Routine Healthcare

Question 1

Management of patients aged 20 years or older with an LDL cholesterol level of 190 mg/dL ?

Answer 1

High intensity statin

Question 2

Post op DVT ppx for for patients undergoing orthopedic surgery without increased bleeding risk?

Answer 2

LMWH and Intermittent pneumatic compression (SCDs)

Continue LMWH for 35 days

Question 3

Rx for depression at end of life?

Answer 3

Methylphenidate (rapid acting)

Question 4

Rx for bacterial conjunctivitis?

Answer 4

Trimethoprim-Polymyxin B Ophthalmic drops

Question 5

Pt presents with unilateral sensorineural hearing loss ( on audiology) and tinnitus.

Next step in management?

Answer 5

MRI and audiometry testing of the internal auditory canal.

This suggest acoustic neuroma.

Question 6

Management of premature ejaculation?

Answer 6

Topical lidocaine

Question 7

What should be given to patients with history of overdose or substance use disorder, other mental health disorder, high opioid dosage [≥50 morphine milligram equivalents/day], concurrent benzodiazepine use, or COPD obstructive sleep apnea?

Answer 7

Naloxone and education on its use.

Question 8

Pain at the elbow that worsens with flexion, paresthesia and numbness of 4th and 5th fingers, weakness of the interosseous muscles. Dx? Rx?

Answer 8

Ulnar nerve entrapment (cubital tunnel syndrome) Elbow pad during day.

Splint at night, activity modification.

Question 9

Important management of trichomoniasis ?

Answer 9

Treat the sexual partner

Question 10

Diffuse sporadic symptom does not appear to have a pathologic basis, and pt is not excessively focused on or functionally limited by her symptom. Dx?

Answer 10

Medically unexplained symptoms.

Question 11

Common side effect of lyrica?

Answer 11

Edema

Question 12

Presence of fatigue of at least 6 months duration with substantial reduction in pre-illness activities, post-exertional malaise, unrefreshing sleep, and either cognitive impairment or orthostatic intolerance.

Dx?

Answer 12

Chronic fatigue Syndrome

Question 13

Fever, dysuria, pain and swelling of unilateral scrotum, moderate tenderness to palpation of scrotum. Dx?

Answer 13

Epididymitis.

Pain relief with testicular elevation (Prehn sign)

Absent Cremaster Reflex concerning for Testicular Torsion.

Question 14

Management of b/l diffuse premenstrual breast pain that worsens before menses and resolves with the menstrual cycle? Dx?

Answer 14

Cyclic mastalgia.

Advise use of well fitting bra.

Question 15

Rx for pressure ulcer?

Answer 15

Advanced Static Mattress

Question 16

Test for overflow incontinence due to neurogenic bladder (long standing DM, dribbling and palpable bladder)

Answer 16

Postvoid residual urine volume measurement

Question 17

Treatment for refractory dyspnea in pt with heart failure and COPD?

Answer 17

Oral Hydromorphone

Question 18

Rx for dull, aching, left-sided scrotal discomfort and fullness with intermittent swelling that increases with Valsalva. Transillumination and prehn sign is negative.

Answer 18

Left sided varicocele

Ibuprofen and scrotal support

Question 19

Adults aged 40 to 75 years without a history of ASCVD who have one or more ASCVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year ASCVD event risk of 10% or higher. Rx?

Answer 19

Low to Moderate intensity statin.

Question 20

52-year-old woman is evaluated for acute onset of right-sided hearing loss x 1 day Soon afterward, she also noted a sensation of ear fullness and ringing in the same ear. No other focal neurologic symptoms. No rhinorrhea, fever, pharyngitis, or ear pain. air conduction is louder. non obstructed TM. Dx

Answer 20

Sudden Sensorineural Hearing Loss.

Urgent referral to ENT, audiometry

Question 21

Medication of choice for acute Epididymitis in older men?

Medication of choice in younger Men?

Answer 21

Ceftriaxone and Levofloxacin (cover for pseudomonas)

Younger Men (Ceftriaxone and Doxycycline)
- Gonorrhea, Chlamydia

Question 22

Pt on Coumadin for NON-vulvular Afib with NO hx of stroke, TIA, Intracardiac thrombus.

Does this patient need to be bridge?

Answer 22

No

Only those with Highest Risk of thromboembolism

Question 23

1. Sudden/Acute onset sever hearing loss, persistent vertigo, horizontal nystagmus, preceded by viral infection, can last for days. Dx?
2. Vertigo most often preceded by a viral infection. horizontal nystagmus, Symptoms are sustained, ranging from days to weeks; however, auditory symptoms are not present.
3. Presents with recurrent, spontaneous, and brief episodes of vertigo, tinnitus, and hearing loss.

Answer 23

1. Labyrinthitis
2. Vestibular neuronitis
3. Meniere disease

Question 24

Rx for persistent Postural Perceptual dizziness.

Answer 24

Sertraline SSRI

Question 25

Medication of choice for Alcohol Use Disorder?

Answer 25

Naltrexone