MN 568 Unit 6 Review

Term
1 / 50
A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
Click the card to flip 👆
Terms in this set (50)
A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a) NSAIDs
b) Beets
c) Vitamin A
d) Red meat

Answer: NSAIDs, high risk for bleeding.
Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?
a) Staphylococcal aureus
b) Clostridium perfringens
c) S. pyrogenes
d) Streptococcus

Answer: Clostridium Perfringens, leading to excessive gas production under the skin making a popping sound, crepitus.
Which of the following is, a linear crack extending from the epidermis to the dermis?
a) An ulcer
b) A fissure
c) Lichenification
d) An excoriation

Answer: A fissure.
The patient is diagnosed with ARF. Which of the following conditions is the most common cause?
a) Renal calculi
b) Acute tubular necrosis
c) Cardiac failure
d) Acute glomerulonephritis

Answer: Acute tubular necrosis.
A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?
a) Refer to a urologist immediately.
b) Obtain a computed tomography (CT) scan.
c) Instruct the patient to elevate the scrotum.
d) Prescribe ibuprofen.

Answer: Refer to a urologist immediately. *Medical Emergency.
Which scalp problem can be caused by a fever and certain drugs?
a) Telogen effluvium (TE)-
common cause of temporary hair loss due to the excessive shedding of resting or telogen hair after some shock to the system.
b) Trichotillomania-
pulling out hair repeatedly
c) Psoriasis
d) Alopecia areata -
common autoimmune skin disease, causing hair loss on the scalp, face and sometimes on other areas of the body

Answer: Telogen effluvium (TE)
A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?
a) Terazosin 2 mg PO once a day
b) Ice pack to the scrotal area
c) Saw palmetto 320 mg per day
d) All of the above

Answer: Terazosin 2 mg PO once a day.
It is an alpha-blocker. It relieves the symptoms of BPH by relaxing the muscles of the bladder and prostate. It lowers blood pressure by relaxing the blood vessels.
What is the most common pre-cancerous skin lesion in Caucasians?
a) A skin tag
b) Actinic keratosis
c) A melanoma
d) A basal cell lesion

Answer- Actinic Keratosis.
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 (UTI). What are some additional symptoms consistent 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

Answer: Blood in urine and frequency. Think acute and common.
Which is the most potent and irritating dose of tretinoin?
a) 0.05% liquid formulation
b) 0.1% cream
c) 1% foam
d) 0.02% cream

