A 40-year-old man with a history of uncontrolled diabetes presents to the clinic for his yearly follow-up. His recent laboratory tests show sodium 132 mEq/L (normal 136–145 mEq/L), creatinine 1.4 mg/dL, GFR 55 mL/min/1.73 m2, and glucose 450 mg/dL. His urinalysis is positive for glucose. He is asymptomatic. Which of the following is high priority and next step in his management?

43. Which of the following antibiotic regimens is most appropriate for empiric therapy in a patient with necrotizing fasciitis?

57. J.T. is a 57-year-old male status post MVA, currently post op day 7 and on high levels of positive pressure ventilation. He is now febrile with worsening leukocytosis. CXR shows increased bilateral diffuse opacifications, increased peak/plateau inspiratory pressures, and increased 02 requirements. This is related to which of the following and what is the most appropriate treatment?

26. What is the first-line and most effective drug for the symptomatic treatment of the above neurologic disorder (#25)?

23. A 27-year-old man presents to the emergency department complaining of muscle pain, weakness, and reddish-brown urine. He states that while moving furniture yesterday he got pinned under a dresser. He has large areas of bruising over his bilateral thighs. Which additional finding would confirm the suspected diagnosis?

91. A 24-year-old woman, with history of recent upper respiratory infection, was admitted to the ICU with a week of progressive ascending weakness. On initial examination she was awake, alert, oriented, and cooperative. She had quadriparesis and areflexia. She subsequently developed respiratory distress and was intubated. Head and cervical spine CT are read as normal. A lumber puncture is performed, which reveals the following CSF profile: 0 WBCs, 0 RBCs, Protein 120 mg/dL, and Glucose 80 mg/dL. What is the next best step in management?

75. A 74-year old male is brought into the emergency department with a chief complaint of substernal chest pressure for the past 30 minutes. This is associated with nausea and diaphoresis. He has a history of angina, which was previously relieved with nitroglycerin (NTG). His pain persists despite nitroglycerin. Physical exam reveals a heart rate of 80 bpm, respiration of 30 bpm, and BP of 104/60 mmg. The EKG demonstrates ST elevation in leads II, III, and aVF. Based on these symptoms and findings, the ACNP knows that which wall of the heart is affected.  

50. What are common pathologies that produce wheezes?

41. A 22-year-old man presents to the emergency department after a motor vehicle collision as an unrestrained driver. He has suffered a penetrating trauma to his chest. He has muffled heart sounds, clear lung sounds bilaterally, and distended neck veins. Currently, his vital signs are BP 81/42 mm Hg, HR 123, RR 23, pulse oximetry 98%, and cardiac output 3 L/min. What is the best initial action?

  53. What disorder is defined by the presence of fever, jaundice, and right upper quadrant pain?