MN 566 Final

Which of the following medications is appropriate to treat Paget's disease? a. Boniva b. Fosamax c. Reclast d. Forteo

C. Reclast

Which of the following would lead the clinician to suspect a tumor when paired with low back pain? a. Minor trauma with sneezing in elderly with osteoporosis b. History of spinal procedure c. Sudden loss of bowel or bladder function d. Unintended weight loss >10% of body weight in 6 months.

D. Unintended weight loss >10% of body weight in 6 months.

Peter presents with complaints of right hearing loss that has been getting worse and a congruent headache. What is the most likely diagnosis? a. Acoustic neuroma b. Presbycusis c. Meniere's disease d. Sensorineural hearing loss

a. Acoustic neuroma

On further questioning, the 21-year-old patient with the chief complaints of fatigue, headache, anorexia, and a runny nose explains that she is sexually active only with her boyfriend, does not use injectable drugs, and works as an aide in a day-care center. Which of the following tests would be most helpful in confirming your diagnosis? a. Anti-HAV IgM b. HAV IgG c. Anti-HCV d. IgM anti-HBs

a. Anti-HAV IgM

The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the knee flexed to 30 degrees. If instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as: a. Apprehension sign b. Bulge sign c. Thumb sign d. Lachman Sign

a. Apprehension sign

A clinician is examining a vertebral fracture, and the examination and diagnostic findings have shown a compression of the anterior column that includes both endplates. What type and subtype are these? a. Compression Fracture, Type A b. Burst fracture, Type B c. Seat-belt type injury, level two d. Fracture-dislocation, shear

a. Compression Fracture, Type A

It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault? a. Depression b. Obsessive-compulsive disorder c. Substance abuse d. PTSD

a. Depression

Which of the following dietary instructions should be given to a patient with GERD? a. Eliminate coffee b. Drink hot toddies to relieve stomach distress c. Recline and rest after meals d. Increase the amount of spicy foods

a. Eliminate coffee

A 45-year-old patient presents with chief complaint of generalized abdominal pain. Her physical examination is remarkable for the left lower quadrant tenderness. At this time, which of the following should be considered in the differential diagnosis? a. Endometriosis b. Yersinia enterocolitica infection c. Appendicitis d. GERD

a. Endometriosis

Which of the following medications for temporomandibular disorder has the warning that patients should NOT drive while taking it? a. Flexeril b. Naprosyn c. Tylenol d. Elavil

a. Flexeril

Jean has acute otitis externa with fluid that is black and malodorous. Which of the following is responsible for the infection? a. Fungal Infection b. Staphylococcus Infection c. Pseudomonas Infection d. Allergic Reaction

a. Fungal Infection

Which of the following is part of the treatment plan for the patient with IBS? a. High-fiber diet b. A discussion that the goal of the treatment is to cure their disease c. Daily laxative d. A conversation about their expected shorter life span

a. High-Fiber diet

Which of the following patients has an increased risk of epigastric hernia? a. Mark, a 45-year-old African American male with chronic obstructive pulmonary disease b. Gladys, a 93-year-old Hispanic female with dyslipidemia c. Tony, a 33-year-old Asian male with hypertension d. Whitney, a 22-year-old Caucasian female with anemia

a. Mark, a 45-year-old African American male with chronic obstructive pulmonary disease

Which of the following patients should be referred to a hepatologist? a. Patient with persistent elevation of HBsAg b. Patient with anti-HAV IgG c. Patient with IgG anti-HBs d. Patient with anti-HEV

a. Patient with persistent elevation of HBsAg

Instead of reporting symptoms of body dysmorphic disorder (BDD) to the primary-care provider, patients often request which of the following? a. Referrals to plastic surgeons, orthodontists, or dermatologists b. Antidepressant medications c. Nutritional counseling services d. Unnecessary laboratory tests

a. Referrals to plastic surgeons, orthodontists, or dermatologists

What is the presentation of a complex motor tic? a. Simultaneous shoulder shrugs and head turns b. Eye blinks and extension of extremities c. Throat clearing and finger raising d. Barking, screaming, and snorting

a. Simultaneous shoulder shrugs and head turns

Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis? a. Vasomotor Rhinitis b. Rhinitis medicamentosa c. Atrophic Rhinitis d. Viral Rhinitis

a. Vasomotor Rhinitis

Robin is a 57-year-old female presenting with diffuse abdominal pain. Which of the following statements from the provider to Robin is correct? a. "It doesn't matter that you feel pain not only in your stomach but also in your shoulder." b. "Does moving around change the nature of your pain?" c. "All causes of abdominal pain do not necessitate a surgical referral." d. "I noticed on examination that your stomach is rigid, and you stated your pain is quite severe. It is only necessary for a nurse to see you concerning this problem."

b. "Does moving around change the nature of your pain?"

