D444 Adult Health I - Set 5 - Part 2

Correct Answer: Green purulent

Option c is correct because green purulent sputum indicates bacterial infection with neutrophil infiltration requiring antibiotic therapy for treatment appropriately given.
Option a is incorrect because clear thin sputum suggests viral infection or allergic response not requiring antibiotics for treatment typically needed bacterially.
Option b is incorrect because white frothy sputum indicates pulmonary edema from heart failure rather than bacterial infection requiring antibiotics specifically prescribed.
Option d is incorrect because pink-tinged sputum suggests blood from irritation or early pulmonary edema, not bacterial infection requiring antibiotics necessarily.

Correct Answer: Check residual volume

Option b is correct because checking gastric residuals prevents overfeeding and regurgitation reducing aspiration risk in patients with decreased consciousness significantly.
Option a is incorrect because continuous feeding without residual checks may lead to gastric distention and aspiration if absorption is impaired potentially.
Option c is incorrect because supine positioning increases aspiration risk; semi-Fowler's position is required during and after tube feeding administration.
Option d is incorrect because rapid bolus feeding increases reflux and aspiration risk compared to slower controlled feeding rates used appropriately instead.

Correct Answer: Clotting factors

Option b is correct because liver synthesizes clotting factors; failure results in prolonged PT from decreased factor production affecting coagulation cascade significantly.
Option a is incorrect because platelets are produced in bone marrow not liver; thrombocytopenia in liver disease results from splenic sequestration instead.
Option c is incorrect because red blood cells are produced in bone marrow; anemia in liver disease has other causes besides production failure.
Option d is incorrect because white cells originate from bone marrow not liver; leukopenia may occur from hypersplenism not production failure directly.

Correct Answer: Incoordination

Option c is correct because choreiform movements cause swallowing incoordination in Huntington's disease leading to aspiration during oral intake attempts frequently occurring.
Option a is incorrect because while swallowing may be affected, the primary issue is incoordination from involuntary movements not delayed initiation specifically problematic.
Option b is incorrect because incomplete closure suggests mechanical problems; Huntington's causes coordination issues from involuntary choreiform movements affecting swallowing control primarily.
Option d is incorrect because Huntington's causes movement disorders not primary muscle weakness; incoordination from chorea is the main swallowing problem present.

Correct Answer: Hyperkalemia

Option b is correct because hyperkalemia from massive cell death can cause cardiac arrhythmias requiring immediate treatment to prevent arrest potentially.
Option a is incorrect because while elevated uric acid needs treatment, hyperkalemia poses more immediate cardiac risk requiring urgent intervention first always.
Option c is incorrect because hypocalcemia in tumor lysis is concerning but hyperkalemia's cardiac effects take priority for immediate treatment needed urgently.
Option d is incorrect because hyperphosphatemia requires management but doesn't pose the immediate life threat of hyperkalemia's cardiac effects requiring intervention.

Correct Answer: Blurred vision

Option b is correct because pilocarpine causes accommodation spasm and miosis producing blurred vision requiring safety precautions especially with driving initially.
Option a is incorrect because pilocarpine causes pupil constriction not dilation; miosis is the therapeutic effect for angle-closure glaucoma treatment given.
Option c is incorrect because pilocarpine doesn't cause dry eyes; it may actually increase tearing through parasympathetic stimulation of lacrimal glands typically.
Option d is incorrect because while miosis occurs, the main concern is blurred vision from accommodation changes affecting daily activities significantly impacting.

Correct Answer: Triple therapy regimen

Option b is correct because triple therapy combining two antibiotics with acid suppression effectively eradicates H. pylori in most patients treated.
Option a is incorrect because antacids provide symptom relief but don't eradicate the bacterial infection requiring antibiotic therapy for cure achieved successfully.
Option c is incorrect because acid suppression alone doesn't eliminate H. pylori; antibiotics are essential for bacterial eradication in infected patients typically.
Option d is incorrect because H2 blockers reduce acid but don't kill bacteria; combination antibiotic therapy is required for eradication effectively accomplished.

