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Board review Jan 2 2020

Quiz by Jumana Antoun

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10 questions
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  • Q1
    A 36-year-old female consults you because of concerns about “fatigue.” After carefully reviewing her history and performing a physical examination, which one of the following would be LEAST valuable in assessing this patient?
    A pregnancy test
    A baseline serum cortisol level
    A TSH level
    An erythrocyte sedimentation rate
  • Q2
    A 15-year-old white female who has had regular periods since age 12 comes to your office because of secondary amenorrhea and a milky discharge from her breasts. A pregnancy test is negative. The best test for initial evaluation of the pituitary in this patient is:
    serum FSH and LH
    plasma ACTH
    plasma antidiuretic hormone
    serum prolactin
  • Q3
    A 45-year-old female presents with a complaint of pain and swelling in her right index finger of 2 days’ duration. She reports that 5 days ago she had artificial nails applied, which she removed yesterday due to the pain. She used hydrogen peroxide on the finger, but it did not help. She denies any systemic symptoms or fever. On examination there is erythema and swelling in the lateral nail fold of the right index finger, with purulent material noted. Which one of the following would be the most appropriate treatment for this patient?
    Topical antibiotics
    Removal of the proximal nail fold
    Topical antifungals
    Topical corticosteroids
  • Q4
    A 30-year-old male complains of the gradual onset of anterior right knee pain on climbing the stairs. On examination there is no effusion, but there is tenderness over the medial retinaculum. There is good ligament strength, and range of motion is normal. When the knee is extended from 90° flexion to full extension, the patella deviates laterally. Which one of the following would be the best initial treatment for this condition?
    Arthroscopic surgery
    Physical therapy
  • Q5
    Which one of the following is appropriate at the routine postpartum visit?
    Thyroid function tests
    A CBC
    A urine dipstick
    Screening for depression
  • Q6
    The induction or inhibition of the cytochrome P450 (CYP) enzyme is responsible for many adverse drug reactions. Which one of the following is an inducer of the cytochrome P450 enzyme?
    Phenytoin (Dilantin)
    Grapefruit juice
    Ciprofloxacin (Cipro)
    Fluconazole (Diflucan)
  • Q7
    A 58-year-old postmenopausal female presents with a recent onset of painless vaginal bleeding. Her last menses occurred 8 years ago and she has had no bleeding until now. She reports that her Papanicolaou smears have always been normal, with the last one obtained a year ago. A pelvic examination today is normal. Which one of the following management options is the preferred next diagnostic step?
    Transvaginal ultrasonography
    Colposcopy with endocervical curettage
    Meperidol (Demerol) for pain control
  • Q8
    A 75-year-old otherwise healthy white female states that she has passed out three times in the last month while walking briskly during her daily walk with the local senior citizens mall walkers’ club. This history would suggest which one of the following as the etiology of her syncope?
    Transient ischemic attack
    Orthostatic hypotension
    Vasovagal syncope
    Aortic stenosis
  • Q9
    Overweight and obesity in children should be determined by which one of the following?
    BMI percentile for age and gender
    Body weight
    Abdominal girth
    Individual BMI
  • Q10
    A 57-year-old male presents to the emergency department complaining of dyspnea, cough, and pleuritic chest pain. A chest radiograph shows a large left-sided pleural effusion. Thoracentesis shows a pleural fluid protein to serum protein ratio of 0.7 and a pleural fluid LDH to serum LDH ratio of 0.8. Which one of the following causes of pleural effusion would be most consistent with these findings?
    Heart Failure
    Pulmonary embolism
    Superior vena cava obstruction
    Nephrotic syndrome

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