Study sets, textbooks, questions
Upgrade to remove ads
Question of the Day
Terms in this set (51)
A 55-year-old male presents complaining of "difficulty wrtiing" using his dominant hand and some "slurred" speech. He has a h/o hypertension, DM type II, and hypertriglyceridemia. Which of the following would you anticipate to find on a CT scan of his head, as the explanation for his chief complaint?
A. hemorrhage in the distribution of his posterior cerebral artery
B. hemorrhage in the distribution of the middle cerebral artery
C. hypodensity measuring 12 mm by 21 mm in the distribution of the posterior cerebral artery
D. hypodensity measuring 4 mm by 4 mm in the internal capsule
E. calcifications bilaterally, in the third ventricles
Answer D: hypodensity measuring 4 mm by 4 mm in the internal capsule
The main clue to this question is that most strokes are ischemic - especially with this patient's history (ruling out hemorrhagic infarct - A & B).
Calcifications (E) are not indicative of stroke at all.
When trying to decide between C & D - the size of the area needs to correlate with the patient's symptoms. If the patient had a HUGE infarct (12 x 21) he would have significantly more signs and symptoms than just some slurred speech and difficulty writing. (In addition, as it turns out, the internal capsule is supplied by the MCA - wch is the most common vessel involved in an ischemic stroke)
A 6-year-old child falls onto his right arm. An x-ray demonstrates a buckle in the cortices of the distal radius, proximal to the growth plate, without angulation. What is the term used to describe this fracture?
A. Salter-Harris Type III
B. Salter-Harris Type IV
C. Salter-Harris Type V
Answer: D Torus fracture
Torus or buckle fracture is most common in a child. This is proximal to the epiphyseal plate and so is not a Salter-Harris issue.
Greenstick fracture is also common in children in long bones and is a fracture which "bends" the bone without fracturing it.
A patient warrants antihypertensive medication use for the duration of her pregnancy. Which of the following is the antihypertensive recommended for such patients?
Answer: A Alpha-methyldopa
Methyldopa (Aldomet) is indicated in pregnancy. ACEI's (captopril) are contraindicated in pregnancy.
ß Blockers can be used but may cause growth restriction.
Diuretics are not used in pregnancy.
Calcium channel blockers and centrally acting agents (while not contraindicated) should be avoided.
All of the following are factors that predispose a patient to the development of gastroesophageal reflux EXCEPT:
A. hiatal hernia
D. an incompetent esophageal sphincter
E. pernicious anemia
Answer: E Pernicious anemia
Pernicious anemia has no correlation with GERD. It is an autoimmune destruction of the gastric parietal cells that make intrinsic factor. Signs and symptoms are not present until B12 levels are very low (and include peripheral neuropathies & ataxia)
Which white blood cell disorder is characterized by the presence of the Philadelphia chromosome in 90% of cases?
A. chronic lymphocytic leukemia (CLL)
B. acute lymphocytic leukemia (ALL)
C. chronic myelogenous leukemia (CML)
D. acute myelogenous leukemia (AML)
E. multiple myeloma
Answer: C Chronic Myeloid Leukemia (CML) - (Philadelphia CreaM cheese)
Philadelphia Chromosome occurs in CML.
ALL occurs in children.
AML is associated with Auer rods.
Multiple myeloma has Bence-Jones protein.
CLL has no clear distinguishing feature except increased lymphocytes.
A 48-year-old nurse with a body mass index of 31 presents for an evaluation of back pain. She relates that historically, she had a positive PPD test a year ago and did not follow-up as directed. She has recently been experiencing night sweats and coughing. An x-ray of her lumbar spine reveals osteopenia and cortical breakdown of vertebral bodies L4 and L5. Which of the following diagnosis is most suspect?
A. compression fractures secondary to obesity
B. degenerative joint disease
C. Potts disease
D. compression fractures secondary to osteoporosis
Answer: C Pott's disease
Pott's disease is TB of the spine. She could have any of the other diseases, but the question states that she had a positive PPD and did not take meds...that is the clue that she has active TB in the spine.
Which of the following thyroid profiles is most compatible with a diagnosis of primary hypothyroidism?
A. a low TSH (thyroid stimulating hormone) level and a high T4
B. a low TSH level and a normal T4
C. a low TSH level and a low T4
D. a high TSH level and a low T4
E. a high TSH and a high T4
Answer: D High TSH level and a low T4
Low T4 is diagnostic for low thyroid function. If the pituitary is normal (as in primary thyroid disease) the TSH should be high as the pituitary tries to stimulate the failing thyroid gland.
A 42 yo female presents after finding a firm, painless bump in her right eyelid. On examination, you note a 6m mass within the tarsus of the right eye. The skin is freely movable of the mass. The remainder of the ophthalmoscopic examination is unremarkable. Which of the following is the most likely diagnosis?
D. external hordeolum
E. internal hordeolum
Answer B: Chalazion
A chalazion is a painless, chronic mass in the eyelid.
Hordeolum are acute, red, and painful.
Pterygium involves the sclera.
Ectropion is when the eyelid says outwardly and the lid doesn't close well.
A female in her third trimester of pregnancy developed hypertension, diffuse edema, proteinuria and hyperreflexia. She was treated with intravenous magnesium sulfate and is now hyporeflexic and drowsy. What do you prescribe now?
C. an amphetamine
D. additional magnesium
Answer: A Calcium
Pre-eclampsia causes hyperreflexia. Magnesium is the treatment. The sign of magnesium toxicity is a loss of reflexes... this is treated with calcium
This papulosquamous eruption is most common in young adults. A single oval patch is generally noted several days before a more generalized, fawn-colored rash erupts. This rash is most prevalent on the trunk, and the proximal upper and lower extremities. The rash spontaneously disappears over five to six weeks. The diagnosis is:
A. pityriasis rosea
B. tinea corporis
D. atopic dermatitis
Answer: A Pityriasis rosea
This is the classic presentation of pityriasis rosea.
Remember that the differential diagnosis includes secondary syphilis, so if there is a positive sexual history - consider ordering a VDRL/RPR.
The "herald" patch which is described is pathognomonic for pityriasis.
A 34-year-old female patient presents to the ER with sharp pleuritic-type chest pain. An x-ray shows an enlarged cardiac silhouette suggestive of pericarditis. On more careful questioning, the patient admits to a polyarticular arthritis involving the small joints of her hands. Her obstetrical history is positive for two third trimester spontaneous abortions. At this point, you would suspect which autoimmune process as the cause of her symptoms:
A. Rheumatoid arthritis
B. Systemic Lupus Erythematosis
C. Wegener's granulomatosis
D. Sjogren's Syndrome
Answer: B Systemic Lupus Erythematosus
40-60% of patients with SLE have serositis (pleuritis and pericarditis). That, combined with joint pains, habitual AB - should cause you to order an ANA.
A patient with AIDS develops severe headaches. A CT scan demonstrates multiple ring-enhancing lesions of the brain. What diagnosis is most likely?
E. Herpes encephalitis
Answer: A Toxoplasmosis
Toxoplasmosis occurs commonly in HIV and is a parasitic infection causing ring-enhancing lesions (but lots of things can cause ring-enhancing lesions).
CMV is common as well and typically causes retinitis.
Herpes encephalitis can happen frequently too but causes a diffuse encephalitis.
A patient presents complaining of generalized swelling. Her urine is positive for protein. Her serum testing reveals hyperlipidemia and hypoalbuminemia. Which of the following is the most likely diagnosis?
B. nephrotic syndrome
C. congestive heart failure
Answer: B Nephrotic syndrome
This is a classic presentation of nephrotic syndrome
A patient is experiencing an acute exacerbation of asthma. Which of the following drugs would be the least useful in the management of this asthma attack?
B. cromolyn sodium
Answer: B Cromolyn sodium
Cromolyn is a mast cell stabilizer and must be present in the system PRIOR to the symptoms. It would be useless in a patient already having symptoms.
59 yo male w a h/o chronic alcohol abuse (pack of beers/day) and alcoholic hepatitis presents to the clinic for recent weight gain and increased abdominal girth. Patient denies any dietary changes. Vital signs are within normal limits. Recent LFT's show AST- 120 and ALT- 65. Previous LFT's from 2.5 years ago showed AST- 363 and ALT- 257. On exam, ascites and gynecomastia are noticed. Which of the following is the best management plan?
