The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment failure in children is:

Question 1 The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment failure in children is: 

 

Amoxicillin (Amoxil).

 

Azithromycin (Zithromax).

 

Prednisone (Deltasone).  

 

Amoxicillin and potassium clavulanate (Augmentin).

 

Question 2 A 72-year-old male patient presents to the clinic for his annual physical. He states that he is worried because he only has a bowel movement every three days. How should the clinician respond? 

 

 “You should have at least three stools per week.”  

 

“There is no such thing as a ‘normal’ pattern of defecation.”

 

 “You should have two to three stools per day.”

 

 “You should defecate once a day.”

 

Question 3 A 30-year-old male presents to the clinic with intermittent diarrhea. He is pretty sure that the antacids taken for heartburn are the cause since the loose stools always occur within 30 minutes after taking them. How should the clinician respond? 

 

 “Antacids contain caffeine, which decreases bowel transit time.”

 

“Antacids may contain magnesium, which decreases bowel transit time and may contain poorly absorbed salts that draw fluid into the bowel.”

 

 “Antacids contain fructose, which may not be totally absorbed, resulting in fluid being drawn into the bowel.”

 

 “Antacids contain sorbitol or mannitol, which are sugars that aren’t absorbed and can cause fluid to be drawn into the bowel.”

 

Question 4 A 21-year-old female patient presents to the clinic for pre-operative tonsillectomy clearance. She has heard about permanent taste changes after a tonsillectomy and is concerned. What should the clinician tell her? 

 

 “About half of the patients have some permanent alterations in the sense of taste.”

 

 “Your ability to recognize sweet from salty taste will be altered for life.”

 

 “You will have some alterations, but we’ll have to wait and see how you are affected personally.”  

 

“You may notice a slight difference initially, but there are no lasting changes in taste.”

 

Question 5 A 29-year-old female just returned from Central America with traveler’sdiarrhea and presents to the clinic for evaluation. Which of the following is the best treatment? 

 

Penicillin antibiotics.  

 

Supportive care.

 

Gastric lavage.

 

Metronidazole (Flagyl).

 

Question 6 In a young child, unilateral purulent rhinitis is most often caused by:

 

A viral infection.

 

An allergic reaction.

 

A foreign body.

 

A bacterial infection.

 

Question 7 Which medications used to treat nausea and vomiting works by affecting the chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal sphincter pressure? 

 

Antidopaminergic agents, such as prochlorperazine (Compazine).

 

Tetrahydrocannabinols, such as dronabinol (Marinol).

 

Anticholinergics, such as scopolamine (Donnatal).  

 

Antidopaminergic and cholinergic agents, such as metoclopramide (Reglan).

 

 

 

Question 8 When the Weber test is performed with a tuning fork to assess hearing and there is no lateralization, the clinician should document this finding as:

 

A normal finding.

 

Nerve damage.

 

Perceptive deafness.

 

Conductive deafness.

 

Question 9 An 82-year-old female has been diagnosed with irritable bowel, chronic constipation, and diverticulosis following a colonoscopy. Which pharmacological agent should the clinician recommend?

 

Lubricants.

 

Stool softeners.

 

Laxatives.  

 

Bulking agents.

 

Question 10 Nausea is difficult to discern in a young child. What question should the clinician ask to determine if a child has nausea?    

 

“Are you hungry?”

 

 “Are you sick to your tummy?”

 

 “Are you nauseous?”

 

 “Are you eating the way you normally eat?”

 

 

 

Question 11 A 38-year-old male patient has recently had an ileostomy for ulcerative colitis. Which self-care measures should the clinician teach him about to relieve food blockage? 

 

Take a hot shower or tub bath.

 

Lie in a supine position.

 

Drink cold fluids.

 

Massage the peristomal area.

 

Question 12 A 75-year-old female presents to your office complaining of dizziness and ringing in both ears for 1 day. She describes the dizziness as feeling like “the room is spinning”. On physical exam, the Rinne test reveals that air conduction is greater than bone conduction bilaterally. The Weber test reveals lateralization to the left. She is unable to hear the examiner’s whisper on the right side but can hear the whisper on the left side. What is the next step in helping this patient’s symptoms? 

 

Refer the patient to the Emergency Room.

 

Start her on high-dose Augmentin.

 

Start the patient on a low-salt diet, prescribe meclizine for vertigo and refer her to an ENT specialist.

 

Order a computed tomography (CT) scan to rule out acoustic neuroma.

 

Question 13 A 67-year old female on multiple medications for chronic conditions was just diagnosed with gastroesophageal reflux disease (GERD). In teaching the patient about the disease, what medication should the clinician recommend that the patient refrain from using? 

 

Oral contraceptives.

 

Antibiotics.

 

Antifungals.

 

Nonsteroidal anti-inflammatory drugs (NSAIDs).

 

Question 14 A 26-year-old male recently returned from a camping trip with symptoms of acute gastroenteritis. He reports that he only ate vegetables from his garden that he canned prior to his outing. Which of the following pathogens might be causing his symptoms? 

 

Clostridium perfringens.  

 

Campylobacter jejuni.

 

Clostridium botulinum.

 

Staphylococcus.

 

Question 15  A 52-year-old female is suspected of having a gastric ulcer and will undergo an Esophagogastroduodenoscopy (EGD). She is concerned because she heard that gastric ulcers can be malignant. How should the clinician respond? 

 

“About 95% of gastric ulcers are benign.”

 

 “Even if it is cancer, surgery is 100% successful.”

 

 “You have about a 50% chance of having gastric cancer from your ulcer.”

 

 “Don’t worry. Gastric ulcers are not cancerous.”

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