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A comprehensive collection of medical questions and answers covering various medical topics. It is designed to help medical students and professionals prepare for exams, refresh their knowledge, and enhance their understanding of clinical scenarios. The questions are presented in a concise and clear format, with detailed explanations for each answer. A wide range of medical specialties, including cardiology, pulmonology, endocrinology, and more. It is a valuable resource for anyone seeking to improve their medical knowledge and skills.
Typology: Exams
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pt who had recently been on CRUISE SHIP NOW HAS productive COUGH- sometime bloody HA MUSCLE ACHE - correct answer LEGIONELLA PNEUMONIA DIAG= URINE LEGIONELLA ANTIGEN WHAT increases the risk of developmental dysplasia of the hip in infants - correct answer BREECH PRESENTATION
REGARDLESS OF DELIVERY BEING C/S OR NSVD CARPET LAYER PT HAS LEFT KNEE SWELLING, MINIMAL TTP NO ERYTHEMA, WARMTH NO TRAUMA DIAGNOSE TXQ - correct answer PRE-PATELLAR BURSITIS = TX= REST ICE COMPRESSION
equiv of olecrenon aseptic bursitis what is ABSOLUTE CONTRAINDICATION TO USE OF TPA/FIBRINOLYTIC THERAPY - correct answer RECENT ISCHEMIC STROKE IN 3 MONTHS OTHERS: ANY HISTORY OF INTRACRANIAL HEMMORHAGE IF SUSPECT ACUTE Acute intracranial hemorrhage Persistent elevated blood pressure (systolic >185 mm Hg or diastolic >110 mm Hg Symptoms of subarachnoid hemorrhage ANY SORTS OF CONCERNS FOR BLEEDS Use of anticoagulant drug Aortic dissection PT HAS SUDDEN LEFT HEARING LOSS NO TRAUMA NO PAIN, NO BLEEDING, DRAINAIGE, , FEVER EAR EXAM COMPLETELY NORMAL DIAGNOSE TX - correct answer IDIOPATHIC sudden sensorineural hearing loss =
Able to bear weight but with significant pain. She reports pain across her right midfoot .An examination reveals edema over the lateral malleolus and diffuse tenderness, but she does not have any pain OVER posterior distal lateral and medial malleoli SHOULD U DO XRAY OR NOT? - correct answer NO XRAY ALTHOUGH LATERAL MALLEOLUS TTP, DISTAL PART OF LATERAL/MEDIAL MELLEOLUS IS NOT TTP OR PAINFUL AND ALTHOUGH PT HAS PAIN, SHE IS ABLE TO BEAR WEIGHT (4 STEPS) = CONSERVATIVE MANAGEMENT D) Lace-up ankle support, ice, compression, and clinical follow-up ACCORDING TO OTTAWA ANKLE RULES WHEN SHOULD U DO ANKLE XRAY VS FOOT XRAY - correct answer DO BOTH ANKLE AND FOOT XRAY IF
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS
OVER 2 REGIONS: NAVICULAR BONE AND/OR BASE OF 5TH MTP JOINT
COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS Which one of the following factors would increase the risk of atrial fibrillation in thispatient? A) Alcohol use B) Treatment with lisinopril (Prinivil, Zestril) C) Treatment with pioglitazone (Actos) D) Use of a continuous positive airway pressure (CPAP) device E) Physical stress3 - correct answer ALCHOL USE
best way to assess the patient's response to oral iron? - correct answer RETICULOCYTE COUNT IN JUST 1-2 WEEKS PT WITH CHRONIC URTICARIA ON LORATADINE= CLARITIN STILL HAS HIVES TX? - correct answer ADD ON H1 BLOCKER = RANITIDINE/CIMETIDINE First- and second-generation H1 antihistamine receptor antagonists are generally considered first- linetreatment for chronic urticaria PT WHOSE BRO HAS ACTIVE TB HIS PPD TEST= 8MM NO SX, PE NORMAL CXR NORMAL SHOULD U TREAT THIS KID IF SO WITH WHAT - correct answer YES TX DUE TO CLOSE CONTACT TO ACTIVE TB PT AND
