TESTBANK i4
LITTLE AND FALACE'S DENTAL MANAGEMENT
4i 4i 4i 4i 4i
OF THE MEDICALLY COMPROMISEDPATIENT
4i 4i 4i i4
9TH EDITION4i
TESTBANK 4
i
,Little: Dental Management of the Medically Compromised Patient, 9th Edition Test Bank
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
Table of Contents 4i 4i
PART ONE: PATIENT EVALUATION AND RISK ASSESSMENT
4i 4i 4i 4i 4i 4i
Chapter 1: Patient Evaluation and Risk Assessment
4i 4i 4i 4i 4i 4i
PART TWO: CARDIOVASCULAR DISEASE 4i 4i 4i
Chapter 2: Infective Endocarditis Chapte 4i 4i 4i 4 i
r 3: Hypertension
4i 4i
Chapter 4: Ischemic Heart Disease Chap 4i 4i 4i 4i 4i
ter 5: Cardiac Arrhythmias
4i 4i 4i
Chapter 6: Heart Failure (or Congestive Heart Failure)
4i 4i 4i 4i 4i 4i 4i
PART THREE: PULMONARY DISEASE 4i 4i 4i
Chapter 7: Pulmonary Disease 4i 4i 4i
Chapter 8: Smoking and Tobacco Use Cessation Chapte
4i 4i 4i 4i 4i 4i 4 i
r 9: Sleep-
4i 4i
Related Breathing Disorders PART FOUR: GASTROIN
4i 4i 4 i 4i 4i
TESTIAL DISEASE 4i
Chapter 10: Liver Disease 4i 4i 4i
Chapter 11: Gastrointestinal Disease 4i 4i 4i
PART FIVE: GENITOURINARY DISEASE 4i 4i 4i
Chapter 12: Chronic Kidney Disease and Dialysis Chapt
4i 4i 4i 4i 4i 4i 4 i
er 13: Sexually Transmitted Diseases
4i 4i 4i 4i
PART SIX: ENDOCRINE AND METABOLIC DISEASE
4i 4i 4i 4i 4i
Chapter 14: Diabetes Mellitus Chapter 1 4i 4i 4i 4i 4i
5: Adrenal Insufficiency Chapter 16: Thy
4i 4i 4 i 4i 4i
roid Diseases 4i
Chapter 17: Pregnancy and Breast Feeding 4i 4i 4i 4i 4i
PART SEVEN: IMMUNOLOGIC DISEASE 4i 4i 4i
Chapter 18: AIDS, HIV Infection, and Related Conditions Chapter 19: All
4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ergy
Chapter 20: Rheumatologic and Connective Tissue Disorders Cha
4i 4i 4i 4i 4i 4i 4 i
pter 21: Organ and Bone Marrow Transplantation
4i 4i 4i 4i 4i 4i
PART EIGHT: HEMATOLOGIC AND ONCOLOGIC DISEASE
4i 4i 4i 4i 4i
Chapter 22: Disorders of Red Blood Cells Chapter 23:
4i 4i 4i 4i 4i 4i 4 i 4i
Disorders of White Blood Cells
4i 4i 4i 4i 4i
Chapter 24: Acquired Bleeding and Hypercoagulable Disorders Chapte
4i 4i 4i 4i 4i 4i 4 i
r 25: Congenital Bleeding and Hypercoagulable Disorders Chapter 26:
4i 4i 4i 4i 4i 4i 4 i 4i 4i
Cancer and Oral Care of the Patient 4i 4i 4i 4i 4i 4i
PART NINE: NEUROLOGIC, BEHAVIORAL, AND PSYCHIATRIC DISORDERS
4i 4i 4i 4i 4i 4i
Chapter 27: Neurologic Disorders 4i 4i 4i
Chapter 28: Anxiety, Eating Disorders, and Behavioral Reactions to Illness Chapter 29: Ps
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ychiatric Disorders 4i
Chapter 30: Drug and Alcohol Abuse 4i 4i 4i 4i 4i
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Page 1 of 74 4i 4i 4i
Chapter 01: Patient Evaluation and Risk Assessment
4i 4i 4i 4i 4i 4i
Little: Dental Management of the Medically Compromised Patient, 9th Edition
4i 4i 4i 4i 4i 4i 4i 4i 4i
MULTIPLE CHOICE 4i
1. Elective dental care should be deferred for patients with severe, uncontrolled hypertension, meaning th
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
at the blood pressure is greater than or equal to
4i 4i 4i 4i 4i 4i 4i 4i 4i mm Hg. 4i
a. 200/140
b. 180/140
c. 180/110
d. 160/110
ANS: C 4i
Elective dental care should be deferred for patients with severe, uncontrolled hypertension, which is
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
blood pressure greater than or equal to 180/110 mm Hg, until the condition can be brought under co
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ntrol.