What is the median reduction in life expectancy among those with mental illness? a. 15.4 years b. 10.1 years c. 5.7 years d. 9.2 years

b. 10.1 years

You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ROM but cannot move it about gravity. Which numeric grade of muscle strength would you give this patient? a. 1 b. 2 c. 3 d. 4

b. 2

Which is the most prevalent psychiatric condition in the United States? a. Depression b. Anxiety c. Substance-related addictions d. Gambling addiction

b. Anxiety

What is the initial treatment for uncomplicated anterior epistaxis? a. Tilting the head back so the blood does not run out the nose b. Applying firm and continuous pressure superior to the nasal alar cartilage for 10 to 15 minutes c. Applying firm and continuous pressure to the nostril for 5 minutes d. Letting the nose bleed blot and and leaning the head forward

b. Applying firm and continuous pressure superior to the nasal alar cartilages for 10 to 15 minutes

Which of the following neuroendocrine abnormalities is implicated in depression? a. Decrease in adrenal size b. Hypersecretion of cortisol c. An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone d. Increased inhibitory response of glucocorticoids to dexamethasone

b. Hypersecretion of cortisol

Which of these is one of the most common dietary triggers of IBS? a. Gluten-free items b. Lactose c. Honey d. Meat

b. Lactose

Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform? a. Allen's test b. Phalen's test c. Tinel's test d. Finkelstein's test

b. Phalen's test

A patient present with nonvesicular lesions that are 2 to 10mm, symmetrical, and scattered on the oropharynx and mouth. What is their most likely diagnosis? a. Corynebacterium diphtheriae b. Primary Syphilis c. Candida infection d. Secondary syphilis

b. Secondary Syphilis

Which of the following is considered first-line treatment for panic disorders? a. Benzodiazepines b. Selective serotonin reuptake inhibitors (SSRIs) c. Tricyclic antidepressants d. Cognitive behavioral therapy

b. Selective serotonin reuptake inhibitors (SSRIs)

Mrs. Allen is a 60-year-old woman who has been diagnosed with osteoporosis. She is very concerned about the risk of breast cancer associated with hormone replacement therapy and is wondering what else is available to her. The clinician explains that biphosphonates are another class of drugs used in the prevention and treatment of osteoporosis. What teaching should the clinician give Mrs. Allen in regard to taking biphosphonates? a. Taking biphosphonates can result in hypercalcemia, so calcium intake should be decreased while taking this class of drugs. b. There is potential for upper gastrointestinal (GI) irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying. c. This class of drugs can be taken at any time of the day without regard to meals. d. None of the above

b. There is potential for upper gastrointestinal (GI) irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying.

What prenatal factor could increase risk for ADHD? a. Exposure to lead b. Zinc Deficiency c. Maternal allergies d. Central nervous system (CNS) infections

b. Zinc Deficiency

What is the recommended daily calcium intake for men 70 years and younger? a. 500 mg/day b. 750mg/ day c. 1,000mg/day d. 1,500 mg/day

c. 1,000mg/day

A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter cold preparations but feels worse. The smell of food makes her nauseated. Her boyfriend had mononucleosis about 1 month ago, and she wonder if she might have it also. Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at this point? a. Stool culture b. Liver enzymes c. Anti-hepatitis D virus d. Thyroid-stimulating hormone test

c. Anti-hepatitis D virus

Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep? a. Every 30 to 40 minutes b. Every 60 to 80 minutes c. Every 90 to 100 minutes d. Every 180 to 200 minutes

c. Every 90 to 100 minutes

A 29-year-old is seen in the office with complaints of pain in his chest and belly. He quit smoking 6 months ago. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer and Pepto-Bismol. The burning pain wakes him at night and radiates up to his chest. Which factor favors a diagnosis of gastric ulcer? a. His use of Pepto-Bismol b. His age c. His use of Alka-Seltzer d. His smoking cessation

c. His use of Alka-Seltzer

Fred has been diagnosed with a trigger finger of the ring finder. Which of the following management strategies is appropriate? a. Surgical removal of the tendon sheath b. NSAIDs c. Local anesthetic injection into the tendon sheath d. Splinting

c. Local anesthetic injection into the tendon sheath

Which of the following causes of gastrointestinal bleeding is found in the lower gastrointestinal tract? a. Erosive esophagitis b. Duodenal ulcer c. Meckel's diverticulum d. Gastric ulcer

c. Meckel's diverticulum

Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? a. Decreased C-reactive protein b. Hyperalbuminemia c. Morning stiffness d. Weight gain

c. Morning stiffness

Which type of stomatitis is caused by continual exposure to chewing tobacco? a. Aphthous stomatitis b. Herpetic stomatitis c. Nicotinic stomatitis d. Allergic stomatitis

c. Nicotinic stomatitis

What is the likely result of the over-prescription, over-supply, and over-production of opioids? a. Opioid use b. Opioid abuse c. Opioid dependence d. Opioid resistance

c. Opioid Dependence

Which of the following is a risk factor for overuse syndrome with tendonitis? a. Body mass index <18 b. Hypothyroidism c. Rheumatoid arthritis d. Cardiac Disease

c. Rheumatoid Arthritis

The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient's mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinical know when the sound fades away. This is an example of which type of test? a. Weber Test b. Schwabach Test c. Rinne Test d. Auditory brainstem response (ABR) test

c. Rinne Test

A provider is examining a patient with temporomandibular joint disease (TMJ). Which of the following results would the provider expect from the exam? a. The mandibular opening is 40 mm b. There are no sounds elicited from the exam c. The mandible deviates to the left side d. The patient is able to open the mouth without pain or sound

c. The mandible deviates to the left side

A patient is diagnosed with GERD, and his endoscopic report reveals that presence of Barrett's epithelium. Which of the following should the PCP include in the explanation of the pathology report? a. This is not premalignant tissue b. This tissue is not resistant to gastric acid c. This tissue supports healing of the esophagus d. This tissue does not have an increased risk of developing esophageal adenocarcinoma.

c. This tissue supports healing of the esophagus

The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane's description of her injury. Which of the following clues in Diane's examination or history would alert the clinician to the need for obtaining radiographs? a. Ability to bear weight immediately after the injury b. Development of minor ankle swelling after the injury c. Slight bruising over the injury site 2 days after injury d. Crepitation with palpation or movement of the ankle

d. Crepitation with palpation or movement of the ankle

Which of the following is a condition that results in colicky abdominal pain? a. Peptic ulcers b. Glisson's capsule around the liver c. Peritoneum irritation d. Gallstones

d. Gallstones

Bipolar disorder requires differential diagnosis from all of the following except: a. Substance abuse and medication effects b. Medical and neurological disorders c. Cluster B personality disorders and depression d. Obsessive-compulsive disorder

d. Obsessive-compulsive disorder

A patient presents to the clinician complaining of ear pain. On examination, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition? a. Otitis media b. Meniere's disease c. Tinnitus d. Otitis externa

d. Otitis externa

A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the examination? a. Lumbar puncture b. Family history of cardiac problems c. Contrast venography d. Pelvic exam

d. Pelvic exam

Which of the following is an example of sensorineural hearing loss? a. Perforation of the tympanic membrane b. Otosclerosis c. Cholesteatoma d. Presbycusis

d. Presbycusis

The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? a. Acetylcholine b. Gamma-amino butyric acid (GABA) c. Dopamine d. Serotonin

d. Serotonin

You have a patient who is a positive for strep on rapid antigen testing (rapid strep test). You order amoxicillin after checking for drug allergies (patient is negative) but he returns 3 days later, reporting that his temperature has gone up, not down (101.5F in office). You also note significant lymphadenopathy, most notably in the posterior and anterior cervical chains, some heptosplenomegaly, and a diffuse rash. You decide: a. To refer the patient b. That he is having an allergic response and needs to be changed to a macrolide antibiotic c. That his antibiotic dosage is not sufficient and should be changed d. That he possibly has mononucleosis concurrent with his strep infection

d. That he possibly has mononucleosis concurrent with his strep infection