The Daily PANCE and PANRE (Questions 1-120)
Questions 1-120
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A | order a serum acid phosphatase level |
B | initiate prazosin and schedule a follow-up appointment in 6 weeks |
C | refer the patient for an ultrasound of the prostate and order a PSA level |
D | reassure the patient and schedule a follow-up appointment in six months |
E | initiate norfloxacin therapy for 7 days and schedule follow-up in two weeks
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Question 2 |
A | leukonychia Hint: Leukonychia is often associated with hypoalbuminaemia that causes partial or complete white discoloration of the nails. Leukonychia may also appear as a rare side effect of systemic chemotherapy in some oncological patients but may also be present with arsenic poisoning, renal failure pneumonia, or heart disease. |
B | koilonychia |
C | clubbing Hint: Clubbing of the nails is an actual thickening or elevation of the nail bed - it is a sign of release of TNF associated with pulmonary disorders (tissue necrosis factor) typically found in bronchiectasis, lung cancers and cystic fibrosis (the nails are NOT necessarily cyanotic.)
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D | onycholysis Hint: Onycholysis is a painless separation of the nail from the nail bed. Several or all nails are usually affected - there are many causes. |
E | paronychia Hint: Paronychia is an infection of the nail bed and nail margin, usually from trauma or more commonly, nail-biting. |
Question 3 |
A | proteinuria |
B | hematuria |
C | hypoalbuminemia |
D | hyperlipidemia |
E | generalized edema |
Question 4 |
A | Silicosis |
B | Sarcoidosis |
C | Alpha-1 antitrypsin deficiency |
D | Histoplasmosis |
E | Tuberculosis |
Question 5 |
A | progressive systemic sclerosis Hint: PSS involves squamous cell thickening and sclerosis causing taut skin of the face and hands and difficulty with esophageal motility. |
B | CREST syndrome Hint: CREST syndrome is a subset of PSS; |
C | osteoarthritis |
D | rheumatoid arthritis |
E | ankylosing spondylitis Hint: Ankylosing spondylitis would have an elevated ESR and negative RF, but mainly involves the SI joint and lumbar/thoracic spine fusion (bamboo spine) |
Question 6 |
A | TSH level Hint: The TSH level would not be indicated (she has not had a pg loss) |
B | hysterosalpingogram |
C | laparoscopy Hint: lap could diagnose the tubal scarring but would be done after an abnormal HSG |
D | PAP smear Hint: Pap smear is screening for cervical cancer and not indicated in this case of infertility; |
E | pelvic ultrasound Hint: pelvic US would yield nothing diagnostically about the tubes. |
Question 7 |
A | pH = 7.52; pC02 = 28; p02 = 80 |
B | pH = 7.44; pC02 = 38; p02 = 70 |
C | pH = 7.60; pC02 = 18; p02 = 60 |
D | pH= 7.40; pC02 = 40; p02 = 60 |
E | pH = 7.27; pC02 - 62; p02 = 64 |
Question 8 |
A | compression fractures secondary to obesity |
B | degenerative joint disease |
C | Potts disease |
D | compression fractures secondary to osteoporosis |
E | spondylolisthesis |
Question 9 |
While suturing a wound, you opt to use lidocaine with epinephrine. The rationale for your choice is:
A | an increase in the absorption of the lidocaine. |
B | an increase in the diffusion of the lidocaine into the nerve's myelin sheath. |
C | an increase in the blood flow to the area of injection. |
D | an increase in the duration of anesthesia. |
E | a decrease in the risk of infection at the site of injection. |
Question 10 |
A | Wenckebach Hint: Wenckebach AVB would have a non-conducted P wave. |
B | third degree heart block Hint: Third degree AVB would have a non-conducted P wave. |
C | atrial fibrillation Hint: A fib would have no P waves and an irregularly irregular rhythm |
