GI
JM presents with a 3 day history of black, tarry stools. Which of the following would NOT be appropriate to order as an initial diagnostic test for JM? - Endoscopy - CBC - Abdominal MRI - Fecal Occult Blood
Abdominal MRI
What is your diagnosis with the following clinical presentation? A 45 year-old mam who drinks 8-10 beers/day with a 12 hours history of acute onset epigastric pain radiating into back with bloating, nausea and vomiting. Objective: Epigastric tenderness, hypoactive bowel sound, abdomen distended and hypertympanic - Erosive gastritis - Acute pancreatitis - Acute appendicitis - Renal colic
Acute pancreatitis
A 66 year old female recently began taking medication for her high blood pressure. She now reports her heartburn has become much worse. Which medication is the most likely cause of her worsening heartburn? - Atenolol - Famotadine - Lisinopril - Amlodipine
Amlodipine
You are evaluating a 54 year old female who believes she has seen blood in her stool. Which interview findings would tend to support a diagnosis of hemorrhoids? - Anal itch, mucous leaking, streaks of bright red blood on the stool - Intermittent diarrhea, black tarry stools, perineal pain - History of rectal carcinoma, chronic constipation, absence of blood in stools - Nulliparous status, chronic high fiber intake, passage of clots with stools
Anal itch, mucous leaking, streaks of bright red blood on the stool
Which of the following is contraindicated in the treatment of a patient with ulcerative colitis? - Sulfasalazine - High-calorie diet - Antidiarrheal agents - Corticosteroids
Antidiarrheal agents
A 22 year old male is seen in your office with complaints of abdominal pain. The discomfort began as a vague epigastric pain about 14 hour ago, but has since shifted to the right lower quadrant of his abdomen. He has been nauseated with vomiting for the past 2 hours. He has positive rebound tenderness & a positive psoas sign. What do you suspect? - Cholecystitis - Appendicitis - Perineal abcess - Colitis
Appendicitis
Most likely cause for the black stools? - Prilosec - Bismuth Subsalicylate - Aspirin - Ibuprofen
Bismuth Subsalicylate
A mother has brought her 3 month old infant into your clinic with a past medical history of poor feeding & diarrhea for the past 24 hours. In your examination, you note moist mucus membranes & pink central skin tones. The fontanel is not depressed and the respirations are unlabored. Which of the following would you also check as a physical indication of possible fluid deficit? - Respiratory rate - Fever - Central pulses - Capillary refill
Central pulses
A 44 year old female is seen in your office with a 10 hour history of right upper quadrant pain, radiating to the shoulder. Her temperature is 101F. She admits to episodic chilling. When questioned, she reports having had similar symptoms for the past couple of months that were self resolving after 24-36 hours. This one is worse than the others, though. Her current weight is 134, although 3 months ago she weight 172#. She admits to being on one of those "fad diets" to lose weight quickly. Your most likely diagnosis for consideration would be? - Cholecystitis - Diverticulitis - Appendicitis - Pancreatitis
Cholecystitis
BO is a 38 year old male who presents to your clinic with a night time cough and a raspy voice for 3 months. After questioning BO he does admit to some heartburn after meals for which he uses over the counter antacids without much relief. What would be the recommended treatment option for BO? - Eliminate foods that reduce LES pressure, stop smoking, sleep with head of bed elevated and continue the OTC antacids as needed. - Refer to GI for consideration for fundoplication. - Eliminate caffeine from the diet, do not eat 1 hour prior to bedtime and Omerprazole 40 mg at bedtime. - Dietary modifications, do not eat 4 hour prior to bedtime and Ranitidine 150 mg PO once daily.
Dietary modifications, do not eat 4 hour prior to bedtime and Ranitidine 150 mg PO once daily.
