34-year-old woman who recently immigrated to the United States from China has laboratory tests


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34-year-old woman who recently immigrated to the United States from China has laboratory tests performed prior to entering

nursing school. The patient has no known past medical history and takes no medications. She is currently in a monogamous

relationship and does not use illicit drugs. The patient believes she is up-to-date with all of her immunizations. She brings the

following report with her to the clinic.

HBsAg Negative

Anli-HBs Positive

Anti-HBC Positive

HBeAg Negative

Anti- HBe Negative

Which of the following is the appropriate interpretation of these serological test results?

  • 0 A Acute hepatitis B infection
  • Q 8. Chronic hepatitis B infection
  • Q C. Recovery phase of hepatitis B infection
  • Q 0. Resolved hepatitis B infection
  • O E. Vaccination against hepatitis B infection

0 voters

27-year-old man comes to the office at his wife’s insistence for problems with concentration that are affecting his job performance

The patient works in information technology and has been easily distracted arid unable to complete his assignments since returning

from a business trip 4 weeks ago. The trip was stressful as it involved giving multiple presentations, which the patient feared were not

up to his boss’s standards. However, since his return, instead of working on current projects with assigned deadlines, he has spent

hours developing new computer programs. His wife reports that he hardly sleeps and is increasingly anxious and irritable, behavior

that is uncharacteristic of him. Last week the patient became angry when she was deeply skeptical of his idea to leave his job and

start his own internet company. The patient has a history of attention-deficit hyperactivity disorder, for which he was treated with

cognitive-behavioral therapy at age 8-12. He used cocaine in his early 20s but has used no illicit drugs in 3years apart from

marijuana on occasion, which “helps me feel less anxious.” Family history is significant for anxiety and depression in his mother. On

examination, the patient is cooperative but appears tense and anxious. He is talkative and very easily distracted. He has difficulty

sitting still and at one point gets up to walk around the room. He has no psychotic symptoms or suicidal ideation. Urine drug screen is

negative Which of the following is the most likely explanation of the patient’s recent behavior?

  • QA Adjustment disorder
  • QB Attention-deficit hyperactivity disorder
  • QC Bipolar disorder
  • Q D Generalized anxiety disorder
  • Q E Substance-induced mood disorder

0 voters

27-year-old man comes to the office at his wife’s insistence for problems with concentration that are affecting his job performance

The patient works in information technology and has been easily distracted arid unable to complete his assignments since returning

from a business trip 4 weeks ago. The trip was stressful as it involved giving multiple presentations, which the patient feared were not

up to his boss’s standards. However, since his return, instead of working on current projects with assigned deadlines, he has spent

hours developing new computer programs. His wife reports that he hardly sleeps and is increasingly anxious and irritable, behavior

that is uncharacteristic of him. Last week the patient became angry when she was deeply skeptical of his idea to leave his job and

start his own internet company. The patient has a history of attention-deficit hyperactivity disorder, for which he was treated with

cognitive-behavioral therapy at age 8-12. He used cocaine in his early 20s but has used no illicit drugs in 3years apart from

marijuana on occasion, which “helps me feel less anxious.” Family history is significant for anxiety and depression in his mother. On

examination, the patient is cooperative but appears tense and anxious. He is talkative and very easily distracted. He has difficulty

sitting still and at one point gets up to walk around the room. He has no psychotic symptoms or suicidal ideation. Urine drug screen is

negative Which of the following is the most likely explanation of the patient’s recent behavior?

  • QA Adjustment disorder
  • QB Attention-deficit hyperactivity disorder
  • QC Bipolar disorder
  • Q D Generalized anxiety disorder
  • Q E Substance-induced mood disorder

0 voters

23-year-old woman with a history of anorexia nervosa is evaluated due to acute-onset confusion while hospitalized. Over the past 6 months,

she has been severely restricting her caloric intake and has lost 7 kg (15.4 lb). On admission, she was tachycardic and orthostatic, and her BMI

was 15 kg/m2. The patient has been receiving intravenous hydration and parenteral nutrition. Today, her family notes that she seems newly

confused and unsteady when walking. Temperature is 36.7 C (98 F), blood pressure is 110/70 mm Hg, and pulse is 86/min. She is not oriented to

time or place. Bilateral pupils are equal and reactive. Her lateral gaze is restricted on both sides and evokes a horizontal nystagmus. There is no

nuchal rigidity or motor weakness. Bilateral ankle reflexes are diminished. The patient walks slowly with short and wide-based steps. Which of

the following is the best next step in management of this patient?

  • QA Intramuscular cobalamin
  • 0 B. Intravenous acyclovir
  • 0 C. Parenteral phosphate
  • 0 D. Systemic glucocorticoids
  • 0 E. Thiamine supplement
  • 0 F Thrombolytic therapy

0 voters