A. Enalapril + HCTZ
B. Spironolactone + Furosemide
C. Losartan + Propranolol
E. Transjugular intrahepatic portosystemic shunts
Answer B: Spironolactone + Furosemide
1. History of chronic ETOH abuse (pack of beers/day)
2. Alcoholic hepatitis
3. Recent weight gain and increased abdominal girth
4. LFT's: Previous AST- 363 & ALT- 199, Current AST- 120 and ALT- 65
5. Ascites and gynecomastia are noticed
These are the five things that should help you come to the dx of liver cirrhosis 2/2 chronic alcohol abuse which as a result is causing ascites.
**MCC of ascites is liver cirrhosis
**MC complication of liver cirrhosis is ascites
You can see AST > ALT. That is consistent with alcoholic hepatitis. Usually, these patients will have a 2:1 AST:ALT ration. LFT's associated with alcoholic hepatitis are much higher than liver cirrhosis. This occurs because in alcoholic hepatitis the freshly injured hepatocytes leak enzymes excessively, whereas, with liver cirrhosis the hepatocytes are permanently damaged and don't have many enzymes in its reservoir.
This same concept is also seen with acute vs chronic pancreatitis where you will see a very significant rise in pancreatic enzymes in the acute phase, but if it keeps reoccurring then the pancreas loses it's ability to produce the appropriate enzymes and therefore we wouldn't see a significant rise in lipase...for that reason, CHRONIC PANCREATITIS can't be dx via lab values
Initial management of ascites involves alcohol abstinence, dietary changes (restrict sodium and water intake) and combination of Spironolactone and Furosemide (dosage may vary depending on the severity of the ascites).
Systemic pressure tends to fall with liver cirrhosis and the renin-angiotensin system plays a key role in maintaining the pressure. Also, systemic arterial pressure is directly correlated with survival in liver cirrhosis and for that reason ACE-I and ARB should be avoided.
Propranolol can prevent vatical hemorrhages, but studies have shown that survival worsens especially with refractory ascites. No direct role in removing excessive fluid which is seen with ascites.
A Caucasian male has a history of a meconium ileus as a newborn, steatorrhea and a positive sweat test. What is the most likely diagnosis?
A. Von Gierke's disease
B. Hurler's syndrome
C. Cystic fibrosis
D. Hunter's syndrome
E. Cri du chat syndrome
Answer: C Cystic fibrosis
This is the classic presentation of Cystic fibrosis
A 35-year-old male complains of acute left eye pain immediately after he struck a nail with a hammer. On examination, you note that the left pupil is elliptical. What diagnostic test/procedure will most likely confirm your diagnostic suspicion?
A. fluorescein staining of the eye
B. pressing on the globe to assess intraocular pressure
C. an X-ray of the orbits
D. testing the extra-ocular eye muscles
E. having the patient finger count
Answer: C X-ray of the orbits
This patient struck a nail (think metal splinter), the pain was immediate (as the splinter entered his eye). His pupil is elliptical, indicating penetration of the globe. He needs X-ray of the globe to look for the metal splinter. Fluorescein staining is for a corneal abrasion - it should not be done if the globe is penetrated
A 14-month-old female is brought to your office with a one day history of a fever of 101 degrees rectally. Suddenly, today, the parent noted small red spots that became bumps and are now blisters. The majority of the lesions are on the thorax. Each vesicle resides on its own erythematous base.
B. Ramsay-Hunt syndrome
C. erythema infectiosum
D. herpes simplex
Answer: E Varicella
This is a typical presentation of varicella (chickenpox)
A 48-year-old male presents with crushing chest pain for 45 minutes. He is diaphoretic, nauseous and short of breath. His EKG demonstrates 4 mm of ST segment depression in leads I, aVL, V5 and V6. What is the most likely diagnosis?
A. esophageal spasm
B. hiatal hernia
C. acute lateral wall subendocardial myocardial ischemia
D. acute inferior wall myocardial subendocardial ischemia
E. acute anterior wall myocardial transmural ischemia
Answer: C Acute lateral wall subendocardial myocardial ischemia
It is obvious this patient is having an AMI. The ECG lead abnormalities suggest occlusion of the high lateral and low lateral walls of the LV - typically supplied by the circumflex - there are no Q waves - so subendocardial. Inferior AMI is leads II, III, avF. Anterior wall AMI is leads +/- VI, with V2-V4, and maybe V5 & V6.