2. The American Heart Association currently recommends antibiotic prophylaxis for a patient with which o
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
f the following cardiac conditions?
4i 4i 4i 4i
a. Mitral valve prolapse 4i 4i
b. Prosthetic heart valve 4i 4i
c. Rheumatic heart disease 4i 4i
d. Pacemakers for cardiac arrhythmias 4i 4i 4i
ANS: B 4i
Previously, the American Heart Association (AHA) recommended antibiotic prophylaxis for many patie
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
nts with heart murmurs caused by valvular disease (e.g., mitral valve prolapse, rheumatic heart diseas
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
e) in an effort to prevent infective endocarditis; however, current guidelines omit this recommendation
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i
on the basis of accumulated scientific evidence. If a murmur is due to certain specific cardiac conditio
4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i 4i
ns (e.g., previous endocarditis, prosthetic heart valve, complex congenital cyanotic heart disease), the
4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i 4i
AHA continues to recommend antibiotic prophylaxis for most dental procedures.
4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i
3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased ability of the body to
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
certain drugs, including local anesthetics and analgesics.
4i 4i 4i 4i 4i 4i
a. absorb
b. distribute
c. metabolize
d. excrete
ANS: C 4i
Patients also may have chronic hepatitis (B or C) or cirrhosis, with impairment of liver function.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
This deficit may result in prolonged bleeding and less efficient metabolism of certain drugs, inclu
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ding local anesthetics and analgesics.
4i 4i 4i 4i
4. Which of the following symptoms and signs is most consistent with allergy?
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
a. Heart palpitations 4i
b. Itching
c. Vomiting
d. Fainting
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ANS: B 4i
Symptoms and signs consistent with allergy include itching, urticaria (hives), rash, swelling, wheezing,
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i
angioedema, runny nose, and tearing eyes. Isolated signs and symptoms such as nausea, vomiting,
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
heart palpitations, and fainting generally are not of an allergic origin but rather are manifestations of dr
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i
ug intolerance, adverse side effects, or psychogenic reactions.
4i 4i 4i 4i 4i 4i 4i
5. Which of the following is true of the patient with a history of tuberculosis?
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
a. A positive result on skin testing means that the person has active TB.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
b. Most patients who become positive skin testers develop active disease.
4i 4i 4i 4i 4i 4i 4i 4i 4i
c. Patients with acquired immunodeficiency syndrome (AIDS) have a high incidence of tuberc
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
ulosis.
d. A diagnosis of active TB is made by a purified protein derivative (PPD) skin test.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
ANS: C 4i4 i
The potential coexistence of tuberculosis and acquired immunodeficiency syndrome (AIDS) should be
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
explored because patients with AIDS have a high incidence of tuberculosis. A positive result on skin te
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i
sting means specifically that the person has at some time been infected with TB, not necessarily that a
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i
ctive disease is present. Most patients who become positive skin testers do not develop active disease
4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i 4i
. A diagnosis of active TB is made by chest x-ray, imaging, sputum culture, and clinical examination.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i
6. Vasoconstrictors should be avoided in patients who cocaine or methamphetamine users 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i because 4
these agents may precipitate
i 4i 4i 4i .
a. severe hypotension 4i
b. severe hypertension 4i
c. respiratory depression 4i
d. cessation of intestinal peristalsis 4i 4i 4i
ANS: B 4i
Vasoconstrictors should be avoided in patients who are cocaine or methamphetamine users 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i becaus
e the combination may precipitate arrhythmias, MI, or severe hypertension.
4i 4i 4i 4i 4i 4i 4i 4i 4i
7. It has been shown that the risk for occurrence of a serious perioperative cardiovascular event
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i (e.g., MI, 4i 4
heart failure) is increased in patients who are unable to meet a -
i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
MET (metabolic equivalent of task) demand during normal daily activity.
4i 4 i 4i 4i 4i 4i 4i 4i 4i
a. 4
b. 6
c. 8
d. 10
ANS: A 4i
Daily activities requiring 4 METs include level walking at 4 miles/hour or climbing a flight of stairs. Activit
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
ies requiring greater than 10 METs include swimming and singles tennis. An exercise capacity of 10 to
