The following are multiple choice questions (with answers) about medical knowledge.   **Question:** An 89-year-old woman is brought to the emergency department by her husband because of diarrhea and weakness for 4 days. She has 2–3 loose stools every day. She has also had 3 episodes of vomiting. She complains of a headache and blurry vision. Three weeks ago, she returned from a cruise trip to the Bahamas. She has congestive heart failure, atrial fibrillation, age-related macular degeneration, type 2 diabetes mellitus, and chronic renal failure. Current medications include warfarin, metoprolol, insulin, digoxin, ramipril, and spironolactone. Her temperature is 36.7°C (98°F), pulse is 61/min, and blood pressure is 108/74 mm Hg. The abdomen is soft, and there is diffuse, mild tenderness to palpation. Laboratory studies show: Hemoglobin 12.9 g/dL Leukocyte count 7200/mm3 Platelet count 230,000/mm3 Serum Na+ 137 mEq/L K+ 5.2 mEq/L Glucose 141 mg/dL Creatinine 1.3 mg/dL Which of the following is the most appropriate next step in management?"   (A) Perform hemodialysis   (B) Perform C. difficile toxin assay   (C) Measure serum drug concentration   (D) Administer oral activated charcoal
['(C) Measure serum drug concentration <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Perform hemodialysis \n (B) Perform C. difficile toxin assay \n (C) Measure serum drug concentration \n (D) Administer oral activated charcoal <> possible answers', '  An 89-year-old woman is brought to the emergency department by her husband because of diarrhea and weakness for 4 days. She has 2–3 loose stools every day. She has also had 3 episodes of vomiting. She complains of a headache and blurry vision. Three weeks ago, she returned from a cruise trip to the Bahamas. She has congestive heart failure, atrial fibrillation, age-related macular degeneration, type 2 diabetes mellitus, and chronic renal failure. Current medications include warfarin, metoprolol, insulin, digoxin, ramipril, and spironolactone. Her temperature is 36.7°C (98°F), pulse is 61/min, and blood pressure is 108/74 mm Hg. The abdomen is soft, and there is diffuse, mild tenderness to palpation. Laboratory studies show:\nHemoglobin 12.9 g/dL\nLeukocyte count 7200/mm3\nPlatelet count 230,000/mm3\nSerum\nNa+ 137 mEq/L\nK+ 5.2 mEq/L\nGlucose 141 mg/dL\nCreatinine 1.3 mg/dL\nWhich of the following is the most appropriate next step in management?" <> context@']