The most cost-effective screening test for determining HIV status is which of the following?
Western blot
Enzyme-linked immunosorbent assay
... [Show More]
Venereal Disease Research Laboratory test Viral load - correct answer Enzyme-linked immunosorbent assay
Which blood test is a nonspecific method and most helpful
for evaluating the severity and course of an inflammatory process?
Erythrocyte sedimentation rate
White blood cell count Polymorphonuclear cells
C-reactive protein (CRP) - correct answer C-reactive protein (CRP)
Cocaine acts as a stimulant by blocking the reuptake of
which neurotransmitter?
GABA
Acetylcholine
Dopamine
Serotonin - correct answer Dopamine
Mrs. Thomas was seen in the office complaining of pain and
point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:
Ecchymosis, edema, and erythema over the lateral epicondyle
Pain at the elbow with resisted movements at the wrist and forearm
Inability to supinate and pronate the arm
Inability to flex or extend the elbow against resistance - correct answer Pain at the elbow with resisted movements at the wrist and forearm
Which of the following statements concerning the
musculoskeletal examination is true?
The uninvolved side should be examined initially and then compared to the involved side.
The part of the body that is causing the patient pain should be examined first.
When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.
Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. - correct answer The uninvolved side should be examined initially and then compared to the involved side.
Which of the following signs or symptoms indicate an
inflammatory etiology to musculoskeletal pain?
Decreased C-reactive protein
Hyperalbuminemia
Morning stiffness
Weight gain - correct answer Morning stiffness
Which causes the greatest percentage of mammalian bites?
Dogs
Cats
Humans
Rodents - correct answer Dogs
A 48-year-old woman is seen in the clinic with complaints of
prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first?
Transvaginal ultrasound
Endometrial biopsy MRI
Abdominal computed tomography scan - correct answer Transvaginal ultrasound
A diabetic patient asks the clinician why he needs to check
his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?
"Control of glucose will help postpone or delay
complications."
"Regularly checking blood sugar will help establish a routine."
"Monitoring glucose will promote a sense of control."
All of the above - correct answer All of the above
"Control of glucose will help postpone or delay
complications."
"Regularly checking blood sugar will help establish a routine."
"Monitoring glucose will promote a sense of control."
A 25-year-old patient presents to the clinic with fatigue, cold
intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?
Serum calcium
TSH
Electrolytes
Urine specific gravity - correct answer TSH
Which of the following medications for type 2 diabetes
mellitus should not be prescribed during pregnancy?
Insulin
Metformin
Glucotrol
Precose - correct answer Glucotrol
During a DRE on a 75-year-old man, the clinician suspects
the patient has prostate cancer. What physical finding should make the clinician suspicious?
An enlarged rubbery gland
A hard irregular gland
A tender gland
A boggy gland - correct answer An enlarged rubbery gland
Eddie, age 4, presents to the ED with a live insect trapped in
his ear canal causing a lot of distress. What should be your first step?
Remove the insect with tweezers.
Immobilize the insect with 2% lidocaine.
Sedate Eddie with diazepam.
Shine a light in the ear for the insect to "find its way out." - correct answer Immobilize the insect with 2% lidocaine.
What is the most common cause of microcytic anemia?
Anemia of chronic disease
Sideroblastic anemia
Iron-deficiency anemia Thalassemia - correct answer Iron-deficiency anemia
An 82-year-old man is seen in the primary care office with
complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?
Benign prostatic hyperplasia (BPH)
Parkinson's disease Prostate cancer
All of the above - correct answer All of the above
Early rheumatoid disease is characterized by:
Pain and swelling in both small and large peripheral joints
Rigid joints with diminished range of motion
Joint swelling and immobility on rising
A cardiac rub or pulmonary friction rub - correct answer Joint swelling and immobility on rising
A 70-year-old female has fallen 2 weeks ago and developed
immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do?
Make an immediate referral for an orthopedic evaluation without further assessment.
Tell her that it takes time for these bruises to improve, so she should be patient.
Obtain a wrist x-ray and place her wrist in a splint or
prescribe a splint.
