HBKim - BIomed Flashcards
A 47-year-old male reports a strong, sometimes irresistible urge to move his legs particularly at night. He also presents with sleep deprivation, fatigue, leg cramps, uncomfortable tingling and burning sensation. What is the proper diagnosis?
Parkinson’s disease
Restless Legs Syndrome
Nightmare disorder
Restless Legs Syndrome
Restless leg syndrome can be associated with:
Iron deficiency
Vitamin D deficiency
Magnesium deficiency
Iron deficiency
Which of the following disorder shares the same pharmaceutical treatment as RLS?
Alzheimer’s disease
Narcolepsy
Parkinson’s disease
Parkinson’s disease
A Pap smear is recommended starting at age until age 75.
14
18
21
28
21
Doctors may recommend colposcopy if result is abnormal.
urinalysis
pap smear
IQ test
testicular exam
pap smear
Colposcopy is a procedure to closely examine:
larynx and trachea
dueodenum
bladder
cervix
Cervix
A 36-year-old female is referred because of a Pap smear reading of ASCUS (atypical
squamous cells of undetermined significance). She has been sexually active, using oral contraception pills for the last 3 years. Which of the following is the next step in evaluation?
Colposcopy and biopsy
Duplex ultrasound
Mammogram
Colposcopy and biopsy
Difference between Radiculopathy and Neuropathy
Radiculopathy - involves one spinal nerve root distribution (Pinched nerve)
Neuropathy - usually involves on peripheral nerve branch, pathology often presents entrapment distally
What procedure should a patient perform to test Cervical Radiculopathy?
Bakody’s Sign The patient should abduct the arm and place the hand on top of the head
A decrease or relief of the patient’s symptoms is a positive test
Positive Bakody’s sign indicates the cervical radiculopathy at the levels of:
C1-C2
C2-C3
C4-C6
C7-C8
C4-C6
Which of the following test is for radiculopathy?
Bakody’s sign
Phalen test
Tinel’s sign
Reverse Phalen test
Bakody’s sign
Which of the following is NOT an example of an antioxidant?
Selenium
Vitamin A
Vitamin C
Vitamin D
Vitamin D
What are the antioxidant vitamins?
A
C
E (selenium)
Which of the following is NOT an example of an antioxidant?
Vitamin E
Vitamin B
Selenium
Bata-carotene
Vitamin B
How often should a patient be tested with an HbA1C?
about once every 3 days
about once every 3 weeks
about once every 3 months
about once every 3 years
about once every 3 months
Which of the following patients has the highest risk factor for diabetic neuropathy?
A1C 5.6
A1C 6.5
A1C 9
A1C 11
A1C 11
What is HbA1C? and what’s the ranges of labwork?
Hemoglobin A1c tests blood sugar in diabetic patients. pre-diabetic is 6.0 (+- 0.4)
Which of the following drugs is NOT an SSRI (selective serotonin reuptake inhibitors)?
A. Escitalopram (Lexapro®)
B. Fluoxetin (Prozac®)
C. Sertraline (Zoloft®)
D. Paroxetine (Paxil®)
E. Citalopram (Celexa®)
F. Venlafaxine (Effexor®)
F. Venlafaxine (Effexor®)
What are some SSRI mneumonic drug names?
Effective - escitalopram
For - fluoxetin
Sadness - sertraline
Panic - paroxetine
Compulsions - citalopram
Which of the following is NOT a common adverse effects of SSRI’s?
Stomach upset
Sexual dysfunction
Serotonin syndrome
Major depressive disorder (MDD)
Major depressive disorder (MDD)
What are the adverse effects of SSRI’s?
Stomach upset
Sexual dysfunction
Serotonin syndrome
A 48-year-old female has been taking Sertraline (Zoloft®) 50mg PO qday for her Major
Depressive Disorder for the last six months. The patient reports no symptomatic improvement. Her family physician increased her Sertraline (Zoloft®) dose to 100mg PO qday and added Venlafaxine (Effexor®) 50mg PO q12hr. After a few day, the patient came back to her physician reporting that she was experiencing agitation, tachycardia, diarrhea, fever and episodes of seizure. What is the most likely diagnosis?
Lithium toxicity
Neuroleptic Malignant Syndrome (NMS)
Serotonin Syndrome
MAOI-induced hypertensive crisis
Serotonin Syndrome
Which of the following foods should you avoid when taking MAOI?
Tyramine-rich foods (cheeses, pickled foods, wine)
purine-rich foods (anchovies, sardines, alcohol)
Fast foods (McDonald’s, Wendy’s, Hardee’s)
Tyramine-rich foods (cheeses, pickled foods, wine)
What hormone is tested to diagnosis pregnancy and where is it produced?
human chorionic gonadotropin
growth hormone
prolactin
oxytocin
human chorionic gonadotropin - placenta
Typically, the hCG levels will double every ___during first trimester of pregnancy.
12-24 hours
48-72 hours
week
month
48-72 hours
Which of the following test confirm an intrauterine pregnancy?
human chorionic gonadotropin
colonoscopy
ultrasound
CT scan
ultrasound
What is the best way to confirm the diagnosis of Giant-Cell Arteritis?
Complete blood count
Basic metabolic panel
Temporal artery biopsy
CT head
Temporal artery biopsy
A high-dose of____should be administered immediately to prevent permanent monocular blindness for Temporal Arteritis patient.
Sildenafil
Prednisone
Acetaminophen
Artificial tears
Prednisone
What is the risk factors for Giant-Cell Arteritis?
> 50, female, polymyaglia rheumatica
50, male, polymyalgia rheumatica
<50, female, fibromyalgia
<50, male, fibromyalgia
> 50, female, polymyaglia rheumatica
A 65-year-old female presents clinic with right-side headache with scalp pain. She reports pain in the jaw associated with chewing, fever, fatigue, recent weight loss, decreased visual acuity of right eye and double vision. She reports temporal tenderness upon gentle pressure. What is the most appropriate diagnosis?
Migraine
Stroke
Bell’s palsy
Temporal arteritis
Temporal arteritis
A 72-year-old male presents with loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite even thought he is not actively trying to lose weight. What is the diagnosis?
Iron deficiency anemia
Lactose intolerance
Cachexia
Osteoporosis
Cachexia
About 50% of all ____ patients suffer from cachexia.
Diabetes mellitus type 2
Hypertension
Hyperlipidemia
Cancer
Cancer
Severe deficiency of niacin (B3) in the diet causes:
Night blindenss
Pellagra
Rickets
pernicious anemia
Pellagra
Severe deficiency of Vitamin B3(Niacin) characterized by:
diarrhea, dermatitis, dementia
pernicious anemia
hemorrhage
osteomalacia
diarrhea, dermatitis, dementia
In addition to other lipid-lowering medications, Niacin has sometimes been used. What is the most common adverse effects of Niacin?
Facial paralysis
Facial drooping
Facial pain
Facial flushing
Facial flushing
A middle-aged female complains of pain located on the bottom of the ball of the foot. The pain is worse by walking, especially while wearing narrow shoes and is relieved by removing the shoe. She also complains numbness, paresthesia, and shooting pain towards the toes. Mulder’s sign positive on physical exam.
Ultrasound may confirm the diagnosis of:
Metatarsal stress fractures
Lumbosacral nerve root irritation
Morton’s neuroma
Foreign-body reaction
Morton’s neuroma
The most frequent location of Morton’s neuroma is in-between:
the third and fourth metacarpals (third webspace)
the third and fourth metatarsals (third webspace)
the first and second metacarpals (first webspace)
the first and second metatarsals (first webspace)
the third and fourth metatarsals (third webspace)
The CAGE is a simple screening questionnaire to identify potential problems with:
tobacco
alcohol
marijuana
painkillers
cocaine
alcohol
C - need to cut down on drinking
A - annoyed by criticism
G - Guilty about it
E - Eye opener first thing in morning
What are the withdrawal symptoms of alcohol?
tremor, tachycardia, hypertension, malaise, nausea, seizures, delirium tremens (DTs),
agitation
A 35-year-old male was brought to the ER with severe abdominal pain and vomiting for 2 days. The patient presents with agitation, global confusion, disorientation, hallucinations, fever, and profuse sweating. The patient’s family gave a history of alcoholism for the past 20 years. The family admitted him to alcohol rehab center three days ago. On examination, the pulse rate was 136 beats/min and BP was 160/90 mmHg, with a respiratory rate of 40 breaths/min. The patient has jaundice with dry tongue.
This patient most likely suffers from:
Delirium tremens
Myxedema coma
Thyroid storm
Hypertensive emergency
Delirium tremens
Wernicke-Korsakoff syndrome (WKS): usually secondary to alcohol abuse. It mainly causes vision changes + ataxia + impaired memory. The cause of the disorder is ______deficiency.
Thiamine B1 deficiency
Which of the following vitamin enhances the absorption of non-heme iron?
Vitamin B
Vitamin C
Vitamin E
Vitamin K
Vitamin C
Deficiency of Vitamin ____ causes scurvy, anemia, depression, infection, tooth/gum problems, muscle deterioration, fragile bones, poor wound healing.
Vitamin B1 (thiamine)
Vitamin B3 (niacin)
Vitamin B12 (cobalamins)
Vitamin C (ascorbic acid)
Vitamin C (ascorbic acid)
_____ may be used to evaluate and diagnose the Bladder cancer.
Cystoscopy
Colposcopy
Lower endoscopy
Laryngoscopy
Cystoscopy
A 61-year-old male presents with painless hematuria. He is a heavy smoker and has occupational exposure to aniline dye in a paint manufacturing plant. After taking his social history, which of the following disease should be ruled out?
Endometrial cancer
Prostate cancer
Bladder cancer
Colon cancer
Bladder cancer
Urodynamic testing is most suitable for which of the following diseases?
bladder cancer
acute kidney injury
chronic kidney injury
urinary incontinence
urinary incontinence
A 37-year-old male complains of inability to achieve or maintain an erection. The patient reports emotional stress due to his current relationship with his spouse. He reports normal nocturnal and early morning erection. His vital signs are within the normal range. His testosterone levels within the normal range. What is the most likely cause of his erectile dysfunction?
Psychogenic
Diabetes Mellitus Type 2
Beta-blocker
Selective serotonin reuptake inhibitors
Psychogenic (early morning erection, sudden, situational)
While Organic ED (no morning erection, gradual and always)
Which Autonomic Nerve mediates ejaculation?
Parasympathetic
Sympathetic
Brain
Spinal cord
Sympathetic
Point (Parasympathetic) & Shoot (sympathetic)
Which drugs are absolutely contraindicated when using Sildenafill?
SSRI
Beta blocker
Nitrates
MAOI
Nitrates (severed hypotension + death)
What are the dermatomes connected to the following body landmarks?
Thumb -
Middle finger
Pinky
Nipple -
Umbilicus
Knee -
Thumb - C6
Middle finger - C7
Pinky C8
Nipple - T4
Umbilicus - T10
Knee - L4
What are the dermatomes connected to the following body landmarks?
Top of the foot
Bottom of the foot
Perineum -
Lateral malleolus
Top of the foot - L5
Bottom of the foot - S1
Perineum - S2-S4
Lateral malleolus - S1
Which of the following spinal nerve supplies dermatome at the anterior knee?
L4
LS
S1
L4
Which of the following spinal nerve supplies dermatome to the nipple?
T2
T4
TS
T6
T4
Which of the following spinal nerve supplies dermatome at the umbilicus?
C6
T4
T1O
LS
T1O
Which of the following spinal nerve supplies dermatome to the perineum?
L4
LS
S1
S2-S4
S2-S4
What are the Water-soluble vitamins, and their excess, deficiency and toxicity?
B, C
- Hyrdrophilic
excreted in urine
-faster onset
less comon toxicx
What are the Fat-soluble vitamins, and their excess, deficiency and toxicity?
A, D, E, K,
- hydrophobic, stored in the body, slower onset therefore more commonly toxic
what does vitamin K help with? and where is it made?
helps blood clot and prevent serious bleeding
Made in the gut
What is VKDB? and whom does it affect
Vitamin K deficiency bleeding , new born lack vit K because it K is made in the gut and don’t get it until they can eat solid food, also called Hemorrhagic Disease of Newborn (HDN)
Which of the following vitamins is classified as Fat-Soluble?
Vitamin E
Vitamin B1
Vitamin B12
Vitamin C
Vitamin E
Deficiency of this vitamin can cause a hemorrhage in newborn infants.
Vitamin A deficiency
Vitamin D deficiency
Vitamin E deficiency
Vitamin K deficiency
Vitamin K deficiency
Bacteria in the gastrointestinal tract naturally makes vitamin .
A
D
K
Vitamin K
A vitamin____ injection after birth eliminates the risk of bleeding.
C
K
Folic acid (B9)
E
K
A vitamin ____ deficiency is particularly common among breastfed infants.
A
K
Niacin (B3)
C
K
Which of the following foods contains the most Vitamin K?
citrus fruits
whole grains
green leafy vegetables
shell fish
green leafy vegetables
Which of the following foods should be avoided for individuals taking Warfarin (Coumadin®)?
citrus fruits
whole grains
green leafy vegetables
green leafy vegetables
What is the mechanism of action for Warfarin (Coumadin®)?
