MKSAP IM IV

Question 1

report the acute onset of pain proximal to the ankle, accompanied by swelling and ecchymosis. Pain can be elicited by compressing the leg at mid-calf (squeeze test), by having the patient cross the legs with the lateral malleolus of the injured leg resting on the other knee (crossed-leg test), or by dorsiflexing and externally rotating the foot with the knee flexed (dorsiflexion-external rotation test). The most common mechanism of injury involves an externally rotated force applied to a dorsiflexed ankle,

Answer 1

High ankle sprain

Question 2

Patients report sudden onset of heel pain and often hear a popping sound at the time of the injury. On examination, patients have weak or absent plantar flexion. Absent plantar flexion with calf squeezing (Thompson test) also suggests the diagnosis.commonly results from sudden, forceful plantar flexion, such as occurs with jumping and sprinting.

Answer 2

Achilles tendon rupture

Question 3

Ottwa ankle and rute rules

Answer 3

According to these validated rules, radiography should be obtained when a patient is unable to walk four steps both immediately after the injury and during evaluation, and when focal tenderness is present at the posterior aspect of the malleolus, the navicular bone, or the fifth metatarsal base.

Question 4

inversion injuries to the lateral ankle ligaments (the anterior and posterior talofibular ligaments and the calcaneofibular ligament). Physical examination reveals ecchymosis, lateral ankle tenderness, and swelling,

Answer 4

Lateral ankle sprains

Question 5

___ is an effective treatment for uncomplicated vulvovaginal candidiasis, which is usually caused by Candida albicans.

Answer 5

Topical antifungal imidazole therapy, such as intravaginal clotrimazole,

Question 6

____ is an appropriate treatment for this patient with unexplained chronic cough (UCC). UCC

Answer 6

Multimodal speech therapy

Question 7

Patients with medically unexplained symptoms may benefit from ____, physical therapy, occupational therapy, individual or group psychotherapy, social support, biofeedback, graded exercise therapy, stress management activities, and training in coping mechanisms.

Answer 7

cognitive behavioral therapy

Question 8

All patients for whom genetic testing is being considered should undergo ___.

Answer 8

genetic counseling, don’t get the test yourself

Question 9

____ is an effective therapy for smoking cessation and should be considered in smokers with a recent cardiac event.

Answer 9

Varenicline

Question 10

All men aged __ to __ years who have ever smoked should undergo one-time abdominal ultrasonography to screen for abdominal aortic aneurysm.

Answer 10

65 to 75

Question 11

report diffuse, poorly localized lateral knee and distal thigh pain; there is often tenderness to palpation 2 to 3 cm proximal to the lateral femoral condyle.

Answer 11

Iliotibial band syndrome

Question 12

What is Meralgia paresthetica?

Answer 12

entrapment of the lateral femoral cutaneous nerve and causes paresthesias on the anterolateral thigh.

Question 13

Patients with noncyclic mastalgia with focal breast pain but no palpable mass should undergo____ because approximately 1% of such patients may have breast cancer at the site of pain.

Answer 13

targeted breast ultrasonography, even if they are young with no risk factors

Question 14

____ are a statistical indicator of how much the result of a diagnostic test will increase or decrease the pretest probability of a disease in a specific patient; a clinical rule of thumb is that positive LRs of 2, 5, and 10 correspond to an increase in disease probability (add to pretest probability) of 15%, 30%, and 45%, respectively.

Answer 14

Likelihood ratios (LRs)

Question 15

For patients undergoing nonorthopedic surgery who are at high risk for postoperative venous thromboembolism as defined by the Caprini score, pharmacologic prophylaxis with ________ recommended.

Answer 15

pharmacologic (LMWH and heparin) AND SCDs

Question 16

preferred initial agent for radiation-induced nausea and vomiting.

Answer 16

Zofran (5-HT antag) because GI mucosal injury and subsequent serotonin release likely the mechanism of nausia. Dex can be added for additional therapy.