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Free STEP3 Exam Braindumps (page: 60)

Page 59 of 202
PDF with 804 Questions

Which of the following statements is true about primary hyperparathyroidism?

  1. It is associated with chronic renal failure and is the result of hypocalcemia caused by hyperphosphatemia.
  2. Seen most commonly in patients with renal failure who undergo kidney transplantation.
  3. Commonly seen as a result of an adenoma in one of the parathyroid glands.
  4. Most patients present with renal stones, bone pain, or mental status changes.
  5. Is more common in men than women.

Answer(s): C

Explanation:

Primary hyperparathyroidism is usually the result of a parathyroid adenoma. It can also be associated with multiglandular hyperplasia. Secondary hyperparathyroidism is associated with the hyperphosphatemia, and resultant hypocalcemia, in chronic renal disease. Tertiary hyperparathyroidism is seen after kidney transplant. Most patients (about 80%) with primary hyperparathyroidism are asymptomatic. Symptoms can include renal stones, bone abnormalities, peptic ulcer disease, and mental status changes. It is more common in females, and the incidence increases with age.



A 45-year-old man presents with suprapubic tenderness, fevers, and nausea. After a thorough evaluation, he is found to have acute cystitis and bladder stones. Which of the following bacteria is most likely responsible for this infection?

  1. Staphylococcus aureus
  2. Pseudomonas
  3. Escherichia coli
  4. Proteus mirabilis
  5. Klebsiella species

Answer(s): D

Explanation:

E. coli is the most common culprit for acute cystitis, although it is often caused by enterococci, S. aureus, Klebsiella, Pseudomonas, and Streptococcus epidermis. P. mirabilis can split urea, which results in alkaline urine and precipitation of calcium. Patients with this organism often present with bladder calculi.



During laparoscopic abdominal procedures, the abdominal cavity is usually insufflated with carbon dioxide to a pressure of 15 mmHg. Increasing the intra-abdominal pressure to these levels produces which of the following1 physiologic responses?

  1. decreased afterload
  2. depressed cardiac output
  3. hypercarbia
  4. depressed diaphragm
  5. alkalosis

Answer(s): C

Explanation:

Increasing abdominal pressures for laparoscopic procedures has several systemic effects. By increasing the carbon dioxide, patients become hypercarbic and acidotic. There is decreased venous return and increased afterload. The peritoneum is distended and the diaphragm elevated. In patients with normal cardiac function, cardiac output is not affected until the abdominal pressures reach about 20 mmHg.



A 21-year-old male presents to the ED after sustaining a gunshot wound to the neck. After evaluation, it is determined that he has C6 quadriplegia.

Which of the following activities will be limited by this injury?

  1. wrist extension
  2. elbow extension
  3. elbow flexion
  4. shoulder flexion
  5. raising his arms above his shoulders

Answer(s): B

Explanation:

This patient should be able to perform any activity that requires innervation from C6 or above. The biceps and deltoid are innervated by C5, so he should be able to lift his arms above his head, have shoulder flexion, and elbow flexion. C6 innervates the extensor carpi radialis, so wrist extension should be preserved. The triceps rely on C7, so he would not be able to perform elbow extension.






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