A 17-year-old male is stabbed in the anterior chest with an ice pick. He quickly becomes hypotensive, tachycardic and obtunded. His breath sounds are equal, his neck veins are distended, and his chest x-ray is normal. What condition is most likely?
A. Simple pneumothorax
B. Tension pneumothorax
C. Pericardial Tamponade
D. aortic laceration distal to the origin of the left common carotid artery
E. inferior vena cava laceration
Answer: C Pericardial Tamponade
This is the typical clinical presentation of tamponade (hypotension, JVD). He was stabbed and probably has a mediastinal bleed (so, I think the mediastinum would be widened on his chest film — but the "normal CXR" is what rules out the pneumothorax - another common problem in a stabbing injury.
An elderly patient is recovering from a pneumonia caused by Influenza. Suddenly, the patient's condition deteriorates. You order a chest x-ray that demonstrates an air-fluid level, suggestive of an abscess. You empirically begin treatment for:
A. Streptococcal pneumoniae
C. Haemophilus influenzae
D. Staphylococcus aureus
E. Legionella pneumophila
Answer: D Staphylococcus aureus
Empyema (lung abscess) is almost always staph aureus. While strep pneumonia is the most common CAP, when a complication like an empyema occurs, it is almost always staph.
An 18-year-old female presents after completing her freshman year at college. Two months ago, she developed "bronchitis" which has persisted. She has become increasingly tired and has frequent night sweats. A chest x-ray today reveals a left mediastinal mass. What is the next step in her evaluation?
A. repeat the chest x-ray in six months
B. ultrasound of the left hemithorax
C. bone scan
D. CT scan of the chest
E. proceed directly to bronchoscopy with biopsy
Answer: D CT scan of the chest
Any patient presenting with mediastinal nodes should have a CT. This patient may have sarcoid or Hodgkin's or another type of cancer - CT is indicated.
A female patient presents for an evaluation for primary amenorrhea. She is noted to be short of stature and have short fourth metacarpals. What diagnosis do you suspect?
E. Trisomy 21
Answer: A XO
This is the genotype for Turner's syndrome. XXY is the genotype for Klinefelter's (which is a tall, mildly retarded male). Trisomy 21 is Down's. The other two are not common genotypes.
A patient with known hyperlipidemia, taking clofibrate, presents to your office complaining of severe myalgias and weakness. He has noted a dark color to his urine. The laboratory calls with a panic value CPK of 8500. He was recently started on a new medication, four days earlier. Which of the following is most likely the new medication?
Answer: A Lovastatin
Statin + fibrate = suspicion for rhabdomyolysis in a patient with myalgias, ALWAYS order a CPK. (statin alone, or fibrate alone may cause it too, but the combination is most likely)
A patient at a Christmas party on a cruise ship develops a terrible headache. His blood pressure is 224/158 mm Hg. Which of the following agents is this patient most likely taking regularly?
A. tricyclic antidepressants
D. monoamine oxidase inhibitors
Answer: D Monoamine oxidase inhibitors
This is a typical scenario for MAOI induced malignant hypertension from eating the "wrong" foods, which are frequently found on a Christmas buffet, (cheese, sausages, red wine, etc).
A 51-year-old male with renal artery stenosis and an elevated BUN and creatinine, is newly diagnosed as hypertensive. Which of the following agents should be avoided?
Answer: A Hydrochlorothiazide-triamterene
This is a potassium-sparing diuretic and should be avoided in anyone with renal disease. ACEI should be avoided as well (but none of these are ACEI's)
A 6-year-old female presents complaining of right ear pain. The tympanic membrane cannot be well visualized. She complains of pain when the tragus is manipulated. Several periauricular lymph nodes are easily palpable. Which of the following is the most likely diagnosis?
