QUESTION: 113

Highest source/cause of increased ACTH in Cushing syndrome:

Increase ACTH from adrenal
Ectopic source
Increase ACTH from pituitary adenoma
Unknown

Answer(s): C

A 36-year-old woman presents with pains in both hands for the last few months and stiffness that improves as the day goes on. Multiple joints are swollen on exam. X-rays of the hands show some erosion.
What is the single most accurate test?

ANA
Rheumatoid factor
Sedimentation rate
Anti-cyclic citrullinated peptide (anti-CCP)

Answer(s): D

Explanation:

Rheumatoid factor (RF) is present in only 75ג€"85 percent of patients with rheumatoid arthritis (RA).It can also be present in a number of other diseases; hence, the
RF is rather nonspecific. Anti-cyclic citrullinated peptide (anti-CCP) is the single most accurate test for RA. It is > 95 percent specific for RA, and it appears earlier in the course of the disease than the RF. There is nothing specific on joint aspiration to determine a diagnosis of RA.

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QUESTION: 115

Which of the following lowers mortality in COPD?

Home oxygen therapy (continuous)
Smoking cessation
Both of above

Answer(s): C

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QUESTION: 116

A 70-year-old man comes to the emergency department having had chest pain for the last hour. His initial EKG shows ST segment elevation in leads V2`"V4.
Aspirin has been given.
Which of the following will most likely benefit this patient?

Diltiazem
Angioplasty
Thrombolytics
Metoprolol

Answer(s): B

Explanation:

Angioplasty will lower the risk of mortality most for this patient. If it can be obtained within 90 minutes, angioplasty is the best therapy. Metoprolol lowers mortality but is not dependent on how soon you give it, as long as the patient receives it before going home.

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QUESTION: 113

QUESTION: 114

Explanation:

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QUESTION: 116

Explanation: