2561; 2018; questions (quizzes) & answers, Q&A, notes, guide lines ... ;
2561; 2018; questions (quizzes) & answers, Q&A, notes, guide lines ... ;
ACP (American College of Physicians); ACS (American Cancer Society); ANS (Autonomic Nervous System); ASD (Atrial Septal Defect); ASV (Average Successive Variability); BMD (Bone Mineral Density); CGM (Continuous Glucose Monitor); COPD (Chronic Obstructive Pulmonary Disease); CT (Computed Tomography); DNA (deoxyribonucleic acid) e.g. from cell to its nucleus to its chromosome (2 strings) to DNA (codes) ... ; Dx (Diagnosis); FDA (Food and Drug Administration); HAL (Hemorrhoidal Artery Ligation); HPV (Human Papilloma Virus); IFF (if-and-only-if); Pt (Patient); Q&A (Questions & Answers); UV (Ultra Violet);
。
CME (Q&A) no. 222; low dose aspirin is (Tx) for prevention of cardiovascular disorder; in 2018/2561, Hyogo College of Medicine (www.hyo-med.ac.jp), Japan, reported at AHA (American Heart Association) 's scientific session, i.e. low dose aspirin can prevent NOT ONLY cardiovascular BUT ALSO
(a) IBD (Inflammatory
Bowel Disease);
(b) dementia (cognitive impairment);
(c) type 1 diabetes' insulin levels;
(d) nasal allergy;
Answer: dementia (cognitive impairment);
。
CME (Q&A) no. 217; regarding 2 weeks old infant's pacifier vs. breastfeeding info would be:
(a) after lactation is
established for 2 weeks old (infant), pacifier can be used;
(b) secretion of milk by mammary glands (lactation) till 4 months of age
(infant);
(c) IFF lactation is established, using pacifier does not affect likelihood of
infant;
(d) statements (a), (b), and (c) are correct;
Also see: Specialties PD;
Answer: statements (a), (b), and (c) are correct;
。
CME (Q&A) no. 200; double stranded
DNA is cut by:
(a) active enzyme; digestive
enzyme; protein digesting enzyme; respiratory enzyme;
(b) type II restriction enzyme;
(c) flavin-enzyme; flavo-enzyme;
(d) enzyme inhibitor (binding molecules);
(e) DNA repairing
enzyme;
(f) enzyme commission number codes;
(g) linked enzyme assay e.g. immuno-sorbent; Enzyme unit;
(h) enzyme kinetic (chemical reaction);
(i) plant enzyme a.k.a. vegetable enzyme;
(j) hydrolytic enzyme (hydrolase is enzyme WHICH catalyzes);
(k) this DOMAIN
(Gene Therapy System)
DNA repairing enzymes;
2020s, early 21st century and
beyond;
well trained kids! replied : HOW could you design this
DOMAIN (Gene Therapy System)
's DNA repairing enzymes sir ? since we know
kouso
enzyme is in liquid
form, enzyme is NOT in physical form;
i
,
me
, me
: you well trained kids! 1st to understand BLI (Body Length Index),
limited by, caused by C
Sequence Number (BF1) growth rate (since
2000s); 2nd to understand enzyme
commission number codes obey
iroColourWaveForm 's color codes and its gravity spots; 3rd to understand
physical
PHYSICS (hole, string)
doko WHERE hole board defines string's direction (a.k.a.
directional since 1980s);
reversed engineering of filters to defined environment would be
DNA
repairing enzymes;
well trained kids! replied; Um! that might be blue vs. green, regarding filters to defined environment, because we're in solar system (our earth, our moon); reversed would be blue must be defined by green, green must be defined blue; are we now thinking correctly sir ?
i
,
me
, me
: Yes.
mochiron
of course; Remark:
use light's instinct, and our earth's 1 way DEE; And Then, hopefully you well
trained kids will be creating
DNA repairing enzymes;
And Then, don't forget to form your own billionaire club;
i
,
me
, me
: have you ever seen DEE pattern in heart shape? have you ever realize mouth
alike
DEE pattern forms at defined momentum
?
well trained kids ! replied: no, not yet; is it dream, guessing, imaginary sir ?
