1.Easy
Uric acid in the blood is a breakdown product of:
- AFats
- BGlucose
- CPurines
- DHemoglobin
2.Easy
What does the term pancytopenia mean?
- ALow red cells with normal platelets
- BHigh white cells with low platelets
- CHigh red cells, white cells and platelets
- DLow red cells, white cells and platelets
3.Easy
Below about which blood glucose level is hypoglycemia usually defined and treated in a person with diabetes?
- A40 mg/dL (2.2 mmol/L)
- B126 mg/dL (7.0 mmol/L)
- C70 mg/dL (3.9 mmol/L)
- D100 mg/dL (5.6 mmol/L)
4.Medium
A patient is on an IV insulin infusion protocol in the ICU. How often is the blood glucose usually checked?
- AOnce every 12 hours
- BOnly if symptoms occur
- CAbout every hour
- DOnce a day before breakfast
5.Medium
Why must vitamin B12 deficiency be ruled out before treating macrocytic anemia with folic acid alone?
- AFolic acid causes iron overload when B12 levels are low
- BFolic acid blocks the absorption of all B12 from the diet
- CFolic acid can fix the anemia while B12-related nerve damage continues
- DFolic acid makes B12 deficiency anemia much worse within a few days
6.Medium
When should blood cultures be taken for a patient with suspected sepsis?
- ABefore the first antibiotic dose, without delaying it much
- BAt any time, since antibiotics do not affect the result
- CAfter the first three doses of antibiotics
- DOnly if the fever lasts more than three days
7.Hard
A patient taking apixaban asks why they do not need regular INR tests like their neighbor on warfarin. What is the best explanation?
- AThe INR is checked secretly together with the other routine blood tests
- BApixaban is monitored with an aPTT every day instead
- CApixaban does not actually thin the blood
- DIts effect is predictable, so routine clotting tests are not needed
8.Hard
Two days after bowel surgery, a patient with nasogastric suction has a distended abdomen, absent bowel sounds and muscle weakness. The potassium is 2.8 mEq/L. Which interpretation is best?
- AHypokalemia from gastric losses is contributing to paralytic ileus
- BThe low potassium is due to the patient drinking too much water
- CHyperkalemia from tissue damage is causing the bowel to stop
- DThe potassium is normal for the second day after surgery
Answer key
- 1. C · Purines
- 2. D · Low red cells, white cells and platelets
- 3. C · 70 mg/dL (3.9 mmol/L)
- 4. C · About every hour
- 5. C · Folic acid can fix the anemia while B12-related nerve damage continues
- 6. A · Before the first antibiotic dose, without delaying it much
- 7. D · Its effect is predictable, so routine clotting tests are not needed
- 8. A · Hypokalemia from gastric losses is contributing to paralytic ileus
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