Buy Acute Illness Diagnosis and Management

Buy Acute Illness Diagnosis and Management
Buy Acute Illness Diagnosis and Management
Questions
Question 1
An 85-year-old man is admitted from
his own home with pneumonia. He has
a past history of cerebrovascular disease
and vascular dementia. He has poor dental health, bi-basal chest crackles and an
impaired swallow. It is suspected that he
has developed pneumonia due to aspiration. Which of the following interventions has been shown to lower the risk of
aspiration pneumonia in older people?
A. improved oral hygiene
B. percutaneous endoscopic gastrostomy
tube feeding
C. physical exercise group activities
D. thickened fluids
Question 2
You see a 92-year-old man acutely
admitted to your ward with cellulitis of
the left leg. As a coincidental discovery, he was found to have atrial fibrillation on his ECG. You are considering
whether to offer him anticoagulation to
reduce the risk of future embolic stroke
but are cautious due to him having moderate to severe frailty. Which of the
following is a component of the HASBLED score?
A. heart failure
B. high blood pressure
C. peptic ulcer disease
D. recent head injury
E. surgery within the last three months
Question 3
While on call you are phoned by a GP
asking for help with the interpretation
of a blood test result for a patient with
suspected heart failure. Which of the following scenarios is more likely to result
in an elevated serum N-terminal pro-Btype natriuretic peptide (NT-proBNP)
concentration?
Buy Acute Illness Diagnosis and Management
A. African or African-Caribbean family
origin
B. age over 70 years
C. current ACE inhibitor use
D. current beta-blocker use
E. obesity
Question 4
A 73-year-old man has been admitted
due to a fall on the background of a general decline in his physical and cognitive
function over the last few weeks. His past
history includes cerebrovascular disease,
vascular dementia and depression. His
usual medications are clopidogrel 75 mg
od, atorvastatin 40 mg nocte, ramipril 5 mg
od and solifenacin 5 mg od. While in hospital he was started on quetiapine for his
agitation and mirtazapine for low mood.
Over the last 24 hours he has been noted to
be drowsier, and is not responding verbally
at present. His temperature is 38.1°C, pulse
118 beats per minute and blood pressure
184/97 mmHg. Examination of his chest
and abdomen are unremarkable. His pupils
are 2 mm bilaterally and reactive to light,
tone is increased in all of his limbs and
reflexes appear normal. What is the most
likely diagnosis?
A. anticholinergic toxicity
B. dementia with Lewy bodies
C. neuroleptic malignant syndrome
D. serotonin syndrome
E. urinary tract infection
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