i
,
me
, me
: hint would be slow-down time period ... ;
because, to be human beings, approx. 23 lunar weeks, or 32 JUN
time period ... ;
answer: type II restriction enzyme;
。
CME (Q&A) no. 186; http://cdc.gov/hiv recommends HIV test (age between 13 and 64) at least once in (regular health care) routines; PEP, post exposure prophylaxis; PrEP, pre exposure prophylaxis; preferred regimen is Tenofovir Disoproxil Fumarate (TDF) 300mg with emtricitabine FTC 200mg once daily, combined with either raltegravir (RAL) 400mg twice daily, or dolutegravir (DTG) 50mg once daily; IFF STD, Gonorrhea and Chlamydia infections can be Dx (diagnosis) by:
(a) if Ag/Ab (combined antigen
and antibody) testing is unavailable, antibody test is
recommended;
(b) nPEP is indicated for persons without HIV infections; i.e. after PEP;
(c) nucleic acid amplification;
(d) Syphilis serology test, for STD;
Remark: all (a, b, c, d) statements are correct, but question emphasizes Gonorrhea and Chlamydia infections;
answer: nucleic acid amplification;
。
CME (Q&A) no. 169; cardiovascular stroke risk increases, coronary & cardiovascular disease risk increases, and non fatal MI risk increases, because of:
(a) abnormal uppermost quintile
ASV in triglycerides;
blood becomes thicker;
(b) HDL cholesterol;
(c) limited number of lipids (e.g. 3 lipids) level for ASV;
(d) non of the above;
Remark: cardiologists monitor patients' Average Successive Variability (ASV) in triglycerides (number mg/dL); HDL cholesterol is known as good cholesterol;
Answer: abnormal uppermost quintile ASV in triglycerides;
。
anemia vs. pneumonia, also see: a G T S U;
CME (Q&A) no. 165; regarding
ultrasound,
normal lung A lines can be defined by:
(a)
(Y = Ln X) spine line (DEE (pleural effusion)) indicates normal lung A lines;
(b)
zero Curvature based lung area is NOT smooth surface;
(c) ultrasound prompts no 3 lines are in vertical distance consecutively;
(d) C Sequence Number
(BF1 distance) based 3 lines are vertically consecutive, and they are
horizontally parallel;
Remark: ultrasound prompts no 3 lines are in vertical distance (i.e. abnormal lung B lines) consecutively; regarding abnormal lung B lines, and consolidated lung of pneumonia, zero Curvature based lung area is NOT smooth surface; ultrasound should be scanned along with "parallel" ribs' (left and right, based on spine's (a.k.a. Mid Line) upward direction and downward direction) regarding scanning of normal lung A lines;
ultrasound normal lung A lines;
Answer: C Sequence Number (BF1 distance) based 3 lines are vertically consecutive, and they are horizontally parallel;
。
CME (Q&A) no. 155; in a health care system (e.g. hospitals), chemotherapy way of Tx, gene therapy system way of Tx, immunological way of Tx, and surgical way of Tx, would be by:
(a) nutritionist;
(b) radiologist;
(c) oncologist;
(d) geriatric psychologist;
Also see: Specialties ON;
Answer: oncologist;
。
CME (Q&A) no. 150; early Parkinson disease (typical tremor) Dx is:
(a) typical tremor in high
frequency;
(b) typically refer to pediatric neurologist;
(c) typical tremor progresses from fingers to forearm;
(d) typical psychogenic tremor consistently;
Also see: Specialties N;
Answer: typical tremor progresses from fingers to forearm;
。
CME (Q&A) no. 149; Medtronic (www.medtronic.com) 's CGM (Continuous Glucose Monitor), FDA (Food and Drug Administration) approved for type 1 diabetes, (age ≥ 14 year), and its (the device) info:
(a) monitor arm's tandem, And
Then, its sensor works automated insulin delivery as data;
(b) previous model device works only at abdomen;
(c) new 2018/2561 model works as
arm-placement indication
(can be on arm, facing the arm's tandem);
(d) statements (a), (b), and (c) are correct;
Also see: Device Acronym;
Answer: statements (a), (b), and (c) are correct;
。
CME (Q&A) no. 144; Tx for erythrasma would be:
(a) Potassium Hydroxide (KOH)
testing result should be negative;
(b) bid, 2 weeks, topical 2% miconazole;
(c) bid, 2 weeks, topical gel, 1% clindamycin;
(d) all a, b and c are correct and should be together as Tx;
Remark: in common, skin is KOH tested 1st; if KOH testing positive, then diff Dx and Tx ... ;
Also see: Specialties D;
Answer: all a, b and c are correct and should be together as Tx;
。
CME (Q&A) no. 141; Pt age < 24 years, having sign and symptom (loud heart sound, mild cough, wheezing) and CT Dx prompts Atrial Septal Defect (ASD), so WHICH one of the following heart condition is ASD:
(a) gated cardiac CT (LA, LV,
RA, RV) flowing from RA to LA to LV;
(b) gated cardiac CT (LA, LV, RA, RV) flowing from LV to LA to RA;
(c) anterior chamber wall disorders cannot be cured;
(d)
Gated Cardiac CT (LA, LV, RA, RV) can be color coded by
this DOMAIN 's
Gene Therapy
System;
Also see: Specialties CD;
Answer: gated cardiac CT (LA, LV, RA, RV) flowing from RA to LA to LV;
。
CME (Q&A) no. 133; virtual mucopexy means:
(a) either infrared coagulation