A. acute otitis media
B. acute otitis externa
C. eustachian tube dysfunction
D. Ramsey-Hunt syndrome
E. perforated tympanic membrane
Answer: B Acute otitis externa
OE is described here. OM would not cause preauricular nodes and tragal tenderness. Eustachian tube dysfunction would cause middle ear pain (like when you're up in a plane). Ramsay-Hunt is herpes zoster of the ear canal and would be visible. A perforated TM would cause middle ear, not external ear pain (typically).
You note raised, red, scaly lesions involving the flexor surfaces of a patient's wrists. The patient has no other lesions. The lesions appear to follow a linear pattern of distribution. What is this phenomenon?
A. Auspitz sign
B. Koebner's phenomenon
C. Darier's sign
D. Gorlin's sign
E. Gottron's papules
Answer: B Koebner's phenomenon
Koebner's phenomenon is described - it suggests psoriasis. Auspitz sign is also present in psoriasis where the scales bleed when removed. Darier's sign is in allergic patients who develop urticaria when the skin is rubbed. Gottron's papules are purple papules on the fingers seen in dermatomyositis. Gorlin's sign is seen in Ehlers-Danlos when a patient can touch the tip of the nose with his tongue (I learn something new every day!!) These last two are not important to know.
A female presents complaining of a grayish, watery vaginal discharge. The KOH prep does not reveal any hyphae. Clue cells are identified on the wet mount. A paucity of WBCs are noted. What diagnosis is most likely?
D. bacterial vaginosis
Answer: D Bacterial Vaginosis
Clue cells mean BV
A 6-year-old male is brought into your office for evaluation of his gait. You note that when ambulatory, the medial aspects of his knees are far apart and his feet are unusually close together. Which of the following best describes this condition?
A. cubitus valgus
B. cubitus varus
C. genu valgus
D. genu varum
E. Legg-Calve-Perthes disease
Answer: D Genu varum
This is genu varum (bow legs). Valgus deformity forms an "L" in the knock-kneed child and has an "L" in the middle of it (try it, it works)
Which of the following agents has a mechanism of action that does not involve beta-receptors?
Answer: D Prazosin
Of these choices, prazosin is an alpha-blocker. Ritodrine and epinephrine cause beta sympathetic stimulation. Albuterol is a beta agonist. Propranolol is a beta blocker.
The results of a barium esophagram reveal esophageal webbing in a woman with long-standing iron deficiency anemia. Her diagnosis is:
A. Barrett's esophagus
C. Plummer-Vinson syndrome
D. Dresslers syndrome
E. Ogilvies syndrome
Answer: C Plummer-Vinson syndrome
Plummer-Vinson is something to know for those who want a 100% on the exam. There is no need to memorize this. More importantly, webbing in the distal esophagus with no other symptoms but dysphagia would be a Schatzki's ring (much more common). Barrett's causes GERD symptoms and dysplasia of the esophageal mucosa. Achalasia is a primary neurologic problem of the esophagus causing dysphagia.
Laboratory report: elevated serum free t4; low serum TSH level. Which of the following is the MOST likely diagnosis?
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. T3 thyrotoxicosis
D. Graves disease
E. Chronic Hashimoto's thyroiditis
Answer: D Graves disease
High T4 (hyperthyroid), with a low TSH, indicates that the pituitary is working normally, and the thyroid is hyperactive i.e. Grave's disease. Primary hypothyroidism (Hashimoto's) is low T4 with a high TSH. Secondary hypothyroidism (from pituitary disease) is a low T4 with a low TSH.
Which of the following agents is effective in the treatment of Parkinson's?
Answer: B Amantadine
Amantadine (Symmetrel) is effective (somewhat). It is also used in treating Influenza A. Another choice is selegiline, and levodopa/carbidopa. The other antibiotics listed here are not useful in the treatment of Parkinson's disease.
The most common cause of preventable blindness in the United States is:
A. Macular degeneration
C. Retinal detachments
Answer: D Glaucoma
The wording is intentionally difficult in this question. Macular degeneration, retinal detachments, and trauma are not preventable. Cataracts are "curable", but the cataract itself is probably not "preventable." Chronic glaucoma can be treated to prevent blindness this is a matter of semantics.
At what age does the first tooth usually erupt in an infant?
A. 2-4 months
B. 6-8 months
C. 10-12 months
D. 14-16 months
Answer: B 6-8 months
The first tooth in an infant to erupt is the central incisor at the average age of 6-8 months.
