#2 Flashcards
Which one of the following statements about the role of antibiotic therapy for acute rhinosinusitis is correct?
A. Approximately 70% of patients improve within two weeks without antibiotics.
B. Antibiotics are recommended for patients with facial pain or purulent nasal discharge.
C. Antibiotics should be prescribed for 14 days to avoid recurrence of symptoms.
D. Respiratory fluoroquinolones are the recommended first-line agent.
A. Approximately 70% of patients improve within two weeks without antibiotics.
Which one of the following statements about nonantibiotic therapies for patients with acute rhinosinusitis is correct?
A. Several randomized controlled trials show that oral decongestants improve symptoms.
B. Antihistamines improve nasal symptoms.
C. Saline nasal irrigation has been shown in a randomized trial to improve symptoms.
D. Intranasal corticosteroids offer no benefit.
C. Saline nasal irrigation has been shown in a randomized trial to improve symptoms.
A 16-year-old patient has amenorrhea and elevated serum levels of free testosterone. Her ovaries are of normal size, and one contains three 2-mm follicles. Which one of the following statements about the diagnosis of polycystic ovary syndrome (PCOS) in this patient is correct?
A. She meets the Rotterdam criteria for PCOS.
B. Hyperandrogenism can be diagnosed only if physical findings such as hirsutism are present.
C. Because of her age and lack of polycystic ovaries, she does not meet the Rotterdam criteria for PCOS.
D. She requires further evidence of ovulatory dysfunction.
C. Because of her age and lack of polycystic ovaries, she does not meet the Rotterdam criteria for PCOS.
A 28-year-old patient presents with long-standing hirsutism, androgenic alopecia, acne, and a five-year history of oligomenorrhea. Her weight is stable. In general, which one of the following is the best next step?
A. Determine luteinizing hormone and follicle-stimulating hormone levels.
B. Perform ultrasonography to confirm the presence of polycystic ovaries.
C. Initiate a workup for an androgen-secreting tumor.
D. Make a clinical diagnosis of PCOS without further testing.
D. Make a clinical diagnosis of PCOS without further testing.
Which one of the following statements best reflects the correct use of metformin in patients with PCOS?
A. It is superior to oral contraceptives for regulating menses.
B. It has replaced clomiphene as a first-line treatment for infertility.
C. It is the most effective therapy for hirsutism.
D. It should be given to treat insulin resistance.
E. It is used for endometrial protection.
D. It should be given to treat insulin resistance.
A patient presents with a palpable humeral head in the axilla following abduction and external rotation of his shoulder while playing football. Which one of the following statements is correct?
A. Magnetic resonance imaging is required for diagnosis.
B. Intra-articular lidocaine should be avoided.
C. Axillary nerve deficits warrant electromyography.
D. Six weeks of immobilization are needed.
C. Axillary nerve deficits warrant electromyography.
A 75-year-old patient has pain with overhead activity after a fall. A rotator cuff tear is suspected. Which one of the following statements is correct?
A. A positive drop-arm test result supports the diagnosis.
B. Axillary and anteroposterior radiographic views are preferred for diagnosing tears.
C. Follow-up evaluation is usually not necessary.
D. Early operative treatment is recommended.
A. A positive drop-arm test result supports the diagnosis.
Which one of the following has the most evidence to support it as a first-line medication for initial treatment of trigeminal neuralgia in persons without multiple sclerosis?
A. Baclofen.
B. Carbamazepine.
C. Gabapentin.
D. Lamotrigine.
B. Carbamazepine.
A healthy 47-year-old woman has never been diagnosed with breast cancer, nor have any of her first-degree relatives. Her digital mammography two years ago was negative, and she asks whether she should be screened again this year. According to the U.S. Preventive Services Task Force, which one of the following approaches to screening is appropriate for this patient?
A. There is insufficient evidence to assess the balance of benefits and harms of screening mammography for this patient.
B. Do not screen for breast cancer, because she has no symptoms.
C. Do not screen for breast cancer, because she is not at increased risk of the disease.
D. If the patient places a higher value on the potential benefit than the potential harms, she may choose to undergo screening mammography again.
E. Do not screen for breast cancer until she is 50 years of age, because at her current age, the harms outweigh the benefits.
D. If the patient places a higher value on the potential benefit than the potential harms, she may choose to undergo screening mammography again.
Which one of the following medications for alcohol use disorder is contraindicated in a patient with end-stage renal disease on hemodialysis?
A. Oral naltrexone.
B. Injectable naltrexone.
C. Acamprosate.
D. Disulfiram.
C. Acamprosate.
According to the American Heart Association/American College of Cardiology (AHA/ACC) recommendations, which one of the following statements about screening for cardiovascular disease (CVD) in athletes is correct?
A. Universal screening of young persons with 12-lead electrocardiography (ECG) is recommended to uncover heart disease.
B. Cardiovascular screening should be done with history and physical examination alone.
C. If ECG screening is used, it should be limited to competitive athletes.
D. The AHA’s 14-point screening guideline includes assessment of family history for hypertrophic cardiomyopathy.
D. The AHA’s 14-point screening guideline includes assessment of family history for hypertrophic cardiomyopathy.
