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9929 Medicine

A 27-year-old woman presents with nose bleeds, rash on her feet, and fevers. She looks unwell, pale, jaundiced, and there are multiple petechiae on her feet. The lungs are clear, heart sounds normal, and abdomen is soft with no palpable spleen or liver. Her bilirubin is 2 mg/dL (mostly indirect), aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase (ALP) are normal. The hemoglobin is 8.7 g/dL, platelets 24,000/mL, PT/PTT normal, and bleeding time is elevated. The blood film reveals anemia, thrombocytopenia, and red cell fragments.For the above patient with a bleeding disorder, select the most likely diagnosis.

Avon Willebrand disease
Bhemophilia A
Chemophilia B
Dthrombotic thrombocytopenic purpura (TTP)
Medicine
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9933 Medicine

A 64-year-old man presents with increased shortness of breath. He has a past history of chronic obstructive pulmonary disease (COPD) and recently developed increased cough and sputum production but no fever or chills. He appears in mild respiratory distress, respirations are 26/min, pulse 120 beats/min, blood pressure 145/84 mm Hg, and oxygen saturation 90%. He has bilateral expiratory wheezes. His ECG reveals multifocal atrial tachycardia (MAT) (discrete P waves with at least three different morphologies).For the above patient with an arrhythmia, select the most appropriate treatment.

Adigitalis
Bverapamil
Cdiltiazem
Dbeta-blockers
Medicine
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