A 42 year-old male comes to your primary care office complaining of hearing loss. He was started on a new medication 8 months ago. His hearing loss progressively became worse over the time. Two months ago, he reduced the dose of the medication, yet his hearing has not improved. Of the following, which group of medications can cause ototoxicity independent of their dose?
A 54-year-old man presents to the clinic for a pre-employment physical examination. He has no complaints other than ‘occasional coughs and colds’. His only concern is elevated blood pressure for the last 4 weeks. He made some lifestyle changes including exercise, weight loss, smoking cessation and a low-salt diet. His temperature is 99 ⁰ F, heart rate is 72 beats per minute, respiratory rate is 14 breaths per minute, and blood pressure is 160/90 mm Hg. You prescribe hydrochlorothiazide to treat his hypertension. Which of the following is true about this medication?
A 58 year-old woman comes to your office with a pre-surgery clearance form. She is going to have cataract surgery next month and her eye doctor wanted her to get a physical examination before the surgery. She reports no medical complaints. Her past medical history is significant for occasional acid reflux disorder. Her serum creatinine level was 1.2 mg/dL two weeks ago. She works as a teller in a local bank and exercises one hour a day in the local gym. Her temperature is 99 °F (37.2 °C), heart rate is 78 beats/min, blood pressure is 125/80 mm Hg, respirations are 19 breaths/min, and oxygen saturation is 98% on room air. Her physical examination is significant for cataracts in both eyes. Of the following, the next step in her management is
A 67-year-old male presents to the emergency room with severe chest pain. His ECG records ST segment elevation and development of new Q waves in precordial leads. Lab findings reveal elevated troponin. He is admitted for definitive treatment. Which of the following is true concerning ventricular remodeling after myocardial infarction?
A 26-year old male comes to the emergency room complaining of syncope. He passed out while exercising in the gym. His father died of sudden cardiac death in his early 40s. Physical examination is significant for paradoxical splitting of second heart sound, S4 gallop, sustained apical impulse and a systolic ejection murmur at left lower sternal border. The murmur increased with the Valsalva maneuver. Patient was admitted for investigative studies. ECG revealed left ventricular hypertrophy with exaggerated septal Q waves. Echocardiogram showed asymmetrical thickening of the interventricular septum, resulting in dynamic obstruction of the LV outflow tract and abnormal systolic motion of the mitral valve. Which of the following medications should be avoided in this patient?
A 55-year-old man presents with fatigue, abdominal distension, and jaundice. Laboratory tests reveal elevated liver enzymes, low albumin, and prolonged prothrombin time. A liver biopsy confirms significant fibrosis and cirrhosis. Of the following, which can cause liver fibrosis and cirrhosis?
Which of the following diagnostic tests is useful to differentiate between Type I Amiodarone-induced thyrotoxicosis and Type II Amiodarone-induced thyrotoxicosis?
