Free Exam: RamCharanMayoMedicine8to12
Number of Questions in Test: 56
Number of Questions in Preview: 5
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You work in an ambulatory clinic. You want to identify each of your patients who might have had an acute pulmonary embolism (PE). Therefore, you use a clinical probability assessment tool as part of your diagnostic algorithm for patients with suspected PE. With this assessment tool, if the responses to all questions are negative, the estimated prevalence of PE is only 10%. You also know that a D-dimer enzyme-linked immunosorbent assay (ELISA) has a sensitivity of 95% and a specificity of 50% for the diagnosis of PE in an ambulatory caresetting. If you used this ELISA D-dimer test as part of your algorithm to clarify the diagnosis in this low-prevalence group, what percentage of that group who test positive would actually have a confirmed PE?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 2
In question 1, what percentage of this group of patients with a negative ELISA D-dimer test, would not have had a PE?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 3
A well-done randomized trial evaluated the efficacy of full-dose subcutaneous low-molecular-weight heparin (LMWH) versus warfarin (international normalized ratio [INR], 2.0-3.0) in reducing recurrent venous thromboembolism (VTE) in a group of patients with VTE and active cancer. The study duration was 6months. During that time, 17% of the cancer patients receiving warfarin had recurrent VTE compared with 9% of patients receiving full-dose subcutaneous LMWH. On the basis of this information, how many patients need to be treated for 6 months with subcutaneous LMWH to prevent one additional VTE?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 4
A 70-year-old diabetic man with arteriosclerosis obliterans is to have aortobifemoral bypass surgery. You perform a preoperative evaluation and are asked to comment specifically on the need for additional preoperative testing. He is fairly inactive because of severe claudication after walking only 100 feet. He golfs but uses a motorized cart. Chest radiographic and electrocardiographic findings are unremarkable. Regarding his preoperative evaluation, which of the following statements is correct?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 5
A 75-year-old woman is referred for preoperative cardiac evaluation before upcoming cataract extraction. Her medical history is significant for insulin-dependent diabetes mellitus and a distant past history of myocardial infarction. Four years ago, she had three-vessel coronary artery bypass grafting. Nine months ago, her echocardiogram demonstrated an ejection fraction of 40%. She is being treated with furosemide, lisinopril, long-acting nitrates, and aspirin. She denies having any current symptoms of angina or congestive heart failure. She has a sedentary lifestyle and it is difficult to assess her functional capacity by history. Her chest radiograph is unremarkable except for mild cardiomegaly. Her electrocardiogram shows no acute changes. Which of the following statements regarding her preoperative evaluation is correct?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |