A researcher is investigating the risk of symptomatic intracerebral hemorrhage associated with tissue plasminogen activator (tPA) treatment in severe ischemic stroke. The outcomes of a large randomized controlled trial of ischemic stroke patients, some of whom were randomized to tPA, is shown: Symptomatic intracerebral hemorrhage No symptomatic intracerebral hemorrhage Received tPA 12 188 Did not receive tPA 25 475 Based on this data, how many patients with severe ischemic stroke would need to be treated with tPA, on average, to contribute to one case of symptomatic intracerebral hemorrhage?
A13
B6
C0.01
D1.2
E100
A 6-month-old male presents to the emergency department with his parents after his three-year-old brother hit him on the arm with a toy truck. His parents are concerned that the minor trauma caused an unusual amount of bruising. The patient has otherwise been developing well and meeting all his milestones. His parents report that he sleeps throughout the night and has just started to experiment with solid food. The patient’s older brother is in good health, but the patient’s mother reports that some members of her family have an unknown blood disorder. On physical exam, the patient is agitated and difficult to soothe. He has 2-3 inches of ecchymoses and swelling on the lateral aspect of the left forearm. The patient has a neurological exam within normal limits and pale skin with blue irises. An ophthalmologic evaluation is deferred. Which of the following is the best initial step?
AGenetic testing
BComplete blood count and coagulation panel
CEnsure the child's safety and alert the police
DPeripheral blood smear
EHemoglobin electrophoresis
A 60-year-old male is admitted to the ICU for severe hypertension complicated by a headache. The patient has a past medical history of insulin-controlled diabetes, hypertension, and hyperlipidemia. He smokes 2 packs of cigarettes per day. He states that he forgot to take his medications yesterday and started getting a headache about one hour ago. His vitals on admission are the following: blood pressure of 160/110 mmHg, pulse 95/min, temperature 98.6 deg F (37.2 deg C), and respirations 20/min. On exam, the patient has an audible abdominal bruit. After administration of antihypertensive medications, the patient has a blood pressure of 178/120 mmHg. The patient reports his headache has increased to a 10/10 pain level, that he has trouble seeing, and he can't move his extremities. After stabilizing the patient, what is the best next step to diagnose the patient's condition?
ADoppler ultrasound of the carotids
BCT head with intravenous contrast
CMRI head without intravenous contrast
DCT head without intravenous contrast
EMRI head with intravenous contrast
+ 7 more in the PDF
Browse all chapters