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Get BrainX Digital Learning System: Internal Medicine Board PDF

By Conrad Fischer

ISBN-10: 0974160423

ISBN-13: 9780974160429

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Extra resources for BrainX Digital Learning System: Internal Medicine Board Practice Exams (2003)

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9 mg/dL. An EKG shows a sinus rhythm with left ventricular hypertrophy. Chest x-ray shows cardiomegaly and increased vascular congestion. 2 mg/dL. Echocardiogram shows left ventricular hypertrophy and an ejection fraction of 57%. What is the next step in management in the management of this patient? (A) Increase the dose of furosemide (B) Restrict salt and fluids and reschedule a return appointment in four weeks (C) Increase the dose of ACE inhibitors (D) Add digoxin (E) Start the patient on carvedilol Answer: (E) Start the patient on carvedilol Explanation: This patient has congestive heart failure (CHF) due to diastolic dysfunction secondary to chronic hypertension, with no mention of left ventricular (LV) systolic dysfunction.

When standing, his blood pressure becomes 148/80, and pulse becomes 98/min. Heart and lung sounds are normal, and his abdomen is benign. Rectal examination reveals a trace guaiac-positive stool. 5 mg/dL; hematocrit 31%; platelets 320,000/mm3. 2 mg/dL EKG: no new ST-T wave abnormalities, no Q waves Chest x-ray: borderline cardiomegaly What is the next best step in the management of this patient? (A) Ferrous sulfate (B) Blood transfusion (C) Colonoscopy (D) Increase the erythropoietin dose (E) Bone marrow biopsy Answer: (C) Colonoscopy Explanation: This patient has an anemia of chronic disease from renal failure as well as iron deficiency.

In fact, cardioversion without anticoagulation is contraindicated because it might allow another embolus to develop. If the patient did not have the atrial arrhythmia, then aspirin alone would be useful. Coumadin should be started in addition to the heparin. As a single agent, the effect of coumadin would not be rapid enough. Topic: Cardiology Record # 32 Question/Fact: A 40-year-old woman presents with severe epigastric pain, nausea, and vomiting. The pain began suddenly and radiates to the back.

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BrainX Digital Learning System: Internal Medicine Board Practice Exams (2003) by Conrad Fischer


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