Final Exam: Quizzes Flashcards
A 14 y/o is seen with c/o severe testicular pain. The clinician suspects testicular torsion. Which of the following is appropriate action?
a. Order a CT scan
b. Prescribe ice and ibuprofen for pain
c. Emergent referral to a urologist
d. Instruct the patient to elevate his scrotum
c. Emergent referral to a urologist
Which of the following medication regimens is most appropriate for your patient with HTN and BPH?
a. Metoprolol 25mg PO BID
b. Finasteride 0.4mg PO BID
c. Lisinopril 10mg PO daily
d. Terazosin 2mg PO HS
d. Terazosin 2mg PO HS
Which of the following is true regarding syphilis?
a. CXR is recommend for all persons with syphilis to screen for aortic dilation
b. RPR turns positive approximately 4 weeks (1 months) after chancre formation appears
c. The preferred diagnostic test is microhemagglutination assay T Pallidum
d. Screening is recommended for all pregnant women at their first prenatal appointment
d. Screening is recommended for all pregnant women at their first prenatal appointment
You are evaluating your patient with symptoms of vaginitis. Your evaluation is guided by you knowledge that the most common cause include:
a. bacteria, trichomonas, candida
b. Mpox, bacteria, candida
c. trichomonas, bacteria, Mpox
d. candida, trichomonas, Mpox
a. bacteria, trichomonas, candida
Your 32 y/o M patient presents with acute onset of fever, chills, and right groin pain. He also experiences lower back pain with sitting. He is generally healthy and does not have chronic medical problems. He does not take any medications. On exam his T is 101.8F, abdominal exam is normal, MS exam is normal, prostate is enlarged, boggy, and tender. What is your top differential diagnosis?
a. Prostate CA
b. Chronic prostatitis
b. Acute bacterial prostatitis
d. BPH
b. Acute bacterial prostatitis
You have diagnosed your patient with genital warts. Which of the following treatments will you recommend?
a. HPV vaccine
b. Cryotherapy with liquid nitrous oxide
c. Podofilox oral tablets
d. Imiquimod topical cream
d. Imiquimod topical cream
Mr. T presents with symptoms suggestive of chronic non-bacterial prostatitis. Which of the following therapeutic regimens will you recommend for him?
a. Metoprolol 25 mg PO BID x21 days
b. Ciprofloxacin 500 mg PO BID x14 days
c. Erythromycin 250 mg PO QID x 14 days
d. Ampicillin and gentamycin IV
b. Ciprofloxacin 500 mg PO BID x14 days
According to the CBC and USPSTF, which of the following patients will you screen for chlamydia in the primary setting?
a. Sexually active female, 22 y/o who has a male partner
b. Transgender female, 33 y/o who has a female partner
c. Sexually active heterosexual male aged 25
d. Pregnant female, 32 y/o who has sex with a monogamous male partner
a. Sexually active female, 22 y/o who has a male partner
Your patient has symptoms suggestive of gonorrhea. They are houseless and follow up is uncertain. What will you include in your treatment plan?
a. Doxycycline 100mg PO BID x12 days
b. Benzathine PNC G 7.2 million units IM now
c. Ceftriaxone 500mg IM now
d. Azithromycin 1g PO now
c. Ceftriaxone 500mg IM now
You are evaluating a 68 y/o M for ED and low libido. You have completed a comprehensive H and P exam. The inital lab evaluation you order would include:
a. cholesterol panel, glucose, PSA, TSH, bioavailable testosterone
b. free testosterone, cholesterol panel, TSH, PSA, CBC, LH
c. hemoglobin A1C, cholesterol panel, total and free testosterone, PSA, CBC, LH
d. exercise treadmill testing, cholesterol panel, random glucose, LH, TSH, CBC
c. hemoglobin A1C, cholesterol panel, total and free testosterone, PSA, CBC, LH
Many women experience mild decreases in memory and cognition at midlife. Which of the following related statements is true?
a. Vitamin B6 deficiencies are common cause of midlife memory and cognitive changes.
b. Every midlife woman must be evaluated for dementia using the MMSE
c. Memory and cognitive changes are much higher among women at midlife compared with men
d. Sleep disturbances frequency causes midlife memory and cognition changes among women.
