夏の後に

wah. akhirnya ngebahas soal juga. walaupun hari ini tidak (terlalu) produktif xD

A 69-year-old woman presents with crushing substernal chest pain and nausea . She is treated with plasminogen activator, oxygen, and morphine sulfate. The patient subsequently becomes hypotensive and suffers cardiac arrest. A cross-section of the patient’s anterior interventricular artery is examined at autopsy (shown in the image). Which of the following best describes the pathologic changes visible in this specimen? The answer is Atherosclerosis . Atherosclerosis is the most common acquired abnormality of large- and medium-sized arteries. Major complications of atherosclerosis, including intermittent claudication, abdominal aortic aneurysm, coronary artery disease, cerebrovascular disease, and peripheral vascular disease, account for more than half of the annual deaths in the United States. Chest pain is the major complaint of patients with coronary artery disease (also referred to as ischemic heart disease). The pain typically occurs in the substern...

Five patients with sexual dysfunction present to their primary care physician for evaluation and treatment. Which of the following would most likely benefit from treatment with this medication yohimbine? (A) A 19-year-old man with sexual arousal difficulties (B) A 29-year-old man with erectile and ejaculatory dysfunction (C) A 47-year-old man with erectile dysfunction and hypertension (D) A 57-year-old man with erectile dysfunction and diabetes mellitus (E) A 80-year-old man with erectile dysfunction and myocardial infarction The answer is A: A 19-year-old man with sexual arousal difficulties.  Yohimbine is a selective competitive a 2- blocker. It is found as a component of the bark of the yohimbe tree and is sometimes used as a sexual stimulant. The efficacy of yohimbine for the treatment of impotence has never been clearly demonstrated.  Yohimbine works at the level of the CNS to increase o the periphery . (B) Th...

A 29-year-old African-American woman with  menometrorrhagia undergoes ultrasound of the pelvis, which reveals uterine masses. Biopsy shows a whorled pattern of smooth muscle . A gross specimen from a patient with similar pathology is shown below. These masses are  most commonly associated with which of the  following conditions? (A) Enlargement during pregnancy (B) Formation of chocolate cysts (C) Malignant transformation (D) Pelvic inflammatory disease (E) Postmenopausal metastasis The correct answer is A. Leiomyomas, or fibroids, are common smooth muscle tumors that are most often seen in African-American  women and present with multiple masses.  These tumors are benign and can be associated with dysmenorrhea (menstrual pain),  menorrhagia/menometrorrhagia (heavy prolonged bleeding), infertility, and abnormal pelvic exams including palpable masses extending from the uterus. Because they are estrogen  sensitive, they tend to increase in siz...

A family who recently emigrated from Romania brings their 7-year-old child to the pediatrician with complaints of conjunctivitis and  periorbital swelling . The child has had coughing with a runny nose and high fever for three  days . Small lesions with blue-white centers are  seen in his oral cavity. Which of the following  is the most likely cause of this child’s symptoms? (A) Diphtheria (B) Pertussis (C) Roseola (D) Rubella (E) Rubeola answer   The correct answer is E. Rubeola, also called  measles, is a relatively rare illness in the United States because of the ubiquity of the  measles/mumps/rubella (MMR) vaccine. It  presents with the prodrome described in this  patient. The rash that spreads from head to  toe over a three-day period develops one or  two days after the appearance of Koplik’s spots,  which are red oral lesions with blue-white centers. Answer A is incorrect. Diphtheria is an illness virtually unkno...