or rubber band ligation can produce satisfactory outcome;
(b) HAL and lifting hemorrhoidal prolapse;
(c) infrared photocoagulation (a.k.a. coagulation therapy) Tx for internal
hemorrhoids;
(d) laser photocoagulation;
Remark: laser photocoagulation is Tx for eyes;
Answer: HAL and lifting hemorrhoidal prolapse;
。
CME (Q&A) no. 130; to prevent fracture, regarding Pt with low BMD (osteoporosis), ACP 's guideline is:
(a) 5 years continuous pharmacologic treatment;
(b) during therapy, Bone Mineral Density (BMD) should be checked every 2 years;
(c) bisphosphonates (aledronate, risedronate) is NOT a class of drug indicated
for male Pt;
(d) myeloma, osteoporosis, and Paget's disease (deterioration of bone tissue)
are NOT age related;
Remark: age related low BMD is osteoporosis disease (this DOMAIN recommends eating dried anchovies fish daily and naturally i.e. to avoid osteoporosis); age related malignant tumor of bone marrow is myeloma disease; age related Paget's disease is deterioration of bone tissue; bisphosphonates, class of drug WHICH increases bone density and bone strength;
Also see: Specialties FP; Specialties OBG; Specialties Skeletal;
Answer: 5 years continuous pharmacologic treatment;
。
CME (Q&A) no. 128; for decreasing Clostridium difficile infection (common infection in colon, a.k.a. C. Difficile) rate, WHICH one is correct intervention:
(a) using chlorhexidine
gluconate for bathing;
(b) coordinated program of antimicrobials (a.k.a. antibiotic stewardship);
(c) using Pulsed Xenon UV disinfection;
(d) cleaning with hydrogen peroxide (H2O2) liquid solution;
Also see: Specialties GE; Specialties ID;
Answer: antibiotic stewardship;
。
CME (Q&A) no. 125; COPD exacerbation can be reduced by:
(a) pro biotic course;
(b) opioid agonist (agonist is Tx drug WHICH activates defined receptors in the
brain);
(c) smoking cessation;
(d) estrogen therapy;
Remark: estrogen therapy is for postmenopausal women; high risk of respiratory depressions EXIST if opioid agonist; smoking causes COPD; Also see: Specialties PCC;
Answer: smoking cession;
。
CME (Q&A) no. 124; common vaginitis Dx and Tx would be:
(a) following statements ((b), (c), and
(d)) are TRUE;
(b) IFF pregnancy, topical antifungal for vulvovaginal candidiasis;
(c) IFF recurrent vulvovaginal candidiasis, weekly follow-up Tx for 6 months;
(d) IFF vaginal discharge with odor, swab specimens for Dx of bacterial
vaginosis;
Answer: all following (b), (c), and (d) are TRUE;
。
CME (Q&A) no. 122; WHICH one is ACS (American Cancer Society)' recommended cancer screening, among the following statements:
(a) cancer screening (rectal):
annual prostate specific antigen testing for male Pt IFF age < 30 years;
(b) cancer screening (cervical): HPV DNA testing for female Pt IFF age (20 - 30), every 5 years;
(c) cancer screening (lung): low dose CT for Pt IFF age (55 - 75) with 30 pack-per-year
smoking history;
(d) cancer screening (breast): annual mammography for female Pt IFF age < 30 years;
Also see: Specialties ON;
Answer: low dose CT for Pt IFF age (55 - 75) with 30 pack-per-year smoking history;
。
CME (Q&A) no. 121; in 2018/2561, www.medicaldevicedepot.com 's discounted medical devices are:
(a) EKG with interpretation,
available by Bionet Cardio Care 2000, Burdick ELI 250c, Schiller AT-2 Plus, and
Welch Allyn CP150;
(b) via your (PC, Personal Computer), Autonomic Nervous System (ANS)
and Sudomotor Assessment, CLIA free allergy test, and Neuro-Cognitive Testing
(e.g. anxiety, dementia, depression, PTSD, TBI, ... );
(c) EMR compatible spirometry; Family Practice Exam Table; GE EKG machine;
Lifeline AED; PC based EMR compatible cardiology; Vital Sign Monitor (blood
pressure, pulse oximetry, temperature);
(d) all a, b and c are correct and should be together as (Dx) medical
devices ... ;
Answer: all a, b and c are correct and should be together as (Dx) medical devices;
。
CME (Q&A) no. 120; opioid (narcotic) addiction can be Tx by:
(a) respiratory depression as
Tx;
(b) Buprenorphine therapy as Tx with its adverse effect constipation;
(c) effectively blunt the heroin as Tx, every 12 hours;
(d) none of the above;
Answer: Buprenorphine therapy as Tx with its adverse effect constipation;
。
CME (Q&A) no. 119; common Tx (treatment) for hemorrhoids is:
(a) hot spring water bath;
(b) reduce drinking water;
(c) lower fiber diet;
(d) using stool softeners;
Also see: Specialties GE;
Answer: using stool softeners;
。
CME (Q&A) no. 117; 17 years old obesity (BMI > 28) teenager is known socially isolated, and then to determine whether the child has been bullied or not, the child should be asked:
(a) the child feels safe at
school;
(b) using evidence based screening tool;
(c) questions on parental supports;
(d) initialized screening question: e.g. have you ever been bullied ?
CHP, Child and Adolescent Psychiatry;
Answer: the child feels safe at school;
。
CME;
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