You know the following statements regarding the pain of acute coronary syndrome are true except:
a. May last longer than 20min
b. May radiate to arms,
... [Show More] back, neck, jaw
c. Present atypically more often in men than women
d. May be retrosternal or poorly localized - Ans-C
You are reviewing a pt chart before the exam. You note that the pt is using topical capsaicin. You know
that topical capsaicin is often used for tx of:
a. Diabetic neuropathy
b. Stress reduction
c. All answers are appropriate
d. Depression
You order bilat wrist XR on a 69yo man c/o pain in both wrists for 6wks not related to known trauma.
You suspect elderly onset rheumatoid arthritis. To guide tx, you look for which radiographic finding?
a. Symmetric joint space narrowing
b. Soft tissue swelling
c. Subluxation of joints
d. Joint erosions - Ans-D
The leading cause of disability worldwide is:
a. Depression
b. Lung Ca
c. Heart dz
d. DM - Ans-A
RD, 65yo African American female presents for annual physical. You are reviewing VS and objective data
prior to exam. Which would raise suspicion for osteoporosis?
a. Wt loss of 5lbs
b. 1in decrease in ht
c. Hair loss
d. Decreased appetite - Ans-B
In differentiating OA from chronic gout, pseudogout, or septic arthritis, the most valuable diagnostic
study would be:
a. CBC
b. CRP
c. Synovial fluid analysis
d. ESR - Ans-C
52yo Caucasian woman comes in for annual exam. She has mitral valve prolapse, no symptoms. PE
reveals clear/equal breath sounds, midsystolic click. You know her stage of HF is:
a. A
b. B
c. D
d. C - Ans-B (Stage B)
Symptoms of depression distinct to elderly include:
a. Loss of pleasure in usual activities
b. Lack of emotions
c. Flat affect
d. Appetite/wt disturbances - Ans-B
LB presents w/following hx and presentation: h/o MI 5yrs ago, currently has SOB, cough, 2+ pitting
edema. Tx will be based on LB's stage of HF, which is:
a. D
b. C
c. A
d. B - Ans-B (Stage C)
You ordered a CBC for pt you suspect has PMR. Which 2 findings are common in pt's with PMR?
a. Normochromic, normocytic anemia and thrombocytosis
b. Macrocytic, hyperchromic anemia and leukocytopenia
c. Neutropenia and hypochromic, normocytic anemia
d. Microcytic, hypochromic anemia and reticulocytopenia - Ans-A
An example of secondary prevention you could recommend/order for elderly would be to:
a. Provide foot care for DM pt
b. Check for fecal occult blood
c. Administer tetanus shot
d. Wear seat belts - Ans-B
ACC 2017 Guidelines for High BP in adults discusses screening/management of other CVD risk factors for
hypertensive pts. According to the guideline, basic testing for primary HTN includes fasting BGL, CBC,
lipids, BMP, TSH, UA, EKG w/optional echo, uric acid, and urinary albumin-to-creatinine ratio.
a. True
b. False - Ans-A
When you recommend exercise for sedentary older adult, which of the following pieces of advice should
be considered for all types of exercise?
a. Focus only on one type of exercise for the first few months
b. Only use equipment recommended by physical trainers
c. Only group exercise is beneficial to someone who has not been active in a long time
d. Start low and go slow - Ans-D
You're reviewing CXR report on 56yo male who presented w/increasing SOB. You suspect COPD. You
know the dx can be made with a high degree of accuracy if 2 of the following criteria are met:
1. Flattening of diaphragm w/blunting of costophrenic angle on PA film
2. Upper zone redistribution of pulmonary blood flow (cephalization)
3. Abnormally enlarged retrosternal space
4. Signs of interstitial edema - Ans-1 and 3
You have completed the first follow up visit for a new COPD pt who is in stable condition. The pt asks
how often he needs to follow up for COPD. You state that stable COPD pts should return for follow up
eval:
a. Yearly
b. Monthly
c. Every 3-6mo
d. Every 2mo - Ans-C
When examining the spine of an older adult, you notice a curvature with a sharp angle. This is referred
to as a:
a. Pectus excavation
b. Scoliosis
c. Kyphosis
d. Lordosis - Ans-C
(more specifically, this is called a Gibbus, which is a specific condition in regards to kyphosis, but Gibbus
wasn't an option)
An effective exercise therapy for RA is:
a. Yoga and/or Pilates
b. Walking 20min daily
c. Bicycle riding
d. Water exercise programs - Ans-D
Pt education for COPD is essential. You know that COPD education includes all of the following except:
a. Increased risk for DM
b. Daily exercise
c. Healthy diet
d. Smoking cessation - Ans-A
The prevalence of depression in nursing home residents is __________ greater than adults living in the
community.
