Comprehensive Clinical Science Flashcards

A 32-year-old woman at 35 weeks gestation presents with BP 160/106 mmHg, severe frontal headache, and 3+ proteinuria. She has no prior history of hypertension. What is the definitive treatment?

Answer: Magnesium sulfate for seizure prophylaxis and proceed with delivery

Severe preeclampsia requires magnesium sulfate seizure prophylaxis and delivery, which is the only definitive treatment regardless of gestational age.

A 3-year-old boy presents with fever (39.1°C), petechiae, neck stiffness, and irritability. He appears toxic. What is the most appropriate immediate action?

Answer: Administer IV ceftriaxone immediately, then LP when clinically safe

Suspected bacterial meningitis requires immediate IV antibiotics; diagnostic lumbar puncture must not delay treatment in an ill-appearing, potentially unstable child.

A 42-year-old woman reports 6 weeks of persistent low mood, anhedonia, hypersomnia, psychomotor slowing, and passive thoughts of death without active suicidal intent. What is the most appropriate first-line treatment?

Answer: SSRI therapy (e.g., sertraline or fluoxetine)

SSRIs are first-line pharmacotherapy for major depressive disorder due to their efficacy, tolerability, and lower lethality in overdose compared to alternatives.

A 28-year-old woman at 22 weeks gestation presents with right lower quadrant pain, fever, and leukocytosis. Pelvic ultrasound is non-diagnostic. What is the preferred next imaging step?

Answer: MRI abdomen without contrast

MRI without gadolinium is the preferred imaging for suspected appendicitis in pregnancy when ultrasound is non-diagnostic, providing high sensitivity without fetal radiation.

A 3-day-old full-term neonate develops jaundice. Total serum bilirubin is 14.5 mg/dL. The infant is breastfeeding well, the direct Coombs test is negative, and blood type incompatibility is absent. What is the most appropriate next step?

Answer: Phototherapy

Phototherapy is the first-line treatment for neonatal hyperbilirubinemia when bilirubin reaches age- and risk factor-adjusted treatment thresholds.

A 35-year-old man presents with 3 weeks of euphoria, grandiosity, decreased sleep need (2 hours/night), pressured speech, and impulsive overspending. No prior psychiatric history. What is the first-line mood-stabilizing treatment for acute mania?

Answer: Lithium carbonate

Lithium is a first-line mood stabilizer for acute mania in bipolar disorder and reduces recurrence risk for both manic and depressive episodes.

A 65-year-old man on postoperative day 5 after sigmoid colectomy develops fever (38.8°C), erythema, warmth, and purulent discharge at the wound site. Which organism is the most likely causative agent?

Answer: Staphylococcus aureus

S. aureus is the most common cause of superficial surgical site infections, typically presenting 4–7 days postoperatively with localized signs of infection.