PLE Category: Internal Medicine

PLE-2155

A 28-year-old female with Cushingoid features complained of blurring of vision. Formal visual field testing revealed bitemporal hemianopsia. You suspect a functioning pituitary adenoma. Which of the following laboratory findings is not consistent with your primary impression?

PLE-2156

After a night of binge-drinking, a 53-year-old male comes into the ER complaining of sudden onset severe mid-epigastric abdominal pain radiating to the back. He also reports symptoms of nausea, vomiting, and anorexia. The patient’s vital signs are as follows: blood pressure 90/50, heart rate 114, respiratory rate 24, and temperature 39°C. The cornerstones for the management of this condition include all of the following except:

PLE-2157

A 28-year-old male presents with fever and jaundice. He has the following hepatitis profile: IgM Anti-HAV (+), HBsAg (+), IgM Anti-HBc (-), and Anti-HCV (-). What does this indicate?

PLE-2158

What is an exception to the recommendations of the Surviving Sepsis Guidelines in the management of sepsis?

PLE-2159

A 12-year-old male was attacked by a stray dog and sustained minor abrasions without bleeding. The patient has had no rabies vaccination. Which of the following is most appropriate?

PLE-2152

According to JNC 7, which of the following lifestyle modification recommendations leads to the greatest reduction in average systolic blood pressure?

PLE-2153

A 55-year-old male heavy smoker presents with a cough productive of sputum and progressive and persistent exertional dyspnea. On physical examination, you note hyperresonant lung fields and poor diaphragmatic excursion on percussion. Which of the following interventions have been demonstrated to influence the natural history of his condition?

PLE-2154

A 25-year-old male, recently diagnosed with type 1 DM, comes in for a routine follow-up after he noticed passing foamy urine. You order a urinalysis, which reveals 3+ proteinuria. You refer the patient to an ophthalmologist who found no evidence of retinopathy. What is the most likely cause of proteinuria in this patient?

PLE-2150

A 26-year-old woman is brought to the emergency department because of marked confusion for 2 hours. She also has had a flu-like illness for 3 days. Over the past 6 weeks, she has had increased fatigue, weakness, and nausea. She recently started thyroid hormone replacement therapy for autoimmune thyroiditis. 1 week ago, her serum thyroid stimulating hormone level was 3µU/mL. Her temperature is 38 C (100.4 F), blood pressure is 80/40 mm Hg, and pulse is 140/min. She appears confused and lethargic. Examination shows cool, mottled skin. There is generalized hyperpigmentation, especially involving the palmar creases. The lungs are clear to auscultation. Abdominal examination shows diffuse mild tenderness and no rebound. Laboratory studies show: Hemoglobin 10 g/dL, leukocyte count 9000/mm3, segmented neutrophils 55%, eosinophils 20%, lymphocytes 25%. Serum: Na+ 124 mEq/L, Cl- 92 mEq/L, K+ 6.4 mEq/L, HCO3- 16 mEq/L. An x-ray film of the chest and urinalysis show normal findings. An ECG shows sinus tachycardia with peaked T waves. Which of the following is most likely to confirm the primary cause of this patient’s condition?