Q- Which of the following is the initial treatment of a significant aortic stenosis?
A- Balloon valvuloplasty
B- Furosemide
C- Hydrochlorothiazide
D- Valve replacement
D- Valve replacement- In significant aortic stenosis, the only definitive and appropriate treatment is aortic valve replacement. Diuretics such as furosemide or hydrochlorothiazide can worsen the condition by reducing preload, and balloon valvuloplasty is not recommended because the valve typically re-stenoses. For severe disease, even when asymptomatic, valve replacement is the correct management when intervention is required.
Q- Which of the following medications may cause acquired angioedema within days to weeks after starting it?
A- Aspirin
B- Benazepril
C- Clopidogrel
D- Propranolol
B- Benazepril- ACE inhibitors (such as benazepril) can cause acquired angioedema due to increased bradykinin levels. This reaction may occur within days, weeks, or even months after starting the medication. Aspirin, clopidogrel, and propranolol may cause other adverse effects, but they do not typically cause bradykinin-mediated angioedema.
Q- Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child?
A- Explain the risks and benefits to them and document the conversation
B- Obtain a court order
C- Proceed with immunizations
D- Report to Department of Health Services (DHS)
A- Explain the risks and benefits to them and document the conversation- When parents refuse vaccinations, the proper next step is to provide clear counseling about the risks of not vaccinating and the benefits of immunization. After discussing, the clinician should document the conversation and respect the parents’ decision unless the situation poses an immediate danger to the child (which routine vaccines do not). Court orders, forced immunization, or reporting to DHS are not appropriate in cases of routine vaccine refusal.
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