#06 Flashcards
A 50-year-old man is struggling with heavy drinking and asks which medications he could take to help him abstain from alcohol use. Which one of the following medications is approved by the U.S. Food and Drug Administration for alcohol use disorder?
A. Topiramate (Topamax).
B. Sertraline (Zoloft).
C. Gabapentin (Neurontin).
D. Naltrexone (Revia, Vivitrol).
D. Naltrexone (Revia, Vivitrol).
For more than a year, a 60-year-old woman with a history of depression has been drinking three to four glasses of wine most nights to help her cope with her sad feelings. Which one of the following is the most appropriate treatment option?
A. Disulfiram (Antabuse), 250 mg daily.
B. Ondansetron (Zofran), 4 mg daily.
C. Fluoxetine (Prozac), 20 mg daily.
D. Naltrexone, 380 mg intramuscularly once per week.
C. Fluoxetine (Prozac), 20 mg daily.
A 65-year-old man with diabetes mellitus and severe renal impairment is seeking treatment for alcohol abuse. He drank heavily the evening before his appointment. Which one of the following is the best treatment option?
A. Sertraline, 50 mg daily.
B. Naltrexone, 50 mg daily.
C. Acamprosate (Campral), two 333-mg tablets three times daily.
D. Disulfiram, 250 mg daily.
B. Naltrexone, 50 mg daily.
Which one of the following recommendations regarding the prevention of endometrial cancer is correct?
A. Use of the levonorgestrel-releasing intrauterine system (Mirena) has been shown to decrease cancer risk in women taking tamoxifen.
B. Women older than 40 years with Lynch syndrome (hereditary nonpolyposis colorectal cancer) should consider a prophylactic hysterectomy.
C. Women older than 65 years should be screened every three to five years.
D. Asymptomatic women who are taking tamoxifen should be screened annually.
B. Women older than 40 years with Lynch syndrome (hereditary nonpolyposis colorectal cancer) should consider a prophylactic hysterectomy.
Which one of the following statements about evaluation for endometrial cancer is correct?
A. The preferred test is a Papanicolaou smear.
B. When transvaginal ultrasonography is used, the cutoff for endometrial thickness in premenopausal women is 5 mm or less.
C. Computed tomography is a useful alternative to transvaginal ultrasonography in the initial evaluation.
D. Endometrial tissue sampling is required for a definitive diagnosis.
D. Endometrial tissue sampling is required for a definitive diagnosis.
Which one of the following tests should be performed to confirm nephrotic syndrome?
A. Anti–double-stranded DNA antibody testing.
B. Renal biopsy.
C. Quantification of proteinuria.
D. Chest radiography.
C. Quantification of proteinuria.
Which one of the following is an appropriate first-line treatment for uncomplicated nephrotic syndrome?
A. Anticoagulants.
B. Fluid restriction.
C. Antibiotics.
D. Dialysis.
E. Lipid-lowering agents.
B. Fluid restriction.
Which one of the following statements about the treatment of chronic anal fissures is correct?
A. Anal stretch is more effective than internal anal sphincterotomy.
B. Internal anal sphincterotomy is more effective than medical therapy.
C. Anal advancement flap is equivalent to internal anal sphincterotomy.
D. No surgical treatments are more effective than medical therapy.
B. Internal anal sphincterotomy is more effective than medical therapy.
A 55-year-old black man presents for a blood pressure evaluation. He takes no medications and his physical examination findings are unremarkable. Your clinic’s technician, using a manual sphygmomanometer on the left arm, measures his blood pressure as 167/95 mm Hg. Based on the U.S. Preventive Services Task Force recommendation statement, which one of the following is the best way to diagnose hypertension in this patient?
A. You can diagnose hypertension based on a single manual measurement done upon entry to the office.
B. You can diagnose hypertension only if repeat office blood pressure measurements are elevated after a three-month period of lifestyle changes.
C. You recommend that the patient wear an ambulatory blood pressure monitoring device for a 24-hour period and return for a follow-up evaluation.
D. You tell the patient that he does not have high blood pressure and should return in one year for rescreening.
C. You recommend that the patient wear an ambulatory blood pressure monitoring device for a 24-hour period and return for a follow-up evaluation.
