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NEW QUESTION: 1
A 58-year-old man was referred to the endocrine clinic after a CT scan of abdomen had shown a 4.5-cm left adrenal mass, with a Hounsfield unit measurement of 11 (consistent with high lipid content). He had a 10-year history of type 2 diabetes mellitus and was taking metformin. He was also taking atenolol for hypertension.
On examination at the clinic, his blood pressure was 162/94 mmHg. He was centrally obese with a body mass index of 27 kg/m2 (18-25).
Investigations:
serum potassium3.9 mmol/L (3.5-4.9)
plasma renin activity (after 30 min upright)1.0 pmol/mL/h (3.0-4.3)
plasma aldosterone (after 4 h upright)680 pmol/L (330-830)
overnight dexamethasone suppression test (after 1 mg dexamethasone):
serum cortisol164 nmol/L (<50)
24-h urinary free cortisol132 nmol (55-250)
24-h urinary catecholamines
(adrenaline and noradrenaline)normal
As the lesion was >4 cm in diameter, laparoscopic adrenalectomy was recommended.
What is the most appropriate advice to give to the surgical team about perioperative
management?
A. give preoperative ?-adrenergic receptor blockade in case the lesion is an occult phaeochromocytoma
B. short tetracosactide (Synacthen@) test 48 h postoperatively
C. give corticosteroid cover during and after surgery and reassess postoperatively
D. measure cortisol and aldosterone 2 weeks postoperatively
E. no special precautions are required
Answer: C
NEW QUESTION: 2
You are meeting with the CIO of a financial institution as part of a hybrid infrastructure engagement.
Which discovery question relates to relevant industry trends and best helps you to uncover an opportunity?
A. Have you heard about HPE hybrid infrastructure and how it stacks up against the competition?
B. What do you understand about hybrid infrastructure and how it is different from traditional infrastructure?
C. As applications are becoming central to business, what are your plans for keeping up with demands and rolling out new services
D. As IT environments become more complex and siloed, what are your top of mind concerns about keeping the lights on?
Answer: C
NEW QUESTION: 3
Which of the following is a required segment of an HL7 message?
A. IN1
B. MSH
C. BLG
D. PV2
Answer: B