D | sinus arrhythmia |
E | atrial flutter Hint: A flutter would have "flutter waves" or a regular rhythm of 150. |
Question 11 |
A | Escherichia coli. |
B | Listeria monocytogenes. |
C | Cytomegalovirus. |
D | Herpesvirus. |
E | Hemophilus influenzae. |
Question 12 |
A | pterygium Hint: Pterygium involves the sclera. |
B | chalazion |
C | ectropion Hint: Ectropion is when the eyelid sags outwardly and the lid doesn't close well. |
D | external hordeolum Hint: Hordeolum are acute and red and painful. |
E | internal hordeolum Hint: Hordeolum are acute and red and painful. |
Question 13 |
A | CT scan Hint: CT would be the imaging test of choice. |
B | skull radiographs |
C | MRI scan Hint: MRI should be done for a more chronic bleed. |
D | EEG Hint: EEG would help to establish brain activity. |
E | PET scan Hint: PET scan (while not done often) would establish physiologic function (uptake of glucose). |
Question 14 |
A | chronic lymphocytic leukemia (CLL) Hint: CLL has no clear distinguishing feature except increased lymphocytes. |
B | acute lymphocytic leukemia (ALL) Hint: ALL occurs in children. |
C | chronic myelogenous leukemia (CML) |
D | acute myelogenous leukemia (AML) Hint: AML is associated with Auer rods |
E | multiple myeloma Hint: Multiple myeloma has Bence-Jones protein. |
Question 15 |
A | a low TSH (thyroid stimulating hormone) level and a high T4 |
B | a low TSH level and a normal T4 |
C | a low TSH level and a low T4 |
D | a high TSH level and a low T4 |
E | a high TSH and a high T4 |
Question 16 |
A | hiatal hernia. |
B | pregnancy |
C | scleroderma. |
D | an incompetent esophageal sphincter |
E | pernicious anemia. |
Question 17 |
A | alpha-methyldopa |
B | captopril Hint: ACEI's are contraindicated in pg. |
C | nifedipine Hint: CCB's (while not contraindicated) should be avoided. |
D | propranolol Hint: B-Blockers can be used but may cause growth restriction. |
E | clonidine Hint: centrally acting agents (while not contraindicated) should be avoided. |
Question 18 |
A | Salter-Harris Type III |
B | Salter Harris Type IV |
C | Salter Harris Type V |
D | torus |
E | greenstick Hint: Greenstick fracture is also common in children in long bones and is a fracture which "bends" the bone without fracturing it. |
Question 19 |
A | hemorrhage in the distribution of his posterior cerebral artery |
B | hemorrhage in the distribution of the middle cerebral artery |
C | hypodensity measuring 12 mm by 21 mm in the distribution of the posterior cerebral artery |
D | hypodensity measuring 4 mm by 4 mm in the internal capsule |
E | calcifications bilaterally, in the third ventricles Hint: Calcifications are not indicative of stroke at all |
Question 20 |
A | calcium |
B | diazepam |
C | an amphetamine |
D | additional magnesium |
E | oxygen |
Question 21 |
A | pityriasis rosea. |
B | tinea corporis |
C | psoriasis. |
D | atopic dermatitis. |
E | sporotrichosis |
Question 22 |
A | cirrhosis |
B | nephrotic syndrome |
C | congestive heart failure |
D | cystitits |
E | pyelonephritis |
Question 23 |
A | albuterol |
B | cromolyn sodium |
C | prednisone |
D | theophyline |
E | epinephrine |
Question 24 |
A | Rheumatoid arthritis |
B | Systemic Lupus Erythematosis |
C | Wegener's granulomatosis |
D | Sjogren's Syndrome |
E | Scleroderma |
Question 25 |
A | Toxoplasmosis |
B | Histoplasmosis |
C | lymphoma |
D | Cytomegalovirus Hint: CMV is common as well and typically causes retinitis. |
E | Herpes encephalitis Hint: Herpes encephalitis can happen frequently too, but causes a diffuse encephalitis. |
Question 26 |
A | von Gierke's disease Hint: Von Gierke disease is a condition in which the body cannot break down glycogen for energy. Gycogen is stored in the liver and muscles and is normally broken down into glucose when you do not eat.
