A46-year-old attorney is noted to have normal cholesterol levels but a very high fasting triglyceride level of 1600. He is otherwise healthy and has no risk factors for CAD. Which of the following statements is correct?
Answer(s): E
Hypertriglyceridemia has not been shown to be a strong independent risk factor for CAD, however, epidemiologic data do suggest a relationship. According to the National Cholesterol Education Program, when tirglycerides are above 200 mg/dL then non-HDL (total HDL) cholesterol becomes a pharmacologic treatment target. Severely elevated triglycerides (1000 mg/dL) are a recognized risk factor for attacks of acute pancreatitis, and control of the triglycerides can prevent these attacks. Diet alone is usually not sufficient at these high levels. A National Institutes of Health Consensus Conference has recommended that treatment be initiated in all patients with triglycerides greater than 500 mg/ 100 mL to prevent acute pancreatitis. Skin lesions are not present with hypertriglyceridemia.
A 60-year-old patient with long-standing diabetes has a creatinine of 3.6, which has been stable for several years. Which of the following antibiotics requires the most dosage modification in chronic renal failure?
Answer(s): B
Many drugs require dosage modifications in chronic renal insufficiency. Bioavailability, distribution, action, and elimination of drugs all may be altered. Drugs that are nephrotoxic may be contraindicated or used only with extreme care in renal insufficiency. The aminoglycosides, vancomycin, ampicillin, most cephalosporins, methicillin, penicillin G, sulfonamides, and trimethoprim all should be given in reduced dosage to patients with chronic renal failure. The aminoglycosides and vancomycin can be nephrotoxic and should be used with caution in renal insufficiency. The small group of antibiotics not needing dosage modification includes chloramphenicol, erythromycin, the isoxazolyl penicillins (nafcillin and oxacillin), and moxifloxacin.
A 57-year-old man is on maintenance hemodialysis for chronic renal failure. Which of the following metabolic derangements can be anticipated?
Answer(s): C
Chronic renal failure treated with hemodialysis results in predictable metabolic abnormalities. The kidneys fail to excrete phosphate, leading to hyperphosphatemia, and fail to synthesize 1,25(OH)2D3. Vitamin D deficiency causes impaired intestinal calcium absorption. Phosphate retention, defective intestinal absorption, and skeletal resistance to parathyroid hormone (PTH) all result in hypocalcemia. Hypocalcemia causes secondary hyperparathyroidism, and the excess PTH production worsens the hyperphosphatemia by increasing phosphorus release from bone. These derangements impair collagen synthesis and maturation, resulting in skeletal abnormalities collectively referred to as renal osteodystrophy.Osteomalacia, osteosclerosis, and osteitis fibrosa cystica may all be seen.
A 25-year-old man was admitted to the intensive care unit with a severe head injury, with fracture of the base of the skull. Approximately 18 hours after the injury, he developed polyuria. Urine osmolality was 150 mOsm/L and serum osmolality was 350 mOsm/L. IV fluids were stopped, and 3 hours later, urine output and urine osmolality remained unchanged. Five units of vasopressin were intravenously administered. Urine osmolality increased to 300 mOsm/L. Which of the following is the most likely diagnosis?
Answer(s): A
Diabetes insipidus, a deficiency of pituitary antidiuretic hormone (ADH) (arginine vasopressin), causes water loss because of failure to facilitate reabsorption of water in the distal tubules and collecting ducts of the kidneys. In central diabetes insipidus, there is impaired production of vasopressin, and in nephrogenic diabetes insipidus, the distal renal tubules are refractory to vasopressin. In central diabetes insipidus, urine osmolality remains unchanged. If water intoxication were present, stopping IV fluids should have increased urine osmolality. With solute overload, serum osmolality would have been higher. In SIADH, urine osmolality is usually higher than serum osmolality.
A70-year-old man with a 60 pack-year smoking history presents with cough and weight loss. He describes recent diffuse darkening of his skin and his CXR shows a mass suspicious for lung cancer in the left hilum. His laboratory tests reveal hypokalemia. Which of the following is the most likely histology of his lung cancer?
Endocrine syndromes are seen in 12% of patients with lung cancer. Squamous cell carcinoma is associated with PTH-related peptide. Adrenocorticotrophic hormone (ACTH) and ADH secretion can be associated with small cell lung carcinoma. ACTH-secreting tumors are associated with darkening of the skin and hypokalemia.
Share your comments for USMLE STEP2 exam with other users:
please upload the c_activate22 dump questions with answer
q10 - the answer should be a. if its c, the criteria will meet if either the prospect is not part of the suppression lists or if the job title contains vice president
this was on the exam as of 1211/2023
great for prep
i think in question 7 the first answer should be power bi portal (not power bi)
on question 10 and so far 2 wrong answers as evident in the included reference link.
wonderful material
i passed!! ...but barely! got 728, but needed 720 to pass. the exam hit me with labs right out of the gate! then it went to multiple choice. protip: study the labs!
correct answer for question 92 is c -aws shield
great !! it is really good
explanations for the answers are to the point.
how can rea next
question: 128 d is the wrong answer...should be c
thanks for az 700 dumps
thank you for this tableau dumps . it will helpfull for tableau certification
good content
just testing if the comments are real
very helpful for exam preparation
question 11: https://help.salesforce.com/s/articleview?id=sf.admin_lead_to_patient_setup_overview.htm&type=5
i think the answer to question 42 is b not c
thanks for the dump
fantastic assessments
i find the xengine test engine simulator to be more fun than reading from pdf.
nice document
thank you for making the questions and answers intractive and selectable.
answers are correct?
can i belive this dump
great site to practice for sitecore exam
good for students
nice practice dumps
nokia 4a0-114 dumps
great content and wonderful to have the answers with explanation
for question #118, the answer is option c. the screen shot is showing the drop down, but the answer is marked incorrectly please update . thanks for sharing such nice questions.
the correct answer for the question 29 is d.