Exam 13: Psychiatry and Psychotherapy

A 28-year-old male intern is currently on a trauma surgery service. After a busy overnight shift, it was impossible to prepare to present all of the patients on the team's list given the workload. At morning rounds, the chief resident made a sarcastic comment that the intern "really put a lot of effort into preparing for rounds." After rounds, while managing the floor with the third year medical student, the intern berates the student that she "needs to step up her game and do a better job." Which of the following is the best explanation for this intern's behavior toward the medical student?

An 18-year-old woman presented to the office due to left arm pain after a fall. The patient fell on her arm, while she was working out at the gym where she uses to exercise regularly. The patient has no prior medical or surgical history. She uses several diets for weight loss, and she is now on a vegan diet. Her last menstrual period was 4 months ago. She does not use tobacco, alcohol, or illicit drugs. Temperature is 36.1 C (97 F), blood pressure is 92/60 mm Hg, and pulse is 53/min. BMI is 18.1 kg/m2. Weight is 51.7 kg (110.2 lb) and height is 169 cm. Physical examination shows tenderness in the left arm. There is parotid enlargement with fine hair widespread over the extremities. A urine pregnancy test is negative. X-rays reveal a nondisplaced fracture of the left humerus and generalized radiolucency of the bone. Which of the following is the most likely diagnosis?

A 17-year-old girl comes to the office for health care follow up. She is a known case of cystic fibrosis. She is doing well with no new compliants. She takes his prophylactic medications regularly. Her physical examination shows no abnormalitis. Review of her records shows that she is due for her annual influenza vaccination. Prior to administration of the vaccine, her skin is disinfected with 70% isopropanol.  Which of the following mechanisms is most likely responsible for the antiseptic properties of isopropanol?