25. A 16-year-old girl calls the physician on a Friday night 2 hours after a condom broke during sexual intercourse with her boyfriend. She asks the physician to prescribe an emergency oral contraceptive. The physician on call is not the patient's regular physician and does not dispense emergency contraception for moral reasons. After the physician respectfully informs the patient that he does not prescribe this contraceptive, it is most appropriate for the physician to state which of the following?
A
) "I am obligated to discuss this with your parents."
B
) "I can have one of my colleagues call you back to further discuss your concerns."
C
) "I recommend that you call the local women's health clinic."
D
) "I will tell your regular physician to call you on Monday to talk with you about your situation."
E
) "I'm sorry, but you will have to research other ways to obtain the prescription yourself."
Can someone explain why C is wrong... Aren't you supposed to refer them elsewhere?
35. A 66-year-old woman is brought to the emergency department by her daughter because of a 2-day history of fever, flank pain, pain with urination, and nausea. Ten days ago, she was admitted to the hospital for similar symptoms and was diagnosed with acute pyelonephritis. She was discharged with instructions to take oral ciprofloxacin after a 3-day course of intravenous ciprofloxacin resulted in improvement. She also has hypertension, hyperlipidemia, and osteoporosis. Current medications also include alendronate, calcium carbonate, ezetimibe, hydrochlorothiazide, and simvastatin. Her temperature is 39.1°C (102.4°F), and blood pressure is130/80 mm Hg. The most likely cause of this patient’s current condition is an interaction between her current oral antibiotic and which of the following medications?
A
) Alendronate
B
) Calcium carbonate
C
) Ezetimibe
D
) Hydrochlorothiazide
E
) Simvastatin
44. A 19-year-old woman is admitted to the hospital for antibiotic treatment of meningococcal meningitis. She is stabilized. Three days later, her pulse is 120/min, and blood pressure is 60/30 mm Hg. Physical examination shows bilateral flank tenderness. Serum studies show a sodium concentration of128 mEq/L, potassium of 5.4 mEq/L, and bicarbonate of 20 mEq/L. Which of the following is the most appropriate next step to determine the cause of this patient's hypotension?
A
) Adrenocorticotropic hormone stimulation test
B
) Blood culture and antibiotic sensitivity test
C
) Dexamethasone suppression test
D
) Thyrotropin-releasing hormone stimulation test
E
) Urine culture and antibiotic sensitivity test
17. A study is conducted to compare the incidence of myocardial infarction in patients undergoing two different types of angioplasty or an operative procedure to manage single-vessel coronary artery disease. A total of 1000 patients are enrolled. Through a chance process, 500 are assigned to undergo the operative procedure, 250 are assigned to undergo one type of angioplasty, and 250 are assigned to undergo a second type of angioplasty. All patients are followed for 3 years to determine the incidence of myocardial infarction. Which of the following best describes this study design?
A
) Case-control study
B
) Community intervention trial
C
) Ecological study
D
) Historical cohort study
E
) Prospective cohort study
F
) Randomized clinical trial
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