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Multiple Choice Questions (MCQ)

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Category: Hematologic and Oncologic Disorders--->Solid Tumors
Page: 1

Question 1#Print Question

A 67-year-old man with past medical history of hypertension, diabetes mellitus, smoking, and recent diagnosis of small cell lung cancer is admitted to the ICU presents with complaints of nausea, vomiting, weakness, and altered mental status. On examination he is somnolent but opens his eyes to voice. He is not oriented to person or place. He appears well hydrated and his vital signs are within normal limits. His basic metabolic panel is notable for:

  • serum sodium level of 119 mmol/L
  • creatinine of 0.65 mg/dL
  • serum osmolality of 260 mOsm/kg

The patient has a seizure as you are examining him. After ensuring adequate oxygenation and ventilation the most appropriate next treatment is ?

A. Fluid Restriction
B. Intravenous furosemide
C. Intravenous 3% NS
D. Tolvaptan


Question 2#Print Question

A 63-year-old woman with a recent diagnosis of lung cancer is admitted to the ICU with hypotension, acute onset of chest pain, cough, and shortness of breath. Her vital signs are:

  • T 37.6
  • HR 123
  • RR 40
  • BP 87/65 mm Hg
  • oxygen saturation of 88% on 6 L NC

Chest X-ray is notable for a right lower lobe consolidation, as well as widened mediastinum. Chest computed tomography with contrast reveals a large pericardial effusion and transthoracic echocardiography shows a large pericardial effusion with diastolic collapse of the right ventricle.

Which of the following is next most appropriate therapeutic intervention at this time?

A. Noninvasive positive pressure ventilation
B. Emergent endotracheal intubation
C. Echocardiography guided pericardiocentesis
D. Emergent radiation therapy


Question 3#Print Question

A 57-year-old woman with history of breast cancer treated with L. mastectomy and chemotherapy and radiation presents with a 1- week history of headaches, gait instability, progressive confusion, and a new onset seizure. On physical examination she is somnolent and only opens her eyes in response to voice. She is only oriented to person (knows her own name) but is not oriented to place or date. She does not follow commands but does withdraw from painful stimuli. Emergent noncontrast head CT is performed, which reveals multiple masses with surrounding edema and no evidence of blood.

Based on the data provided what is the patient’s Glasgow Coma Score? 

A. 11
B. 8
C. 12
D. 9


Question 4#Print Question

A 57-year-old woman with history of breast cancer treated with L. mastectomy and chemotherapy and radiation presents with a 1- week history of headaches, gait instability, progressive confusion, and a new onset seizure. On physical examination she is somnolent and only opens her eyes in response to voice. She is only oriented to person (knows her own name) but is not oriented to place or date. She does not follow commands but does withdraw from painful stimuli. Emergent noncontrast head CT is performed, which reveals multiple masses with surrounding edema and no evidence of blood. 

What is the most appropriate intervention for this patient at this time?

A. Endotracheal intubation
B. IV dexamethasone therapy
C. Radiation therapy
D. Extra ventricular drain placement


Question 5#Print Question

A 47-year-old man with recent diagnosis of pheochromocytoma is admitted to the ICU for management of hypertensive crisis. A radial arterial catheter is placed, and the patient is started on sodium nitroprusside with goal systolic blood pressure of 140 to 160 mm Hg. During rounds on the second day following ICU day, the bedside nurse notifies you that the patient’s blood pressure has been progressively increasing despite up titration of the nitroprusside infusion. On examination, the patient is complaining of headache and appears anxious and confused. His skin is flushed and he is tachycardic and hypertensive. The sodium nitroprusside is discontinued, oxygen administered, and a nicardipine infusion is started.

What is the most appropriate to administer for treatment of this patient? 

A. Silver nitrate
B. Sodium thiosulfate
C. Methylene blue therapy
D. Fenoldopam




Category: Hematologic and Oncologic Disorders--->Solid Tumors
Page: 1 of 1