A 65-year-old asymptomatic female is found to have extensive sigmoid diverticulosis on screening colonoscopy. She asks whether there are any dietary changes she should make.
In addition to increasing fiber intake, which one of the following would you recommend?
Correct Answer E:
Patients with diverticulosis should increase dietary fiber intake or take fiber supplements to reduce progression of the diverticular disease. Avoidance of nuts, corn, popcorn, and small seeds has not been shown to prevent complications of diverticular disease.
Which one of the following is the best radiographic test for confirming the diagnosis of renal colic?
Correct Answer C:
Non-contrast helical CT is the gold standard for the diagnosis of renal colic. Its sensitivity and specificity are superior to those of ultrasonography (choice B) and intravenous pyelography (choice D). Non calcium stones may be missed by plain radiography (choice A) but visualized by CT. MRI (choice E) is a poor tool for visualizing stones.
A 27-year-old white male construction worker suffers from severe plaque-type psoriasis that has required systemic therapy.
Which one of the following is associated with this condition?
Correct Answer D:
Psoriasis is a genetic inflammatory condition that has been associated with a significant risk of cardiovascular morbidity and mortality. Children of patients with the disorder are at increased risk. This is especially true if both parents have the disorder. Life expectancy is somewhat reduced in patients with severe psoriasis, particularly if the disease had an early onset. Plaque psoriasis is usually a lifelong disease; this is in contrast to guttate psoriasis, which may be self-limited and never recur.
Cigarette smoking may increase the risk of developing psoriasis. Psoriasis is also associated with an increased likelihood of obesity, diabetes mellitus, and metabolic syndrome.
The recent CMA guidelines have stated that the potential cardiovascular benefits of daily aspirin use outweigh the potential harms of gastrointestinal hemorrhage in certain populations.
The CMA currently recommends daily aspirin use for which one of the following populations?
The CMA recommends daily aspirin use for males 45-79 years of age when the potential benefit of a reduction in myocardial infarction outweighs the potential harm of an increase in gastrointestinal hemorrhage, and for females 55 79 years of age when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage.
The CMA has concluded that the current evidence is insufficient to assess the balance of benefits and harms of aspirin for cardiovascular disease prevention in men and women 80 years of age or older. It recommends against the use of aspirin for stroke prevention in women younger than 55, and for myocardial infarction prevention in men younger than 45.
Hantavirus pulmonary syndrome results from exposure to the excreta of:
Hantavirus pulmonary syndrome results from exposure to rodent droppings, mainly the deer mouse. About 10% of deer mice are estimated to be infected with hantavirus. In other parts of the country the virus is carried by the white footed mouse. While other rodents are carriers of the virus, they are less likely to live near dwellings, and populations are less dense.
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