Category: Uncategorized

Which process involves examining multiple life dimensions to detect patterns for further exploration?

Using the DSM-5 without proper expertise raises ethical concerns. Which practice ensures responsible and effective use?

Which of the following is correct regarding antimicrobials in the treatment of patients with septic shock?

LM is a 41-year-old female who presents to the HIV clinic with a new diagnosis of HIV.  Her past medical history is significant for hypertension.  She has no known allergies.  Her labs today reveal a CD4 count of 35 cells/mm3 and viral load of 129,000 copies/ml.  What antimicrobials would be beneficial for this patient?

Select ALL of the CORRECT statement(s) regarding hemorrhagic cystitis with ifosfamide. 

Donal has metastatic NSCLC and will be treated with carboplatin (AUC 5) and pemetrexed (500 mg/m2/dose). Donal is 70 inches tall and weighs 180 pounds. Calculate the pemetrexed dose for Donal [dose1] mg and volume of drug needed [dose2] mL. Pemetrexed is available as a 500-mg powdered vial and requires injecting 20 mL 0.9% sodium chloride to prepare the medication.

BR is a 78-year-old man who diagnosed with Hodgkin’s Lymphoma. and started on induction chemotherapy, resulting in an absolute neutrophil count of 60 cells/mm3, which is expected for at least the next 7 days.  His Tmax spikes to 101.9⁰F on day 3 with blood pressure 90/59 mm Hg and respiratory rate 24 breaths/min. Blood cultures are pending.  The team wants an antimicrobial recommendation for this patient.  What should you recommend? 

RS is 31 -year-old male who is HIV positive.  At his last visit 6 months ago, he was stable with a CD4 count of 375 cells/mm3 and viral load of 10,000 copies/ml and refused to take any anti-retroviral therapy.  He urgently presents to the clinic today with mild symptoms of shortness of breath, fever and cough.  His laboratory studies at this visit reveal a CD4 count of 175 cell/mm3 and viral load of 175,000 copies/ml.  He states that he is allergic to sulfa but does not know the reaction.  His chest x-ray is consistent with Pneumocystis jerovici pneumonia.  His provider wants to start therapy.  What first line therapy would you recommend?

MM is a 66-year-old female who presents to clinic with fever following induction chemotherapy for treatment of leukemia 4 days prior. Laboratory work up reveals an absolute neutrophil count of 310 cells/mm3, serum creatinine 0.8 g/dL, and normal LFTs.  She is otherwise in stable condition with no significant comorbidities or medical issues. Which of the following treatment options should you recommend for this patient?

History of Present Illness: 82 yo woman referred for outpatient pulmonary rehab by her pulmonologist,  with chronic hypoxia due to emphysema.  She has had increasing LE weakness since her previous trial of pulmonary rehab 1 year ago. Medications: Spiriva (Tiotropium bromide), advil (for low back pain) Past Medical History: COPD, OA (low back), cellulitis, hemorrhoids, diverticulitis, previous hospitalization with SOB (attributed to viral myositis and influenza) Social History: The patient is R hand dominant.  She has a 40 pack- year history of smoking and is a social drinker.  She completed high school.  Living Environment: Lives with her husband in a single family home.  She has stairs to the second floor with a rail on the right.  Master Bedroom and bath on second floor. Prior Level of Function:  Patient was independent with all mobility without an assistive device, ADLs, and IADLs prior to admit.  She is retired.  She doesn’t engage in any exercise beyond her normal daily activities or chores.  She uses continuous flow oxygen (2L at rest and 4L with exertion). Patient Goal: Be stronger; Breathe easier; Feel better Chief Complaint: Arm and leg weakness (especially stair climbing and squatting to pick up objects off the floor), shortness of breath that is affecting her ability to complete ADLs (dressing and bathing) and IADLs (walking, shopping) Systems Review Pain: 2-4/10 pain in her lower back, relieved with Advil Relevant Tests: PFTs:     FEV1: 0.60 (41% predicted, no significant change with bronchodilator) FEV1/FVC: 34% Lung volumes are normal and diffusion capacity is severely depressed (25% of predicted) Aerobic Capacity:  Blood Pressure (BP): 120/78  Rest 166/80 Peak Heart rate (HR): 76  Rest   118 Peak Respiratory rate:  18 Rest   28 Peak SpO2:  97% at rest, 92% at peak Borg (6-20 scale): 7 at rest, 14 at peak   Practical Examination: This is patient’s first outpatient pulmonary rehabilitation session, proceed with your evaluation/assessment/interventions/education. I have read the above case and am prepared for the practical exam: