MKSAP IM VI

Question 1

HPV vaccine recommendation

Answer 1

all patients aged 11 or 12 years or between the ages of 13 and 26 years if not previously vaccinated

Question 2

Hormone therapy is an option for women with moderate to severe vasomotor symptoms of menopause who are younger than _____ and within _____ of menopause onset, provided they are at low risk for breast cancer, coronary heart disease, stroke, and thromboembolic disease.

Answer 2

60 years; 10 years

Question 3

Key distinction between vestibular neuronitis and labyrinthitis

Answer 3

Auditory symptoms not present in vestibular neuronitis

Question 4

Can you give intrasnasal glucocorticoids to treat symptoms of URI?

Answer 4

Yes

Question 5

______ is the preferred opioid to treat cancer-related pain in patients with chronic kidney disease.

Answer 5

Hydromorphone

Question 6

pain between the metatarsal heads (mostly between 3 and 4th digit), the sensation of walking on a pebble, and no obvious abnormalities of the foot upon clinical examination or palpation. Hx of wearing heels or constricting shoes.

Answer 6

Morton neuroma

Question 7

associated with constricting footwear; it refers to a proximal interphalangeal joint flexion deformity with dorsal interphalangeal joint extension and extended or neutral position of the metatarsophalangeal joint.

Answer 7

Hammertoe

Question 8

A _____ involves measuring current practices against desirable outcomes, which are usually guideline based. Feedback is often provided at the individual level.

Answer 8

clinical audit

Question 9

The treatments of choice for persistent postural-perceptual dizziness are vestibular and balance rehabilitation therapy and ____.

Answer 9

SSRIs/SNRIs

Question 10

_____ provide longer-term, higher-intensity medical treatment, such as complex wound care, mechanical ventilation weaning, and treatment with intravenous medications; such facilities also provide physical rehabilitation services.

Answer 10

Long-term acute care hospitals

Question 11

_____ at a skilled nursing facility is a good option for patients who are not physically ready to return to their previous living situation but cannot tolerate at least 3 hours of therapy per day, 5 days per week. Skilled nursing facilities have physician directors but do not have the physician or staff resources to provide the complex medical care this patient requires.

Answer 11

Subacute rehabilitation

Question 12

_____ occurs when early detection of a disease with a screening test leads to an increase in measured survival but not overall survival time.

Answer 12

Lead-time bias

Lead-time bias occurs when survival time (time from diagnosis to death) appears to be lengthened because the screened patient is diagnosed earlier during the preclinical phase but does not live longer in actuality. To guard against this bias, disease-specific mortality rates rather than survival time should be used as an outcome derived from randomized clinical trials.

Question 13

Length time bias

Answer 13

Screening is also more likely to detect indolent disease, which has a long latent period, than aggressive disease, which has a short latent period and is most often detected with onset of symptoms. This causes length-time bias, in which a screen-detected cohort will have overrepresentation of indolent disease, whereas a symptom-detected cohort will have overrepresentation of aggressive disease.

Question 14

Contraindication to acamprosate

Answer 14

acamprosate not be used as first-line therapy in persons with mild to moderate kidney impairment, but if used, the dosage should be reduced. Acamprosate is contraindicated in cases of severe kidney disease (estimated glomerular filtration rate <30 mL/min/1.73 m2). Additionally, the thrice-daily dosage regimen can hinder adherence to acamprosate.

Question 15

A lipid panel should also be obtained ___ to ___ weeks after initiation of statin therapy to determine treatment adherence and response.

Answer 15

4 to 12 weeks

Question 16

recommends routine screening for abnormal blood glucose and diabetes in asymptomatic adults aged _____ with overweight or obesity.

Answer 16

40 to 70 years

Question 17

recommends that screening be performed in patients of ____ age with overweight or obesity and one or more additional risk factors for diabetes. Risk factors include a first-degree relative with diabetes; high-risk race or ethnicity (African American, Latino, Native American, Asian American, Pacific Islander); history of CAD; hypertension; HDL cholesterol level less than 35 mg/dL and/or triglyceride level greater than 250 mg/dL; PCOS; physical inactivity; and other conditions associated with insulin resistance (such as acanthosis nigricans and severe obesity). In patients with normal results, the ADA recommends repeat screening at 3-year intervals.

Answer 17

any

Question 18

In the absence of risk factors for diabetes, the ADA recommends that all patients be screened for diabetes at age ____.

Answer 18

45 years.