5MM INDURATION
INH FOR 9 MONTHS
TB TEST POSITIVE IF >5MM FOR WHICH POPULATION - correct answer An induration of 5 or more millimeters is considered positive in -HIV-infected persons -A recent contact of a person with ACTIVE TB disease -Persons with fibrotic changes on chest radiograph consistent with prior TB -Patients with organ transplants -Persons who are immunosuppressed An induration of 10 or more millimeters is considered positive in - correct answer An induration of 10 or more millimeters is considered positive in -Recent immigrants (< 5 years) from high-prevalence countries -Injection drug users -Residents and employees of high-risk congregate settings ===> HEALTH CARE WORKERS PRISONER/ JAIL HOME LESS SHELTER NURSING HOME An induration of 15 or more millimeters is considered positive in - correct answer >An induration of 15 or more millimeters is considered positive in any person, with no known risk factors for TB. SHOULD PT WITH SHELLFISH ALLERGY NOT GOT ORAL OR IV CONTRAST - correct answer NO SAFE TO GIVE CONTRAST PAIN WITH INTERNAL ROTATION OF SHOULDER WHAT MUSCLE AFFECTED - correct answer SUBSCAPULARIS
WHAT MUSCLE AFFECTED - correct answer TERES MINOR INFRASPINATOUR == supraspinatus and deltoid are involved in abduction of theshoulder FOR AFRICAN AMERICAN PT WHAT HTN PREFERRED - correct answer THIAZIDE CCB FOR DM MEDS NAME 2 MEDS THAT would be most effective for reducing his blood glucose level AND lowering his risk of cardiovascular events? - correct answer C) Liraglutide (Victoza)--- GLP 1 AGONIST Empagliflozin, an SGLT2 inhibitor, KIDS WITH SICLE CELL SHOLD BE SCREENED FOR WHAT - correct answer STROKE= TRANSCRANIAL DOPPLER US OTHER THAN FLATTENED PHILTRUM WHAT OTHER PE FINDING COMMON IN BABIES WITH fetal alcohol syndrome - correct answer Curvature of the fifth digit of the hand (clinodactyly SHOULD KIDS W/ OTITIS MEDIA WITH EFFUSION===OME BE TX WITH ANTIBIOTIC - correct answer NO TX OF OTITIS MEDIA "WITH" EFFUSION---OME
OTITIS MEDIA WITH EFFUSION - correct answer pneumatic otoscopy PT WITH GERD NOW HAS NEUROPATHY IN EXTREMTITIS TOW - correct answer PPI S/E===>B12 DEFICIENCY==ALSO S/E OF METFORMIN Q27-Stone cutting, mining RISK FACTOR FOR WHAT LUNG CONDITION - correct answer SILICOSIS ALSO SAND BLASTING ===
agricultural dusts (fungal spores, vegetable products, insect fragments, animaldander, animal feces, microorganisms, and pollens) can result in "farmer's lung," a hypersensitivitypneumonitis pt has HYPOTENSION HYPOKALEMIA HYPERPIGMENTATION TOW - correct answer PRIMARY ADRENAL INSUFFICIENCY AKA ADDISON DISEASE -NO ALDOSTERONE==HYPOKALEMIA -NO CORTISOL, NO ALDOSTERONE== HYPOTENSION 3 YR OLD PT HAS ABD CRAMPING DIARRHEA N/V 2 DAYS DURATION ONLY MILD SIGNS OF DEHYDRATION ON PE
TX - correct answer VIRAL GASTROENTERITIS TX= HYDRATION ==> HALF STRENTGH APPLE JUICE SYSTOLIC MURMUR THAT INCREASE WITH VALSALVA TOW - correct answer HYPERTROPHIC CARDIOMYOPATHY VALSALVA= DECREASES PRELOAD =LESS BLOOD IN HEART= MURMUR GETS WORSE CAN TX WITH = B-BLOCKER FOR HYPERTROPHIC CARDIOMYOPATHY IF B-BLOCKER DOESN'T WORK WHAT OTHER MED CAN BE USED WHAT MED SHOULD BE AVOIDED - correct answer CAN TRY CCB- ONLY ONES THAT ACT IN THE HEART = VERAPAMIL DILTIAZEM
