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Q 1 . A 68-year-old woman with stage IIIB squamous cell carcinoma of the lung is admitted to the hospital because of altered mental status and dehydration. Upon admission, she is found to have a calcium level of 19.6 mg/dL and phosphate of 1.8 mg/dL. Concomitant measurement of parathyroid hormone was 0.1 pg/mL (normal 10–65 pg/mL), and a screen for parathyroid hormone–related peptide was positive. Over the first 24 h, the patient receives 4 L of normal saline with furosemide diuresis. The next morning, the patient’s calcium is now 17.6 mg/dL and phosphate is 2.2 mg/dL. She continues to have delirium. What is the best approach for ongoing treatment of this patient’s hypercalcemia? A. Continue therapy with large-volume fluid administration and forced diuresis with furosemide. B. Continue therapy with large-volume fluid administration, but stop furosemide and treat with hydrochlorothiazide. C. Initiate therapy with calcitonin alone. D. Initiate ther...

Q21: Dose of Gentamicin is reduced in the elderly due to: a) Liver failure b) Reduced renal function c) Decreased GI absorption d) Decreased metabolism Correct Answer: b Explanation: Gentamicin is one of the Aminoglycosides. In elderly like all other body functions renal function is also slightly reduced. For Aminoglycosides such as Gentamicin, remember the following three important side effects: Ototoxicity Nephrotoxicity Neurmuscular dysfunction Teratogenic Aminoglycosides are used for severe gram negative rod infections. Since they require oxygen for their uptake, they are therefore ineffective against anaerobes.

Q20: A patient has difficulty closing his right eye and also has distorted facial appearance. He has damage to: a) Right facial nerve b) Right trigeminal nerve c) Left facial nerve d) Left trigeminal nerve Correct Answer : a Explanation: UMN Lesion: Upper face receives bilateral Upper motor neuron (UMN) innervation while lower face receives only contra lateral UMN innervation, so that if there is an UMN lesion ther e is contralateral paralysis of lower face only. LMN Lesion of Facial Nerve: In LMN lesion of facial nerve, whole (upper plus lower) face on the ipsilateral side is affected. So if the patient is unable to close right eye (upper face part) this definitely means that there is a LMN lesion or in other words the facial nerve on the affected side is lesioned.