a. 5 times
b. 3-4 times
c. 2-3 times
d. 1-2 times - Ans-B
Which of the following statements about OA is true?
a. The metacarpal phalangeal joints are commonly involved.
b. Prolonged morning stiffness is common.
c. It is a systemic inflammatory illness
d. It affects primarily weight-bearing joints - Ans-D
55yo woman presents with somatic complaints. You suspect anxiety. You know that somatic symptoms
of anxiety include:
a. All answers are appropriate
b. Palpitations, CP, tachycardia
c. Fatigue, insomnia, diaphoresis
d. Diarrhea, nausea, vomiting - Ans-A
You know that the gold standard for COPD dx is:
a. Spirometry
b. Dyspnea, chronic cough w/sputum production
c. Irreversible airflow limitation
d. Decreased breath sounds, wheezes at lung bases - Ans-A
The best evidence rating drugs to consider in a post MI pt include:
a. ASA, ACE/ARB, BB, aldosterone blockage
b. Long-acting nitrates, warfarin, ACE, ARB
c. ASA, plavix, nitrates
d. ACE, ARB, CCB, ASA - Ans-A
2017 HTN guidelines categorize a healthy 54yo African American woman with a BMI of 23 and
consistent BP readings of 120-128/76-78 as:
a. Normal BP
b. HTN stage 1
c. Elevated BP
d. HTN stage 2 - Ans-C
ACC 2017 guidelines for high BP in adults, adults w/stage 1 HTN and high ASCVD risk should be managed
w/both nonpharm and antihypertensive drug therapy. You know the pt should return for a follow up
appointment which includes BP check in:
a. 3wks
b. 1wk
c. 1mo
d. 2wks - Ans-C
Mrs. G, 65yo Caucasian, presents for her annual physical. Chart review reveals she smokes 1PPD, drinks
2 beers every evening since she retired. She does not exercise, likes to sit and knit. As part of health
maintenance, DEXA was ordered. You have received results, T-score of -2.0, which is consistent with:
a. Normal result
b. Osteopenia
c. At risk for fragility fracture
d. Osteoporosis - Ans-B
The purpose of Beers Criteria is to:
a. Define Type A reactions
b. All answers are appropriate
c. Define changes in drug metabolism in elderly
d. Improve quality and safety when prescribing meds - Ans-D
Which best describes pain associated w/OA?
a. Pain is persistent and motion can be limited in affected joint
b. Dull and primarily affected by exposure to cold/barometric pressure
c. Constant burning and throbbing w/acute onset
d. Begins upon arising and after prolonged wt bearing and/or use of the joint - Ans-A
RV is 58yo African American male w/poorly controlled HTN. He hasn't been compliant w/meds, only
takes Rx when he has a bad HA or feels like his pressure is high. You know that tx goals include
prevention of target organ damage. During your eval you will assess for evidence of:
a. Blood clotting disorders
b. L ventricular hypertrophy
c. Insulin resistance
d. Lipid abnormalities - Ans-B
59yo woman presents w/following: h/o MI, new onset SOB, especially w/exertion, an occasional rapid
fluttering heartbeat and swollen feet. You know this pt's stage of HF is:
a. Stage A
b. Stage B
c. Stage D
d. Stage C - Ans-D (stage C)
IW is 65yo man who is new to your practice. He has h/o COPD, CAD, HTN, T2DM. He has had no
immunizations since his discharge from the military at 25yo. Childhood dz's include chickenpox, measles,
mumps, and German measles. He presents for dz management visit. Which immunizations would you
recommend for him?
a. Influenza, pneumococcal, PPD, Hep B
b. Tdap, pneumococcal, influenza, Zostavax
c. Hep B, influenza, pneumococcal, Hep A
d. MMR, influenza, pneumococcal, Zostavax - Ans-B
You're working with an older male w/a long h/o ETOH abuse and 30yr h/o smoking. In recommending an
intervention for him, your responsibility is to:
a. Make him abandon his own health practices and follow your recommendations
b. ID the barriers he will encounter
c. Register him for local intervention program and secure payments
d. Promote positive change in lifestyle changes - Ans-D [Show Less]