleptic malignant syndrome (NMS)
A 4-year-old child manifests symptoms of fever, sore throat, and swollen lymph nodes. The spleen tip is palpable. Throat culture and rapid slide (Monospot) test results are negative. The next logical diagnostic procedure would involve which of the following?
A2-year-old child is brought to the emergency department with sudden onset of nresponsiveness, miosis, bradycardia, and muscle fasciculations. These findings are most suggestive of poisoning with which of the following? acetaminophen
Identify the most likely diagnosis with the case descriptions below. A 23-year-old violinist reports to his neurologist that he thinks he has had a stroke. He is unable to feel anything with his left fingers and is barely able to hold down the violin strings with this same hand because of "paralysis." The numbness he describes reaches to his wrist only, and he "even feels a band" around the wrist delineating the sensitive from the insensitive areas. body dysmorphic disorder conversion disorder factitious disorder
A45-year-old woman, seen by her medical internist, has been experiencing fears that she may have a serious illness. She complains that after eating she experiences "a lot of gas" and abdominal pain, followed by diarrhea on occasion. Her heart at times seems to be beating rapidly, and she feels faint at times, has chest "discomfort," and wonders if she is having a heart attack. Multiple tests have identified only a mild irritable bowel syndrome. The woman's fears are not allayed by this. She makes repeated calls to be seen by her doctors as well as seeking consultation from other specialists. She insists that "there's something there" and believes the doctors are not taking her seriously. Which of the following is the most effective long-term management of this patient?
A 13-year-old boy presents for evaluation of short stature. His growth chart from ages 2 through 12 years is shown in Figure. His growth in the first 2 years of life was typically at the 25th percentile. He has been healthy, has a good appetite, and is doing well in school. He lives with his parents and is an only child. His parents' heights are both at the 50th percentile. His father states that he grew several inches after he completed high school. A complete physical examination is normal. His Tanner stage is I Which of the following tests is the most appropriate next step in the care of this patient?
A38-year-old woman presents to the ER with heavy vaginal bleeding. A pelvic examination using a speculum to visualize the cervix reveals a large, friable, fungating cervical mass. On bimanual examination, the mass extends to the right pelvic sidewall. A biopsy from a recent gynecologic visit reveals invasive squamous cell carcinoma of the cervix. An abdominal/pelvic CT scan shows enlarged pelvic lymph nodes and right hydronephrosis. Her hematocrit (HCT) in the ER is 24%, but she is hemodynamically stable with a BP of 124/70 and a pulse of 73. The cervical mass is actively bleeding. Your initial treatment of the vaginal bleeding in the ER only partially controls the bleeding, and she is requiring frequent retreatment. The best definitive treatment to control the bleeding at this time is which of the following?
A 16-year-old girl presents with a history of primary amenorrhea. On examination, short stature and a short neck with a low posterior hairline are noted. Chromosomal analysis most likely would reveal which of the following?
A beekeeper's previously healthy 6-month-old son develops gradual onset of lethargy, poor feeding, constipation, and generalized weakness. On taking a history, you determine that the child has recently been placed on a homemade formula consisting of evaporated milk, water, and honey. Which of the following is the most likely explanation for this symptom complex?
A 12-month-old patient has allergies to multiple foods. The child's mother has eliminated the foods from the diet and wants to know if these allergies will be lifelong. You tell her that some allergies do get better if the food is eliminated for 12 years. In which of the following is the allergy most likely to resolve, with elimination of the food from the diet?
Which of the following is characteristic of Hirschsprung's disease?
A 25-year-old male comes to the ER after a motor vehicle collision, complaining of vague left-sided abdominal pain. After initial evaluation, a CT of the abdomen is obtained as shown in Figure. Which of the following statements is true concerning the injury?
A 2-year-old boy presents with refusal to use his right arm for 1 day. He is otherwise well.His mother states she pulled upward on his arm the previous evening to keep him from tripping down the stairs. Which of the following is the most likely diagnosis?
A 4-year-old child presents with an enlarged submandibular node that is 4 cm in diameter, nontender, and not fluctuant. The node has been enlarged for about 4 weeks, and there is no history of fever or contact with any person who was ill. A CBC is normal, and a Mantoux test with 5 tuberculin units of PPD shows 6 mm of induration. Which of the following is the most likely diagnosis?