WHAT ELSE CAN SHE TRY - correct answer CAN TX DYSFUNCTIONAL UTERINE BLEEDING WITH NEXPLANON= PROGESTERONE RELEASING BEST TX FOR ARTHRITIS PAIN - correct answer PHYSICAL THERAPY IS SIMVASTATIN A HIGH OR MODERATE INTENSITY STATIN - correct answer MODERATE INTENSITY NAME A STATIN OTHER THAN ATORVASTATIN THAT IS ALSO HIGH INTENSITY - correct answer CRESTOR-Rosuvastatin = EVEN AT 20 MG IS HIGH INTENSITY PT HAS SUBCLINICAL HYPER-THYROIDISM LOW TSH NORMAL T PT IS ASYMTOMATIC Treatment for this condition would be indicated if the patient has an abnormal A) calcium level B) DXA scan C) glucose level D) lipid level
E) thyroid ultrasonography study - correct answer DEXA SCAN- OSTEOPROSIS Even in the absence of overt hyperthyroidism these patients are at higher risk for several health conditions, including atrial fibrillation, heart failure, and osteoporosis. For this reason it is important to assess for these conditions and consider treating the underlying thyroid condition AT WHAT TSH LEVEL SHOULD SUBCLINICAL HYPER-THYROIDISM BE TX EVEN IF PT HAS NO SX - correct answer IF TSH <0. AT WHAT TSH LEVEL SHOULLD SUBCLINICAL HYPO-THYROIDISM BE TX EVEN IF PT HAS NO SX - correct answer IF TSH > === IF TSH BETWEEN 5- -CHECK FOR ANTIBODIES (ANTI THYROID PEROXIDASE, ANTI THYROGLOBULIN -IF POSITIVE==> CAN TX WITH LEVOXYL HOW DO U KNOW IF DIX HALPIKE MANEUVER IS POSITIVE WHEN TESTING PT FOR BPPV - correct answer IF AFTER PLACING PT IN SPECIFIC POSITION FOR DIX HALPIKE -moving the patient from an upright to a supine position with the head turned 45° to one side and the neck extended 20° with the affected ear down
aka Nystagmus when vertigo is elicited Which SSRI should be avoided in pregnancy? - correct answer Paroxetine (Paxil) WHICH SSRI SHOULD DOC PICK FOR ELDERLY PT A) Amitriptyline B) Escitalopram (Lexapro) C) Imipramine (Tofranil) D) Paroxetine (Paxil) - correct answer Escitalopram === AVOID PAROXETINE IN GENERAL IN EVERYONE === IN ADOLESCENT - FLOXETINE FOR DEPRESSION WHAT KIND OF FRACTURE OCCURS WITH FALLING ON OUTSTRETCHED HAND - correct answer DISTAL RADIUS FRACTURE Prompt surgical intervention is recommended in patients with neurovascular compromise, open fractures, or evidence of compartment syndrome WHAT KIND OF SPLINT SHOULD BE APPLIED TO DISTAL RADIUS/WRIST FRACTURE radial gutter splint B) sugar tong splint - correct answer SUGAR TONG SPLINT
Radial gutter splints are indicated for uncomplicated fractures of the second and third metacarpals. Thumb spica splints are often used in patients with suspected scaphoid fractures PT WHO HAS HAD GASTRIC BYPASS SHOULD NEVER TAKE WHAT MED - correct answer NSAID KID WITH PROTEIN URIA ON URINE DIP NO SX NEXT BEST STEP - correct answer GET URINE SPOT PROTEIN/CREATININE RATIO == PROTEIN URIA IN KID CAN BE: functional (exercise/stress-induced) and orthostatic proteinuria are common types of proteinuria and are transient. Which one of the following is an advantage of the recombinant zoster vaccine (Shingrix) compared to the live zoster vaccine (Zostavax)? A) Improved efficacy B) Lower cost
C) Subcutaneous administration D) Proven safety for immunocompromised patients E) Administration as a single dose 16 - correct answer recombinant zoster vaccine (Shingrix) = MORE EFFECTIVE It requires two intramuscular doses separated by 2-6 months, compared to only one subcutaneous dose with the live vaccine. PT HAS 3 MONTH OF MINIMALLY PRODUCTIVE COUGH NO OTHER SX PE REMARKABKLE FOR swollen nasal turbinates. TOW TX WITH WHAT - correct answer ALLERGIES; post nasal drip-->cough TRIAL OF intranasal corticosteroid -- can also given claritin etc ===
causes of chronic cough GERD ASTHMA ALLERGIES PT WITH CONSTIPATION PREDOMINANT IBS SHOULD U TX WITH MIRALAX? - correct answer NO TX CONSTIPATION ASSOCIATED WITH IBS WITH D) Polyethylene glycol male presents with pain in the right antecubital fossa after lifting a trailer On examination you note ecchymosis and tenderness in the antecubital fossa. You suspect a possible distal biceps tendon rupture. Which one of the following would be most appropriate at this point? A) A Speed's test B) Plain radiographs of the elbow C) MRI of the elbow D) A local corticosteroid injection E) Referral for physical therapy - correct answer C) MRI of the elbow == WRONG ANS= XRAY Bony abnormalities do not contribute to the evaluation of this tendon. PT WITH DMT2 ON METFORMIN
C) Start basal insulin at 10 units/day D) Stop metformin and start a sulfonylurea E) Stop metformin and start a basal and bolus insulin regimen - correct answer C) Start basal insulin at 10 units/day == NO NEED TO STOP METFORMIN ONLY ORAL MEDS THAT PT ON ON INSULIN NEED TO BE ON: METFORMIN SGLT2 INHIBITOR PT HAS B/L LE EDEMA ALSO HAS VERY HIGH LIPID LEVELS TOW CAN BE CAUSING THIS EDEMA WHAT TO ORDER TO DIAGNOSE - correct answer NEPRHOTIC SYNDROME = ANASARCA, HYPERLIPIDEMIA = ORDER URINE PROTEIN Nephrotic-range proteinuria is a spot urine showing a
protein/creatinine ratio >3.0-3.5 mg ORAL OPIODS opioids such as morphine, oxycodone, and hydromorphone VS IV OPIODS HAVE PEAK EFFECT WHEN AFTER MED IS GIVEN - correct answer ORAL OPIOD = PEAK EFFECT 1 HOUR AFTER MED GIVEN IV OPIOD = EFFECT 10 MIN AFTER MED GIVEN Which one of the following antihypertensive drugs may reduce the severity of sleep apnea? A) Amlodipine (Norvasc) B) Hydralazine C) Lisinopril (Prinivil, Zestril) D) Metoprolol E) Spironolactone (Aldactone) - correct answer E) Spironolactone (Aldactone) Diuretics lessen the severity of obstructive sleep apnea and reduce blood pressure. = PROB WHY DIURETIC LIKE CHLORTHALIDIZONE GOOD AS FIRST LINE BP MED ==
irregular menses, acne, and hirsutism C) Levonorgestrel/ethinyl estradiol D) Metformin (Glucophage) E) Spironolactone (Aldactone) - correct answer OCP=C) Levonorgestrel/ethinyl estradiol
MOST EFFECTIVE FOR HIRSUTISM AND IRREGULAR PERIODS 13 Y OLD HAS SHOULDER PAIN AFTER TAKING PART IN OVERHEAD THROWS TOW WHAT TO ORDER FOR IMAGING - correct answer LITTLE LEAGUE SHOULDER Unique to children, is a repetitive use injury causing disruption at the proximal growth plate of the humerus = SEEN IN KIDS WHOSE GROWTH PLATE HASN'T FULLY FORMED
