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Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level of L5- S1. She is currently in the emergency room with suspician of cauda equna compression. Which of the following is a sign or symptom of cauda equina compression? a. gastrocnemius weakness b. reduced or absent ankle refles c. numbness of the lateral foot
d. paresthesia of the perineum and buttocks - correct answer d. paresthesia of the perineum and
buttocks The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In order to plan care, the clinician understands that this criteria score has which of the following meanings? a. a high mortality rate b. an increased chance of recurrence c. 7% chance of the disease becoming chronic
d. all of the above - correct answer a. a high mortality rate
Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load What does this indicate a. a favorable diagnostic trend b. disease progression c. the need to be more aggressive with Reuben's medications
d. the eradication of the HIV - correct answer a. a favorable diagnostic trend
Which is the differentiating symptom mbetween labyrinthitis and vestibular neuritis? a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the onet is more gradual
b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis c. symptoms with labyrinthitis are usually acute in onset, ,whereas with vesticular neuritis the onset is more gradual
d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. - correct
answer d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis.
A 27 year old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection. what are some additional symptoms consistant with a diagnosis of lower UTI? a. back and abdominal pain b. fever, chills, costovertebral angle (CVA) tenderness c. blood in urine and frequency
d. foul-smelling discharge, perineal itch - correct answer c. blood in urine and frequency
The differential diagnosis for vertigo can be classified into which of the following categories: a. peripheral vestibular disease b. CNS disorders c. Systemic disorders
d. all of the above - correct answer d. all of the above
Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? a. morning stiffness and limited mobility of the lumbar spine b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate
d. all of the above - correct answer d. all of the above
Which of the following data are indicative of testicular torsion? a. absent cremasteric reflux b. pain relived on testicular elevation c. testicle very low in the scrotum
d. swollen scrotum with a red dot sign - correct answer a. absent cremasteric reflux
Most nosocomial pneumonias are caused by: a. Fungi. b. Viruses c. Gram-negative bacteria.
d. Pneumococcal pneumonia. - correct answer c. Gram-negative bacteria.
A family practice office for all 5 of your clinical rotations will guarantee that you will gain the required pediatric exposure a. true
b. false - correct answer b. false
The most common precancerous skin lesion found in Caucasians is a. skin tags b. actinic keratosis c. melanoma
d. basal skin lesion - correct answer b. actinic keratosis
Which obstructive lung disease is classified as reversible? a. Asthma b. Chronic bronchitis c. Emphysema
d. COPD - correct answer a. Asthma
Which of the following is an example of an articular structure a. bone b. synovium c. tendons
d. fascia - correct answer b. synovium
Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? a. posterior dislocations are more common than anterior dislocations b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal
pulses - correct answer b. there is a risk of neurovascular and neurosensory trauma, so the clinician
should check for distal pulses Which of the following statements is true concerning the management of the client with a herniated disc? a. muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use b. an epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.
a. 3-7 days b. 14-21 days c. 3-6 weeks
d 6-12 weeks - correct answer d 6-12 weeks
The A in SNAPPS stands for Assessment a. true
b. false - correct answer b. false
A patient is diagnosed with Giardia after backpacking trip in the mountains. Which of the following would be the appropriate treatement? a. Vancomycin b. Penicillin c. Metronidazole
d. Bactrim - correct answer c. Metronidazole
The most cost effective screening test to determine HIV status is which of the following? a. western blot b. enzyme-linked immunosorbent assay (ELISA) c. venereal disease research laboratory test (VDRL)
d. Viral load - correct answer b. enzyme-linked immunosorbent assay (ELISA)
The clinician sees a patient who is 5 feet tall and weighs 150 pounds (:BMI 29.3). How would the clinician classify this patient?
