21-50

Question 1

Infant 22 weeks gestation –thin upper lip, philtrum flat,

& curvature of 5th MC (clindactyly).

Answer 1

Fetal Alcohol Syndrome

Question 2

3 y/o with effusion in Rt. ear,

Answer 2

No Rx;f/u in 3 months.

Question 3

32 y/o M with LBP, minimal tenderness.

Answer 3

Rx:Muscle relaxants/NSAID’s

Question 4

48 y/o F with GERD X 2yrs Rxed with P P Inhibitor with numbness in feet.

Answer 4

Vitamin D12 Deficiency

Question 5

60 y/o M with cough & SOB on exertion; Exam:tachypnea, bibasilar rales,CXR:Interstical opacities

Answer 5

Dx: Silicosis (Stone cutter)

Question 6

28 y/o F with diffuse hyperpigmentation (creases & areolae) & elevated K+

Answer 6

Dx; Primay Pituitary Insufficiency (Get ACTH).

Question 7

3 y/o F 2 day Hx abd. cramps,watery stools,emesis (2)

+Sx’s in classmates

Answer 7

Rx: 1/2 strength apple juice & food on demand.

Question 8

32 y/o F SEM inc. with Valsalva M., exertional dyspnea

& mod chest pain;Echo-hypertrophic cardiomyopathy.

Answer 8

Rx: Beta-Blockers (CA+CB, if not well tolerated).

Metroprolol

Question 9

85 y/o F w advanced Alzheimer’s-agitation, aggression

& delusions.

Answer 9

Rx: Abilify (Aripiprazole).

Question 10

30 y/o F w anovulatory uterine bleeding (Nl exam& blood testing.

Answer 10

Rx:Levonorogestrel-releasing IUD.

Question 11

73 y/o M w advanced arthritis of knees.

Answer 11

Rx: PT for quadriceps strengthening.

Question 12

66 y/o M w persistant angina; post angioplasty.

Answer 12

Rx: Crestor 20 mgs. Qd (Rosuvastin)

Question 13

62 y/o F requests thyroid eval. for Hx abn. thyroid tests.

Answer 13

Dx: DXA scan.

Question 14

Benign Paroxysmal Positional Vertigo

Answer 14

Dx:Dix-Hallpike test + when Nystagmus when vertigo elicited.

Question 15

75 y/o pt. with depression.

Answer 15

Rx: Lexapro (Escitalopram).

Question 16

58 y/o pt. w 30pk-year smoking Hx for COPD screening

Answer 16

Dx: No screening.

Question 17

Dietary herbal with highest drug interactions.

Answer 17

St, Jon’s wort (Hypericum porforatum).

Question 18

32 y/o F w severe anxiety in social situations.

Answer 18

Rx: Lexapro (Escitalopram).

Question 19

67 y/o F w swollen wrist due to fall on outstretched hand.

Answer 19

Rx: Sugar Tong splint (before surgical intervention).

Question 20

7 y/o F w 4th episode of wheezing using short-acting B-agonist inhaler.

Answer 20

Rx: Inhaled Corticosteroid.

Question 21

55 y/o F w new onset of palpitations.

Answer 21

Dx: Cardiac cause if it affects her sleep.

Question 22

69 y/o F w scaling, redness & irritation under breasts,

Answer 22

Dx: Wood’s lamp=coral pink: +fungus.

Question 23

25 y/o F w yearly Paps neg.;only needs STI screen.

Answer 23

Yearly paps unnecessary because proc. exceeds potential benefits.

Question 24

42 y/o M w BP 185/105 asymptomatic ;H&P-Nl

Answer 24

Dx: 30 min. rest;repeat BP.

Question 25

53 y/so F w DM,HTN,HLD & GERD w inc. ALK. Phos/ALT

+Throbocytopenia.

Answer 25

Dx: “NASH” (Chronic Liver Disease).

Question 26

Pt, w sleeve gastrectomy for wt. loss.

Answer 26

Avoid: Ibuprofen (NSAID).

Question 27

11 y/o F soccer player w 2+ urine protein; asymptomatic.

Answer 27

Get spot protein/creatinine ratio in early AM.

Question 28

Posttraumatic Stress Disorder in children.

Answer 28

Rx: Intensive Behavioral Intervention.

Question 29

recombinant “Shingrix” vs live “Zostavax”

Answer 29

Rx: “Shingrix”–improved efficacy.