AAFP Mixed 1

Question 0

Patient presents with abdominal pain, nonbloody diarrhea and 20 pound weight loss over last year. No Other relevant history. Differential?

Answer 0

#Celiac sprue (look for dermatitis herpetiformis)
#Collagenous colitis
#Crohn's

Question 1

Extra intestinal manifestations of celiac’s disease? Highly sensitive serum test? Gold standard for diagnosis?

Answer 1

Dermatitis herpetiformis, Elevated transaminases, osteopenia, iron deficiency anemia

IGA for tissue transglutaminase; biopsy showing villous atrophy

Question 2

Plasma aldosterone/renin test interpretation?

Answer 2

Ratio over 20 with aldosterone level over 15 indicates primary hyperaldosteronism

Question 3

Hemodynamically stable child presents with suspected community acquired pneumonia – treatment? Do not order?

Answer 3

amoxicillin

Laboratory evaluation not helpful

Question 4

Treatment for tibial stress fracture?

Answer 4

#Avoid painful activities
#Can use Aircast ( leg brace)

*casting not recommended

Question 5

Suspect low testosterone – test?

Answer 5

#TOTAL testosterone level
#Free testosterone level recommended only if total level is borderline

Question 6

Patient presents with sharp, searing pain in right heel. Pain worse after periods of low activity (in the morning when getting out of bed) and at the end of the day. Becomes better with activity. Suspected diagnosis? first-line treatment?

Answer 6

Planter fasciitis

#Over-the-counter heel inserts
#Second line treatment – Custom-made consoles, night splints, corticosteroids

Question 7

Best test for ACL tear?

Answer 7

Lachman test (knee at 20-30°)&raquo_space; anterior drawer test (knee at 90°)

Question 8

Test for meniscal tear?

Answer 8

McMurry

Question 9

Unilateral lower extremity mononeuropathy common in diabetes patients?

Answer 9

Femoral neuropathy (decreased sensation to pinprick and light touch over interior, reduced motor strength on hip flexion and extension)

Question 10

OCP lowers risk of which cancer? By how much?

Answer 10

Ovarian; 50%

Question 11

Cachectic and dehydrated patient with serum albumin of 1.9. Given fluids and feeding tube. Signs of referring syndrome? Classic electrolyte abnormality?

Answer 11

nausea, vomiting, hypotension and delirium

hypophosphatemia (can also see hypokalemia, hypomagnesemia, changes in sodium)

Question 12

Pt taking oral corticosteroids for asthma. How to lower risk of oral candida?

Answer 12

Rinsing mouth after each administration and using valved holding chamber

Question 13

Common causes of Horseness? Will need laryngoscopy if?

Answer 13

#Reflux
#Inhaled corticosteroids
#Overuse

Symptoms persist for over three months

Question 14

Patient taking codeine will test positive for what drug?

Answer 14

Morphine

Question 15

Patient with malignancy percents with hypercalcemia – management?

Answer 15

# fluid replacement
#Loop diuretics if patient in danger of fluid overload

Question 16

Melanosis coli – caused by?

Answer 16

Laxative abuse

Question 17

Downside of using a PEG tube in older patient?

Answer 17

#No reduction in aspiration risk
#No improvement in nutritional status
#No improvement in quality of life

Question 18

High risk for colorectal cancer? Screening for these patients?

Answer 18

# One first-degree relatives with colorectal cancer before 860
#2 second-degree relatives with colorectal cancer

Colonoscopy at age 40 and then every five years

Question 19

Drugs that cause lupus pleuritis?

Answer 19

Hydralazine, procainamide, quinidine

Question 20

Medical Treatment for WPW?

Answer 20

Procainamide or amiodarone

Question 21

Diabetes medication that needs to be stopped for CT contrast scans?

Answer 21

Metformin