d. Sleep disturbances frequency causes midlife memory and cognition changes among women
You are assessing Martinique’s concerns about her decrease in libido. She is a 53 y/o married women with LMP 14 months ago. She is healthy with well managed HTN. As you talk with her you remain aware that:
a. relationship issues are the single most important component of sexual health for midlife women
b. testosterone level decreases affect sexual and libido changes for most midlife women
c. genitourinary syndrome of menopause symptoms affect libido for most midlife women
d. most women experience an increase in libido at midlife related to multitude of factors.
a. relationship issues are the single most important component of sexual health for midlife women
Myia is a 54 y/o F. Her LMP was 14 months ago. She presents today with c/o vaginal dryness and painful intercourse. She has some hot flashes that do not really bother her. She is a healthy woman, has had no surgeries, and has a FH of osteoporosis in her mother and father. Her most recent DXA results were hip T-score of -0.7. In addition to a local lubricant for sexual activity, which of the following therapy options is most appropriate for Myia?
a. Systemic estrogn-progestogen therapy
b. SSRI
c. Systemic estrogen therapy
d. Local vaginal estrogen therapy
d. Local vaginal estrogen therapy
Bio-identical compounded hormones my be the best option for a woman with bothersome moderate to severe hot flashes who…
a. Has a history of breast CA
b. Wants to follow hormones levels in her saliva to evaluate efficacy
c. Needs a dose not available from pharmaceutical produced hormones
d. Prefers to take hormones that are identical to those made by her own body.
c. Needs a dose not available from pharmaceutical produced hormones
Your postmenopausal patient is experiencing a wide array of related symptoms. When explaining how the symptoms are related to postmenopause, you will educate her about:
a. Increases in her endogenously produced estrogen and progesterone hormones
b. Shifts in her FSH that reduces likelihood of ovulation
c. Locations of estrogen and progesterone receptors throughout her body, which relate to symptoms
d. Effects of inhibins on the hypothalamic-pituitary-ovarian axis
c. Locations of estrogen and progesterone receptors throughout her body, which relate to symptoms
Sharon is a postmenopausal woman who presents with hot flashes and night sweats. She is generally healthy with a history of HTN and hLD, well managed by taking lisinopril and atorvastatin, respectively. She has no other ongoing medical problems and takes no other regular medications. She has never had surgery. She takes Calcium, Vitamin D, and a multivitamin daily. In addition to lifestyle changes, which of the following medication regimens is the most appropriate EBP option for Sharon?
a. Venlafaxine 37.5 mg PO daily
b. Estradiol/norethindrone acetate transdermal (Combipatch) 0.05/0.14 mg/d patch 2x weekly
c. Gabapentin 100 mg, 2 tablets PO HS
d. Conjugated estrogen 0.3mg PO daily with medroxyprogesterone 10mg for 10 days every 3-4 months
b. Estradiol/norethindrone acetate transdermal (Combipatch) 0.05/0.14 mg/d patch 2x weekly
You are evaluating Deirdre, a 52 y/o F, who has concerns about sleep problems, hot flashes, and memory “blips” occurring when she cannot recall the correct word or must refer to her calendar more often to keep track of meetings. Which of the following DDx is most important to consider in addition to menopause-related symptoms?
a. Diabetes
b. Depression
c. New onset breast CA
d. Eating disorder
b. Depression
Theresa is a 54 y/o Black F whose LMP was 3 year ago when she had a hysterectomy due to uterine fibroids with excessive bleeding. She is c/o increased hot flashes recently and wants to discuss medication to control them. She has a history of poorly controlled diabetes and HTN. Her family includes MI in her father, breast CA in her mother and sister, and thyroid dysfunction in her brother. In addition to a local lubricant for sexual activity, which of the following management plans is most appropriate for Theresa?