a. overweight b. Mild Obesity c. Moderate Obesity
d. morbid obesity - correct answer b. Mild Obesity
One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular srtucture? A. Fascia B. Bone C. Synovium
D. Tendons - correct answer C. Synovium
Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? a. posterior dislocations are more common than anterior dislocations b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal
pulses - correct answer b. there is a risk of neurovascular and neurosensory trauma, so the clinician
should check for distal pulses Which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? a. necrotizing fascitis b. periorbital cellulitis c. erysipelas
d. all of the above - correct answer d. all of the above
Which of the following information is essential before prescribing Bactrim DS to a 24 year old woman witht urinary tract infection? a. last menstrual period b. method of birth control c. last unprotected sexual contact
d. all of the above - correct answer d. all of the above
A 22 year old male is seen in the clinic because he found a hard lump in his testicle during a testicular self exam (TSE). which of the following shoud be included in the differential diagnosis. a. testicular cancer b.. inguinal hernia c. varicocele
d. all of the above - correct answer d. all of the above
Which of the following dietary information should be given to a patient with gastroesophageal reflux disease (GERD)? a. eliminate coffee b. drink peppermint ice to relieve stomach distress c. recline and rest after meal
d. limit the amount of antacids - correct answer a. eliminate coffee
Which of the following are predisposing factors for pyelonephritis? a. pregnancy
d. dehydration c. smoking
d. alkaline urine - correct answer d. alkaline urine
A patient is seen in the clinic with right upper quadrant pain (RUQ) that is radiating to the middle of the back. The clinical suspects acute cholelithasis. The clinician should expect with of the following laboratory findings? a. Decreased alanine anminotransferase (ALT) and aspartate aminotransferase (AST) b. elevated alkaline phosphatase c. elevated indirect biliruben
d. decreased white blood cell (WBC) count - correct answer b. elevated alkaline phosphatase
A 25 year old patient presents to the clinic with fatigue, cold intolerance, weght gain and constipation for the past 3 months. On physical exam, the clinican notices a sinus bradycardia, muscular stiffness, coarse dry hair and a delay in relaxation in deep tendon reflexes (DTR's). Which of the following tests should be ordered next? a. Serum Calcium b. Thyroid Stimulating Hormone (TSH) c. electrolytes
d. urine specific gravity - correct answer b. Thyroid Stimulating Hormone (TSH)
You are preforming muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete range of motion with gravity eliminated. Which numeric grade of muscle strength would you give this patient? a. 1 b. 2 c. 3
b. there are red papules on his face c. there are crusted placques in Josh's groin area
d. there are white streaks on his neck - correct answer a. there are round hypopigmented macules
on his back The clinican has instructed Sam, a 25 year old patient with low back strain, to use NSAID's to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate withn teaching sam about the use of NSAID' to manage his pain a. you should start with the lowest dose that is effective in managing your pain because long term use of NSAIDS can result in gastrointestinal (GI) disorders such as ulcers and hemmorhage b. you should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication c. you should take the maximum recommended dose of NSAID's so that you will not need to take
narcotics to control your pain - correct answer a. you should start with the lowest dose that is
effective in managing your pain because long term use of NSAIDS can result in gastrointestinal (GI) disorders such as ulcers and hemmorhage Which of the following patients are at risk for developing urinary tract cancer? a. the 45 year old woman who is 100 pounds overweight b. the 78 year old man who smokes three packs of cigarettes a day c. the 84 year old man who worked in the asbestos mines
d. all of the above - correct answer d. all of the above
SNAPPS pneumonic used to describe a technique in orally presenting a patient. A. true
b. false - correct answer A. true
The clinician is caring for Diane, a 22 year old woman who presents with an injured ankle. Diane asks if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiography is dependent on the exam and Diane's description of the injury. Which of the following clues in Diane exam or history would alert the clinician to the need for obtaining radiographs a. if she was not able to bear weight immediately after the injury b. if the ankle developed marked swelling and discoloration after the injury c. if crepitation occurs with palpation or movement of the ankle
d. all of the above - correct answer d. all of the above
A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting and diaphoresis. In addition to nephrolithasis, which of the following should be added to the list of differential diagnosis a. Pancreatitis' b. peptic ulcer disease c. diverticulitis
d all of the above - correct answer d all of the above
Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure a. 0 to 7 mmHg b 8 to 21 mmHg c. 22 to 40 mmHg
d. 40-80mmHg - correct answer b 8 to 21 mmHg
A 28 year old patient is seen with complaints of diarrhea. Which of the following questions would help the clinician establish the diagnosis of irratible bowel syndrome?
d. Benign prostatic hypertrophy - correct answer d. Benign prostatic hypertrophy
Joyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable, and that her hair will not hold a curl anymore. On physical exam, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis could be which of the following?
