Property:AnswerAExp
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''' Incorrect ''' : Hypercalcemic syndrome can cause neurological symptoms as seen in this patient, but is not associated with mucosal bleeding. +
''' Incorrect ''' : There is no quantitative platelet loss in this patient that requires platelet transfusion. +
''' Incorrect ''' : Platelet transfusion is not normally recommended and is usually unsuccessful in raising a patient's platelet count. This is because the underlying autoimmune mechanism that destroyed the patient's platelets to begin with will also destroy donor platelets. An exception to this rule is when a patient is bleeding profusely, when transfusion of platelets can quickly form a platelet plug to stop bleeding, a life-threatening hemorrhage. Intravenous immunoglobulin administration, with the platelet transfusion, may improve their survival. +
''' Incorrect ''' : Vitamin B12 is used to treat megaloblastic anemia caused by its deficiency. +
''' Correct ''' : Secondary polycythemia is caused by either natural or artificial increases in the production of erythropoietin that result in an increased production of erythrocytes. This patient has secondary polycythemia due to smoking and lung diseases that result in hypoxia induced erythropoietin production. +
''' Correct ''' : This pateint has heparin induced skin necrosis which is not associated with thrombocytopenia. +
''' Correct ''' : The patient can be withdrawn from previous medications as her BP is well within the control limits. +
A corresponds to the enzyme carbamoyl phosphate synthetase I, which is the rate-limitng step of the urea cycle. Carbamoyl phosphate synthetase I activation requires ATP and the cofactor N-acetylglutamate. +
OTC deficiency is a genetic disorder that is usually inherited in an X-linked recessive pattern. +
NADPH and NAD+ are cofactors for aldose reductase and sorbitol dehydrogenase, respectively. Both enzymes and their cofactors are involved in sorbitol metabolism. +
Incorrect
In NSTEMI thrombolytic do not lower mortality. Thrombolytic used only if there is ST segment elevation or a new LBBB within 12 hours of the onset of chest pain. +
Incorrect
Calcium channel blockers as verapamil and diltiazem have not been shown to prevent recurrence of atrial fibrillation in patients with of paroxysmal atrial fibrillation. +
Incorrect
While chest x-ray is one of the initial tests to be ordered, acute pulmonary edema is a clinical diagnosis, and starting with a life saving medications has the priority. +
Incorrect
Digoxin has been shown to improve symptoms in patients with severe CHF; however, it has no effect on mortality due to its proarrhythmic effect +
Incorrect
Medical therapy, such as lidocaine, amiodarone, or procainamide, can be used for sustained ventricular tachycardia that is hemodynamically stable. +