Answer 50

50.  Choice A is the correct answer.  Broad spectrum antibiotics are not indicated in the initial management of a patient in Sickle Cell Crisis with stable vital signs.  Oxygen, IV Fluids, and opioid analgesics are all indicated in the initial management of sickle cell crisis.

Question 50

50.  Your patient is a 45 year old African American Female that presents with an acute pain crisis with of Sickle Cell.  The patients vital signs are normal.  All of the following are ideal for initial management of this patient except:

A.  Broad Spectrum Antibiotics
B.  Oxygen
C.  IV Fluids
D.  Opioid Analgesics

Answer 49

49.  Choice C is the correct answer.  Parenteral injections of Vitamin B12 are best for this patient.  This patient likely has pernicious anemia which is a lack of intrinsic factor produced from the stomach which is necessary for absorption of Vitamin B12 from the small intestine.  

Question 49

49.  Your patient is a 23 year old female diagnosed with a macrocytic anemia.  During the course of her workup she was found to have a low Vitamin B12 level.  Which of the following is the best management option for this patient?

A.  Start daily multivitamins
B.  Start daily supplementation with Vitamin B12
C.  Monthly injections of Vitamin B 12
D.  Do a pregnancy test on this patient, she is likely pregnant

Answer 48

48.  Choice C is the correct answer.  However, it is considered low risk to start someone warfarin with known Protein C deficiency unless there is a known first degree relative that has had warfarin induced skin necrosis.

Question 48

48.   Which of the following clotting disorders has been associated with warfarin induced skin necrosis?

A.  Protein S Deficiency
B.  Protein C Deficiency
C.  Antithrombin III Deficiency
D.  Factor V Leiden

Answer 47

47.  Choice B is the correct answer.  The goal INR for DVT is 2.0-3.0 for up to six months for the initial DVT.  The second DVT requires anticoagulation for life.

Question 47

47.  Your patient is a 46 year old that was recently diagnosed with an extensive DVT in her left leg.  What is the goal INR for this patient while on warfarin therapy?

A.  1.5-2.5
B.  2.0-3.0
C.  2.5-3.5
D.  3.5-4.5

Answer 46

46.  Choice A is the correct answer.   Renal disease is not a cause of thrombocytopenia but can be a cause of anemia secondary to decrease in EPO production.

Question 46

46.  All of the following are causes of thrombocytopenia except:

A.  Renal Disease
B.  Bone Marrow Suppression
C.  Platelet Destruction or Consumption
D.  Splenomegaly