Correct Answer: Sustained maximal inspiration

Option c is correct because sustained maximal inspiration with breath holding reopens collapsed alveoli through maintained positive pressure achieving re-expansion effectively accomplished.
Option a is incorrect because pursed-lip breathing helps COPD patients maintain airway patency during exhalation, not specifically re-expand collapsed alveoli present currently.
Option b is incorrect because diaphragmatic breathing improves ventilation efficiency but doesn't provide the sustained pressure needed for alveolar recruitment specifically required.
Option d is incorrect because rapid shallow breathing would worsen atelectasis; deep sustained breaths are needed for alveolar re-expansion occurring progressively achieved.

Correct Answer: Uremic toxins

Option b is correct because uremic toxins accumulating from decreased renal clearance cause severe itching requiring dialysis for relief typically provided.
Option a is incorrect because potassium elevation causes cardiac and neuromuscular effects rather than the pruritus characteristic of uremia specifically present commonly.
Option c is incorrect because sodium imbalances cause neurological symptoms and fluid shifts, not the intense itching of uremic toxin accumulation occurring.
Option d is incorrect because glucose elevation in diabetes causes different symptoms; uremic toxins specifically cause the severe pruritus described characteristically.

Correct Answer: Blood pressure

Option b is correct because rapid large-volume paracentesis causes fluid shifts potentially causing hypotension and circulatory collapse requiring close monitoring throughout procedure.
Option a is incorrect because temperature doesn't change significantly during paracentesis; hemodynamic stability is the primary concern during fluid removal occurring.
Option c is incorrect because while breathing may improve from decreased abdominal pressure, hypotension is the main risk requiring monitoring during procedure.
Option d is incorrect because oxygenation typically improves with paracentesis; blood pressure monitoring for hypotension takes priority during fluid removal performed carefully.

Correct Answer: Aged cheese

Option b is correct because aged cheese contains tyramine which causes dangerous hypertension when MAO inhibitors prevent its metabolism occurring normally.
Option a is incorrect because fresh fruits are safe; only overripe bananas with high tyramine pose risk with MAO inhibitor therapy given.
Option c is incorrect because white bread contains no tyramine and is safe with MAO inhibitors unlike aged or fermented foods typically.
Option d is incorrect because plain rice is tyramine-free and safe; aged, fermented, or preserved foods require avoidance with MAOIs specifically.

Correct Answer: Lifting heavy objects

Option b is correct because heavy lifting increases intra-abdominal pressure potentially rupturing fragile varices causing life-threatening hemorrhage requiring immediate intervention urgently.
Option a is incorrect because walking is safe low-impact exercise that doesn't significantly increase pressure on esophageal varices when performed appropriately daily.
Option c is incorrect because swimming provides good exercise without the straining and pressure increases that threaten variceal integrity when done properly.
Option d is incorrect because gentle yoga is acceptable though positions increasing abdominal pressure should be avoided for safety maintained consistently throughout.

Correct Answer: Severe airway obstruction

Option b is correct because severe airway obstruction causes exaggerated intrathoracic pressure swings producing paradoxical pulse indicating critical asthma status present currently.
Option a is incorrect because cardiac failure causes different hemodynamic changes; paradoxical pulse specifically indicates severe airway obstruction in asthma typically occurring.
Option c is incorrect because pneumonia doesn't cause paradoxical pulse; this finding specifically indicates severe airway obstruction requiring immediate intervention urgently needed.
Option d is incorrect because medication reactions cause various symptoms but paradoxical pulse specifically indicates severe airway obstruction in asthma attacks occurring.