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i
13 METs indicates excellent physical conditioning.
4i 4i 4i 4i 4i
8. Which of the following alterations in the fingernails is associated with cirrhosis?
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
a. Yellowing
b. Clubbing
c. White discoloration 4i
d. Splinter hemorrhages 4i
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GRADESMORE.COM
LITTLE AND FALACE'S DENTAL MANAGEMENT
4i 4i 4i 4i 4i
OF THE MEDICALLY COMPROMISEDPATIENT
4i 4i 4i i4
9TH EDITION4i
TESTBANK 4
i
,Little: Dental Management of the Medically Compromised Patient, 9th Edition Test Bank
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
Table of Contents 4i 4i
PART ONE: PATIENT EVALUATION AND RISK ASSESSMENT
4i 4i 4i 4i 4i 4i
Chapter 1: Patient Evaluation and Risk Assessment
4i 4i 4i 4i 4i 4i
PART TWO: CARDIOVASCULAR DISEASE 4i 4i 4i
Chapter 2: Infective Endocarditis Chapte 4i 4i 4i 4 i
r 3: Hypertension
4i 4i
Chapter 4: Ischemic Heart Disease Chap 4i 4i 4i 4i 4i
ter 5: Cardiac Arrhythmias
4i 4i 4i
Chapter 6: Heart Failure (or Congestive Heart Failure)
4i 4i 4i 4i 4i 4i 4i
PART THREE: PULMONARY DISEASE 4i 4i 4i
Chapter 7: Pulmonary Disease 4i 4i 4i
Chapter 8: Smoking and Tobacco Use Cessation Chapte
4i 4i 4i 4i 4i 4i 4 i
r 9: Sleep-
4i 4i
Related Breathing Disorders PART FOUR: GASTROIN
4i 4i 4 i 4i 4i
TESTIAL DISEASE 4i
Chapter 10: Liver Disease 4i 4i 4i
Chapter 11: Gastrointestinal Disease 4i 4i 4i
PART FIVE: GENITOURINARY DISEASE 4i 4i 4i
Chapter 12: Chronic Kidney Disease and Dialysis Chapt
4i 4i 4i 4i 4i 4i 4 i
er 13: Sexually Transmitted Diseases
4i 4i 4i 4i
PART SIX: ENDOCRINE AND METABOLIC DISEASE
4i 4i 4i 4i 4i
Chapter 14: Diabetes Mellitus Chapter 1 4i 4i 4i 4i 4i
5: Adrenal Insufficiency Chapter 16: Thy
4i 4i 4 i 4i 4i
roid Diseases 4i
Chapter 17: Pregnancy and Breast Feeding 4i 4i 4i 4i 4i
PART SEVEN: IMMUNOLOGIC DISEASE 4i 4i 4i
Chapter 18: AIDS, HIV Infection, and Related Conditions Chapter 19: All
4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ergy
Chapter 20: Rheumatologic and Connective Tissue Disorders Cha
4i 4i 4i 4i 4i 4i 4 i
pter 21: Organ and Bone Marrow Transplantation
4i 4i 4i 4i 4i 4i
PART EIGHT: HEMATOLOGIC AND ONCOLOGIC DISEASE
4i 4i 4i 4i 4i
Chapter 22: Disorders of Red Blood Cells Chapter 23:
4i 4i 4i 4i 4i 4i 4 i 4i
Disorders of White Blood Cells
4i 4i 4i 4i 4i
Chapter 24: Acquired Bleeding and Hypercoagulable Disorders Chapte
4i 4i 4i 4i 4i 4i 4 i
r 25: Congenital Bleeding and Hypercoagulable Disorders Chapter 26:
4i 4i 4i 4i 4i 4i 4 i 4i 4i
Cancer and Oral Care of the Patient 4i 4i 4i 4i 4i 4i
PART NINE: NEUROLOGIC, BEHAVIORAL, AND PSYCHIATRIC DISORDERS
4i 4i 4i 4i 4i 4i
Chapter 27: Neurologic Disorders 4i 4i 4i
Chapter 28: Anxiety, Eating Disorders, and Behavioral Reactions to Illness Chapter 29: Ps
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ychiatric Disorders 4i
Chapter 30: Drug and Alcohol Abuse 4i 4i 4i 4i 4i
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Page 1 of 74 4i 4i 4i
Chapter 01: Patient Evaluation and Risk Assessment
4i 4i 4i 4i 4i 4i
Little: Dental Management of the Medically Compromised Patient, 9th Edition
4i 4i 4i 4i 4i 4i 4i 4i 4i
MULTIPLE CHOICE 4i
1. Elective dental care should be deferred for patients with severe, uncontrolled hypertension, meaning th
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
at the blood pressure is greater than or equal to
4i 4i 4i 4i 4i 4i 4i 4i 4i mm Hg. 4i
a. 200/140
b. 180/140
c. 180/110
d. 160/110
ANS: C 4i
Elective dental care should be deferred for patients with severe, uncontrolled hypertension, which is
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
blood pressure greater than or equal to 180/110 mm Hg, until the condition can be brought under co
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ntrol.
