Questions for Exam 2 Primary Care 2 Dunphy

Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure which makes it a good diagnostic test? a. B-type natriuretic peptide (BNP) b. C-reactive protein (CRP) c. Serum albumin d. Erythrocyte sedimentation rate (ESR)

B-type natriuretic peptide (BNP)

Which of the following is the most commonly experienced symptom of a patient with a migraine? a. Light sensitivity c. Sound sensitivity b. Pulsatile pain d. Experiencing an aura

a. Light sensitivity

As diabetic retinopathy progresses, the presence of "cotton wool" spots can be detected. Cotton wool spots refer to: a. Nerve fiber layer infarctions. c. Venous beading. b. Blood vessel proliferation. d. Retinal hemorrhage.

a. Nerve fiber layer infarctions.

Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course? a. Nuclear cataracts c. Posterior cataracts b. Cortical cataracts d. Immature cataracts

a. Nuclear cataracts

Tinea unguium is also known as: a. Onychomycosis. c. Tinea manuum. b. Tinea versicolor. d. Tinea corporis.

a. Onychomycosis.

Which of the following medications used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape? a. Pilocarpine c. Brinzolamide b. Timolol d. Acetazolamide

a. Pilocarpine

Prevalence of psoriasis is highest in which group? a. Scandinavians c. Asians b. African Americans d. Native Americans

a. Scandinavians

Sandra has palpitations that are occurring with muscle twitching, paresthesia, and fatigue. What might a specific diagnostic test be to determine the cause? a. Serum calcium b. Electrocardiogram (ECG) c. Thyroid-stimulating hormone (TSH) test d. Complete blood cell count (CBC)

a. Serum calcium

When 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 c. Pseudohyphae b. Leukocytes d. Epithelial cells

a. Spores

Which typical electrocardiogram (ECG) change is usually seen with cardiac ischemia? a. T-wave inversion c. Significant Q wave b. ST-segment elevation d. U-wave

a. T-wave inversion

Josh, 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.

a. There are round hypopigmented macules on his back.

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

a. Vasomotor rhinitis

The clinical risk factors for deep vein thrombosis (DVT), which include venous insufficiency, poststroke, and heart failure, fit into which of Virchow's Triad for being a causative factor for DVT? a. Venous stasis c. Hypercoagulability b. Vessel injury

a. Venous stasis

Which type of stomatitis results in necrotic ulceration of the oral mucous membranes? a. Vincent's stomatitis c. Apthous stomatitis b. Allergic stomatitis d. Herpetic stomatitis

a. Vincent's stomatitis

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 clinician 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 blood pressure (BP) of 142/92 is considered: a. Normal. c. Stage 1 hypertension. b. Prehypertension. d. Stage 2 hypertension.

c. Stage 1 hypertension

Which 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 only be performed by a dermatologist.

c. Use gel foam to control bleeding.

Which type of angina do you suspect in Harvey who complains of chest pain that occurs during sleep and most often in the early morning hours? a. Stable angina c. Variant (Prinzmetal's angina) b. Unstable angina d. Probably not angina but hiatal hernia

c. Variant (Prinzmetal's angina)

The most significant precipitating event leading to otitis media with effusion is: a. Pharyngitis. b. Allergies. c. Viral upper respiratory infection (URI). d. Perforation of the eardrum.

c. Viral upper respiratory infection (URI).

A Delta wave on the electrocardiogram (ECG) may be present in which condition? a. Prinzmetal's angina c. Wolff-Parkinson-White syndrome b. Bundle Branch Block d. Aortic stenosis

c. Wolff-Parkinson-White syndrome

Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually order in nonpregnant patients but is listed as a Pregnancy category C? a. Cleocin vaginal cream c. Terazol 3 vaginal cream b. Monistat combination pack d. Diflucan 150 mg

Diflucan 150 mg

True or false? Severe pain associated with acute otitis media signifies perforation of the tympanic membrane.

False

Which is the most potent and irritating dose of tretinoin? a. 0.05% liquid formulation c. 1% foam b. 0.1% cream d. 0.02% cream

a. 0.05% liquid formulation

Nitroglycerine (NTG) is given for a patient having ischemic chest pain. One tablet or one spray should be used under the tongue every 5 minutes for three doses. What should be done if the pain has not been relieved after three doses? a. 911 should be called, and the patient should be transported immediately to the emergency department (ED). b. One more dose of NTG may be tried. c. The person should be given two aspirin to chew. d. A portable defibrillator should be located to ascertain the cardiac rhythm.

a. 911 should be called, and the patient should be transported immediately to the emergency department (ED).

Harvey has a rubbery, smooth, round mass on his chest which is compressible and has a soft to very firm texture. What do you diagnose this as? a. A lipoma c. A skin tag b. A nevi d. A possible adenoma

a. A lipoma

A bulla is: a. A vesicle larger than 1 cm in diameter. b. An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular. c. A superficial elevated lesion filled with purulent fluid. d. Thinning of the skin (epidermis and dermis) that appears white or translucent.

a. A vesicle larger than 1cm in diameter.

Mary has hypertension and previously had a stroke. Which hypertensive drug would you order for her? a. ACE inhibitor b. Calcium channel blocker c. Angiotensin II receptor blocker (ARB) d. Beta blocker

a. ACE inhibitor

What antiplatelet agent is most widely used for secondary prevention of stroke? a. Aspirin c. Clopidogrel b. Ticlopidine d. Aspirin and clopidogrel

a. Aspirin

You are assessing Sigred for metabolic syndrome. Which of her parameters is indicative of this syndrome? a. Her waist is 36 inches. b. Her triglyceride level is 140 mg/dL. c. Her blood pressure (BP) is 128/84. d. Her fasting blood sugar (BS) is 108 mg/dL.

a. Her waist is 36 inches.

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? a. His age b. His cholesterol level c. His systolic BP d. The fact that he is on antihypertensive medication

a. His age- gives him 10 points. Cholesterol level gives him 3 points based on his age.

Otitis media is considered chronic when: a. Inflammation persists more than 3 months with intermittent or persistent otic discharge. b. There are more than six occurrences of otitis media in a 1-year period. c. Otitis media does not resolve after two courses of antibiotics. d. All of the above

a. Inflammation persists more than 3 months with intermittent or persistent otic discharge.

Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? a. "Most patients have complete recovery in a few weeks to a few months." b. "Unfortunately, you'll probably have a small amount of residual damage." c. "Don't worry, I'll take care of everything." d. "You may have a few more episodes over the course of your lifetime but no permanent damage."

b. "Unfortunately, you'll probably have a small amount of residual damage."

6. Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure? a. 0 to 7 mm Hg c. 22 to 40 mm Hg b. 8 to 21 mm Hg d. 40 to 80 mm Hg

b. 8 to 21 mm Hg

Which of the following is "a linear crack extending from the epidermis to the dermis"? a. An ulcer c. Lichenification b. A fissure d. An excoriation

b. A fissure

What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster? a. A stabbing type of pain on one small area of the body b. A vesicular skin lesion on one side of the body

b. A vesicular lesion on one side of the body is what the answer is, but the notes and book say stabbing pain 48 hours prior to lesion. a. A stabbing type of pain on one small area of the body

What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster? a. A stabbing type of pain on one small area of the body b. A vesicular skin lesion on one side of the body c. A pain that is worse upon awakening d. A lesion on the exterior ear canal

b. A vesicular skin lesion on one side of the body- however the notes say A. A stabbing type of pain... I think the difference may be that it's one SMALL area of the body and the the pain usually affects a dermatone

What percentage of patients with angina pectoris will have simultaneous dyspnea, caused by transient increase in pulmonary venous pressures that accompany ventricular stiffening during an episode of myocardial ischemia? a. About 20% c. About 50% b. About 30% d. Almost all

b. About 30%

The most common precancerous skin lesion found in Caucasians is: a. A skin tag. c. A melanoma. b. Actinic keratosis. d. A basal cell lesion.

b. Actinic keratosis

Which of the following drug categories commonly prescribed for hyperlipidemia should not be given if the triglycerides are over 400 mg/dL? a. Folic acid derivatives c. HMG-CoA reductase Inhibitors b. Bile acid sequestrants d. Folic acid derivatives

b. Bile acid sequestrants

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 c. S. pyrogenes b. Clostridium perfringens d. Streptococcus

b. Clostridium perfringens

The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection? a. HSV Type 2 c. Pneumonia b. HIV d. Syphilis

b. HIV

An acutely presenting, erythematous, tender lump within the eyelid is called: a. Blepharitis. c. Chalazion. b. Hordeolum. d. Iritis.

b. Hordeolum

Jeffrey has atopic dermatitis. You are prescribing a low-dose topical corticosteroid for him. Which would be a good choice? a. Betamethasone dipropionate 0.05% c. Halcinonide 0.1% b. Hydrocortisone base 2.5% d. Desonide 0.05%

b. Hydrocortisone base 2.5%

When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect? a. A piece of hair or a thread c. Leukocytes b. Hyphae d. Spores

b. Hyphae

Which immunoglobulin mediates the type 1 hypersensitivity reaction involved in allergic rhinitis? a. IgA c. IgG b. IgE d. IgM

b. IgE

The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? a. Overweight c. Moderate obesity b. Mild obesity d. Morbid obesity

b. Mild obesity

A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause? a. Gonorrhea c. Influenza b. Mononucleosis d. Herpes zoster

b. Mononucleosis

In which type of AV block does the PR interval lengthen until a beat is dropped? a. First-degree AV block c. Second-degree Mobitz II AV block b. Second-degree Mobitz I AV block d. Third-degree AV block

b. Second-degree Mobitz I AV block

Which assessment tool is used for peripheral artery disease? a. FAQ c. MMSE b. WIQ d. MOCA

b. WIQ

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."

c. "The cause is unknown, but we suspect it is due to an immunologic mechanism."

Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than: a. 4 weeks. c. 12 weeks. b. 8 weeks. d. 16 weeks.

c. 12 weeks.

When teaching patients post myocardial infarction (MI) about their nitroglycerine tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months? a. 1 month b. 3 months c. 6 months d. As long as they are kept in this special bottle, they will last forever.

c. 6 months

An example of ecchymosis is: a. A hematoma. c. A bruise. b. A keloid. d. A patch.

c. A bruise.

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? a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment. b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen. c. A throat culture should be performed to confirm the results of the rapid strep test. d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

c. A throat culture should be performed to confirm the results of the rapid strep test.

Which diagnostic test has long been considered the "gold standard" for a diagnosis of venous thromboembolism? a. Ultrasound c. Ascending venogram b. Magnetic resonance imaging (MRI) d. D-dimer

c. Ascending venogram

The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis? a. Viral conjunctivitis c. Bacterial conjunctivitis b. Keratoconjunctivitis d. Allergic conjunctivitis

c. Bacterial conjunctivitis

Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts? a. The body converts bilberry to vitamin A, which helps to maintain a healthy lens. b. Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes. c. Bilberry boosts oxygen and blood delivery to the eye. d. Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs.

c. Bilberry boosts oxygen and blood delivery to the eye.

Ian, age 62, presents with a wide, diffuse area of erythematous skin on his left lower leg that is warm and tender to palpation. There is some edema involved. You suspect: a. Necrotizing fasciitis. c. Cellulitis. b. Kaposi's sarcoma. d. A diabetic ulcer.

c. Cellulitis.

Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a: a. Filiform/digitate wart. c. Condyloma accuminata. b. Dysplastic cervical lesion. d. Koilocytosis.

c. Condyloma accuminata.

If chest pain may be alleviated with time, analgesics, and heat applications, what might the differential diagnosis be? a. Peptic ulcer c. Costochondritis b. Hiatal hernia d. Pericarditis

c. Costochondritis

Which pain characteristic is usually indicative of cardiac pathology? a. Fleeting c. Diffuse b. Moving d. Localized

c. Diffuse

Which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? a. Necrotizing fasciitis c. Erysipelas b. Periorbital cellulitis d. "Flesh-eating" cellulitis

c. Erysipelas

The majority of HSV-1 and HSV-2 infections are asymptomatic, so that only which elevated antibody titer shows evidence of previous infection? a. IgA c. IgG b. IgE d. IgM

c. IgG

Which of the following patients is more susceptible to irritant contact dermatitis? a. Jan, aged 18, with severe acne b. Julie, aged 20, who has asthma c. Jill, aged 50, who has venous stasis in her lower extremities d. Mark, aged 42, who takes a lot of pain medications for his arthritis

c. Jill, aged 50, who has venous stasis in her lower extremities

Which of the following antibiotics provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected? a. Penicillin V c. Levofloxacin b. Amoxicillin d. Clindamycin

c. Levofloxacin

A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma? a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma. b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient. c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist. d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.

For the best therapeutic effect after a myocardial infarction (MI), thrombolytics should be administered within the first 3 hours (ideally 30 minutes) of presentation of symptoms. Studies have shown that thrombolytic therapy, however, can be of benefit up to how many hours after the initial presentation of symptoms of MI? a. 6 hours c. 10 hours b. 8 hours d. 12 hours

d. 12 hours

Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: a. Severe asthma. b. A common valvular lesion. c. Severe hypertension. d. A previous coronary artery bypass graft (CABG).

d. A previous coronary artery bypass graft (CABG).

In which of the following situations would referral to a specialist be needed for sinusitis? a. Recurrent sinusitis b. Allergic sinusitis c. Sinusitis that is refractory to antibiotic therapy d. All of the above

d. All of the above

Patients with acute otitis media should be referred to a specialist in which of the following situations? a. Concurrent vertigo or ataxia b. Failed closure of a ruptured tympanic membrane c. If symptoms worsen after 3 or 4 days of treatment d. All of the above

d. All of the above

The "B" in the ABCDEs of assessing skin cancer represents: a. Biopsy. c. Boundary. b. Best practice. d. Border irregularity.

d. Border irregularity.

Sally, aged 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. She has not been adequately treated recently. Which type of impetigo is this? a. Bullous impetigo b. Staphylococcal scalded skin syndrome (SSSS) c. Nonbullous impetigo d. Ecthyma

d. Ecthyma

Which high-density lipoprotein (HDL) level is considered cardioprotective? a. Greater than 30 c. Greater than 50 b. Greater than 40 d. Greater than 60

d. Greater than 60

Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens? a. Coxsackievirus c. Francisella tularensis b. Cytomegalovirus d. Group A streptococcus

d. Group A streptococcus

Tori is on systemic antifungals for a bad tinea infection. You are aware that they may cause: a. Renal failure. c. Breathing difficulties. b. Skin discoloration. d. Hepatotoxicity.

d. Hepatotoxicity

Marci 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.

d. It is a simple treatment that should be tried first.

5. Lifestyle modifications to manage hypertension include: a. Maintaining a body mass index (BMI) of 17. b. Restricting dietary sodium to 2 g per day. c. Encouraging 90 minutes of exercise per day. d. Limiting beer intake to 24 oz/day.

d. Limiting beer intake to 24 oz/day.

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 c. Tinnitus b. Meniere's disease d. Otitis externa

d. Otitis externa

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

d. Presbycusis

Which heart sound may be heard with poorly controlled hypertension, angina, and ischemic heart disease? a. A physiologic split S2 c. S3 b. A fixed split S2 d. S4

d. S4

There are four stages of heart failure classified as A to D that describe the evolution and progression of disease. Patients in which stage have refractory symptoms of heart failure at rest despite medical therapy, are hospitalized, or require specialized interventions or hospice care? a. Stage A c. Stage C b. Stage B d. Stage D

d. Stage D