Answer: 0.1% foam.
Prevalence of psoriasis is highest in which group?a) Scandinavians b) African Americans c) Asians d) Native Americans Answer: ScandinaviansA 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?a) Pancreatitis b) Peptic ulcer disease c) Diverticulitis d) All of the above Answer: All of the above.Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?a) "You must be under a lot of stress lately." b) "It is hereditary. Did your father experience this also?" c) "The cause is unknown, but we suspect it is due to an immunologic mechanism." d) "We'll have to do some tests." Answer: The cause is unknown, but we suspect it is due to an immunologic mechanism."Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?a) Keratosis pilaris b) Dennie's sign c) Keratoconus d) Pityriasis alba Answer: Dennie's signAn example of ecchymosis is:a) A hematoma b) A keloid c) A bruise d) A patch Answer: A bruiseHarvey has a rubbery, smooth, round mass on his chest that is compressible and has a soft-to-very-firm texture. What do you diagnose this as?a) A lipoma b) A nevi c) A skin tag d) A possible adenoma Answer: A lipomaWhen instructing your elderly client about treating her xerosis (severely dried skin), what do you tell her?a) A daily hot bath may help the associated pruritus. b) Rub the skin briskly to make sure it is completely dry after bathing. c) Only take short tepid showers. d) Use a gel that is alcohol-based after bathing to soften the skin. Answer: Only take short tepid showers.A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis. In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?a) Escherichia coli b) Staphylococcus aureus c) Chlamydia trachomatis d) Pseudomonas aeruginosa Answer: Chlamydia trachomatisWhich of the following instructions should be given to the patient with nephrolithiasis?a) Take ibuprofen, 600 mg every 8 hours. b) Take Tums→ for stomach upset. c) Drink more black tea. d) Increase intake of vegetables, like spinach. Answer: Take ibuprofen, 600 mg every 8 hours.A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?a) The scrotum will be dark. b) The scrotum will appear light pink or yellow. c) The scrotum will appear milky white. d) The internal structures will be clearly visible. Answer: The scrotum will appear light pink or yellow.Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?a) Bullous impetigo b) Staphylococcal scalded skin syndrome (SSSS) c) Nonbullous impetigo d) Ecthyma Answer: EcthymaWhy do people of African descent have a lower incidence of non-melanoma skin cancer?a) They have an increased number of melanocytes. b) Their darker skin protects from ultraviolet radiation. c) Their skin is thicker. d) Their immune system is stronger. Answer: Their darker skin protects from ultraviolet radiation.The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?a) 3 to 7 days b) 14 to 21 days c) 3 to 6 weeks d) 6 to 12 weeks Answer: 6-12 wksTinea unguium is also known as:a) Onychomycosis b) Tinea versicolor c) Tinea manuum d) Tinea corporis Answer: OnychomycosisAn 86-year-old woman is seen in the clinic for recurrent hematuria. The provider suspects bladder cancer. Which of the following data from the history is considered a risk factor for this type of cancer?a) History of alcoholism b) Sedentary lifestyle c) Obesity d) 65-year smoking history Answer: 65-year smoking historyDuring a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?a) An enlarged rubbery gland b) A hard irregular gland c) A tender gland d) A boggy gland Answer: An enlarged rubbery glandJosh, aged 22, has tinea versicolor. Which description is the most likely for this condition?a) There are round, hypopigmented macules on his back. b) Josh has red papules on his face. c) There are crusted plaques in Josh's groin area. d) There are white streaks on his neck. Answer: There are round, hypopigmented macules on his back.A patient is seen in the clinic and diagnosed with Stage I renal cancer. The provider should refer the patient to a nephrologist for which of these treatments?a) Chemotherapy b) Nephrectomy c) Palliative treatment d) Radiation Answer: NephrectomyA patient presents with CVA tenderness and a several-day history of high fever, chills, and dysuria. Which of the following diagnoses is most likely given the above information?a) Pyelonephritis b) Cystitis c) Renal calculi d) Bladder tumor Answer: PyelonephritisA 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?a) Lower urinary tract infection b) Chlamydia infection c) Candidiasis d) Pyelonephritis Answer: Lower urinary tract infectionWhen looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?a) Spores b) Leukocytes c) Pseudohyphae d) Epithelial cells Answer: SporesAn example of a primary skin lesion is a/an:a) Bulla b) Scale c) Excoriation d) Fissure Answer: BullaA 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis?a) Psychogenic nocturia b) Urethral polyp c) Irritative posterior urethral lesion d) Benign prostatic hypertrophy Answer: Benign prostatic hypertrophyA 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?a) Urethral polyps b) Urinary tract infection (UTI) c) Anticholinergic medication d) All of the above Answer: Urinary tract infection (UTI)A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is diagnosed with acute pyelonephritis. How should this patient be managed?a) 3-day course of oral antibiotics b) Hospitalization c) Encourage cranberry juice intake. d) 6-week course of antibiotics Answer: HospitalizationA 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?a) The cancer involves the seminal vesicles. b) There is metastatic disease to regional lymph nodes. c) The cancer is confined to the capsule. d) There is metastasis to distant organs. Answer: The cancer involves the seminal vesicles.The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis?a) Gram-positive cocci b) Gram-negative cocci c) Gram-positive bacillus d) Gram-negative bacillus Answer: Gram-negative bacillusA 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next?a) Send a urine specimen for microscopy and evaluate for fungal colonies. b) Increase the dose of antibiotic. c) Order a cytoscopy. d) Order a different antibiotic. Answer: Send a urine specimen for microscopy and evaluate for fungal colonies.Which of the following tests is most useful in determining renal function in a patient suspected of CRF?a) BUN and creatinine- labs b) Electrolytes c) Creatinine clearance- in a UA d) Urinalysis Answer: Creatinine clearanceThe patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?a) Erectile dysfunction b) Glaucoma c) Hypotension d) Headache Answer: Erectile dysfunctionWhich of the following foods should be limited in a patient with CRF?a) Milk b) Bananas c) Soy sauce d) All of the above Answer: All of the above. Consider what is in each food choice and the function of the kidney.Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers?a) Necrotizing fasciitis- anywhere b) Periorbital cellulitis- eye c) Erysipelas- infection of the upper layers of the skin (superficial) d) "Flesh-eating" cellulitis Answer: ErysipelasTori is on systemic antifungals for a bad tinea infection. You are aware that the antifungals may cause:a) Renal failure b) Skin discoloration c) Breathing difficulties d) Hepatotoxicity Answer: HepatoxicityA bulla is:A vesicle larger than 1cm in diameterMarci has a wart on her hand. She says she heard something about "silver duct tape therapy." What do you tell her about his?a) It is an old wives' tale. b) It is used as a last resort. c) Salicylic acid is more effective. d) It is a simple treatment that should be tried first. Answer: It is a simple treatment that should be tried first.An 82-year-old woman with renal failure is seen in the clinic. The provider should question the patient about the intake of which of these substances that can cause renal toxicity?a) Ibuprofen b) Captopril c) Losartan d) All of the above Answer: All of the aboveA patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?a) Every month b) Every 3 to 4 months c) Every 6 to 12 months d) Every year Answer: Q6-12 moWhich of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?a) Do not use lidocaine as it may potentiate bleeding. b) Pinch the skin taut together. c) Use gel foam to control bleeding. d) This should be performed by a dermatologist only. Answer: Use gel foam to control bleeding.A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?a) Peyronie's disease b) Damage to the pudendal artery c) Scarring of the cavernosa d) All of the above Answer: Peyronie's diseaseJeffrey has atopic dermatitis. You are prescribing a low-dose topical corticosteroid for him. Which would be a good choice?a) Betamethasone dipropionate 0.05% b) Hydrocortisone base 2.5% c) Halcinonide 0.1% d) Desonide 0.05% Answer: Hydrocortisone base 2.5%