widening at the growth plate. OF PROXIMAL HUMERUS COMPARED TO CONTRALATERAL HUMERUS IF XRAY POSITIVE -->CAN DO MRI = TO RULE OUT OTHER INJURIES LIKE ROTATOR CUFF TEARS ETC ==== TX cessation of throwing, followed by PT 60 Y OLD PT HAS LEFT EYE PAIN REDNESS diffuse conjunctival injection on the left. headache, light sensitivity, and mild nausea. IMPAIRED VISION - correct answer PAIN IN EYE, ==> ACUTE CLOSE ANGLE GLUACOMA
The examination findings include conjunctival redness, corneal edema, a poorly reactive mid-dilated pupil, decreased vision, severe eye pain, headache, and nausea Which one of the following would be most specific for fibromuscular dysplasia? A) A serum creatinine level B) An aldosterone:renin ratio C) 24-hour urine for metanephrines D) Renal ultrasonography E) Magnetic resonance angiography of the renal arteries - correct answer E) Magnetic resonance angiography of the renal arteries WHAT DOUBLES RISK OF PT GETTING OA - correct answer OBESITY 90 YR OLD PT LIVING IN SNF PMH= HTN, CHRONIC URINE INCONTINENCE STAFF CALLS DOC SAYING PT HAS HAD DIZZINESS She does not have dysuria and has had no change to her incontinence. VITAL SIGNS, PE= NORMAL
WHAT SHOULD U TX THIS PT WITH - correct answer DONT NEED TO TX ASYPTOMATIC UTI ESP IN PT WHO HAS HAD CHRONIC INCONTINENCE THEREFORE CONTAMINANT IN U.CX IS HIGHLY LIKELY B) CT angiography VS D) Magnetic resonance angiography (MRA) WHAT WOULD U ORDER TO DIAGNOSE acute mesenteric ischemia. - correct answer B) CT angiography FEMALE PT WANTS CONTRACEPTION she takes lisinopril (Prinivil, Zestril) for hypertension and also takes sumatriptan (Imitrex) occasionally for migraines at the first sign of flashing lights or zigzagging lines in her vision. which contraception can u give her: A) Transdermal norelgestromin/ethinyl estradiol (Ortho Evra) B) The etonogestrel/ethinyl estradiol vaginal ring (NuvaRing) C) Neither method due to her migraines D) Neither method due to her age E) Losing weight before starting either method - correct answer C) Neither method due to her migraines ANY CONTRACEPTION WITH ESTROGEN IN CONTRAINDICATED IF PT HAS MIGRAINE WITH AURA SMOKER
also i think HTN what removal procedure should be done for skin cancer on FACE - correct answer MOHS SURGERY Which one of the following should be considered when starting or adjusting the dosage of a NOAC? (NOACs) include apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa), and rivaroxaban (Xarelto). A) Serum albumin B) INR C) Liver enzymes D) Partial thromboplastin time E) Renal function - correct answer E) Renal function === The INR is used to adjust warfarin dosing and the partial thromboplastin time is used to adjust heparin dosing. FOR PT WITH ALCOHOL USE DISORDER Which one of the following pharmacologic agents could help reduce this patient's alcohol consumption and increase abstinence? A) Acamprosate
B) Amitriptyline C) Paroxetine (Paxil) D) Promethazine E) Venlafaxine (Effexor XR) 26 - correct answer Acamprosate note- naltrexone not an option pt with MARFAN SYNDROME WHAT KIND OF HEART PROBLEM CAN HE HAVE Aortic stenosis VS D) Aortic insufficiency - correct answer D) Aortic insufficiency ==> Aortic regurgitation CAN ALSO HAVE MVP= MITRAL VALVE PROLAPSE == MARFANS = an arm span greater than height, a high arched palate, kyphosis, lenticular dislocation, mitral valve prolapse, myopia, and pectus excavatum. Rome IV criteria HELPS DIAGNOSE IBS