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ABFM HOSPITAL MEDICINE exam with complete solutions 2024.
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ABFM HOSPITAL MEDICINE exam with complete solutions 2024.
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ABFM HOSPITAL MEDICINE exam withj j j j
complete solutions 2024
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A j42-year-old jconstruction jworker jwith ja j3-day jhistory jof jcough, jfever, jchills,
jdyspnea, jand jright jposterolateral jchest jpain jwith jinspiration jis jbrought jto jthe
jemergency jdepartment jby jhis jwife. jHe jhas jbeen jin jgood jhealth juntil jthis
jillness, jand jhas jnever jbeen jhospitalized. jHe jdoes jnot jtake jany jroutine
jmedications, jdoes jnot jsmoke, jand jdrinks jalcohol jonly joccasionally.On
jexamination jhe jappears jill jand jin jmild jrespiratory jdistress. jHis jtemperature jis
j40.3°C j(104.5°F), jpulse jrate j130 jbeats/min, jrespiratory jrate j32/min, jblood
jpressure j136/70 jmm jHg, jand joxygen jsaturation j88% jon jroom jair. jHe jhas
jdiminished jbreath jsounds jin jthe jright jposterolateral jchest. jHis jPneumonia
jSeverity jIndex jis j97. jBased jon jthe jseverity jof jhis jillness jyou jrecommend
jhospital jadmission.Antibiotic jchoices jrecommended jfor jempiric jtreatment jin
jthis jpatient jinclude jwhich jof jthe jfollowing? j(Mark jall jthat jare jtrue.)
Ceftriaxone j(Rocephin) jplus jazithromycin j- jANSWER✓✓-A, jB, jE
Relative jrisk jstratification jshould jbe jperformed jfor jpatients jwith jcommunity-
acquired jpneumonia, jusing ja jclinical jprediction jtool jsuch jas jthe jPneumonia
jSeverity jIndex j(PSI) jor jthe jCURB-65 j(SOR jA). jThese jtools jcan jbe jused jalong
jwith jthe jjudgment jof jthe jphysician jto jdecide jwhether jor jnot ja jpatient jcan jbe
jtreated jas jan joutpatient jor jshould jbe jadmitted jto jthe jhospital. jThis jpatient jis
jmoderately jill jand, jbased jon jhis jpresentation, jhas ja jPSI jscore jof j97 j(based jon
jhis jage, jrespiratory jrate, jtemperature, jand jpulse joximetry). jThis jscore jindicates
jthat jhe jshould jinitially jbe jtreated jin jthe jhospital.A jmacrolide jplus ja jβ-lactam jis
jrecommended jfor jcombination jtherapy jin jpatients jhospitalized jwith
jcommunity-acquired jpneumonia jwho jare jat jlow jrisk j(PSI jscore jof j71-130) j(SOR
jA). jIn jaddition jto ja jβ-lactam, jdoxycycline jcan jbe jused jas jan jalternative jto ja
jmacrolide j(SOR jB). jA jrespiratory jfluoroquinolone j(levofloxacin, jgemifloxacin,
jmoxifloxacin) jcan jbe jused jas jmonotherapy j(SOR jA). jBecause jof jconcerns
jabout jincreasing jlevels jof jresistance, jmacrolides jare jnot jrecommended jas
jmonotherapy jfor ja jmoderately jill jpatient j(SOR jC). jCiprofloxacin, ja jfirst-
generation jquinolone, jhas jno jantimicrobial jactivity jagainst jStreptococcus
jpneumoniae jand jis jtherefore jnot jappropriate jtreatment jfor jcommunity-acquired
jpneumonia j(SOR jC).
, A j32-year-old jnonpregnant jfemale jwith ja jhistory jof jpoorly jcontrolled jtype j2
jdiabetes jmellitus jis jadmitted jto jthe jhospital jfor jabdominal jwall jcellulitis. jOn
jhospital jday j2 jshe jdevelops jmild jshortness jof jbreath. jHer jphysical
jexamination jis jnormal, jwith jthe jexception jof ja jrespiratory jrate jof j22/min jand
jabdominal jwall jerythema, jwarmth, jand jtenderness. jLaboratory jfindings jare
jnormal jwith jthe jexception jof ja jfasting jblood jglucose jlevel jof j268 jmg/dL jand
jmild jleukocytosis. jHer jD-dimer jlevel jis j250 jng/mL.True jstatements jregarding
jthe juse jof jthe jD-dimer jassay jfor jdiagnosing jpulmonary jembolism jin jthis
jsituation jinclude jwhich jof jthe jfollowing? j(Mark jall jthat jare jtrue.)
It jhas jgood jsensitivity
It jhas jgood jspecificity
It jhas ja jgood jpositive jpredictive jvalue
It jhas ja jgood jnegative jpredictive jvalue j- jANSWER✓✓-A, jD
D-dimer jis ja jdegradation jproduct jof jcross-linked jfibrin. jThe jPIOPED jII
jinvestigators jrecommend jstratification jof jall jpatients jwith jsuspected
jpulmonary jembolism jaccording jto jan jobjective jclinical jprobability jassessment.
jD-dimer jshould jbe jmeasured jby ja jquantitative jrapid jenzyme-linked
jimmunosorbent jassay j(ELISA), jand jthe jcombination jof ja jnegative jD-dimer jwith
ja jlow jor jmoderate jclinical jprobability jcan jsafely jexclude jpulmonary jembolism
jin jmany jpatients. jThe jsensitivity jof jthe jD-dimer jassay jis j90%-95% jfor
jpulmonary jembolus, jbut jD-dimer jlevels jare jnormal jin jonly j40%-68% jof jpatients
jwithout jpulmonary jembolus j(SOR jA). jA jD-dimer jvalue j>500 jng/mL jis
jconsidered jto jbe jabnormal. jValues j≤500 jng/mL jhave ja jhigh jnegative jpredictive
jvalue jfor jpulmonary jembolism jin jpatients jwith ja jlow jto jmoderate jpretest
jprobability j(SOR jA).
A j58-year-old jmale jwith jtype j2 jdiabetes jmellitus jundergoes jelective jknee
jsurgery. jAfter jthe jsurgery jhe jis jrestarted jon jall jof jhis jusual jmedications jwith
jintensive jglucose jmonitoring. jOn jhis jfirst jpostoperative jday jhe jis jfound jto jbe
jconfused jand jlethargic jwith ja jblood jglucose jlevel jof j32 jmg/dL.When jused
jalone, jwhich jof jthe jfollowing jdiabetes jmedications jcan jcause jthis jproblem?
j(Mark jall jthat jare jtrue.)
Nateglinide j(Starlix)
Glipizide j(Glucotrol)
Insulin jglargine j(Lantus)
Metformin j(Glucophage)
Pioglitazone j(Actos) j- jANSWER✓✓-A, jB, jC
Some jdiabetes jmedications jcan jlead jto jhypoglycemia jin jhospitalized jpatients.
jBoth jnateglinide jand jglipizide jstimulate jinsulin jproduction, jwhich jcan jlead jto
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