PB presents to your clinic with a 1 day history of abdominal pain. Upon examination PB demonstrates LLQ tenderness, involuntary guarding and rigidity. Fecal Occult Blood is positive and CBC shows mild leukocytosis. Past medical history: Asthma, Diverticulosis, GERD and sleep apnea. She currently takes no prescription medications. What is the most likely diagnosis? - Acute constipation - Colon Cancer - Diverticulitis - Appendicitis
Diverticulitis
What is your diagnosis with the following clinical presentation? A 34 year-old man with 3 months history of intermittent upper abdominal pain described as epigastric burning, gnawing pain about 2-3 hours after meal. Relief with foods and antacids. Awakening at 1-2 AM with symptoms. Objective: Tender at the epigastrium, LUQ, slightly hyperactive bowel sounds - Duodenal Ulcer - Renal colic - Acute pancreatitis - Acute appendicitis
Duodenal Ulcer
You are caring for 44 year old female with complaints of stomach pains that occur before meals. She reports she often feels better for awhile after eating, but then the nagging pain returns. You suspect an ulcer. Which of the following tests would be most appropriate to order in her care? - Thyroid profile - Barium enema - Abdominal ultrasound - H. pylori
H. pylori
Which of the following is most likely to be reported in a patient with severe GERD? - Chronic sore throat - Diarrhea - Hematemesis - Melena
Hematemesis
You are caring for a 14 year old male who recently attended his local community rodeo. He was there for two days, ate food from several booths, played all the games he could afford, & now is experiencing symptoms of marked tiredness, nausea, vomiting, and loss of appetite. His mother thinks his color looks faintly sallow. The rest of his history is unremarkable. What do you suspect? - Hepatitis A infection - Mononucleosis - Dysentery - Appendicitis
Hepatitis A
All of the following are risk factors for cholecystitis except? - Obesity - Hypocholesterolemia - Rapid weight loss - Pregnancy
Hypocholesterolemia
You are caring for a 32 year old male with celiac disease. He is at your office for follow up. When questioning him about his dietary habits, which of the following answers show he understands the - I avoid all solid, difficult to digest foods. - I eat fruits, vegetables, & grains. I avoid red meats. - I stay away from breads & cereal products. - I eat mostly foods with low residue.
I stay away from breads & cereal products
Why are proton pump inhibitors generally prescribed for the treatment of ulcers? - Increase the rate of stomach emptying - Inhibit the action of the COX-1 enzyme - Coat the stomach, offering protection from stomach acid - Inhibit stomach acid secretion
Inhibit stomach acid secretion
You are evaluating an 18 month old female patient. The mom reports she's had colicky abdominal pain. She also reports the child drew her legs up to her abdomen & screamed uncontrollably about 8 hours ago. The child vomited, the pain subsided, & then she was sleepy. Some time after the pain started, the child passed a bloody/mucus-like stool. What do you suspect? - Intussusception - Crohn's disease - Appendicitis - GERD
Intussusception
You are examining a 2 year old child in your office for her wellness exam. When examining her abdomen you note her spleen is 1 cm below her left costal margin. The rest of her exam is unremarkable. Which of the following statements is correct regarding this finding? - It is normal. - It is indicative of infection. - It is indicative of carcinoma. - It is indicative of an enlarged spleen.
It is normal.
In differentiating between Hirschsprung's disease & functional constipation, which symptom is NOT generally associated with Hirschsprung's disease? - Failure to thrive - Lack of abdominal pain - Large, formed stools - Male gender
Large, formed stools
When examining a 33 year old female for suspected gall bladder disease, which of the following signs would you expect to be positive? - Right lower quadrant rebound tenderness - Obdurator sign - Lachman's test - Murphy's sign
Murphy's sign
Which of the following is most likely to be found in a patient with erosive gastritis? - Melena - H Pylori infection - NSAID use - Weight gain
NSAID use
A 32 year old female is in your office with nausea & vomiting after attending her sisters wedding reception the day before. You suspect an uncomplicated Salmonella infection based upon the information she gives to you. What is the antibiotic of choice for her treatment? - No antibiotic is indicated - Ciprofloxin - Ampicillin - Azithromycin
No antibiotic is indicated
A nursing student is about to begin her series of hepatitis B vaccinations. In reviewing her records, you note she was previously positive for hepatitis B surface antibodies (HbsAb). What instructions would you give her? - Obtain a HcsAb screen before beginning the immunizations - Begin her scheduled series of immunizations - Not worry about the vaccinations; she's already immune - Contact her physician about the possibility of a previous hepatitis C infection
Not worry about the vaccinations; she's already immune
You are examining a 10 month old infant whom you suspect has GERD. Which of the following is NOT a potential complication of the disease? - Pneumonia - Failure to thrive - Dysphagia - Obesity
Obesity
You are examining the chart of a new patient. In a recent report, you note the findings of Grey Turner's & Cullen's signs. What would these indicate? - Pancreatitis - Pregnancy - Appendicitis - Splenic rupture
Pancreatitis
Ann is a 53 year old female who is complaining of left upper quadrant pain. All of the following will be in your differential diagnosis except? - Gastric ulcer - Pelvic inflammatory disease - Pancreatitis - Pleurisy
Pelvic inflammatory disease
A 54 year old male is seen in your office with a 3 day history of intermittent bloody vomiting. Which of the following is NOT a cause of upper gastrointestinal bleeding? - Esophageal varices - Peptic ulcer disease - Rectal carcinoma - Erosive gastritis
Rectal carcinoma
Mary is scheduled to have an ileostomy performed as treatment for her inflammatory bowel disease. What type of fecal output do you counsel her to expect? - Intermittent, soft stools with mild odor - Continuous, semi-formed, mostly odorless stools - Hard, marble-like intermittent stools - Very liquid/soft to watery stools, with strong odor
Very liquid/soft to watery stools, with strong odor
