A severely traumatized patient who has been receiving prolonged parenteral alimentation develops diarrhea, mental status changes, alopecia, and perioral and periorbital dermatitis. Administration of which of the following trace element is most likely to reverse these complications?
Answer(s): B
Symptoms of zinc deficiency include diarrhea, mental status changes, alopecia, and periorbital, perinasal, and perioral dermatitis. Persons who have cirrhosis, who are receiving steroids, who have excessive loss of GI secretions, or who are severely traumatized are at risk for zinc deficiency. Deficiency states resulting from inadequate ingestion of selenium, silicon, and tin have not been described. Deficiency of iodine produces hypothyroidism.
A man who underwent total thyroidectomy 24 hours ago now complains of a generalized "tingling" sensation and muscle cramps. Appropriate treatment would include which of the following?
Answer(s): A
During total thyroidectomy, parathyroid glands may inadvertently be removed or their vascular supply interrupted. Hypoparathyroidism may then develop, the manifestations of which include tingling, muscle cramps, convulsions, and a positive Chvostek's sign (contraction of facial muscles after tapping the facial nerve). These symptoms are dramatically relieved by intravenous administration of calcium. Oral calcium and vitamin D are administered for long-term correction of hypocalcemia.
Vital capacity is best described as the volume of air which is:
Answer(s): E
Vital capacity is an important measure of respiratory function. It is defined as the maximum volume of air a person can expel following a maximum inspiratory effort. When vital capacity is normal, significant restrictive pulmonary disease is not present. Acutely decreased vital capacity indicates decreased ventilatory reserve.
The most common site of aortic transection in deceleration injuries is which of the following?
Answer(s): D
In deceleration injuries, laceration involving the aorta most frequently occurs just distal to the left subclavian artery at the level of the ligamentum arteriosum. This is where the aorta is fixed and thus more susceptible to shear forces. The tear may be complete or partial. Diagnosis is difficult, but is suggested by a widened mediastinum on chest x-ray and confirmed with a CT scan of the chest or an aortogram.
Which of the following is the most common site for a gastrinoma?
Answer(s): C
A gastrinoma, a gastrin-secreting tumor, produces Zollinger-Ellison syndrome, which is associated with markedly elevated gastric acid secretion and ulcer disease of the upper GI tract. The most common location for these tumors is the pancreas. However, they can be found in the gastric antrum, duodenum, spleen, and ovary. Removal of the gastrinoma can result in a cure. Athorough search must be made at the time of surgical exploration to locate the tumor, which in early stages will be small. The gastrinoma triangle, where 90% of gastrinomas are located, is defined as the area between the junction of the cystic and common bile ducts, the junction of the second and third portions of the duodenum, and the junction of the pancreatic neck and body
Post your Comments and Discuss USMLE STEP3 exam prep with other Community members:
Our website is free, but we have to fight against AI bots and content theft. We're sorry for the inconvenience caused by these security measures. You can access the rest of the STEP3 content, but please register or login to continue.