a. SSRI
b. Systemic oral black cohosh
c. Systemic oral estrogen-progestogen therapy
c. Local vaginal estrogen therapy
a. SSRI
Cassandra is a 53 y/o F who presents with complaint of severe hot flashes. She had her LMP 13 months ago and her hot flashes have been progressively. She estimates that she is having 8-10 per day and 6-7 per night. She often has drenching sweats with the hot flashes. Her PMH includes well controlled HTN, overweight (BMI 26.2), and low bone mass (T-socre -2.0). She has had no surgeries. She takes lisinopril 10 mg PO daily and a calcium with Vit D supplement. She does aerobic exercise for 30 minutes most days of the week and recently started yoga. She is trying to watch what she eats to lose some weight. She does not smoke. She drinks alcohol socially, usually 2-3 drinks per week. Her BP and PE are normal. Considering her symptoms and history, and that she is open to trying what you recommend, which of the following would be the most effective EBP management plan for Cassandra?
a. Advise her to avoid triggers, dress in layers, and begin taking red clover isoflavone extract 50 mg PO daily
b. Advise her to avoid triggers, use fans in the bedroom with light sheets, and prescribe a combined estrogen-progestin patch for continuous use
c. Advise her to increase aerobic exercise to 60 minutes daily, increase water consumption, and prescribe gabapentin 100 mg, 2 tablets PO HS
d. Advise her to dress in layers with breathable fabrics, avoid high sugar content foods, and prescribe venlafaxine 37.5 mg PO daily
b. Advise her to avoid triggers, use fans in the bedroom with light sheets, and prescribe a combined estrogen-progestin patch for continuous use
When considering herbal dietary supplements for managing menopause-related symptoms, which of the following is true?
a. The US Pharmacopeia mark means they have been tested and contain the ingredients on the label
b. Manufacturing standards are very similar to pharmaceutical produced medications
c. Doses of herbal dietary supplements are the same from brand to brand
d. Rheum rhaponticum (ERr-731) has a strong estrogen-receptor alpha effect and thus reduces anxiety
a. The US Pharmacopeia mark means they have been tested and contain the ingredients on the label
In a patient with Hepatitis B infection, the HBeAg:
a. suggests increased risk for HCC
b. indicates a favorable host immune response to hepatitis B virus
c. suggests co-infection with HCV
d. appears after HBsAg in early infection
d. appears after HBsAg in early infection
Your 20 y/o patient was recently diagnoses with acute Hepatitis B. He is sexually active, monogamous, and reports using a condom about 60% of the times. Which of the following is recommended for his male sexual partner who has the following lab results: negative HBsAg, negative anti-HBs, negative anti-HCV, positive anti-HAV?
a. HBV vaccine
b. HBIG
c. No vaccine is required at present
d. Both HBV vaccine and HBIG
a. HBV vaccine
Mr. P is a 52 y/o M who has chronic Hepatitis C. His RF for HCV included having male sex partners and IVDU. His only medication is methadone 130 mg per day. Mr. P has not used alcohol or drugs for 2 years now. He smokes 1/2 pack of cigarettes a day. Mr. P is worried about his hepatitis. He has a friend who just started treatment, and he wants to know if you think he should start treatment too. He has heard that HCV treatmtent is painful and causes depression. You order blood work at this visit. Here are some of the results:
-HCV DNA 3,000,000
-HCV Genotype 3
-ALT 100
-AST 80
-Platelets 100,000
-Hgb: 13.0
-WBC: 3
Given the above results, how would you counsel Mr. P on hepatitis C treatment?
a. I am glad that you are considering treatment. Your lab results indicated that you have chronic hepatitis C; however your genotype and viral load do not match with current treatments. I recommend that you wait and start therapy in 6-12 months.
b. I would not recommend Hepatitis C treatment now. It has a lot of side effects. New medications are being developed that have better side-effect profiles and will be available soon.
c. You will likely clear the HCV on your own. I recommend that you give it some time.
d. I am glad you are considering treatment. Your lab results indicate that you have chronic hepatitis C infection, and your liver function is affected. I recommend that you start hepatitis C treatment now.
d. I am glad you are considering treatment. Your lab results indicate that you have chronic hepatitis C infection, and your liver function is affected. I recommend that you start hepatitis C treatment now.
Jane is a 38 y/o sex worker who was recently screened for Hepatitis B. Her HBsAg was positive. Follow up labs show positive total anti-HBc, negative IgM, and negative anti-HBs. What is her diagnosis?
a. False positive for Hepatitis B
b. Acute hepatitis B
c. Chronic hepatitis B
d. Recovered/immune to Hepatitis B
c. Chronic hepatitis B