A 14-month-old female is brought to your office with a 3-day history of a fever of 104 degrees rectally. Suddenly, today, the fever stopped and a rash developed. Examination reveals a diffuse, fine, maculopapular rash. Presently, the child does not appear ill. The most likely diagnosis is:
C. erythema infectiosum (Fifth's disease)
E. Chicken pox
Answer: D Roseola
This is typical for Roseola. Rubella has a mild illness with a fine macular rash. Rubeola (measles) is an acute illness, the child is toxic, has conjunctivitis and Koplik spots. Fifth's disease has mild illness with a "lacy" rash on the extremities. Chickenpox has vesicles.
Upon review of an EKG you notice periodic, repetitively absent QRS complexes and "grouped beating." Which of the following is the explanation?
A. Third degree heart block
B. Mobitz Type II heart block
C. Mobitz Type I heart block
D. first degree heart block
E. sinus tachycardia
Answer: C Mobitz Type I heart block
I don't like the wording of this question, but typically "group beating" suggests Wenckebach. The fact that there are absent QRS complexes means there is a second or third-degree AVB. In Mobitz II, the PR intervals are the same - so no "grouped" beating, in Third degree, there is no rhyme or reason to the rhythm. In Wenckebach, the rhythm "repeats", causing a "regularly irregular" rhythm.
A patient describes a history of a "curtain being brought down over my right eye it stayed there for a few minutes then was lifted back up." In which of the following arteries is the etiology of this complaint located?
A. anterior cerebral
B. middle cerebral
C. posterior cerebral
D. internal carotid
E. external carotid
Answer: D Internal Carotid
This is amaurosis fugax....a form of "TIA" of the optic artery — it arises from the internal carotid - most common location for occlusion in TIA
A 32-year-old male presents with dyspnea and a nonproductive cough. He is tachycardic, tachypneic, and febrile. Auscultation of his chest reveals scattered rhonchi. His chest x-ray demonstrates a diffuse interstitial infiltrate. His ABG demonstrates moderate hypoxemia and his LDH is elevated. What is the most likely diagnosis?
A. Streptococcal pneumoniae pneumonia
B. Mycoplasma pneumoniae pneumonia
C. Pneumocystis carinii pneumonia
D. Bowen's disease
E. Steven-Johnson syndrome
Answer: C Pneumocystis carinii pneumonia
Formerly PCP Pneumonia now called (PJP) Pneumocystis jiroveci. Many AIDS patients present initially with PJP. These are the classic signs and symptoms of PJP pneumonia. While mycoplasma patients can be acutely ill, they are more likely (especially on the Boards) to present as mildly ill with a normal physical exam and no hypoxia. S. pneumonia is the most common community-acquired pneumonia but would present with a focal/lobar consolidation.
-Common in HIV-infected patients with a low CD4 count of less than 200
-Prophylaxis for high-risk patients with a CD4 count of less than 200 or with a history of PJP infection
This drug causes gingival hyperplasia and hirsutism. At high doses it can cause nystagmus, ataxia and diplopia. Which drug is best described by these statements?
E. valproic acid
Dilantin (phenytoin) causes these typical symptoms
Which of the following choices is associated with meconium staining of the amniotic fluid?
A. bowel obstruction
B. peeling of the infant's skin
C. aspiration pneumonitis and respiratory distress syndrome
D. infection with E. coli
E. intrauterine cataract formation and sensorineural hearing loss
Aspiration pneumonitis and respiratory distress syndrome
When the infant has meconium in the amniotic fluid, he has been in distress, and the meconium is frequently aspirated prior to delivery and can cause pneumonitis and respiratory distress syndrome in the neonate.
A 32-year-old male presents after slipping and falling off the roof of his home and striking his head. He suffered a brief loss of consciousness. Since that time, he has noted increasing urination and thirst. His serum chemistries reveal an elevated sodium level. His urine specific gravity is 1.003. Which of the following is the most likely diagnosis?
A. cerebral contusion
B. subarachnoid hemorrhage
C. epidural hematoma
D. diabetes insipidus
E. renal contusion
Diabetes insipidus (ADH deficiency) can occur after acute head trauma. ADH is secreted by the posterior pituitary gland and causes the body to retain fluid (to increase volume).