Correct Answer: Lactulose administration

Option b is correct because lactulose promotes ammonia excretion through the bowel preventing its absorption and subsequent encephalopathy development effectively managed prophylactically.
Option a is incorrect because high protein increases ammonia production worsening encephalopathy; protein restriction is often needed in liver disease management.
Option c is incorrect because fluid restriction helps manage ascites but doesn't prevent ammonia accumulation causing hepatic encephalopathy in cirrhosis patients.
Option d is incorrect because potassium supplements don't affect ammonia levels; lactulose specifically reduces ammonia preventing encephalopathy development in cirrhosis effectively.

Correct Answer: Three negative cultures

Option c is correct because three consecutive negative sputum cultures indicate non-infectiousness allowing discontinuation of isolation and return to activities safely.
Option a is incorrect because one negative culture is insufficient to confirm non-infectiousness; three consecutive negatives are required for clearance typically needed.
Option b is incorrect because two negative cultures don't meet standard criteria; three consecutive negative cultures confirm non-infectious status for release appropriately.
Option d is incorrect because three consecutive negative cultures are sufficient; requiring four would unnecessarily prolong isolation without additional benefit provided clinically.

Correct Answer: Coffee

Option b is correct because caffeine in coffee can increase theophylline levels and toxicity risk requiring intake limitation for safety maintained.
Option a is incorrect because orange juice doesn't interact with theophylline metabolism; caffeine-containing beverages are the concern for toxicity risk present.
Option c is incorrect because milk doesn't affect theophylline levels or metabolism; caffeine is the dietary factor requiring limitation with theophylline.
Option d is incorrect because sports drinks without caffeine don't interact with theophylline; coffee and other caffeinated beverages require restriction specifically.

Correct Answer: Anion gap closing

Option b is correct because closing anion gap indicates resolution of ketoacidosis as ketones clear and acidosis corrects with treatment provided effectively.
Option a is incorrect because dropping blood pressure suggests inadequate fluid resuscitation or other complications rather than successful DKA treatment occurring appropriately given.
Option c is incorrect because temperature changes don't specifically indicate DKA resolution; anion gap closure confirms metabolic improvement achieved through treatment successfully.
Option d is incorrect because increasing heart rate may indicate dehydration or other problems; closing anion gap specifically confirms DKA resolution progressing appropriately.

Correct Answer: Gallstone pancreatitis

Option b is correct because gallstones passing through common bile duct can obstruct pancreatic duct causing pancreatitis with characteristic back pain radiation.
Option a is incorrect because cholecystitis causes right upper quadrant pain radiating to shoulder, not epigastric pain radiating to back typically seen.
Option c is incorrect because bile duct obstruction causes jaundice and right upper quadrant pain, not the epigastric-to-back pattern described specifically here.
Option d is incorrect because liver abscess causes fever and right upper quadrant pain, not epigastric pain radiating to back characteristically present.

Correct Answer: Lateral toe

Option b is correct because arterial ulcers occur at distal pressure points like toes where circulation is poorest in arterial disease typically.
Option a is incorrect because medial malleolus is the classic location for venous ulcers from venous stasis, not arterial insufficiency ulceration occurring.
Option c is incorrect because posterior calf ulcers suggest venous disease or trauma rather than the distal arterial insufficiency ulcers typically seen.
Option d is incorrect because anterior shin ulcers often result from trauma; arterial ulcers occur distally at toes and pressure points characteristically.

Correct Answer: Elevated creatinine

Option c is correct because rising creatinine indicates declining transplant function from rejection requiring immediate immunosuppressive therapy adjustment to save graft.
Option a is incorrect because increased urine output suggests improving function; decreased output with rising creatinine indicates rejection occurring requiring intervention immediately.
Option b is incorrect because decreased creatinine indicates improving kidney function not rejection; rising creatinine signals transplant rejection developing progressively requiring treatment.
Option d is incorrect because weight loss alone doesn't indicate rejection; elevated creatinine with decreased urine output confirms rejection requiring intervention urgently.