D444 Adult Health I - Set 4 - Part 3

Correct Answer: Kaposi's sarcoma

Option b is correct because Kaposi's sarcoma presents as purple lesions in AIDS patients when CD4 counts fall below two hundred typically.
Option a is incorrect because basal cell carcinoma appears as pearly nodules not the purple lesions characteristic of Kaposi's sarcoma in AIDS.
Option c is incorrect because melanoma presents as irregular dark lesions rather than the purple patches of Kaposi's sarcoma specifically seen.
Option d is incorrect because squamous cell carcinoma creates scaly rough lesions not the purple vascular lesions of Kaposi's sarcoma characteristically present.

Correct Answer: Left side

Option b is correct because left side positioning keeps gastric contents below esophageal junction reducing reflux in hiatal hernia patients.
Option a is incorrect because right side positioning allows stomach contents to reflux more easily through the herniated gastroesophageal junction typically occurring.
Option c is incorrect because prone position increases abdominal pressure potentially worsening reflux through the hiatal hernia defect present structurally compromised.
Option d is incorrect because supine flat position allows easy reflux; elevation with left lateral position optimally reduces symptoms experienced nocturnally.

Correct Answer: Reduce azathioprine

Option b is correct because allopurinol inhibits azathioprine metabolism requiring dose reduction to prevent dangerous bone marrow suppression occurring potentially.
Option a is incorrect because increasing azathioprine with allopurinol would cause severe toxicity from drug interaction increasing blood levels dangerously elevated.
Option c is incorrect because stopping azathioprine may cause Crohn's flare; dose reduction maintains therapeutic effect while preventing toxicity safely managed.
Option d is incorrect because maintaining same dose with allopurinol causes azathioprine accumulation leading to bone marrow suppression and pancytopenia potentially.

Correct Answer: Hypomagnesemia

Option b is correct because magnesium depletion from diuretics and malnutrition in cirrhosis commonly causes muscle cramps requiring replacement therapy needed.
Option a is incorrect because cirrhosis typically causes hyponatremia from fluid retention rather than hypernatremia causing muscle cramps described specifically here.
Option c is incorrect because cirrhosis with diuretic use typically causes hypokalemia not hyperkalemia, though both can cause muscle symptoms differently.
Option d is incorrect because while phosphate abnormalities occur, magnesium deficiency more commonly causes the muscle cramps in cirrhosis patients typically.

Correct Answer: Corticosteroid inhaler

Option b is correct because corticosteroids should follow bronchodilators which open airways allowing better steroid penetration and deposition for effectiveness.
Option a is incorrect because bronchodilators should be used first to open airways for subsequent medication delivery, not last in sequence.
Option c is incorrect because anticholinergics are bronchodilators used before corticosteroids to optimize airway patency for steroid delivery into lungs.
Option d is incorrect because mast cell stabilizers are preventive medications but corticosteroids should still be last after bronchodilators open airways.

Correct Answer: Decreased vital capacity

Option b is correct because declining vital capacity indicates respiratory muscle weakness approaching failure requiring mechanical ventilation support urgently needed.
Option a is incorrect because hand weakness occurs early in Guillain-Barre and doesn't specifically indicate respiratory failure approaching imminently requiring intubation.
Option c is incorrect because dysphagia indicates bulbar involvement but vital capacity better predicts need for mechanical ventilation support timing precisely.
Option d is incorrect because ascending numbness is expected progression but vital capacity measurement specifically indicates respiratory muscle failure approaching critically.

Correct Answer: Periumbilical region

Option b is correct because caput medusae describes dilated periumbilical veins resembling Medusa's hair from portal hypertension collateral formation visible externally.
Option a is incorrect because esophageal collaterals form varices internally not the visible periumbilical veins called caput medusae specifically described traditionally.
Option c is incorrect because rectal collaterals form hemorrhoids not the periumbilical venous pattern of caput medusae seen on abdominal examination.
Option d is incorrect because splenic collaterals aren't visible externally like the characteristic periumbilical pattern of caput medusae in portal hypertension.

Correct Answer: Avoid contact lenses

Option c is correct because rifampin's orange discoloration permanently stains contact lenses requiring patients to wear glasses during treatment instead.
Option a is incorrect because artificial tears don't prevent or remove the orange discoloration from rifampin affecting all body fluids normally.
Option b is incorrect because protective eyewear doesn't address the staining issue; avoiding contacts prevents permanent lens discoloration from occurring inevitably.
Option d is incorrect because cool compresses provide no benefit for harmless discoloration; the issue is contact lens staining not irritation.

Correct Answer: Upright positioning maintained

Option b is correct because maintaining upright position during and after meals uses gravity preventing aspiration in neurological dysphagia effectively employed.
Option a is incorrect because thin liquids may increase aspiration risk; thickened liquids and modified textures are safer for dysphagia management.
Option c is incorrect because continuous suctioning is impractical during meals and doesn't prevent aspiration as effectively as proper positioning techniques.
Option d is incorrect because parenteral nutrition is reserved for complete dysphagia; positioning and texture modification allow safer oral intake continued.

Correct Answer: Hepatitis B immunoglobulin

Option b is correct because newborn hepatitis B immunoglobulin with vaccine at birth prevents vertical transmission in ninety-five percent of cases.
Option a is incorrect because delivery mode doesn't significantly affect transmission rates when proper immunoprophylaxis is given at birth immediately afterward.
Option c is incorrect because breastfeeding is safe after newborn receives immunoglobulin and vaccine; transmission occurs during delivery not through milk.
Option d is incorrect because while maternal antivirals help, newborn immunoprophylaxis is most critical intervention preventing vertical transmission effectively in infants.