Kill bacteria
Increase heart rate
Activates anti-thrombin
Inhibits synthesis of vitamin K
Inhibits synthesis of vitamin K
What is the antidote for Warfarin (Coumadin®)?
Protamine
Vitamin K
Oxygen
Glucose
Naloxone
Ethanol
Vitamin K
What is the indication of anti-coagulants (“blood thinners”)?
deep vein thrombosis (DVT)
pulmonary embolism (PE)
atrial fibrillation (A-Fib)
artificial heart valve
All of the above
All of the above
- most important is A-Fib
What is the effective therapeutic INR range for people taking Warfarin for disorders such as atrial fibrillation or a blood clot in the legs or lungs?
1.1 or below
1 to 2
2 to 3
S to 6
All of the above
2 to 3
A 46-year-old male with a medical history of hypertension complains of palpitations and dyspnea. His blood pressure is 124/8O and the heart rate is 11O. EKG shows following. What is the diagnosis?
Atrial fibrillation
Sinus tachycardia
Sinus bradycardia
Asystole
Atrial fibrillation
Which of the following risk factors helps with estimating the risk of stroke in patients with atrial fibrillation?
Congestive heart failure
Hypertension
Age >7S years
Diabetes mellitus
Prior stroke or TIA or Thromboembolism
All of the above
All of the above
C (ongestive heart failure)
H (ypertension)
A (age >75)
D (iabetes Mellitus)
S (troke)
Which of the following is the drug choice in the treatment of atrial fibrillation?
Anticoagulant
Thrombolytics
COX inhibitors
Antipsychotic
Anticoagulant
Which of the following drugs treats atrial fibrillation?
Warfarin (Coumadin®), Rivaroxaban (Xarelto®)
Clopidogrel (Plavix®), Aspirin
Alteplase (tPA), Streptokinase
Celecoxib (Celebrex®), Meloxicam (Mobic®)
Warfarin (Coumadin®), Rivaroxaban (Xarelto®)
Too much vitamin___ in your diet can lower the effect of Warfarin (Coumadin ). Avoid eating large amounts of leafy green vegetables (kale, spinach, brussels sprouts, parsley, collar greens, mustard greens, endive), as many of them contain large amount of vitamin _____
Vitamin K
Which of the following herbs can potentiate the effect of Warfarin (Coumadin®)?
Dang Gui (Radix Angelicae Sinensis)
Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae)
Chuan Xiong (Rhizoma Chuanxiong)
All of the above
All of the above
What is a blood clot attached to wall of a vein or artery?
Thrombus
Embolus
Thrombus
What is a foreign object, such as a blood clot or tissue, that is circulating in the blood stream?
Thrombus
Embolus
Embolus
Which of the following anti-thrombotics can dissolve an already formed thrombus?
Anticoagulant
Antiplatelets
Thrombolytics
Thrombolytics
Which of the following drugs works by making platelets less able to stick together?
Heparin
Enoxaparin (Lovenox®)
Warfarin (Coumadin®)
Clopidogrel (Plavix®)
Clopidogrel (Plavix®)
A 6S-year-old male with a past medical history of hypertension, diabetes mellitus, congestive heart failure, and atrial fibrillation presents to the emergency room with complaints of sudden weakness of the left arms and legs, slurred speech, and loss of balance and coordination. The patient states that his symptoms started two hours ago. A Head CT scan ruled out evidence of bleeding. The patient reports no history of a bleeding disorder. Which of the following “clot buster” drug can be used?
heparin
warfarin
aspirin
clopidogrel
tPA (tissue plasminogen activator)
tPA (tissue plasminogen activator)
A 51-year-old female complains of hot flashes, vaginal atrophy and dryness, insomnia, anxiety, irritability, poor concentration, mood changes, dyspareunia, and loss of libido. Which of the following elevated hormone levels are measured to confirm menopause?
Estrogen
FSH (follicle-stimulating hormone)
Progesterone
Testosterone
FSH (follicle-stimulating hormone)
Once a women is postmenopausal, she should be routinely screened for osteoporosis. ______ is used to measure bone mineral density (BMD).
CT scan
MRI
DEXA scan
Doppler Ultrasound
DEXA scan
A barium enema is an X-ray exam that can detect changes or abnormalities in the ______.
Esophagus
Stomach
Duodenum
Colon
Colon
A barium enema is also called:
Upper GI Tract X-ray Radiography
Lower GI Tract X-ray Radiography
Dual energy X-ray absorptiometry
Computed tomography
Magnetic resonance imaging
Lower GI Tract X-ray Radiography
A 40-year-old male with history of gallstones presents to the ER with severe epigastirc pain for the last few hours. The pain radiates to the back and is relieved by sitting forward. He also presents with nausea, vomiting, and fever. He was drinking a lot until late last night. What is the most likely diagnosis?
Acute pancreatitis
Appendicitis
Cholecystitis
Celiac disease
Acute pancreatitis
What is the most common cause of acute pancreatitis?
Ethanol, Trauma
Gallstone, Ethanol
Steroid, Mumps
Scorpion sting, Hypertriglyceridemia
Gallstone, Ethanol
Lipase and Amylase are elevated in:
Cholecystitis
Appendicitis
Pancreatitis
Morton’s neuroma
Pancreatitis
What are the 3 main causes for Acute Pancreatitis?
G (allstones)
E (thanol Alcohol)
T (rauma)
S teroids
M umps virus
A utoimmune disease
S corpion stings
H ypertriglycerdiema
E RCP (endoscopic retrograde)
D rugs
What are the symptoms for Acute Pancreatitis?
Presents with abdominal pain - typically in the ‘midepigastric region’ - that ‘radiates to the back’, may be ‘relieved by sitting forward’, and lasts hours to days.
Nausea, vomiting, and fever are also common
What are the signs & symptoms for chronic pancreatitis in adults?
Pancreatic insufficiency, ‘steatorrhea’, fat-soluble vitamin deficiency, ‘diabetes mellitus’, increased risk of pancreatic adenocarcinoma, ‘calcification of pancreatitis’
What is the most common cause of chronic pancreatitis in adult?
Alcohol
Gallstone
Trauma
Alcohol
(the other 2 are also causes, but not the MOST common)
A 62-year-old female with a history of ‘chronic alcohol abuse’ complains of persistent, recurrent episodes of severe abdominal pain for last six months. She also presents with “anorexia, nausea, steatorrhea”, weight loss, and “diabetes mellitus”. A CT scan reveals “pancreatic calcifications”. What is the most likely diagnosis?
Peptic ulcer disease
Ulcerative colitis
Acute pancreatitis
Chronic pancreatitis
Chronic pancreatitis
What are the treatment options for chronic pancreatitis?
Analgesia
Pancreatic enzyme replacement
Avoidance of alcohol
Surgery for structural causes
All of the above
All of the above
What are the signs/symptoms of Impetigo?
Presents with well-localized vesicles filled with serous fluid, usually in exposed areas of the skin. The vesicles rapture, leaving a thin yellow “honey-colored” crusts.
A 10-year-old male presents with yellowish crusts on the face, arms, and legs. The lesions are painful and itchy at times. On physical exam, well-localized vesicles and honey-colored scabs are found on the lesions. What is the most likely diagnosis?
Impetigo
Erysipelas
Cellulitis
folliculitis
Impetigo
What is the treatment option for patient with Impetigo?
Topical corticosteroids ointment
Topical mupirocin ointment
Oral Clindamyci
Oral Doxycycline
Topical mupirocin ointment
A 52-year-old female with a medical history of diabetes and IV drug use presents with “red, hot, swollen”, tender skin in the right lower leg as well as a fever. Her tongue is red with a yellow coating; the pulse is wiry and rapid. What is the most likely diagnosis?
Impetigo
Stasis dermatitis
Cellulitis
Necrotizing fasciilitis
Cellulitis
What is the risk factor for cellulitis?
Diabetes
IV drug use
Venous stasis
Immune compromise
All of the above
All of the above
What are the S/Sx of celiac disease (SPRUE)?
Lead to malabsorption with chronic diarrhea, “steatorrhea and weight loss”
Also present with nausea, abdominal pain, iron-deficiency anemia, muscle wasting, and osteoporosis
Associated with dermatits herpetiformis and an risk of increased GI malignancies
Oscar is a 39-year-old white male who complains of chronic diarrhea. He states that his symptoms get worse when he eats specific foods such as wheat or rye. He also presents with steatorrhea, nausea, and weight loss. He has a chronic blistering skin condition which is intensely itchy and was recently diagnosed with dermatitis herpetiformis by a dermatologist. A biopsy of the small intestine reveals flattening of the villi. What is the most likely diagnosis?
Lactose intolerance
Irritable bowel syndrome
Celiac disease
Ulcerative colitis
Celiac disease
What is the most appropriate long-term treatment for celiac disease?
Lactose-free diet
Gluten-free diet
Fiber supplements
Topical antibiotics
Gluten-free diet
Aortic aneurysms are most commonly associated with:
atherosclerosis
hypertension
cuban cigars
kentucky bourbon
atherosclerosis
What is the screening test of choice for abdominal aortic aneurysms (AAA)?
Barium enema
abdominal ultrasound
MRI
CT scam
abdominal ultrasound
Which of the following patient should be screened for abdominal aortic aneurysms (AAA)?
45-55 years of age, for any male or female
45-55 years of age, for male who have ever smoked
65-75 years of age, for any male or female
65-75 years of age, for male who have ever smoked
65-75 years of age, for male who have ever smoked
Which of the following sizes of abdominal aortic aneurysms (AAA) is a candidate for surgical repair?
> 1.5 cm
2.5 cm
5.5 cm
7.5 cm
> 5.5 cm
Aortic dissections are most commonly associated with:
atherosclerosis
hypertension
diabetes mellitus
history of IV drug use
hypertension
A 69-year-old male with a past medical history of uncontrolled “hypertension” presents to the ER with severe, tearing chest pain that radiates to his back. His current BP is “180/110” with HR 90. Which of the following is the most likely diagnosis?
Aortic dissections
Aortic aneurysm
Cardiac tamponade
Pericarditis
Aortic dissections
What is the MCV range for macroocytic anemia?
MCV < 80
MCV 80-100
MCV > 100
MCV > 1000
MCV > 100
Vitamin B12 deficiency causes _______ anemia.
Mircocytic
Normocytic
Macrocytic
Macrocytic
Lab reveals increased homocystein and methymalonic acid (MMA). Which of the following is the correct diagnosis?
Folate (B9) deficiency
Cobalamin (B12) deficiency
Iron deficiency anemia
Cobalamin (B12) deficiency
MCV (mean corpuscular volume) is the average volume of red cells. Which of the following is the possible MCV for pernicious anemia?
30
60
90
120
120
Which of the following vitamin deficiency can cause (associated with) megaloblastic anemia and pernicious anemia?
Vitamin B1 (thiamine) deficiency
Vitamin B2 (riboflavin) deficiency
Vitamin B9 (folic acid) deficiency
Vitamin B12 (cobalamin) deficiency
Vitamin B12 (cobalamin) deficiency
Hysteroscopy is a procedure that allows a physician to look inside of the .
Bladder
Cervix
Uterus
Cecum
Uterus
Colposcopy is a procedure to closely examine the .
Bladder
Cervix
Uterus
Cecum
Cervix
Cystoscopy is a procedure that allows a physician to look inside of the .
Bladder
Cervix
Uterus
Cecum
Bladder
What is the order of Meninges from outer- most to inner-most?
Arachnoid - Pia - Dura
Dura - Arachnoid - Pia
Dura - Pia - Arachnoid
Pia - Arachnoid - Dura
Dura - Arachnoid - Pia
Which of the following is the most superficial level of intracranial bleeding?
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
lntracerebral hemorrhage
Epidural hematoma
What kind of headache is related to the subarachnoid hemorrhage? What diagnosis?
Thunderclap headache (worse type of HA), connected to Berry aneurism (circle of willis). CTscan without contrast and lumbar puncture if CT is negative.
What are some causes for Epidural hematoma
lucid interval (in and out of consciousness), trauma, biconvex shape in CT scan
A 17-year-old male was hit on the temple with a baseball and he became unconscious. After about ten minutes, he regained consciousness, but he soon became lethargic, and over the next two hours, he was stuporous. His pupils were unequal. Urgent CT scan likely reveals:
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
lntracerebral hemorrhage
Epidural hematoma
lucid interval = lose consciousness, then regained consciousness, then stuporous
What is the most appropriate treatment option for epidural hematoma?
Surgical evacuation
Acupuncture at DU20 and DU16
Acupuncture at LV3 and UB67
Moxa at Si Shen Cong
Surgical evacuation
A 65-year-old man presents to ER with severe headache started a hour ago. Patient states that “it is the worst headache of my life”. He also presents with vomiting, neck stiffness, and photophobia. What is the likely diagnosis?
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
lntracerebral hemorrhage
Subarachnoid hemorrhage
Rupture of Berry aneurysm can lead to:
Subarachnoid hemorrhage
lntracerebral hemorrhage
Subdural hematoma
Epidural hematoma
Subarachnoid hemorrhage
A 76-year-old male with a medical history of alcohol abuse presents with a headache, altered mental status, and hemiparesis. Patient diagnosed with subdural hematoma after the CT scan. Head CT scan likely shows:
Triangle-shaped
Biconvex-shaped
Lens-shaped
Crescent-shaped
Crescent-shaped
Taste fibers from the anterior two-third of the tongue travel via cranial nerve .
3
7
9
10
7
Taste fibers from the posterior one-third of the tongue travel via cranial nerve .
V
Vll
lX
X
lX
Which of the following cranial nerve do NOT contain taste fibers?
Cranial Nerve 7
Cranial Nerve 9
Cranial Nerve 10
Cranial Nerve 12
Cranial Nerve 12
Which cranial nerve innervates the intrinsic and extrinsic muscles of the tongue?
CN V
CN Vll
CN lX
CN Xll
CN Xll
What happens when CN9 (glossopharyngeal nerve) is damaged?
Decreased sense of taste and salivation, diminished or inhibits gag reflex, weak cough reflex
What happens when CN10 (glossopharyngeal nerve) is damaged?
Difficulty swallowing, nasal regurgitation, reduced or lost gag reflex. Hoarse, breathy, wet, voice. lnability to vary pitch
What happens when CN12 (glossopharyngeal nerve) is damaged?
lnability to position food for chewing, resulting in food getting pocketed in cheeks.
Which of the following cranial nerve does NOT involve with swallowing?
Glossopharyngeal nerve (CN 9)
Vagus nerve (CN10)
Accessory nerve (CN11)
Hypoglossal nerve (CN12)
Accessory nerve (CN11}
A 35-year-old college student presents with abdominal discomfort. She complains of incomplete relief with defecation, abdominal bloating, excess gas, intermittent diarrhea or constipation. She is highly stressed due to studying for her final exam. Colonoscopy result were unremarkable. Upon history, this patient most likely suffer from:
Colon cancer
Crohn’s disease
Ulcerative colitis
lrritable bowel syndrome (lBS)
lrritable bowel syndrome (lBS)
A 30-year-old woman complains of vague, crampy abdominal pain that is mitigated with defecation. The patient is concerned that her illness may be serious and is worried that her children may be taken away from her, as she recently divorced and is now a single mother. What is the likely diagnosis?
lrritable bowel syndrome
Celiac Sprue
Crohn’s disease
Ulcerative colitis
lrritable bowel syndrome
Half of all patients with lBS have comorbid _________ disturbance.
Cardiac
Pulmonic
Hematologic
Psychiatric
Psychiatric
Which of the following is NOT an treatment option for lrritable Bowel Syndrome?
Psychological
Dietary
Pharmacologic
Surgery
Surgery
lnflammatory bowel disease (lBD) is an umbrella term used to describe disorders that involve chronic inflammation of your digestive tract. Types of lBD include:
lrritable bowel syndrome
Crohn’s disease
Ulcerative colitis
A & B
B & C
B & C
A 27-year-old man comes to your office complaining of diarrhea and weight loss. He states that his diarrhea often contains mucus but denies any blood in his stool. He also describes having difficulty eating food because of ulcers in his mouth. What is the likely diagnosis?
lrritable bowel syndrome
Ulcerative colitis
Crohn’s disease
Gastritis
Crohn’s disease
biomed5
Leonardo is a 36-year-old man who owns his own company. He has been used to working long hours. He likes junk food, the hotter and spicier, the better. Lately he has been having bouts of diarrhea, especially after Chinese dinners. He also complains of nausea, abdominal cramps, and saw blood in the toilet. What is the likely diagnosis?
lrritable bowel syndrome
Ulcerative colitis
Crohn’s disease
Gastritis
Crohn’s disease
biomed5
Blood and mucus in stool with left lower quadrant pain
What are the parts of the small intestine in order?
Jejunum - lleum - Duodenum
lleum - Jejunum - Duodenum
Duodenum - lleum - Jejunum
Duodenum - Jejunum - lleum
Duodenum - Jejunum - lleum
biomed5
Rheumatoid arthritis most commonly affects and the age of onset is usually
between
women, 20-50
men, 20-50
women, 60-80
men, 60-80
women, 60-80
biomed6
Which of the following is INCORRECT regarding Osteoarthritis?
It is a chronic condition that can get worse with age
Certain jobs or sports that involve repetitive motions can also lead to developing OA.
It is triggered by an autoimmune disorder whereby harmful antibodies are produced that attack the healthy joint tissue in patients.
Old injuries or ones that didn’t heal properly can also increase the risk of developing OA.
It is triggered by an autoimmune disorder whereby harmful antibodies are produced that attack the healthy joint tissue in patients.
biomed6
Common signs and symptoms of Rheumatoid arthritis include morning stiffness of _________ affecting the PIP, MCP, wrists and knees It is in ________ pattern
> 30 minutes, asymmetrical
30 minutes, symmetrical
< 30 minutes, asymmetrical
< 30 minutes, symmetrical
> 30 minutes, symmetrical
biomed6
Which of the following joint involvement is more specific for Osteoarthritis compare to Rheumatoid arthritis?
Wrist
MCP (metacarpophalangeal} joint
PIP (proximal interphalangeal} joint
DIP (distal interphalangeal} joint
DIP (distal interphalangeal} joint
biomed6
Heberden’s node are hard or bony swelling that can develop in the______. They are a sign of Osteoarthritis and are caused by formation of osteophytes
Wrist
MCP joint
PIP joint
DIP joint
DIP joint
biomed6
Bouchard’s nodes are osteophytosis (bone spur formation) at the______. They are seen in OA, or RA
Wrist
MCP joint
PIP joint
DIP joint
PIP joint
biomed6
Ulnar deviation is a hand deformity in which the swelling of the metacarpophalangeal joints causes the fingers to become displaced, tending towards the little finger Ulnar deviation is likely to be a characteristic of___
Gout
Pseudogout
Osteoarthritis
Rheumatoid arthritis
Rheumatoid arthritis
biomed6
Swan neck deformity and boutonniere deformity occurs in about SO percent of Rheumatoid arthritis (RA) Which deformity consists of DIP flexion with PIP hyperextension?
Swan neck deformity
Boutonniere deformity
Swan neck deformity
biomed6
Boutonniere deformity is characterized by:
hyperextension of DIP & PIP with flexion of MCP
hyperextension of PIP & MCP with flexion of DIP
hyperextension of DIP & MCP with flexion of PIP
hyperextension of DIP, PIP & MCP
hyperextension of DIP & MCP with flexion of PIP
biomed6
A 7S-year-old patient presents to your office complaining of pain in his left hand He complains of pain in his fingers that becomes worse throughout the day as he works in the garden On physical examination, you note bony overgrowth at the proximal and distal interphalangeal joints. The most likely diagnosis is:
Osteoarthritis
Rheumatoid arthritis
Psoriatic arthritis
Osteoporosis
Osteomyelitis
Osteoarthritis
biomed6
A 39-year-old female is seen for a 3-months history of fatigue, weight loss and intermittent low-grade fever Over the past 6 weeks, she has also noticed multiple joint stiffness both sides, particularly in the morning lasting about an hour On physical exam, you note tenderness, pain and warmth of bilateral proximal interphalangeal and metacarpophalangeal joints, wrists, and knees Lab revealed increased serum erythrocyte sedimentation rate. The most likely diagnosis is:
Gout
Pseudogout
Rheumatoid arthritis
Osteoarthritis
Rheumatoid arthritis
biomed6
Which of the following lab test is most specific for Rheumatoid arthritis?
RF (Rheumatoid factor)
Anti-CCP (anti-cyclic citrullinated peptide) antibody
ESR (Erythrocyte sedimentation rate)
CRP (C-Reactive protein}
Anti-CCP (anti-cyclic citrullinated peptide) antibody
biomed6
Which of the following drug slow down disease progression of Rheumatoid Arthritis?
NSAIDs
Colchicine
Allopurinol
DMARD
DMARD
biomed6
Which of the following is NOT an pharmaceutical treatment option for Rheumatoid arthritis?
DMARD
NSAIDs
Corticosteroids
Antibiotics
Antibiotics
biomed6
A 4O-year-old obese female was diagnosed with mild left knee osteoarthritis by radiographic finding What is the first-line treatment?
Weight loss, physiotherapy, low-impact exercise
Acetaminophen, NSAIDs
Intra-articular corticosteroid or hyaluronic acid injection
Joint replacement
Weight loss, physiotherapy, low-impact exercise
biomed6
A S6-year-old woman was recently diagnosed with osteoarthritis She has been taking NSAIDs prescribed by her family physician Two months later she started having abdominal pain that worsens with the consumption of food What is the likely diagnosis?
NSAIDs inhibit the COX enzyme, which exists in two forms
Gastric ulcer
Duodenal ulcer
Irritable bowel syndrome
Crohn’s disease
Gastric ulcer
biomed6
Joint pain worse with activity and weight bearing but improve with rest, stiff joints, restricted joint motion, crepitus, Heberden’s and Bouchard’s nodes
The above symptoms are most likely related to:
Osteoarthritis
Rheumatoid arthritis
Gout
Ankylosing spondylitis
Osteoarthritis
biomed6
Symmetric joint swelling, morning stiffness > 1 hour, pain in wrist, MCP, and PIP joints, Boutonnieres and Swan-neck deformity. The above symptoms are most likely related to:
Osteoarthritis
Rheumatoid arthritis
Gout
Ankylosing spondylitis
Rheumatoid arthritis
biomed6
Swollen tender and warm joints with sudden onset, podagra (1st MTP joint), tophi
The above symptoms are most likely related to:
Osteoarthritis
Rheumatoid arthritis
Gout
Ankylosing spondylitis
Gout
biomed6
Hip pain, lower back pain that worsens with inactivity and in the morning, Radiography shows fused sacroiliac joint and bamboo spine
The above symptoms are most likely related to:
Osteoarthritis
Rheumatoid arthritis
Gout
Ankylosing spondylitis
Ankylosing spondylitis
biomed6
What is the causative agent for whooping cough?
Bordetella pertussis
Epstein-Barr virus
Rubella virus
Rotavirus
Bordetella pertussis
biomed7
Pertussis is spread through:
Bloodborne transmission
Airborne transmission
Contaminated water
Feces
Airborne transmission
biomed7
Pertussis is a highly contagious respiratory infection that causes uncontrollable, violent coughing.
Pertussis can be prevented by:
MMR vaccine
DTaP vaccine
HPV vaccine
Rotavirus vaccine
DTaP vaccine
biomed7
Which of the following is a booster immunization given at age 10 to 64 that offers continued protection from pertussis.
DTaP vaccine
Tdap vaccine
Td vaccine
Tdap vaccine
biomed7
A 23-year-old college student who was seen in your office two weeks ago for rhinitis, sneezing, and cough returns to the clinic complaining of worsening symptoms. She says the cough is now paroxysmal and followed by sweating.
Today her cough was followed by emesis. Laboratory studies reveal lymphocytosis. Chest X-ray is clear. The most likely etiological organism is:
Mycoplasma pneumonia
Bordetella pertussis
Chlamydia psittaci
Haemophilus influenza
Klebsiella pneumonia
Bordetella pertussis
biomed7
Reye syndrome occurs when children are given _______ during a varicella or upper respiratory infection. It manifests as heavy vomiting, delirium, and fatty liver followed by coma.
Acetaminophen {Tylenol)
Acetylsalicylate acid {Aspirin)
Acyclovir {Zovirax)
Oseltamivir {Tamiflu)
Acetylsalicylate acid {Aspirin)
biomed7
A 20-year-old female develops migraine after drinking red wine. Which of the following drug can be used for migraine prophylaxis?
Lisinopril {Zestril)
Losartan {Cozar)
Propranolol {Inderal)
Furosemide {Lasix)
Propranolol {Inderal)
biomed7
Which of the following class of medications can be used for migraine prevention?
ACE inhibitor
ARB
Beta blockers
Diuretic
Beta blockers
biomed7
What is the mechanism of action for OCPs (oral contraceptives)?
Inhibit FSH
Inhibit LH
Inhibit FSH and LH
Foreign body results in inflammation
Inhibit FSH and LH
biomed7
A 9-year-old otherwise healthy female is rushed to the hospital with the complaint of delirium and vomiting. History reveals that the patient had an upper respiratory tract infection last week that was treated at home with aspirin. Physical examination is remarkable for hepatomegaly. The patient experiences a seizure while in the emergency room. The most likely diagnosis is
Febrile seizure
Cerebral palsy
Meningitis
Reye syndrome
Reye syndrome
biomed7
Hirsutism is excessive body hair on parts of the body where hair is normally absent or minimal. The most common cause of female hirsutism is:
Pregnancy
Adrenal gland tumors
Polycystic ovary syndrome
hCG-secreting tumors
Polycystic ovary syndrome
biomed7
A 21-year-old obese female is seen in the clinic with the complaint of excessive body hair for the last 15 months. Her menstrual periods were irregular but approximately every 45-48 days. Physical examination reveals dark hair on her upper lip and lower abdomen. LH/FSH ratio is 3:1. The most likely diagnosis is:
Ovarian tumors
Polycystic ovarian syndrome
Endometriosis
Cushing’s syndrome
Polycystic ovarian syndrome
biomed7
Which of the following pharmaceutical agents does NOT indicate hyperthyroidism?
Propranolol
Methimazole or Propylthiouracil
Radioactive 131I thyroid ablation
levothyroxine
levothyroxine
biomed7
_______, also known as toxic diffuse goiter, is an autoimmune disease that affects the thyroid. It frequently results in and is the most common cause of hyperthyroidism.
Grave’s disease
Thyroid storm
Hashimoto’s thyroiditis
Myxedema coma
Grave’s disease
biomed7
________is defined as severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to slowing of function in multiple organs. It is a medical emergency with a high mortality rate.
Thyroid storm {a.k.a. Thyrotoxic crisis)
Myxedema coma {a.k.a. Myxedema crisis)
Myxedema coma {a.k.a. Myxedema crisis)
biomed7
A 30-year-old woman presenting with weight loss and heat intolerance is found to be tachycardic. Labs reveal a suppressed TSH and an increased T4 level. What is the most common cause of these findings?
Grave’s disease
Hashimoto’s thyroiditis
Grave’s disease
biomed7
A 32-year-old female presents to the office complaining of heavy menstrual bleeding for two weeks. Further history reveals the patient recently started using extra blankets to keep warm in the evenings. She also admits to fatigue and recent depressed mood. Laboratory studies reveal high TSH and low T4 levels. Physical examination reveals painless thyroid enlargement.
The most likely diagnosis is
Hashimoto’s thyroiditis
Graves’ disease
Hyperthyroidism
Thyroid storm
Hashimoto’s thyroiditis
biomed7
A 34-year-old female is being evaluated for altered mental status. Her son states that she has been confused for the past two hours. She is alert and orient only to place. Physical examination is significant for a temperature of 96.2F, blood pressure 90/60 mmHg, and respiratory rate of 6.The blood sugar is normal.
Noncompliance with which of the following medications most likely caused this condition?
Propranolol
Methimazole
Levothyroxine
Insulin
Levothyroxine (hypothyroidism)
biomed7
________ is mainstay of symptomatic therapy for thyroid storm; antiadrenergic effects block effects of excess thyroid hormone. _________ also plays a role in the prevention of peripheral conversion of T4 to T3.
IV calcium channel blocker
IV alpha-blocker
IV beta-blocker
IV levothyroxine
IV beta-blocker
biomed7
If one drinks a lot of juice while taking certain statin drugs to lower cholesterol, too much of the drug may stay in your body, increasing your risk for liver damage and muscle breakdown that can lead to kidney failure.
Grapefruit
Apple
Orange
Grapefruit
biomed8
Which of the following drugs act by competitively inhibiting
HMG-CoA reductase?
Levodopa
Paroxetine
Warfarin
Statins
Statins
biomed8
What are the side effects of -statins?
muscle pain
increase liver enzyme - causing liver inflammation
increased blood sugar or type 2 diabetes
neurological effects
biomed8
Which of the following is NOT a common risk of Statins?
Liver damage
Muscle injury
Diabetes
Facial flushing
Facial flushing
biomed8
Statin use may damage which of the following organs?
Heart
Spleen
Liver
Lung
Liver
biomed8
One of the most common complaints of people taking statin is:
Muscle pain
hypotension
GI Bleeding
bradycardia
Muscle pain
biomed8
What is the most common cause of Chronic Kidney Disease?
Hypertension
Diabetes Mellitus
Glomerulonephritis
Polycystic kidney disease
Diabetes Mellitus
biomed8
____________have been shown to decrease the progression of chronic kidney disease.
Ibuprofen (Advil)
Naproxen (Aleve)
Celecoxib (Celebrex)
ACE inhibitor
ACE inhibitor
biomed8
Which of the following class of drugs improve diabetic nephropathy?
Thiazide diuretic
ACE inhibitor
Statins
ACE inhibitor
biomed8
Which of the following is an common adverse effect of ACE inhibitor?
Myalgia
Liver damage
Dry cough
Dry cough
biomed8
Which of the following is a common adverse effect of ACE inhibitor?
Myalgia
Liver damage
Dry Cough
Dry Cough
biomed8
Calcitonin, which is released from the thyroid gland, _____blood calcium levels.
Increases
decreases
decreases
biomed8
Calcitonin decreases blood calcium levels by _________ osteoclasts, ________ osteoblasts, and stimulating calcium excretion by the kidneys.
Inhibiting, inhibiting
Stimulating, stimulating
Stimulating, inhabiting
Inhibiting, stimulating
Inhibiting, stimulating
biomed8
Which of the following hormones increase the blood calcium level by increasing absorption of calcium from food by intestines?
Calcitonin
Parathyroid hormone
Melatonin
Renin
Parathyroid hormone
biomed8
What is the most common cause of scapular winging?
Trapezius paralysis
Levator scapulae paralysis
Serratus anterior paralysis
Rhomboid major paralysis
Serratus anterior paralysis
biomed8
The most common cause of scapular winging is serratus anterior paralysis. This is typically caused by damage to the .
Spinal accessory nerve (CN XI)
Long thoracic nerve
Dorsal scapular nerve
Long thoracic nerve
biomed8
Cerebrospinal fluid (CSF) acts as a cushion or buffer for the brain. CSF occupies the space and the ventricular system around and inside the brain and spinal cord.
Epidural
Subdural
Subarachnoid
Subarachnoid
biomed8
Lumbar puncture (spinal tap) can help diagnose all of the following EXCEPT:
Meningitis
Hydrocephalus
Subarachnoid hemorrhage
Epidural hematoma
Epidural hematoma
biomed8
Which of the following is NOT a indication of oral corticosteroid?
Asthma
Rheumatoid arthritis
Addison’s disease
Osteoporosis
Osteoporosis
biomed9
The treatment for Addison’s disease involves hormone replacement therapy to correct the levels of ______ hormones one’s body is not producing.
Steroid
Thyroid
Insulin
Steroid
biomed9
Which of the following medications increases the risk of osteoporosis?
bisphosphonates
corticosteroid
antibiotics
NSAIDs
anti-hypertensive
corticosteroid
biomed9
_______ are a class of drugs that prevent the loss of bone density, used to treat osteoporosis.
bisphosphonates
corticosteroid
antibiotics
bisphosphonates
biomed9
A female patient presents to the office complaining that her upper eyelids appear droopy and she feels unilateral proximal muscle weakness at the end of each day. The most likely diagnosis is:
Myasthenia Gravis
Lambert-Eaton Myasthenic Syndrome
Multiple Sclerosis
Guillain-Barre Syndrome
Amyotrophic Lateral Sclerosis (ALS)
Myasthenia Gravis
biomed9
A male patient presents with muscle weakness experienced at the end of each day. He also complains of ptosis and diplopia. History reveals that these complaints are usually not present for the first few hours of each morning.
You suspect the patient has Myasthenia Gravis. Which of the following is the a great test to use at bedside for patients with ptosis?
Edrophonium (Tensilon test)
Ice-pack test
Single-fiber electromyography
Ach receptor antibodies
Ice-pack test
biomed9
A female patient says that at the end of each day, her upper eyelids become droopy and she experiences proximal muscle weakness. Diagnosis confirms Myasthenia Gravis. The most likely pathophysiology is autoantibodies against:
Pre-synaptic Calcium channel
Post-synaptic Calcium channel
Pre-synaptic acetylcholine receptor
Post-synaptic acetylcholine receptor
Post-synaptic acetylcholine receptor
biomed9
A 31-year old man complains that when he looks up to catch a baseball, he sees 2 balls and cannot make the catch. Exam shows ptosis and weakness in all extraocular muscles. He also complains of generalized fatigue. What is the most likely diagnosis?
Strabismus
Esotropia
Exotropia
Myasthenia Gravis
Myasthenia Gravis
biomed9
Which of the following creatine kinase is a cardiac marker used to assist diagnosis of an acute myocardial infarction?
CK-BB
CK-MB
CK-MM
CK-MB
biomed9
Which of the following is the most sensitive and specific test for myocardial damage?
Troponin
CK-MB
Myoglobin
Lactate dehydrogenase
Troponin
biomed9
Which of the following cardiac enzyme is useful for diagnosis myocardial reinfarction?
Troponin
CK-MB
CK-MB
biomed9
A 21-year-old primigravida at 30 weeks gestation is seen at the clinic for routine prenatal examination. Her past medical history is unremarkable. Physical exam reveals a mild ankle edema and blood pressure of 150/95 mmHg on repeat test. Urine dipstick reveals 2+ proteinuria. The most likely diagnosis is:
HELLP syndrome
Gestational hypertension
Chronic hypertension
Preeclampsia
Eclampsia
Preeclampsia - since there is no seizures
biomed9
A 23-year-old female at 33 weeks gestation who was diagnosed with preeclampsia at 24 weeks gestation is brought to the emergency room by her husband. He states that he witnessed a grand mal seizure a few minutes earlier. The most likely diagnosis is:
Preeclampsia
Eclampsia
HELLP syndrome
Hyperemesis gravidarum
Eclampsia
bviomed9
A 2-year-old child is brought to your office for a bloody nose. On physical examination, you note unilateral nasal discharge with a foul smell. The most likely diagnosis is
Bacterial sinusitis
Viral sinusitis
Cystic fibrosis
Foreign body
Nasal polyp
Foreign body
biomed9
Which of the following is a first aid procedure used to treat upper airway obstructions by foreign objects?
CPR
Heimlich maneuver
Heimlich maneuver
biomed9
A 2-year-old boy brought to you by a mother for sudden onset cough and wheezing started today while eating breakfast. Mother said that her older son has asthma and TCM treatment works well. The boy does not have rhinorrhea, fever, or Gl symptoms. Which of the following must be ruled out first?
Foreign body aspiration
Acute asthma attack
Acute bronchitis
Foreign body aspiration
Foreign body aspiration is a common cause of mortality and morbidity in children, especially in those younger than years of age.
One
Two
Three
Four
Two
biomed9
Before the 20th century, aspiration of an foreign body had a 24 percent mortality rate. With the development of modern techniques, mortality has fallen dramatically.
Bronchoscopy
Colposcopy
Cystoscopy
Endoscopy
Bronchoscopy
biomed9
Which of the following pneumonia occurs when food, saliva, liquids, or vomit is breathed into the lungs or airways?
Viral pneumonia
Fungal pneumonia
Bacterial pneumonia
Aspiration pneumonia
Aspiration pneumonia
biomed9
The _________ middle and lower lung lobes are the most common sites affected by aspiration pneumonia, due to the larger caliber and more vertical orientation of the right mainstem bronchus.
Aspiration pneumonia
Right
Left
Right
biomed9
The Trendelenburg gait pattern is an abnormal gait caused by weakness of the ________ muscles of the lower limb, gluteus medius and gluteus minimus.
Abductor
Adductor
Flexor
Extensor
Abductor
biomed10
The Trendelenburg gait pattern is also known as
Gluteus maximus lurch
Gluteus medius lurch
Gluteus medius lurch
biomed10
The gluteus medius muscles and gluteus minimus muscle are innervated by
Inferior gluteal nerve
Superior gluteal nerve
Superior gluteal nerve
biomed10
The Trendelenburg gait is found in people with weak abductor muscles of the hip which are supplied by the
Sciatic nerve
Pudendal nerve
Interior gluteal nerve
Superior gluteal nerve
Superior gluteal nerve
biomed10
TRENDELENBURG SIGN: If the patient has weakness of the RIGHT side of the pelvis and when the patient stands on RIGHT side, the pelvis on side will drop.
RIGHT
LEFT
LEFT
biomed10
A positive Trendelenburg sign occurs when there is dysfunction of muscle and the body is unable to maintain the center of gravity on the side of the stance leg.
Extensor
Flexor
Abductor
Adductor
Abductor
biomed10
A 42-year-old patient complains of unbalanced hip movement during walking, running, and jumping. Physical exam reveals Trendelenburg sign positive as picture shown below. Which of the following is the correct interpretation?
(image: standing on right leg, left hip is tilted down when foot is raised)
Right gluteus maxiums weakens
Right gluteus medius weakness
Left gluteus maximus weakness
Left gluteus medius weakness
Right gluteus medius weakness
biomed10
Many people on ketogenic diets and similar diets, such as the Atkins diet, report that their breath takes on a _______ smell because the ketone acetone is partly expelled via your breath.
Bitter almonds
Garlic
Ammonia
Fruity
Fruity
biomed10
Ketoacidosis is most common in untreated
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Type 1 diabetes mellitus
biomed10
Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. Ketoacidosis caused by
Alcohol
Starvation
Diabetes
All of the above
All of the above
biomed10
if patient has vomiting, abdominal pain, deep gasping breathing (Kussmaul breathing), increased urination, weakness, confusion, and occasionally loss of consciousness, fruity breath. What is happening and what do you do?
Diabetic Ketoacidosis (DKA)
Send to ER immediately
biomed10
A 22-year-old female is brought to the emergency department because she was found by her roommate lying face down in her bedroom. At that time, she was difficulty to arouse and appeared very lethargic and confused. On arrival to the emergency room, the patient is unable to give medical history due to her mental state. Her roommate states that the patient has been losing weight and has been excessively tired. She states that the patient is a college student, and she does not believe that she has a history of drug or alcohol abuse. Patient presents with fruity breath odor, hyperpnea, nausea, abdominal pain, and excessive fatigue. Physical examination is within normal limits. Laboratory results are significant for sodium of 134 mEq/L, potassium of 5.8 mEq/L, chloride of 97 mEq/L, bicarbonate of 19.2 mEq/L, and glucose of 623 mg/dL. A urinalysis is significant for glucose and ketones. A urine drug screen is negative. The most likely diagnosis is:
Drug abuse
Diabetic ketoacidosis
Hyperglycemic Hyperosmolar State
Acute Pancreatitis
Diabetic ketoacidosis
biomed 10
A 23-year-old patient brought to your office with complains of nausea, vomiting, abdominal pain, and excessive fatigue. Patient appears extremely dehydrated. Patient’s breath smells sweet and fruity. Patient present with deep and labored breathing. Blood pressure is 125/82 mmHg with heart rate 80. Blood glucose was 480 mg/dL measured by glucometer. What is the proper management for this patient?
Needle Wei Guan Xia Shu with strong stimulation
Prescribe Yu Quan Wan (Jade spring pill)
Make an appointment with endocrinologist for the following week
Send patient to emergency department
Send patient to emergency department
biomed10
Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), also known as Hyperosmolar Hyperglycemic State (HHS) is a dangerous condition resulting from very high blood glucose levels. HHNS can affect both types of diabetics, yet it usually occurs amongst people with diabetes.
Type 1
Type 2
Type 2
biomed 10
Which of the following is the most important treatment goal for hyperosmolar hyperglycemic state (HHS)?
To vigorously rehydrate the patient while maintaining electrolyte homeostasis
To correct hyperglycemia
To treat underlying diseases
To monitor and assist cardiovascular, pulmonary, renal, and central nervous system (CNS) functions
To vigorously rehydrate the patient while maintaining electrolyte homeostasis
biomed10
Which of the following types of diabetes is due to autoimmune pancreatic beta cell destruction, leading to insulin deficiency and abnormal glucose metabolism?
Type I
Type II
Type I
biomed10
Which of the following types of diabetes is a dysfunction in glucose metabolism due to varying degrees of insulin resistance in peripheral tissues that may ultimately lead to beta-cell failure and complete insulin dependence?
Type I
Type II
Type II
biomed10
A 32-year-old female comes to the emergency department complaining of pelvic pain, dysmenorrhea, and dyspareunia. Physical exam reveals afebrile female in mild distress with tender nodularity on the uterosacral ligaments. Urine b-hCG is negative.
The most likely diagnosis is:
PCOS
Endometriosis
Ectopic pregnancy
Endometriosis
biomed 11
What is the gold standard for the diagnosis of the above disease?
Pelvic ultrasound
Magnetic resonance imaging
Laparoscopy
CT scan of abdomen
Laparoscopy
biomed11
A 29-year-old female is being evaluated for abdominal pain and fever on post-operative day two following an emergency cesarean section. She presents with a foul- smelling lochia. Vitals signs include a temperature of 101.7F, heart rate of 108 bpm and blood pressure of 110/77 mmHg. Physical examination reveals breast engorgement without pain. The fundus is firm and tender. Urinalysis is unremarkable.
The most likely diagnosis is:
UTI
Mastitis
Endometriosis
Endometritis
Endometritis
biomed11
A 3-year-old boy with a past medical history of eczema presents with wheezing and labored breathing for one hour. He was diagnosed with acute asthma exacerbation. What is the first-line treatment?
Albuterol (short acting beta-2 agonist)
Salmeterol (long acting beta-2 agonist)
Budesonide (inhaled steroid)
Budesonide/Formoterol (steroid + LABA)
Albuterol (short acting beta-2 agonist)
biomed11
The MMR vaccine is an immunization vaccine against all of the following EXCEPT
Epidemic parotitis (mumps)
Rubeola
German measles
Pertussis
Pertussis
biomed11
A 10-year-old presents with a four day history of cough, coryza and conjunctivitis and several grey spots on the buccal mucosa. Today a maculopapular rash started on his face and is spreading to his neck.
The most likely diagnosis:
Measles
Rubella
Mumps
Roseola
Measles
biomed11
A 5-year-old child is brought to the office with fever, coryza, cough, and conjunctivitis. On physical exam, you note an erythematous and maculopapular rash and blue-white spots on the buccal mucosa.
Question 1 of 3 in set
Which one below is the most likely diagnosis EXCEPT:
Rubeola
Measles
9-day measles
German measles
German measles
biomed11
Question 2 of 3 in set
Which of the following treatments has shown to reduce morbidity and mortality in patients affected by this condition (measles)?
Acyclovir
Erythromycin
Vitamin A
MMR vaccine
Vitamin A
biomed11
The patient (w measles) should be advised to
Return to school 1 days after the onset of the rash
Return to school 5 days after the onset of the rash
Be placed in a new school
Return to school 5 days after the onset of the rash
biomed11
A 5-year-old male presents with a maculopapular rash that started on his face and is spreading to his neck and extremities. He says that he has been experiencing a lot of “bone pain”. On physical exam, you note suboccipital lymphadenopathy.
Measles
Rubella
Mumps
Roseola
Rubella
biomed11
Which of the following viruses can cause severe birth defects if a pregnant woman becomes infected?
Rubeola
Rubella
Rubella
biomed11
Which of the following infections does NOT belong to TORCH infections which is a acronym for a set of perinatal infections?
Toxoplasmosis
Syphilis, hepatitis, HIV
Rubeola
Cytomegalovirus (CMV)
Herpes simplex (HSV)
Rubeola - Rubella not rubeola
biomed11
During a medical relief trip to the Congo in Central Africa, a 3-year-old boy presents with right sided flaccid paralysis and absent deep tendon reflexes. Which of the following channels are used for this disorder EXCEPT:
Yangming channel
Shaoyang channel
Taiyang channel
Du channel
Ren channel
Ren channel
biomed11
Which of the following is the result from taking drugs or substance repeatedly?
Tolerance
Dependence
Addiction
All of the above
All of the above
biomed11
It takes a higher dose of the drug to achieve the same effect as when the person first used it.
Tolerance
Dependence
Addiction
Tolerance
biomed11
When a person stops using a drug, their body goes through “withdrawal”.
Tolerance
Dependence
Addiction
Addiction
biomed11
What is the correct terminology for “physical adaption to a drug which leads to the withdrawal and/or tolerance”?
Physical dependence
Psychological dependence
Physical dependence
What is the correct terminology for “behavioral drug-seeking adaption to a drug with impaired control over drug use”?
Dependence
Addiction
Addiction
biomed11
Temporary maladaptive experience of behavioral or psychological changes due to the accumulation of the substance in the body.
Substance intoxication
Substance withdrawal
Substance intoxication
biomed11
The group of symptoms that occur upon the abrupt discontinuation or decrease in intake of medications or recreational drugs.
Substance intoxication
Substance withdrawal
Substance withdrawal
biomed11
Restlessness, insomnia, diuresis, muscle twitching, arrhythmias, psychomotor agitation.
Caffeine intoxication
Caffeine withdrawal
Caffeine intoxication
biomed11
Headache, lethargy, depression, weight gain, irritability, craving.
Caffeine intoxication
Caffeine withdrawal
Caffeine withdrawal
biomed11
Irritability, headache, anxiety, weight gain, craving.
Nicotine intoxication
Nicotine withdrawal
Nicotine withdrawal
biomed11
Restlessness, insomnia, anxiety.
Nicotine intoxication
Nicotine withdrawal
Nicotine intoxication
biomed11
Disinhibition/impaired judgement, emotional lability, slurred speech, ataxia, aggression, hypoglycemia, blackouts (retrograde amnesia), coma.
Alcohol intoxication
Alcohol withdrawal
Alcohol intoxication
biomed11
Tremor, tachycardia, hypertension, malaise, nausea, seizures, Delirium Tremens, agitation, hallucination. May be life threatening and require hospitalization.
Alcohol intoxication
Alcohol withdrawal
Alcohol withdrawal
biomed11
Irritability, anger, aggression, insomnia, disturbed dreams, decreased appetite, weight loss, depressed mood, shakiness/tremors, chills, headache.
Marijuana intoxication
Marijuana withdrawal
Marijuana withdrawal
biomed11
Euphoria, slowed sense of time, impaired judgment, “heightened senses,” social withdrawal, 1’appetite, dry mouth, diaphoresis, conjunctival injection, hallucinations, anxiety, paranoia, tachycardia, hypertension, amotivation.
Marijuana intoxication
Marijuana withdrawal
Marijuana intoxication
biomed11
What are the correct symptoms for caffeine intoxication?
Restlessness, insomnia, diuresis, muscle twitching, arrhythmias, psychomotor agitation.
Restlessness, insomnia, anxiety.
Impaired judgement, emotional lability, slurred speech, ataxia, aggression, hypoglycemia, blackouts, coma.
Euphoria, slowed sense of time, impaired judgment, “heightened senses,” 1’appetite, hallucinations, paranoia, tachycardia, amotivation.
Restlessness, insomnia, diuresis, muscle twitching, arrhythmias, psychomotor agitation.
biomed11
What are the correct symptoms for alcohol withdrawal?
Headache, lethargy, depression, weight gain, irritability, craving.
Irritability, headache, anxiety, weight gain, craving.
Tremor, tachycardia, hypertension, malaise, nausea, seizures, Delirium Tremens, agitation, hallucination.
Anger, aggression, insomnia, disturbed dreams, decreased appetite, shakiness/tremors, chills, headache.
Tremor, tachycardia, hypertension, malaise, nausea, seizures, Delirium Tremens, agitation, hallucination.
biomed11
Which one is NOT a symptom of opioids intoxication?
CNS depression
Respiratory depression
Constipation
Pupillary dilation
Pupillary dilation
biomed11
Which of the following substances cause pupil constriction while intoxicated?
Opioids (Percocet, Vicodin, oxycodone, heroin)
LSD (mushrooms, acid)
Cocaine
Opioids (Percocet, Vicodin, oxycodone, heroin)
biomed11
A 77-year-old man with a history of hypertension, hypercholesterolemia, COPD, and a 90-pack-year smoking history presents to your clinic for acupuncture treatment. His temperature is 36.9°C (98.5°F), BP is 82/54 mm Hg, pulse is 125/min, and RR is 16/min. A pulsatile abdominal mass is palpable just superior to the
umbilicus. There is diffuse abdominal tenderness, although rebound tenderness and guarding are absent. There is also slight skin discoloration noted in the left lower back. What is your next course of action?
Needle PC6 + SP4 combination
Needle Four Doors: RN12, ST25, RN6
Cupping therapy on local region
Send the patient to emergency department
Send the patient to emergency department
AAA - Abdominal Aortic Aneurysm
biomed12
A patient complains of abdominal pain with a pulsatile abdominal mass is palpable just superior to the umbilicus. Low back that’s aggravated with defecation What is the diagnosis?
Thoracic aortic aneurysms
Abdominal aneurysm
Pancreatitis
Bowel obstruction
Abdominal aneurysm
biomed12
A 62-year-old woman presents to the acupuncture clinic complaining of severe abdominal pain for the past 12 hours, first beginning as dull pain near the umbilicus but now localized to the right lower quadrant. She initially thought she was suffering from heartburn, but decided to come to the hospital because of the unrelenting pain. On examination the patient appears in distress secondary to pain, tachycardic, slightly hypotensive, and febrile at 39°C (102°F). She has a diffusely tender abdomen with point tenderness over her right lower quadrant, accompanied by guarding and rebound. Which of the following is the most appropriate management?
Call 911 for emergent appendectomy
Needle Lan Wei Xue
Prescribe Da Huang Mu Dan Tang (Rhubarb and Moutan Decoction)
Needle Lan Wei Xue and prescribe Da Huang Mu Dan Tang (Rhubarb and Moutan Decoction)
Call 911 for emergent appendectomy
biomed12
Which of the following group of medications helps block excess acid production and provide longest relief?
H2 blockers
Proton Pump Inhibitor
OTC Antiacids
Beta 2 agonist
Proton Pump Inhibitor
biomed12
Which of the following does NOT belong to Proton Pump Inhibitors?
Omeprazole (Prilosec)
Esomeprazole (Nexium)
Pantoprazole (Protonix)
Ranitidine (Zantac)
Ranitidine (Zantac)
biomed12
Which one of the following does NOT belong to H2 blockers?
Ranitidine (Zantac)
Famotidine (Pepcid)
Esomeprazole (Nexium)
Cimetidine (Tagamet)
Esomeprazole (Nexium)
biomed12
Which one of the following belongs to Proton Pump Inhibitors (PPI)?
Famotidine
Pantoprazole
Tums
Pepto-Bismol
Pantoprazole
biomed12
Which group of medicines reduces the amount of acid produced by the cells in the lining of the stomach?
H1 blockers
H2 blockers
H3 blockers
H4 blockers
H2 blockers
biomed12
Which of the following is a competitive H1 antagonist and is used for allergic reactions?
Ranitidine (Zantac)
Famotidine (Pepcid)
Cimetidine (Tagamet)
Loratadine (Claritin)
Loratadine (Claritin)
biomed12
Creatine kinase (CK), also known as creatine phosphokinase (CPK), is an enzyme expressed by various tissues and cell types. Clinically, creatine kinase is assayed in blood tests as a marker of damage of CK-rich tissue such as in myocardial infarction, rhabdomyolysis, muscular dystrophy, autoimmune myositides, and acute kidney injury. In a case of acute myocardial infarction, levels begin to rise begin to rise 5 to 6 hours after the onset of chest pain.
CK-MM
CK-MB
CK-BB
CK-HB
CK-MB
biomed12
Assessing the active and passive range of motion are an important part of musculoskeletal physical exam.
Which range of motion is attained by the examiner without the patient’s assistance?
A. Active range of motion
B. Assisted Active range of motion
C. Passive range of motion
D. A and B
C. Passive range of motion
biomed12
Normally, _______is slightly greater than _____ because joints have a small amount of motion at the end range that is not under voluntary control.
A. AROM, PROM
B. PROM, AROM
B. PROM, AROM
biomed12
Assessing and treating loss of knee extension range of motion is an important component for rehabilitation following any knee surgery. What is the normal range of motion of knee in full extension?
A. 0 degree
B. 90 degree
C. 140 degree
D. 180 degree
A. 0 degree
biomed12
Degenerative joint diseases also known as ________, this type of arthritis is caused by breakdown and eventual loss of the cartilage of the joints. _______ is the most common type of arthritis and it usually affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees.
Osteoarthritis
Rheumatoid arthritis
Crystal arthritis
Ankylosing spondylitis
Osteoarthritis
biomed12
A 75-year-old males complains of right knee pain for the last 3 months. He states that he has trouble going up stairs due to pain. Physical exam revels decreased range of motion, crepitus, effusion, and tenderness on palpation at the joint line. There is no sign of redness and the joint is cool to touch. What is the diagnosis?
Rheumatoid arthritis
Septic arthritis
Gout
Degenerative Joint disease
Degenerative Joint disease
biomed12
Cerebrospinal fluid (CSF) is a clear, colorless body fluid found in the brain and spinal cord. There is about 125 mL of CSF at any one time, and about 500 mL is generated every day. CSF occupies the __________ and the ventricular system and inside the brain and spinal cord.
Epidural space
Subdural space
Subarachnoid space
Subpia space
Subarachnoid space
biomed12
Which of the following is caused by bleeding into the area between the arachnoid membrane and the pia mater and causes thunderclap headache?
Epidural hematoma
Subdural hemorrhage
Subarachnoid hemorrhage
Intracerebral hemorrhage
Subarachnoid hemorrhage
biomed12
Tardive dyskinesia is a side effect of which of the following medications?
Antipsychotics
Monoamine oxidase inhibitors (MAOIs)
Tricyclic antidepressants (TCAs)
Selective serotonin reuptake inhibitors (SSRI)
Antipsychotics
biomed12
Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium,
magnesium, and phosphate, and multiple other biological effects. What is the side effect of Vitamin D when it is overdosed?
considered non-toxic
rough skin, hair loss
burning flush on face and hands
nausea, vomiting, loss of appetite, diarrhea, constipation
nausea, vomiting, loss of appetite, diarrhea, constipation
biomed12
MEGALOBLASTIC ANEMIA is an anemia that results from inhibition of DNA synthesis during red blood cell production and is characterized by red blood cells that are larger than normal. It’s known that ____ or FOLATE deficiency causes MEGALOBLASTIC ANEMIA.
Alcohol abuse
Vitamin B12
Vitamin C
Vitamin D
Vitamin B12
biomed12
Secondary hypertension is a type of hypertension which by definition is caused by an identifiable underlying primary cause. Which organ disease is a well known cause of secondary hypertensions?
Pulmonary disease
Hepatic disease
Renal disease
Gastrointestinal disease
Renal disease
biomed12
A 63-year-old male who was diagnosed with large central disc herniation last year complains of lumbar and buttock pain, lower limb weakness, and perianal discomfort. Patient also reports bowel retention, urinary incontinence, and sexual dysfunction. Physical exam reveals saddle anesthesia including the back of the leg, buttocks, and soles of the feet. Which of the following is the most appropriate management?
Needle UB40, DU3, UB23
Cupping on the lower back and buttock region
Send patient home with Du Huo Ji Sheng Tang (Angelica Pubescens and Sangjisheng Decoction)
Refer the patient to neuro surgery
Refer the patient to neuro surgery
biomed12
The Babinski sign can indicate lesion constituting damage to the corticospinal tract.
A. Upper Motor Neuron
B. Lower Motor Neuron
C. Interneuron
D. Sensory neuron
B. Lower Motor Neuron
biomed13
The Babinski reflex is one of the __________ reflexes in infants. The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot.
A. normal
B. abnormal
A. normal
biomed13
What part of the knee acts as shock absorbers to cushion the lower part of the leg from the weight of the rest of the body?
A. anterior/posterior cruciate ligaments
B. medial/lateral collateral ligaments
C. medial/lateral menisci
D. Patella
C. medial/lateral menisci D. Patella
biomed13
The ______ is a rotational maneuver of the knee that is frequently used to aid in the diagnosis of meniscal tears.
A. Lachman’s test
B. Anterior drawer test
C. Pivot shift test
D. McMurray’s test
D. McMurray’s test
biomed13
The VALGUS STRESS test, is a test for damage to the MEDIAL COLLATERAL LIGAMENT of the knee. It involves
placing the leg into extension, with one hand placed as a pivot on the knee. The VALGUS STRESS test is also called:
A. Lateral stress test
B. Medial stress test
C. Anterior stress test
D. Posterior stress test
B. Medial stress test
biomed13
Name the following knee deformities
Genu Varum (Varus knee)
Genu Valgum (Valgus knee)
Genu Recurvatum
Genu Varum (Varus knee) - bowed Knee
Genu Valgum (Valgus knee) - knocked
Genu Recurvatum - backed knee
biomed13
The UNHAPPY TRIAD injury occurs due to a ______ force to the knee causing the rupture in three structures of the knee.
A. Anterior
B. Posterior
C. Lateral
D. Medial
C. Lateral
biomed13
Which of the following structures does NOT belong to the UNHAPPY TRIAD injury?
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial collateral ligament
D. Medial meniscus
B. Posterior cruciate ligament
biomed
Which drug is a beta 2 agonist and is used to prevent and treat wheezing and shortness of breath caused by asthma or COPD?
A. Metoprolol
B. Propranolol
C. Albuterol
C. Albuterol
biomed13
Which drug can reduce heart rate by antagonizing the beta 1 receptor and may increase the risk of bradycardia if it is overdosed?
A. Metoprolol
B. Propranolol
C. Albuterol
A. Metoprolol
biomed13
Which drug is a non-selective beta blocker and could precipitate severe bronchospasm in patients with asthma, especially at high doses?
A. Metoprolol
B. Propranolol
C. Albuterol
B. Propranolol
biomed13
Propranolol (Inderal®) is the that has been used and studied the most when it comes to MIGRAINE PREVENTION.
A. Alpha agonist
B. Beta agonist
C. Alpha blocker
D. Beta blocker
D. Beta blocker
biomed13
The effects on smooth muscle cause dilation of bronchial passages and they are primarily used to treat asthma and other pulmonary disorders, such as Chronic obstructive pulmonary disease (COPD).
A. Alpha agonist
B. Beta agonist
C. Alpha blocker
D. Beta blocker
B. Beta agonist (beta2)
biomed13
For a patient with unexplained weight loss, fatigue, and persistent low-grade fever, which one of the following diseases is the most important to rule out?
A. Spleen Qi deficiency
B. Kidney Yin deficiency
C. Cancer
D. Stress
C. Cancer
biomed13
A 52-year-old male presents to the office with a 3-day history of copious hemoptysis. History reveals that the patient has smoked two packs of cigarettes per day for the past 15 years. Physical examination is remarkable for decreased breath sounds on the left. What is your next course of action?
A. Moxa at LU6
B. Give Bai He Gu Jin Tang (Lily Bulb Decoction to Preserve the Metal)
C. Cupping on UB13 and UB43
D. Send the patient to Emergency Room
D. Send the patient to Emergency Room
biomed13
Gamma-glutamyl transferase (GGT) is an enzyme that is found in many organs throughout the body, with the highest concentrations found in the . Elevated serum GGT level remains the most widely used marker of .
A. liver, alcohol abuse
B. lung, tobacco abuse
C. lung, alcohol abuse
D. kidney, opioid abuse
A. liver, alcohol abuse
biomed13
A 40-year-old female is brought to the clinic by her daughter complaining of partial visual loss in the right eye. History reveals that last year, she experienced parasthesia in her lower extremities for two days that was relieved without treatment. The most likely diagnosis is:
A. Myasthenia gravis
B. Guillain-Barre syndrome
C. Multiple sclerosis
D. Amyotrophic lateral sclerosis
C. Multiple sclerosis
biomed13
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a disease that causes the death of neurons controlling voluntary muscles. ALS can present with muscle stiffness, overactive reflexes, muscle atrophy, and muscle twitches (fasiculation). ALS also called motor neuron disease, affects:
A. upper motor neuron
B. lower motor neuron
C. both motor and sensory neurons
D. both upper and lower motor neurons
D. both upper and lower motor neurons
biomed13
A 56-year-old woman begins discussing a medical condition socially with a physician who she meets at a banquet. The discussion includes medical treatments of the condition. The physician’s duty to exercise reasonable care arises only:
upon first physical contact the physician has with the patient
when the patient schedules an appointment to see the doctor
when the patient sends an e-mail to the doctor requesting medical advice
once the patient is examined, diagnosed, treated, or an agreement to do so is made
once the patient is examined, diagnosed, treated, or an agreement to do so is made
biomed13
Clinicians are required by law to report suspected abuse. Which of the following abuse cases are required to report even if the victim requests against it?
A. Child abuse
B. Elderly abuse
C. Spousal abuse
D. All of the above
E. A and B only
F. A and C only
E. A and B only
biomed13
A male patient presents to the office complaining of muscle weakness experienced at the end of each day. He also complains of drooping eyelid and double vision. History reveals that these complaints are usually not present for the first few hours of each morning. The most specific diagnostic modality is
Myasthenia gravis
Guillain-Barre syndrome
Multiple sclerosis
Amyotrophic lateral sclerosis
Myasthenia gravis
biomed13
A patient with a drooping eye is suspected of Myasthesia Gravis. Which non-invasive test can be done by an acupuncturist?
A. Acetylcholine receptor antibody test
B. Ice pack test
C. Repetitive nerve stimulation
D. Single-fiber electromyography
B. Ice pack test
biomed13
The ICD-10 code published by the World Health Organization is for the classification of:
A. disease or medical conditions
B. consultation
C. diagnostic procedures
D. surgical procedures
A. disease or medical conditions
biomed13
The Bakody Sign is used to assess:
A. Carpal tunnel syndrome
B. De Quervain syndrome
C. Cervical radiculopathy
D. Meningitis
C. Cervical radiculopathy
biomed13
The Bakody sign is the test for cervical nerve root pain in C4-C6. The Bakody sign is positive if pain ______ when the patient places his or her hand on top of his or her head.
A. increases B. decreases
B. decreases
biomed13
A 65-year-old female patient worries about risk of fracture due to her family history. Which of the following imaging modalities is a common technique used to measure bone density?
DEXA
MRI
X-RAY
CT SCAN
DEXA
biomed14
A patient underwent a DEXA scan and her T-score results show -3.0 on the spine. This patient has:
Osteomalacia
Normal bone density
Osteopenia
Osteoporosis
DEXA
biomed14
A 45-year-old women has been wearing a high-heeled shoes for a long time. She feels like she has a pebble in her shoe or a fold in a sock. She also complains of a sharp, burning pain and numbness in the ball of her foot as well as the third and fourth metatarsal joint. What is most likely diagnosis?
Gout
Morton’s neuroma
Ankle sprain
Plantar fasciitis
Morton’s neuroma
biomed14
A 45-year-old triathlete complains of burning pain in the ball of his foot and feels like he has a pebble in his shoe. He was diagnosed with Morton’s neuroma. Where is the most common area for Morton’s neuroma?
Between 1st and 2nd toe
Between 2nd and 3rd toe
Between 3rd and 4th toe
Between 4th and 5th toe
Between 3rd and 4th toe
biomed14
A 45-year-old female found a cytological abnormality on her Pap smear. A Colposcopy is recommended by her gynecologist. Colposcopy is the medical diagnostic exam for:
Ovary
Uterus
Cervix
Vulva
Cervix
biomed14
Which medical diagnostic procedure is used to examine a magnified view of the cervix to detect cervical cancer or precancerous lesions?
Colonoscopy
Colposcopy
Cystoscopy
Uteroscopy
Colposcopy
biomed14
Pellagra is a disease caused by a lack of the Niacin (vitamin B3). Symptoms include EXCEPT:
Dermatitis
Diarrhea
Dementia
Flushing
Flushing
biomed14
A patient presents with diarrhea, dementia, dermatitis. Which vitamin deficiency most likely caused these
symptoms?
Vitamin B1 deficiency
Vitamin B2 deficiency
Vitamin B3 deficiency
Vitamin B12 deficiency
Vitamin B3 deficiency
biomed14
Which diet is characterized by eating very low-carb and high-fat?
Paleo diet
Atkins diet
Vegan diet
Ketogenic diet
Ketogenic diet
biomed14
_______ is a natural metabolic state. It involves the body producing ketone bodies out of fat and using them for energy instead of carbs. One can get into by following a very low-carb, high-fat diet.
Gluconeogenesis
Ketosis
Ketosis
biomed14
A 50-year-old male was recently had a COVID-19 infection and was diagnosed with Bell’s Palsy. Which cranial nerve is involved with Bell’s Palsy?
Cranial Nerve 5
Cranial Nerve 7
Cranial Nerve 9
Cranial Nerve 12
Cranial Nerve 7
biomed14
A 50-year-old male was recently had a viral infection and was diagnosed with Bell’s Palsy. Which of the following does NOT indicate RIGHT side Bell’s Palsy?
Inability to close eyes on the RIGHT
Loss of nasolabial folds on the RIGHT
Dropping of the mouth on the RIGHT
Wrinkles on the forehead on the RIGHT
Wrinkles on the forehead on the RIGHT
biomed14
MYXEDEMA is a term used synonymously with severe _________ . Symptoms of myxedema include thickening of the skin and other symptoms associated with _______, including fatigue, weight gain, cold intolerance, depression, dry skin, and brittle hair, among others.
Hyperthyroidism
Hypothyroidism
Hypothyroidism
biomed14
THYROID STORM is a life-threatening health condition that is associated with untreated .
Hyperthyroidism
Hypothyroidism
Hyperthyroidism
biomed14
HASHIMOTO THYROIDITIS is an autoimmune condition where the immune system mistakenly attacks the thyroid gland and it is the most common cause of _____ .
Hyperthyroidism
Hypothyroidism
Hypothyroidism
biomed14
GRAVES’ DISEASE is an autoimmune disorder that causes . The resulting signs may include bulging eyes (exophthalmos), anxiety, hand tremor, heat sensitivity, weight loss and enlarged thyroid.
Hyperthyroidism
Hypothyroidism
Hyperthyroidism
biomed14
pulse diagnosis on a 74-year-old man reveals irregularly irregular heartbeat. The patient denies chest pain, palpitation, headache, or any other symptoms. What is the best course of action?
Send the patient to emergency room immediately
Use 8 extra combination: PC6 + SP4
Tell patient to take Zhi Gan Cao Tang (Honey-Fried Licorice Decoction)
Provide acupuncture treatment including PC6 and refer patient to primary physician
Provide acupuncture treatment including PC6 and refer patient to primary physician
biomed14
Which of the following drug is used for an A-fibrillation patient?
Thrombolytics
Antiplatelet
Anticoagulants
Anticoagulants
biomed14
The linear burrow tracks and intense itching between the fingers or genital region are characterized by:
Allergic reactions
Ringworm
Syphilis
Scabies
Scabies
biomed14
Human scabies is caused by an infestation of the skin by the human itch (Sarcoptes scabiei var. hominis).
Mite
Flea
Tick
Lice
Mite
biomed14
Scabies is most often spread during a relatively period of direct skin contact with an infected person such as that which may occur during sex or living together.
Short
Long
Long
biomed14
Ankylosing spondylitis is a type of arthritis in which there is a long-term inflammation of the joints of the spine. Onset is typically in:
Male, early adulthood
Male, elderly
Female, early adulthood
Female, elderly
Male, early adulthood
biomed14
A 20-year-old male complains of chronic dull back pain in the lower back and gluteal region combined with stiffness of the lower back. The patient also complains of fatigue, fever and weight loss. X-ray shows bamboo spine appearance. What is the most likely diagnosis?
Psoriatic spondyloarthritis
Reactive arthritis
Ankylosing spondylitis
Arthritis associated with Irritable Bowel Disease
Ankylosing spondylitis
biomed14
What is the most common complaint of people taking STATIN?
Nephrotoxic
Neurotoxic
Psychosis
Myopathy
Myopathy
biomed14
A patient is on multiple medications. His Primary care physician recently increased his dose of Statin, Tizanidine, Ibuprofen and Fluoxetine. The Patient started having muscle aches one week after increasing the doses of the drugs. What is most likely cause of the muscle aches?
Tizanidine
Statin
Ibuprofen
Tylenol
Statin
biomed14
An enlarged spleen is usually detected during a physical exam. Which part of the abdomen do you need to palpate?
Right upper abdomen
Left upper abdomen
Right lower abdomen
Left lower abdomen
Left upper abdomen
biomed14
Which of the following disorders is a set of symptoms due to elevated androgens in females and associated with irregular menstrual periods, excess body and facial hair, acne, pelvic pain, infertility, obesity, and type 2 diabetes?
Hypothyroidism
Ovarian tumors
Polycystic ovarian syndrome
Cushing syndrome
Polycystic ovarian syndrome
biomed14
Sildenafil (Viagra®) acts by blocking phosphodiesterase 5 (PDE-5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. Which of the following is the side effect of Sildenafil?
Tachycardia
Pulmonary hypertension
Hypertension
Hypotension
biomed14
The vasodilating action of sildenafil affects both the arteries and the veins. Reported side effects in the normal healthy population are usually associated with vasodilation. These include:
A 67-year-old male is taking a drug for his erectile dysfunction. What is the side effect of the drug?
Hypotension
Hypertension
Hypotension
biomed14
Sildenafil (Viagra®) and ______ both cause the muscles that control the size of blood vessels to relax. When these muscles relax, the vessels enlarge in diameter and, as a result, blood pressure drops. When Sildenafil and are taken together, the effects are greater than when either one is used alone.
Midodrine
Nitrates
Nitrates
biomed14
Bulimina Nervosa can cause which of the following electrolyte imbalance?
A. Hyperkalemia
B. Hyperchloremia
C. Hypokalemia
D. Hypermagnesemia
Hypokalemia
biomed15
Which of the following diseases is caused by inflammation of the inner ear due to viral or bacterial infection and manifest with severe vertigo and nystagmus?
A. Labyrinthitis
B. Meniere’s disease
C. Presbycusis
D. Benign paroxysmal positional vertigo
Labyrinthitis
biomed15
Which of the following diseases is a disorder of the inner ear that is characterized by episodes of feeling like the world is spinning, ringing in the ears and hearing loss?
A. Labyrinthitis
B. Meniere’s disease
C. Presbycusis
D. Benign paroxysmal positional vertigo
Meniere’s disease
biomed15 (Ban Xia Bai Zhu Tian Ma Tang)
Which of the following terminology indicates age-related hearing loss?
A. Labyrinthitis
B. Meniere’s disease
C. Strabismus
D. Presbycusis
Presbycusis
biomed15
A medical triad is a group of three signs or symptoms. Which of the following is the triad of Meniere’s disease?
Hypertension + Edema + Proteinuria
Dementia + Wide gait + Urinary incontinence
Deafness + Vertigo + Tinnitus
Headache + Fever + Neck rigidity
Deafness + Vertigo + Tinnitus
Biomed15
Anorexia nervosa and Bulimia nervosa are both eating disorders in which a person tries to lose weight in unhealthy ways. Which eating disorder involves significant weight loss of 15% or more of ideal body weight due to self-starvation?
A. Anorexia Nervosa
B. Bulimia Nervosa
A. Anorexia Nervosa
biomed15
Which of the following is the medical triad of meningitis?
Low back pain + Saddle anesthesia + Bowel/bladder dysfunction
Headache + Fever + Neck rigidity
Urethritis + Conjunctivitis + Arthritis
Dysmenorrhea + Dyspareunia + Dyschezia
Headache + Fever + Neck rigidity
biomed15
What is the medical triad for Unhappy Triad (knee)
ACL, MCL, medial meniscus
biomed15
What is the medical triad for Cauda Equina Syndrome?
Low Back pain, Saddle Anesthesia, Bowel or Bladder dysfunction
biomed15
What is the medical triad for Meningitis?
Headache, Fever, Neck stiffness
biomed15
What is the medical triad for Reactive arthritis?
Urethritis (can’t pee)
Conjunctivitis (can’t see)
Arthritis (Can’t climb a tree)
biomed15
What is the medical triad for Meniere’s Disease?
Hearing loss, Vertigo, Tinnitus
biomed15
What is the medical triad for Normal Pressure Hydrocephalus?
Dementia (wacky)
Wide Gait (Wobbly)
Urinary Incontinence (wet)
biomed15
What is the medical triad for Pre-Eclampsia?
Hypertension, Edema, Proteinuria
biomed15
What is the medical triad for Endometriosis?
Dysmenorrhea, (Menstruation)
Dyspareunia (uncomfortable sex),
Dyschezia (difficult bowel)
biomed15
What is the medical triad for Ectopic Pregnancy?
Abdominal pain, Amenorrhea, Vaginal bleeding
biomed15
Which of the following group of drugs has an anti-pyretic effect?
NSAIDs
Antibiotics
Antivirals
Antifungal
NSAIDs
biomed15
Which of the following does NOT belong to the four cardinal signs of inflammation?
A. Redness
B. Swelling
C. Heat
D. Loss of function
D. Loss of function
biomed15
A 34-year-old female presents with a 2-month history of pelvic pain, menstrual cramps, pain with sexual intercourse and painful bowel movement. Physical examination reveals an afebrile female in mild distress with tender nodularities on the broad ligament. The most appropriate diagnosis is:
A. Endometriosis
B. Endometritis
C. Mittelschmerz
D. Menopause
A. Endometriosis
biomed15
A 33-year-old female comes to the emergency department complaining of pelvic pain, dysmenorrhea, dyspareunia and dyschezia. History reveals regular monthly cycles with her last menstrual period 28 days prior. Physical examination reveals an afebrile female in mild distress with tender nodularities on the uterosacral ligaments. Urine hCG is negative. Which of the following is the most appropriate to diagnose this patient’s disease?
A. Colposcopy
B. Laparoscopy
C. Cystoscopy
D. Hysteroscopy
Laparoscopy
biomed15
A 25-year-old female with a history of pelvic inflammatory disease presets with a 2-day history of left lower quadrant abdominal pain and vaginal spotting. Her last menstrual periods was 8 weeks ago. What is the most likely diagnosis?
A. Endometriosis
B. Appendicitis
C. Ectopic pregnancy
D. Urinary tract infection
C. Ectopic pregnancy
biomed15
A 25-year-old female with a history of pelvic inflammatory disease presets with a 2-day history of left lower quadrant abdominal pain and vaginal bleeding. Vitals signs reveal a BP of 85/55 mmHg and a heart rate of 110. Physical exam reveals guarding and rebound tenderness. What is the best course of action?
Needle SP6, RN3, ST29, Zi Gong, Ti Tuo
Use Dan Shen 15g, Chi Shao 9g, Tao Ren 9g, Ru Xiang 9g, Mo Yao 6g, San Leng 6g, E Zhu 6g
Tell the patient to call her gynecology office and make an appointment
Send the patient to the emergency room immediately
Send the patient to the emergency room immediately
biomed15
All of the below vitamins act as antioxidants EXCEPT for?
A. vitamin A
B. vitamin B
C. vitamin C
D. vitamin E
B. vitamin B
All of the below trace minerals act as antioxidants EXCEPT for?
A. Calcium
B. Copper
C. Selenium
D. Zinc
A. Calcium
Biomed15 (macro)
A 52-year-old female presents to your office after noticing a rapid change in the appearance of one breast, over the course of several weeks. Physical examination reveals dimpling on the skin of the affected breast similar to an orange peel as well as a red and bruised appearance of breast. What is the most likely diagnosis?
A. Fibrocystic changes
B. Mastitis
C. Breast Cancer
D. Trauma
C. Breast Cancer
biomed15
In a woman over 50, a mammogram should be performed at least every ____ years.
A. 1
B. 2
C. 5
D. 10
B. 2
biomed15
___ enzymes can be inhibited or induced by drugs, resulting in clinically significant drug-drug interactions that can cause unanticipated adverse reactions or therapeutic failures. Interactions with warfarin, antidepressants, antiepileptic drugs, and statins often involve the ________ enzymes.
A. Cytochrome P100
B. Cytochrome P200
C. Cytochrome P365
D. Cytochrome P450
D. Cytochrome P450
biomed15
______ decreases the activity of the cytochrome P450 enzymes that are responsible for breaking down many drugs and toxins. When a person who takes STATIN eats large amounts of _______, the STATIN level in their blood can increase, raising the possibility of side effects such as muscle aches.
A. Grapefruit
B. Grape
C. Lemon
D. Orange
A. Grapefruit
biomed15
______ is a popular herbal product used to treat depression but it has been implicated in drug interactions. The predominance of clinical reports indicates that increases the activity of the cytochrome P450 enzyme and reduces plasma concentrations of certain drugs such as warfarin, digoxin, cyclosporine, HIV drugs, etc. _______ is also known to interact with selective SSRIs, in the same way as serotonergic drugs by further increasing the serotonin level in the brain.
A. Black cohosh
B. Milk thistle
C. St. John’s wort
D. Saw palmetto
C. St. John’s wort
biomed15
The CDC recommend that all U.S. health care workers get vaccinated annually against .
A. HPV
B. Influenza
C. Tetanus
D. Hepatitis
B. Influenza
biomed15
Korotkoff sounds are the “tapping” sounds heard with a stethoscope as the cuff is gradually deflated. The systloic pressure is defined as:
A. The first clear tapping sound
B. The soft swishing sound
C. The Blowing sound
D. Silence
A. The first clear tapping sound
biomed15
The Erythrocyte Sedimentation Rate (ESR) is the rate at which red blood cells in anticoagulated whole blood descend in a standardized tube over a period of one hour. It is a common hematology test, and is a non-specific measure of _________ .
A. kidney function
B. anemia
C. inflammation
D. infection
C. inflammation
biomed15
The Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) are both biomarkers for inflammation and they are often ordered as a pair for laboratory testing
A. Specific
B. Non-specific
B. Non-specific
biomed15
Which of the following class of drugs can be used for Hyperthyroidism or Thyroid storm?
A. Diuretic
B. Anticoagulant
C. Anti-histamine
D. Beta-blocker
D. Beta-blocker
biomed15
Active myofascial ____ points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial _____ points are also the targets for acupuncture and/or dry needling therapies. Current evidence shows that spontaneous electrical activity at myofascial ______ point originates from the extrafusal motor endplate.
A. Trigger
B. Tender
A. Trigger
biomed15
A father of a 13-year-old patient requests a health care provider to obtain a copy of his child’s health record including laboratory reports, x-rays and prescriptions. Which of the following is correct?
Provide the child’s health care record
Do not provide the child’s health care record
Provide the child’s health care record
biomed15
A 15-year-old married female presents to the office without her parents complaining of a three day history of cough. The patient lives with her parents, denies alcohol or drug use, and has a 3-month-old son whom she supports with her husband. The patient should:
not be treated because this is not drug or alcohol related
not be treated because this is not related to sexually transmitted diseases
be treated because this complaint is not emergent
be treated because she is married
be treated because she is married
biomed15
A 5-year-old with acute abdominal pain is brought to the emergency department by her nanny. Suspecting acute appendicitis, you would like to order a CT-scan. Meanwhile, both the nanny and emergency room staff have made several attempts to reach the child’s parents without success. Can you treat this child without parental permission?
No. Parental consent is always required before treating children this young.
You may treat the child without parental consent but only if you have treated the child previously.
In this instance, you may proceed without parental consent.
Because the parents cannot be reached, you should first obtain a court order before treating the child.
In this instance, you may proceed without parental consent.
biomed15
A 19-year-old male presents to the office for a pre-employment physical examination. Laboratory values reveal a red blood cell count of 1.79, hemoglobin of 3.4 and hematocrit of 10.4. You recommend a transfusion and the patient refuses on the grounds that he is a Jehovah’s Witness. On a second visit the patient loses consciousness in the waiting area. It is ethically permissible to:
Treat the patient with a blood transfusion anyway because if not he will certainly die
Not to treat the patient with a blood transfusion, but use any other life saving measures to stabilize him
Call the legal department and have the patient declared “incompetent” so that you can make healthcare decisions for him and proceed with the blood transfusion
Transfer the patient immediately to another facility equipped to handle critical care patients.
Not to treat the patient with a blood transfusion, but use any other life saving measures to stabilize him
biomed15
Lung sounds can be auscultated across the anterior and posterior chest walls with a stethoscope. What is the optimal systemic way to listen to the lung sounds?
A. Use the ‘stepladder’ approach to compare one side of the chest with the other
B. Alternate anterior lung position and posterior lung position on each level of the intercostal spaces
A. Use the ‘stepladder’ approach to compare one side of the chest with the other
biomed16
The Trendelenburg test is a quick physical examination that can assist clinicians in assessing hip dysfunction. A positive Trendelenburg test usually indicates weakness in the which of the following hip abductor muscles?
A. Gluteus maximus + Gluteus medius
B. Gluteus maximus + Gluteus medius
C. Gluteus medius + Gluteus minimus
D. Gluteus maximus + piriformis
C. Gluteus medius + Gluteus minimus
biomed16
Which of the following urinary tract infections manifest with upper back and flank pain, high fever, shaking
and chills, nausea and vomiting?
A. Pyelonephritis
B. Ureteritis
C. Cystitis
D. Urethritis
A. Pyelonephritis
biomed16
Costovertebral angle tenderness, also known as CVA tenderness or Murphy’s punch sign, is a medical test in
which is positive in people with an infection of the:
A. Pancreas
B. Kidney
B. Kidney
biomed16
Cystitis is an inflammation of the ______ and it is the cause of ____ urinary tract infection (UTI).
A. urethra, lower
B. bladder, upper
C. kidney, upper
D. bladder, lower
D. bladder, lower
biomed16
Which one of the following belongs to LOWER respiratory tract infection?
A. Sinusitis
B. Pharyngitis
C. Tracheobronchitis
D. Laryngitis
C. Tracheobronchitis
biomed16
_________ is a disorder of the blood caused by an inherited abnormal hemoglobin.African patients experience chronic hemolytic anemia and vaso-occlusive episodes due to clustering of crescent-shape red blood cells.
A. Vitamin B12 deficiency anemia
B. Anemia of chronic disease
C. Iron deficiency anemia
D. Sickle cell anemia
D. Sickle cell anemia
biomed16
The esophagus is the tube that connects the throat to the stomach. The trachea is the tube that connects the throat to the windpipe and lungs. The ______ runs behind the ____ and heart, and in front of the spine.
A. trachea (wind-pipe), esophagus (food-pipe)
B. esophagus (food-pipe), trachea (wind-pipe)
B. esophagus (food-pipe), trachea (wind-pipe)
biomed16
Pharynx and larynx are two structures found in the neck region. Both AIR and FOOD pass through the ________.
A. Pharynx
B. Layrnx
A. Pharynx
biomed16
What type of hernia is a condition in which the upper part of the stomach bulges through an opening in the diaphragm?
A. Umbilical hernia
B. Incisional hernia
C. Hiatal hernia
D. Inguinal hernia
C. Hiatal hernia
biomed16
Many drugs alter the coupled cellular responses of osteoclasts and osteoblasts, leading to clinically evident osteopenia or osteoporosis. Which one of the following drugs does NOT lead to osteoporosis?
A. Synthetic glucocorticoids (Prednisone)
B. Alendronate (Fosamax)
C. Proton pump inhibitors (Omeprazole)
D. Antiepileptic drugs (Phenytoin)
B. Alendronate (Fosamax)
biomed16 (treats osteoporosis)
Opportunistic infections (OIs) are infections that occur more frequently and are more severe in people with weakened immune systems, including people with HIV. The lower the CD4 count, the higher the risk of OIs. Which one of the following OIs is associated with CD4 count less than 200 cells/mL EXCEPT for?
A. Oral candidiasis
B. Pneumocystis jirovecii pneumonia
C. Cryptococcal meningitis
D. Disseminated Mycobacterium Avium Complex (MAC)
A. Oral candidiasis
biomed16
A 40-year-old otherwise healthy gardener presents with several subcutaneous nodules on his right hand, where he had cut himself on rose thorns. Physical exam reveals several erythematous fluctuant lesions. What is most likely diagnosis?
A. Tinea pedis
B. Onychomycosis
C. Yeast infection
D. Sporotrichosis
D. Sporotrichosis
biomed (every rose has its thorn)
A 68-year-old female patient states that she has jaw pain when she is chewing food. She also complains that the right side of her scalp aches when she combs her hair. After completion of your physical exam, you note tenderness on the scalp just above the right ear.
4 What is the most likely diagnosis?
A. Tension headache
B. Migraine headache
C. Giant cell arteritis
D. Cluster headache
C. Giant cell arteritis
biomed16
A 68-year-old female patient states that she has jaw pain when she is chewing food. She also complains that the right side of her scalp aches when she combs her hair. After completion of your physical exam, you note tenderness on the scalp just above the right ear.
Which one of the following is most likely to confirm the diagnosis?
A. Erythrocyte sedimentation rate (ESR)
B. Temporal artery biopsy
C. C-reactive protein (CRP)
D. Monitor response to NSAID
B. Temporal artery biopsy
biomed16
A 68-year-old female patient states that she has jaw pain when she is chewing food. She also complains that the right side of her scalp aches when she combs her hair. After completion of your physical exam, you note tenderness on the scalp just above the right ear.
What is the appropriate medical treatment?
A. High dose corticosteroids
B. Low dose corticosteroids
C. 100% oxygen
D. Sedate left GB38, sedate right LV2
A. High dose corticosteroids
biomed16
A 29 year old male complains of a unilateral sharp, stabbing, periorbital headache that occurs when he sleeps, especially in the winter. He states that his eyes are also “watery” when he experiences theses headaches.
What is the most likely diagnosis?
A. Cluster headache
B. Migraine headache
C. Temporal arteritis
D. Tension headache
E. Chronic daily headache
A. Cluster headache
biomed16
29-year-old male complains of a unilateral sharp, stabbing, periorbital headache that occurs when he sleeps, especially in the winter. He states that his eyes are also “watery” when he experiences theses headaches.
While obtaining his history and physical, the patient has an episode of the headache he is describing. What is the appropriate medical treatment?
A. verapamil
B. ibuprofen
C. corticosteroid
D. 100% oxygen
D. 100% oxygen
biomed16
What is the key term for each of these headaches:
Cluster HD
Migraine HD
Tension HD
Temporal Arteritis
Cluster HD - ipsilateral lacrimation, pressure around eyes
Migraine HD - phonophobia, photophobia,
Tension HD - most common, vise like constant pressure,
Temporal Arteritis - pain in the temples
biomed16
A 23-year-old woman presents to the office complaining of a two-hour history of headache. The patient describes a sharp, right-sided headache which she rates as 8/10 on the pain scale. The pain is made worse by loud noise and bright light. She also has associated nausea and vomiting. The most likely diagnosis is:
A. Cluster headache
B. Migraine headache
C. Subarachnoid hemorrhage
D. Tension headache
B. Migraine headache
biomed16
Which headache is mostly caused by stress, inadequate sleep as well as poor posture and often described as feeling like tight band around the head?
A. Cluster headache
B. Migraine headache
C. Trigeminal neuralgia
D. Tension headache
D. Tension headache
biomed16 (liver QI stagnation)
A 65-year-old female presents to the clinic complaining of pain when she applies makeup. She describes the pain as burning and stabbing and rated 10/10 in severity when pressure is placed on the face. The pain is otherwise 0/10 or 1/10. The most likely diagnosis is:
A. Trigeminal neuralgia
B. Temporal arteritis
C. Migraine headache
D. Subarachnoid hemorrhage
A. Trigeminal neuralgia
biomed16
A 46-year-old male presents to the acupuncture clinic with a complaint of headache that started abruptly
about an hour ago. He has an episode of vomiting in the clinic. In addition, the patient states he has never experienced a headache with such severity before. He denies smoking, illicit drug use and alcohol. He does not recall any traumatic events.
4 What is the most likely diagnosis?
A. Subdural hematoma
B. Subarachnoid hemorrhage
C. Epidural hematoma
D. Meningitis
B. Subarachnoid hemorrhage
biomed16
A 46-year-old male presents to the acupuncture clinic with a complaint of headache that started abruptly
about an hour ago. He has an episode of vomiting in the clinic. In addition, the patient states he has never experienced a headache with such severity before. He denies smoking, illicit drug use and alcohol. He does not recall any traumatic events.
What is the best course of action?
Needle LU7, the command point of head and neck
Call his wife and tell her that her husband is having the worst headache in his life because of her
Tell the patient to make an appointment with a neurologist
Send the patient to the emergency room
Send the patient to the emergency room
biomed16 - bleeding in meningis
A 46-year-old male presents to the acupuncture clinic with a complaint of headache that started abruptly
about an hour ago. He has an episode of vomiting in the clinic. In addition, the patient states he has never experienced a headache with such severity before. He denies smoking, illicit drug use and alcohol. He does not recall any traumatic events.
The most appropriate diagnostic test to order is:
A. CT scan with contrast
B. MRI
C. CT scan without contrast
D. Skull X-ray
C. CT scan without contrast
biomed16
A 30-year-old female is brought to the hospital with confusion and slurred speech. Physical examination
reveals miosis, respiratory depression, and hypoxia. After treating the patient’s hypoxia, the most appropriate treatment is:
Diazepam
B. Haloperidol
C. Naloxone
D. Morphine
C. Naloxone
biomed16
What do elevated CPK show?
3 types, 1 MAJOR one
MI (Myocardial infarction)
EtOH (ethanol, alcohol)
Skeletal Muscle disease
What does elevated RBC possibly show?
Polycythemia (blood stagnation)
CardioVascular disease
Pulmonary disease
Renal disease
What does low RBC possibly show?
Anemia
Hodgkin’s leukemia
Sickle cell disease
What are the 4 shoulder muscle names?
Supraspinatus
Infraspinatus
Subscapularis
Teres Minor
What is the name of the location where the nerve connects to the muscle
motor end plate
What disease has the following: cervical adenopathy, fatigue, and weight loss
Lymphoma
What is a drug to treat hyperlipidemia?
HME-CoA reductase inhibitors
What are the causes and signs/symptoms of Cushing’s ?
Excess cortisol levels causing
Weight gain in the face (moon face)
Fatty lump between the shoulders
pink and purple stretch marks
What is the hormone involved with a moon face and buffalo hump?
ACTH
TSH
Growth hormone
Thyroxine
ACTH
Cushing’s
Chronic venous insufficiency signs
Skin looks like leather, turns reddish-brown discoloration
