Lectus

A 62-year-old man presents to the emergency department with fatigue and shortness of breath on exertion. He says that his symptoms began gradually five days ago and have worsened progressively. His medical history is significant for chronic alcoholism. His vital signs are: Blood pressure 100/60 mm Hg, temperature 36.9°C (98.4°F), respiratory rate 18/min, and pulse rate 98/min. Physical examination reveals bilateral pedal edema and decreased sensation in both feet. Bibasilar crackles and rhonchi are heard bilaterally on pulmonary auscultation. Cardiac examination is unremarkable. A chest X-ray shows cardiomegaly. What vitamin deficiency is most likely responsible for this patient’s condition?Deselect Answer

A 45-year-old patient with diabetes mellitus is admitted to the hospital for elective cholecystectomy. The patient receives insulin as ordered, but due to a medication administration error involving multiple system failures, receives 10 times the prescribed dose and develops severe hypoglycemia requiring intensive care. The attending physician is determining how to approach this adverse event. According to current best practices in medical error management, which of the following approaches most effectively addresses both patient safety and organizational learning?Deselect Answer

A 64-year-old man presents with a unilateral severe chest pain that started a day ago. He describes the chest pain as sharp in nature and predominantly localized to his right side. He also complains of mild shortness of breath but says that it is tolerable. He denies any recent history of fever, sweating, dizziness, or similar episodes in the past. His past medical history is significant for chronic lymphocytic leukemia for which he was started on chemotherapy. He has currently completed 3 cycles with the last one ending a few days ago. His temperature is 36.5°C (97.7°F), blood pressure is 118/75 mm Hg, pulse is 95/min, and respirations are 20/min. The lungs are clear to auscultation bilaterally. There is severe tenderness to palpation over the right chest and a painful stripe of vesicular lesions, but there is no evidence of bruising or trauma. An electrocardiogram is normal and a chest radiograph is unremarkable. Cardiac enzymes are pending. Laboratory studies show:

Which of the following is the best course of treatment for this patient?Deselect Answer

A 13-year-old obese male presents with a two-month history of progressive right hip pain and limping. Physical examination reveals restricted internal rotation and abduction of the right hip. X-ray demonstrates posterior and inferior displacement of the femoral epiphysis relative to the femoral neck. He undergoes surgical fixation of the slipped capital femoral epiphysis (SCFE). During the procedure, the surgeon is particularly cautious about preserving certain vascular structures to prevent avascular necrosis (AVN). Which of the following blood vessels provides the primary blood supply to the femoral head that is most at risk in this patient?Deselect Answer