In a patient who has damaged the posterior pituitary, ADH is not secreted, so the body urinates "water." There is frequent large volume urination with a very low specific gravity and will cause hypernatremia unless the patient is given large quantities of water to drink.
You are educating a patient that has just been advised that he has "polyps" in his colon. Which of the following statements is FALSE?
A. The larger the colonic polyp, the greater the risk of malignant transformation
B. Villous adenomas have a 30-70% risk of malignant transformation
C. The greater the number of concomitant colonic polyps, the greater the risk of malignant transformation
D. The majority of colonic polyps are hyperplastic in origin
E. The majority of colonic polyps are > 3 cm in size
The majority of colonic polyps are > 3 cm in size
Most polyps are, in fact, quite small. All the rest of these statements are true
Wolff-Parkinson-White (WPW) and Lown-Ganong-Levine (LGL) syndrome are both characterized by:
A. left ventricular dysfunction
B. a shortened PR interval
C. the presence of delta waves
D. large pericardial effusions
E. marked left ventricular hypertrophy
Shortened PR interva
Wolff-Parkinson-White (WPW) and Lown-Ganong-Levine (LGL) both have short PR intervals.
WPW also has a "delta wave" and predisposes the patient to supraventricular tachyarrhythmias.
A patient that you are examining for carpal tunnel syndrome reveals that her paresthesias occur in all five digits. Which digit does NOT experience paresthesias with median nerve neuropathy?
A. first (thumb)
B. second (index)
C. third (long)
D. fourth (ring)
E. fifth (pinky)
The fifth finger is ALWAYS innervated by the ulnar nerve, and would not be affected in a true carpal tunnel syndrome.
A 22-year-old female complains of vaginal bleeding for 24 hours. Her last menstrual cycle was seven weeks ago She has had an IUD, but currently uses no form of contraception. Her HCG is positive. She denies fever, chills and vaginal discharge, prior to the onset of the vaginal bleeding. You order a pelvic ultrasound to rule out:
B. pelvic inflammatory disease
C. dysfunctional uterine bleeding
D. an ectopic pregnancy
Any patient with an IUD, or with a tubal ligation, or known obstruction of a tube, who has a positive HCG needs an ultrasound to r/o ectopic pregnancy
The examination of a 26-year-old male demonstrates a "bag of worms" consistency within the left hemiscrotum. This finding is suggestive of a(n):
A. acute case of balanitis
This is a description of varicocele (varicose veins of the scrotum).
A hydrocele is just a water collection in the scrotum.
Spermatocele is just a fluid collection which happens to contain sperm (sperm are not palpable)
A patient presents with a recurrent history of swelling on the right side of the jaw that begins while eating and subsides within two hours postprandially. You suspect:
D. an abscessed tooth
E. conjunctivitis manibularis
Sialo(salivary gland) lithiasis (stone) is described in this question.
Parotitis would be inflammation and infection of the parotid gland (usually due to a stone that is stuck in the duct). A parotitis patient would be acutely ill with redness of the gland and fever.
Which of the following is the earliest manifestation of diabetic nephropathy?
B. a progressive decline in the creatinine clearance
C. an elevated serum haptoglobin
D. renal insufficiency
Tiny amounts of albumin (microalbumin) show up first - but need a special test ordered to detect it. Intervention at this point with an ACEI prolongs the length of time before the patient progresses to albuminuria (noted on a typical urine "dip")
Fluid from a thoracentesis is grossly purulent. The effusion from which this fluid was aspirated is best described as a(n):
A. loculated effusion
A grossly purulent tap would suggest staph (empyema).
Loculated effusion does not describe either a trans or exudative effusion.
Chylo and hydrothorax suggest a transudative effusion (nonpurulent).
And hemothorax is blood
Sets with similar terms
60 PANCE Practice Questions
PANCE Practice Exam #1
PANCE Practice Exam #3
Other sets by this creator
Clin Med Pulmonology
Other Quizlet sets
Life Science Test #1
Body System Notes Julianna
history chapter 2 test
Demings 14 points: Guidelines for quality improvem…