2. The American Heart Association currently recommends antibiotic prophylaxis for a patient with which o
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
f the following cardiac conditions?
4i 4i 4i 4i
a. Mitral valve prolapse 4i 4i
b. Prosthetic heart valve 4i 4i
c. Rheumatic heart disease 4i 4i
d. Pacemakers for cardiac arrhythmias 4i 4i 4i
ANS: B 4i
Previously, the American Heart Association (AHA) recommended antibiotic prophylaxis for many patie
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
nts with heart murmurs caused by valvular disease (e.g., mitral valve prolapse, rheumatic heart diseas
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
e) in an effort to prevent infective endocarditis; however, current guidelines omit this recommendation
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i
on the basis of accumulated scientific evidence. If a murmur is due to certain specific cardiac conditio
4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i 4i
ns (e.g., previous endocarditis, prosthetic heart valve, complex congenital cyanotic heart disease), the
4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i 4i
AHA continues to recommend antibiotic prophylaxis for most dental procedures.
4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i
3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased ability of the body to
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
certain drugs, including local anesthetics and analgesics.
4i 4i 4i 4i 4i 4i
a. absorb
b. distribute
c. metabolize
d. excrete
ANS: C 4i
Patients also may have chronic hepatitis (B or C) or cirrhosis, with impairment of liver function.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
This deficit may result in prolonged bleeding and less efficient metabolism of certain drugs, inclu
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
ding local anesthetics and analgesics.
4i 4i 4i 4i
4. Which of the following symptoms and signs is most consistent with allergy?
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
a. Heart palpitations 4i
b. Itching
c. Vomiting
d. Fainting
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, WWW.GRADESMORE.COM
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Page 1 of 74 4i 4i 4i
ANS: B 4i
Symptoms and signs consistent with allergy include itching, urticaria (hives), rash, swelling, wheezing,
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i
angioedema, runny nose, and tearing eyes. Isolated signs and symptoms such as nausea, vomiting,
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
heart palpitations, and fainting generally are not of an allergic origin but rather are manifestations of dr
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i
ug intolerance, adverse side effects, or psychogenic reactions.
4i 4i 4i 4i 4i 4i 4i
5. Which of the following is true of the patient with a history of tuberculosis?
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
a. A positive result on skin testing means that the person has active TB.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
b. Most patients who become positive skin testers develop active disease.
4i 4i 4i 4i 4i 4i 4i 4i 4i
c. Patients with acquired immunodeficiency syndrome (AIDS) have a high incidence of tuberc
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
ulosis.
d. A diagnosis of active TB is made by a purified protein derivative (PPD) skin test.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
ANS: C 4i4 i
The potential coexistence of tuberculosis and acquired immunodeficiency syndrome (AIDS) should be
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i
explored because patients with AIDS have a high incidence of tuberculosis. A positive result on skin te
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i
sting means specifically that the person has at some time been infected with TB, not necessarily that a
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i
ctive disease is present. Most patients who become positive skin testers do not develop active disease
4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i 4i
. A diagnosis of active TB is made by chest x-ray, imaging, sputum culture, and clinical examination.
4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i 4i
6. Vasoconstrictors should be avoided in patients who cocaine or methamphetamine users 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i because 4
these agents may precipitate
i 4i 4i 4i .
a. severe hypotension 4i
b. severe hypertension 4i
c. respiratory depression 4i
d. cessation of intestinal peristalsis 4i 4i 4i
ANS: B 4i
Vasoconstrictors should be avoided in patients who are cocaine or methamphetamine users 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i becaus
e the combination may precipitate arrhythmias, MI, or severe hypertension.
4i 4i 4i 4i 4i 4i 4i 4i 4i
7. It has been shown that the risk for occurrence of a serious perioperative cardiovascular event
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i (e.g., MI, 4i 4
heart failure) is increased in patients who are unable to meet a -
i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
MET (metabolic equivalent of task) demand during normal daily activity.
4i 4 i 4i 4i 4i 4i 4i 4i 4i
a. 4
b. 6
c. 8
d. 10
ANS: A 4i
Daily activities requiring 4 METs include level walking at 4 miles/hour or climbing a flight of stairs. Activit
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i
ies requiring greater than 10 METs include swimming and singles tennis. An exercise capacity of 10 to
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4 i 4i 4i 4i 4i 4i
13 METs indicates excellent physical conditioning.
4i 4i 4i 4i 4i
8. Which of the following alterations in the fingernails is associated with cirrhosis?
4i 4i 4i 4i 4i 4i 4i 4i 4i 4i 4i
a. Yellowing
b. Clubbing
c. White discoloration 4i
d. Splinter hemorrhages 4i
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