Send her to the emergency room for reduction of this obvious wrist fracture. - correct answer Obtain a wrist x-ray and place her wrist in a splint or
prescribe a splint.
The criteria for diagnosing generalized anxiety disorder in
the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:
1 month
3 months
6 months
12 months - correct answer 6 months
A 60-year-old man presents with an enlarged scrotum. The
clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?
The scrotum will be dark.
The scrotum will appear light pink or yellow.
The scrotum will appear milky white.
The internal structures will be clearly visible. - correct answer The scrotum will appear light pink or yellow.
According to Kübler-Ross, the stages of grief occur in which
order?
Anger, denial, depression, bargaining, acceptance
Anger, denial, bargaining, acceptance, depression
Denial, anger, depression, bargaining, acceptance
Denial, anger, bargaining, depression, acceptance - correct answer Denial, anger, bargaining, depression, acceptance
Reuben, age 24, has HIV and just had a routine viral load
test done. The results show a falling viral load. What does this indicate?
A favorable prognostic trend
Disease progression
The need to be more aggressive with Reuben's medications
The eradication of the HIV - correct answer A favorable prognostic trend
The exanthem of Lyme disease is:
Erythema infectiosum
Laterothoracic exanthem
Erythema migrans
Morbilli exanthem - correct answer Erythema migrans
You have detected the presence of crepitus on examination
of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:
Articular
Inflammatory
Nonarticular
A and B - correct answer Articular
What is the recommended daily calcium intake for adults
over the age of 50 with low bone mass?
1,200 mg/day
1,000 mg/day
1,300 mg/day
1,500 mg/day - correct answer 1,500 mg/day
When assessing a woman for infertility, which of the
following tests should be done first?
Analysis of partner's sperm
Magnetic resonance imaging (MRI)
Hysterosalpingogram
Estrogen level - correct answer Analysis of partner's sperm
Which type of burn injury results in destruction of the
epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
Superficial burns
Superficial partial-thickness burns
Deep partial-thickness burns
Full-thickness burns - correct answer Deep partial-thickness burns
A 23-year-old sexually active woman presents for her first
Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?
Human papillomavirus (HPV)
Endometrial hyperplasia Vagismus
Polycystic ovarian syndrome - correct answer Human papillomavirus (HPV)
As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?
Two
Three
Four
Five - correct answer 3
Sam is a 25-year-old who has been diagnosed with low
back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
Morning stiffness and limited mobility of the lumbar spine
Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
Fever, chills, and elevated erythrocyte sedimentation rate
Pathologic fractures, severe night pain, weight loss, and fatigue - correct answer Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
A 30-year-old man is seen with a chief complaint of loss of
libido. Which of the following laboratory tests would help establish a diagnosis
Testosterone level
Prostate-specific antigen
Nocturnal penile tumescence
and rigidity
Prolactin level - correct answer Testosterone level
The clinician prescribes glipizide (Glucotrol) for a diabetic
patient. Which statement made by the patient would indicate that your teaching has been effective?
"I'll take my pill at least 30 minutes before breakfast."
"I'll take my Glucotrol before bedtime."
"It is important to take my medication right after I eat."
"Since I only like to eat two meals a day, I can take the pill
between my meals." - correct answer "I'll take my pill at least 30 minutes before breakfast."
In the United States, what is the second most common
connective tissue disease and the most destructive to the joints?
Osteoarthritis
Systemic lupus erythematosus (SLE)
Rheumatoid arthritis
Sjögren's syndrome - correct answer Rheumatoid arthritis
The effectiveness of benzodiazepines in treating anxiety
disorders suggests that which of the following neurotransmitters plays a role in anxiety?
Acetylcholine
Gamma-aminobutyric acid (GABA)
Dopamine
Serotonin - correct answer Gamma-aminobutyric acid (GABA)
A 14-year-old male is seen with complaints of severe
testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?
Refer to a urologist immediately.
Obtain a computed tomography (CT) scan.
Instruct the patient to elevate the scrotum. [Show Less]