The patient is seen complaining of “leaking urine when I sneeze.” Which of the following actions should the clinician take first?
Question 1. The patient is seen complaining of “leaking urine when I sneeze.” Which of the following actions should the clinician take first?
Order a cystometrogram
Obtain a computed tomography (CT) scan
Instruct the patient on Kegel exercises
Prescribe Imipramine
Question 2. George has cardiovascular disease (CVD), is 64 years old, has a total cholesterol of 280 mg/dL, has a systolic blood pressure (BP) of 158, and is being treated for hypertension. You are doing a Framingham Risk Assessment on him. Which assessment factor would give him the highest number of points on the scale?
His age
His cholesterol level
His systolic BP
The fact that he is on antihypertensive medication
Question 3. Which of the following is the most commonly experienced symptom of a patient with a migraine?
Light sensitivity
Pulsatile pain
Sound sensitivity
Experiencing an aura
Question 4. A chronic cough lasts longer than:
3 weeks.
1 month.
6 months.
1 year.
Question 5. Which of the following is most effective in diagnosing appendicitis?
History and physical
Sedimentation rate
Kidneys, ureter, bladder (KUB) radiograph
Complete blood cell (CBC) count with differential
Question 6. Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking?
Inhaled corticosteroid
Leukotriene receptor antagonist
Systemic corticosteroid
Methyl xanthenes
Question 7. A patient presents to the clinician with a sore throat, fever of 100.7°F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
A throat culture should be performed to confirm the results of the rapid strep test.
The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.
Question 8. You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?
Baker phenomenon
Arnold reflex
Cough reflex
Tragus reflex
Question 9. A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives. Following this, she has diarrhea for a couple of days. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be?
Obtain a complete history.
Order a barium enema.
Schedule a Bernstein’s test.
Prescribe a trial of antispasmodics.
Question 10. In which of the following situations would referral to a specialist be needed for sinusitis?
Recurrent sinusitis
Allergic sinusitis
Sinusitis that is refractory to antibiotic therapy
All of the above
Question 11. Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months for which he takes Tums with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain?
The pain seems better when he smokes to relieve his nerves.
Coffee and fried foods do not bother him.
He awakens at night coughing with a bad taste in his mouth.
All of the above
Question 12. Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:
“L-dopa is neuroprotective.”
“The primary goal of therapy is to replace depleted stores of dopamine.”
“This is the only drug that can provide symptomatic benefit.”
“This is the initial monotherapy drug.”
Question 13. A blood pressure (BP) of 142/92 is considered:
Normal.
at goal
Stage 1 hypertension.
not at goal
Question 14. Which immunoglobulin mediates the type 1 hypersensitivity reaction involved in allergic rhinitis?
IgA
IgE
IgG
IgM
Question 15. A 46-year-old female patient is seen in the clinic with abdominal pain. Which of the following tests is essential for this patient?
Complete blood cell (CBC) count with differential
Urine hCG
Barium enema
Computed tomography (CT) of the abdomen
Question 16. The most common precancerous skin lesion found in Caucasians is:
A skin tag.
Actinic keratosis.
A melanoma.
A basal cell lesion.
Question 17. Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course
Nuclear cataracts
Cortical cataracts
Posterior cataracts
Immature cataracts
Question 18. Otitis media is considered chronic when:
Inflammation persists more than 3 months with intermittent or persistent otic discharge.
There are more than six occurrences of otitis media in a 1-year period.
Otitis media does not resolve after two courses of antibiotics.
All of the above
Question 19. Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?
The body converts bilberry to vitamin A, which helps to maintain a healthy lens.
Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes.
Bilberry boosts oxygen and blood delivery to the eye.
Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs.
Question 20. Which patient is more likely to have a cluster headache?
A female in her reproductive years
A 40-year-old African American male
A 55-year-old female who drinks 10 cups of coffee daily
A 45-year-old male awakened at night
Question 21. Jason, aged 62, has obstructive sleep apnea. What do you think is one of his contributing factors?
He is a recovering alcoholic of 6 years.
His collar size is 17 inches.
He is the only person in his family who has this.
He is extremely thin.
Question 22. A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?
Pancreatitis
Peptic ulcer disease
Diverticulitis
All of the above
Question 23. Which of the following is a specific test for multiple sclerosis (MS)?
Magnetic resonance imaging (MRI)
Computed tomography (CT) scan
A lumbar puncture
There is no specific test.
Question 24. African American patients seem to have a negative reaction to which of the following asthma medications?
Inhaled corticosteroids
Long-term beta-agonist bronchodilators
Leukotriene receptor agonist
Oral corticosteroid
Question 25. Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:
4 weeks.
8 weeks.
12 weeks.
16 weeks.
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