#10 Flashcards
A 35-year-old man with a body mass index of 32 kg per m2 presents with heartburn and regurgitation that began a few months ago and now occurs several times per week during the daytime only. He has no weight loss or dysphagia. Which one of the following is an appropriate next step?
A. Upper endoscopy to screen for Barrett esophagus.
B. Testing for Helicobacter pylori.
C. A four- to eight-week trial of a once-daily proton pump inhibitor (PPI).
D. Omeprazole/sodium bicarbonate (Zegerid) at bedtime.
C. A four- to eight-week trial of a once-daily proton pump inhibitor (PPI).
Which one of the following statements about surgery for gastroesophageal reflux disease is correct?
A. It provides higher symptom remission rates than medical therapy.
B. It is associated with a high quality of life in select patients.
C. It improves outcomes for patients with Barrett esophagus.
D. Outcomes are better in patients with a poor response to PPIs.
B. It is associated with a high quality of life in select patients.
A 20-year-old man with a history of recurrent upper respiratory symptoms presents with a discrete, tender, erythematous mass located laterally in the anterior cervical triangle. Other than a lymph node, which one of the following is the most likely diagnosis?
A. Lymphoma.
B. Branchial cleft cyst.
C. Thyroglossal duct cyst.
D. Laryngocele.
B. Branchial cleft cyst.
A 66-year-old patient has a persistent neck mass suspicious for malignancy. The diagnostic evaluation should generally begin using which one of the following?
A. Contrast-enhanced computed tomography.
B. Fine-needle aspiration biopsy.
C. Positron emission tomography.
D. Magnetic resonance angiography.
A. Contrast-enhanced computed tomography.
Which one of the following factors is associated with back pain lasting longer than three months?
A. Imaging findings.
B. Type of injury.
C. Occurrence of injury at work.
D. Physical examination findings.
C. Occurrence of injury at work.
Based on the best available evidence, which one of the following nonsurgical interventions can modestly improve outcomes at six months for chronic low back pain?
A. Spinal manipulation therapy.
B. Skeletal muscle relaxants.
C. Spinal cord stimulator placement.
D. Transcutaneous electrical nerve stimulation.
A. Spinal manipulation therapy.
Which single treatment is most likely to be beneficial in an adult with acute sore throat due to an upper respiratory tract infection?
A. Nonsteroidal anti-inflammatory drugs.
B. Antibiotics.
C. Acetaminophen.
D. Corticosteroids.
C. Acetaminophen.
According to the U.S. Preventive Services Task Force, which one of the following recommendations on screening for carotid artery stenosis is appropriate for a 65-year-old woman in generally good health?
A. Screen using carotid ultrasonography.
B. Screen using auscultation of the neck.
C. Use a risk calculator to assess whether the patient should be screened.
D. Do not screen the patient.
D. Do not screen the patient.