- Myxedema
- Cushing's Syndrome
- Pan-hypopituitism
- Thyrotoxicosis - correct answer • Thyrotoxicosis As diabetic retinopathy progresses, the presence of "cotton wool" spots can be detected. Cotton wool spots refer to: a) Venous beading. b) Retinal hemorrhage. c) Nerve fiber layer infarctions.
d) Blood vessel proliferation - correct answer c) Nerve fiber layer infarctions.
Which of the following instructions should be given to a patient with nephrolithasis? a. take ibuprofen 600mg every 8 hours b. take tums for upset stomach c. drink more black tea
d. increase intake of vegetables like spinach - correct answer a. take ibuprofen 600mg every 8 hours
Joyce is taking a long-acting beta agonist for her moderate persistent asthma. What additional medication should she be taking? a. Inhaled corticosteroid (Flovent) b. Leukotriene receptor antagonist
c. Systemic corticosteroid (Prednisone)
d. Methyl xanthenes (Theophylline - correct answer a. Inhaled corticosteroid (Flovent)
You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: A. Articular B. Inflammatory C. Nonarticular
D. A and B - correct answer A. Articular
Harvey has a rubbery, smooth, round mass on his chest which is compressible and has a soft to very firm texture. What do you diagnose this as? a. Lipoma b. Nevi c. skin tag
d. Adenoma - correct answer a. Lipoma
The patient with Gastroesophageal reflux disease (GERD) should be instructed to eliminate which of these activities? a. Swimming b. weight lifting c. Golfing
d. Walking - correct answer b. weight lifting
...responded to antibiotic therapy. Which of the following actions should be taken next?
The clinical suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed and the knee is placed in extension. NExt the patella is displaced laterally and the knee flexed to 30 degrees. IF instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as: a. apprehension sign b. bulge sign c. thumb sign
d. none of the above - correct answer a. apprehension sign
If your preceptor is out ill on a day that you are scheduled to be in the clinical setting, another preceptor can supervise you as long as they are willing to take you on as a student and they meet the minimum preceptor qualifications. a. true
a. false - correct answer a. false
Which of the following should be considered in a patient presenting with erectile dysfunction a. diabetes mellitus b. hypertension c. atherosclerosis
d. all of the above - correct answer d. all of the above
A 23 year old sexually active man is seen in the clinic with unilateral painful testicular swelling and diagnosed with epididymitis. In order to prescribe the correct drub, the clinician understands that which of these is them most common causative organism? a. escheichia coli b. staphylococcus aureus
c. chlamydia trachomatis
d. pseudomonas aerugonisa - correct answer c. chlamydia trachomatis
The most common offending agents for medication induces resting tremor are: a. selective serotonin reuptake inhibitore (SSRIs) b. Beta-Blockers c. Floroquinolone antibiotics
d. anti-psychotics - correct answer d. anti-psychotics
Which of the following type of tremor is characterized by an increase in amplitude when the patient attemps voluntary movements a. resting tremor b. postural tremor c. intention tremor
d. medication-induced tremor - correct answer c. intention tremor
Ian, age 62, presents with a wide, diffuse area of erythematous skin on his left lower leg that is warm and tender to palpation. There is some edema involved. You suspect: a. Necrotizing fasciitis. b. Kaposi's sarcoma. c. Cellulitis.
d. A diabetic ulcer. - correct answer c. Cellulitis.
Parkinsons disease is a progressive neurological disorder that is associated with which type of tremor? a. resting tremor
