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 - 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) - ANSWER C-reactive protein (CRP)
Cocaine acts as a stimulant by blocking the reuptake of
which neurotransmitter?
GABA
Acetylcholine
Dopamine
Serotonin - 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 - 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. - 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 - ANSWER Morning stiffness
Which causes the greatest percentage of mammalian bites?
Dogs
Cats
Humans
Rodents - 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 - 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 - 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 - ANSWER TSH
Which of the following medications for type 2 diabetes
mellitus should not be prescribed during pregnancy?
Insulin
Metformin
Glucotrol
Precose - 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 - 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." - 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 - 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 - 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 - 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. - 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 - 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. - 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 - 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 - ANSWER A favorable prognostic trend
The exanthem of Lyme disease is:
Erythema infectiosum
Laterothoracic exanthem
Erythema migrans
Morbilli exanthem - 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 - 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 - 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 - 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 - 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 - 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 - 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 [Show Less]