Medical
Browse, search and filter 3,531 questions.
3,531 questions
An 18-month-old boy is taken to his family doctor for evaluation of easy bruising and decrease range of motion of the right knee. On examination, he had multiple large ecchymoses, mostly in the lower extremities, and a right knee hemarthrosis. He has not had surgery or family history of a bleeding disorder. Initial blood tests reveal a prolonged activated partial thromboplastin time (aPTT) with a normal PT and platelet count. What further tests should be ordered to make a diagnosis in this boy?
Which of the following delusions would most likely be observed in a psychotically depressed person?
A23 year old female presents to the emergency department (ED) with "abdominal cramping" nausea, and vaginal bleeding. Ahuman chorionic gonadotropin (hCG) level returns 5150 mIU/mL. A vaginal probe ultrasound is performed and notes no evidence of an intrauterine pregnancy, normal appearing ovaries, a mild amount of fluid in the cul-de-sac, and no evidence of ectopic gestation. The ED physician can exclude which diagnosis from the differential?
A 31-year-old female presents to her physician complaining of rapid onset of hirsutism, deepening of the voice, irregular menses, clitoral enlargement, and acne. Which of the following is the most likely cause of this clinical presentation?
An 8-year-old boy suffers from compulsive eating, obesity, small stature, hypogonadism, and mental retardation. Which of the following is his most likely diagnosis? phenylketonuria
You are called to the ICU to see a 65-year-old female who is 2 days status post hip surgery. The medical team is concerned because the patient is having visual hallucinations and did not sleep last night. She scored 21/30 on a Mini-Mental Status Examination (MMSE) with 5 points off for disorientation and 2 off for both concentration and shortterm memory. The patient is restrained because she pulled out her IV last night. Records indicate she has no previous psychiatric history and that her cognitive functioning presurgery was normal. Which of the following is the most likely axis I diagnosis?
A 17-year-old female presents with delayed puberty. Her mother reports her daughter has never menstruated. On examination, the patient is 59 in. (4 ft 11 in.) tall and is shown in Figure. Which of the following tests is most likely to confirm the diagnosis?
You are called to the ICU to see a 65-year-old female who is 2 days status post hip surgery. The medical team is concerned because the patient is having visual hallucinations and did not sleep last night. She scored 21/30 on a Mini-Mental Status Examination (MMSE) with 5 points off for disorientation and 2 off for both concentration and shortterm memory. The patient is restrained because she pulled out her IV last night. Records indicate she has no previous psychiatric history and that her cognitive functioning presurgery was normal. Which of the following is not a predisposing factor for the above condition?
In order to prevent unintended pregnancy following an episode of unprotected intercourse, by when is it recommended that "emergency" oral contraception should be initiated?
A 56-year-old man with a dual diagnosis of schizophrenia and alcohol dependency was arrested for "driving under the influence." After 2 days in jail, he was noted to be acting agitated and "crazy," claiming that the guards were going to kill him that night. When questioned about his profuse sweating, he claimed that he had just come in from his job working in the heat and humidity. He was distracted by various noises, claiming that these were made by people watching him and waiting for him. He appeared to watch things that seemed to be moving on the walls. On further examination, it was noted that he was very tremulous, unable to follow an object with his eyes only, and quite ataxic. The working diagnosis at this point is most likely which of the following?
A 61-year-old female is diagnosed with osteoporosis by a screening dual-energy x-ray absorptiometry (DEXA) scan. Which of these is a risk factor for postmenopausal osteoporosis?
A 56-year-old man with a dual diagnosis of schizophrenia and alcohol dependency was arrested for "driving under the influence." After 2 days in jail, he was noted to be acting agitated and "crazy," claiming that the guards were going to kill him that night. When questioned about his profuse sweating, he claimed that he had just come in from his job working in the heat and humidity. He was distracted by various noises, claiming that these were made by people watching him and waiting for him. He appeared to watch things that seemed to be moving on the walls. On further examination, it was noted that he was very tremulous, unable to follow an object with his eyes only, and quite ataxic. Which of the following benzodiazepines can reliably be given intramuscularly to this patient to help control his symptoms?
A 5-year-old girl presents for evaluation of breast development, history of multiple bone fractures, and vaginal bleeding. Physical examination is notable for "café au lait" spots on her skin, tanner stage 2 breasts, and she appears tall for her age. What is the most likely cause of precocious puberty in this child?
A 25-year-old woman presents with a recurrent depression, and says she has taken many antidepressant medications from several different classes of drugs in the past. Which of the following atypical antidepressants is a presynaptic alpha-2 receptor noradrenergic antagonist and a 5-HT2 and 5-HT3 receptor serotonergic antagonist?
A39-year-old obese female presents with irregular menstrual periods, mild acne and hirsutism, and acanthosis nigricans on the nuchal fold, axilla, and intertriginous areas (inner upper thighs). You suspect PCOS. Which of the following laboratory tests would be most important to perform to rule out a likely confounding diagnosis?
A 60-year-old man disappears from his home and travels 100 miles to a small town, where he opens a small grocery store using a different name. Six weeks later, he awakens in some agitation, uses his original name, and asks to know where he is. He wishes to return to his home. Which of the following is the most likely diagnosis?
A 17-year-old female presents with primary amenorrhea. On physical examination, she has normal secondary sexual characteristics, scant pubic and axillary hair, and a blind ending vaginal pouch. Apelvic MRI indicates inguinal gonads and no uterus. Her karyotype is 46,XY. Which of the following is the most likely etiology of primary amenorrhea in this patient?
A 35-year-old woman comes into the ER after cutting her wrists for the 10th time. She did this after her boyfriend of 2 weeks left her yesterday. She reports a history of unstable interpersonal relationships, chronic feelings of emptiness, impulsive sexual relationships, and problems with her sense of identity. Which of the following is the most likely axis II diagnosis?
A15-year-old female presents to the emergency room (ER) with acute onset right lower quadrant pain and nausea. She recently became sexually active and is "in the middle" of her menstrual cycle. Physical examination is notable for generalized guarding, rebound, and 8/10 pain in both lower quadrants. A pelvic examination shows no vaginal discharge, a normal appearing cervix, and general pelvic tenderness, but the examination is limited by the patient's guarding. Her complete blood count is notable for a borderline elevated white blood cell (WBC) count, and a urinary -hCG is negative. Pelvic ultrasound shows a 2-cm simple appearing cyst on the right ovary and a mild amount of fluid in the cul-de-sac. Acomputed tomographic (CT) scan cannot definitively visualize the appendix, confirms the presence of a 2-cm cystic structure in the right ovary, and otherwise notes normal anatomy. Which of the following is the most appropriate next step?
A 35-year-old woman comes into the ER after cutting her wrists for the 10th time. She did this after her boyfriend of 2 weeks left her yesterday. She reports a history of unstable interpersonal relationships, chronic feelings of emptiness, impulsive sexual relationships, and problems with her sense of identity. The one psychotherapeutic technique to avoid would be: