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