Von Gierke disease is also called Type I glycogen storage disease (GSD I). |
B | Hurler's syndrome |
C | cystic fibrosis |
D | Hunter's syndrome |
E | Cri du chat syndrome |
Question 27 |
A | Streptococcal pneumoniae pneumonia Hint: S. pneumo is the most common CAP, but would present with a focal/lobar consolidation. |
B | Mycoplasma pneumoniae pneumonia Hint: While mycoplasma patients can be acutely ill, they are more likely (especially on the Boards) to present as mildly ill with normal PE and no hypoxia. |
C | Pneumocystis carinii pneumonia |
D | Bowen's disease |
E | Steven-Johnson syndrome |
Question 28 |
A | anterior cerebral |
B | middle cerebral |
C | posterior cerebral |
D | internal carotid |
E | external carotid |
Question 29 |
A | third degree heart block Hint: in third degree, there is no rhyme or reason to the rhythm. |
B | Mobitz Type II heart block Hint: In Mobitz II, the PR intervals are the same - so no "grouped" beating |
C | Mobitz Type I heart block |
D | first degree heart block |
E | sinus tachycardia |
Question 30 |
A | rubella Hint: Rubella has mild illness with a fine macular rash. |
B | rubeola Hint: Rubeola (measles) is an acute illness, the child is toxic, has conjunctivitis and Koplik spots. |
C | erythema infectiosum (Fifth's disease) Hint: Fifth's disease has mild illness with a "lacey" rash on the extremities. |
D | Roseola |
E | chicken pox Hint: Chicken pox has vesicles. |
Question 31 |
A | Topical corticosteroids Hint: Topical corticosteroids are not used to treat diabetic retinopathy. They may be used to reduce inflammation in the eye in certain conditions, but they do not address the underlying issue of abnormal blood vessel growth in the retina. |
B | Laser photocoagulation |
C | Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections Hint: Intravitreal anti-VEGF injections are used to treat macular edema and some types of PDR, but they are not the first-line treatment for PDR. They are usually reserved for cases that do not respond to laser photocoagulation or in combination with laser therapy. |
D | Oral hypoglycemic agents Hint: Oral hypoglycemic agents are used to control blood sugar levels in patients with diabetes but do not treat the underlying cause of diabetic retinopathy. |
E | Beta blockers Hint: Beta blockers are used to treat conditions such as hypertension, glaucoma, and migraines, but they are not used to treat diabetic retinopathy. |
Question 32 |
A | penicillin |
B | amantadine |
C | erythromycin |
D | acyclovir |
E | cephalexin |
Question 33 |
From the list of disorders (A-E), choose the one that BEST matches the descriptions of classic hematologic changes associated with it. Each choice is to be used once, more than once, or not at all.
Hematologic change: Elevated reticulocyte count; Negative guaiac test; Elevated serum LDH
A | Thalassemia Hint: Thalassemia is a microcytic anemia, with no reticulocytosis (no cell lysis), and a negative guaiac. |
B | Lead poisoning Hint: Lead poisoning would cause a microcytosis with basophilic stippling and sideroblasts. |
C | Folate deficiency Hint: Folate deficiency is a macrocytic anemia with no reticulocytosis (until you give folate)
|
D | Malignant hypertension |
E | Late iron deficiency Hint: Late iron deficiency anemia, treated with iron would be a microcytic anemia with an elevated reticulocytosis and a positive guaiac (presumably the iron deficiency is from a GI bleed) |
Question 34 |
A | Thalassemia Hint: Thalassemia is a microcytic anemia, with no reticulocytosis (no cell lysis), and a negative guaiac. |
B | Lead poisoning |
C | Folate deficiency Hint: Folate deficiency is a macrocytic anemia with no reticulocytosis (until you give folate) |
D | Malignant hypertension Hint: Malignant hypertension causes a hemolysis (so an elevated retic, increased LDH and negative guaiac) |
E | Late iron deficiency Hint: Late iron deficiency anemia, treated with iron would be a microcytic anemia with an elevated reticulocytosis and a positive guaiac (presumably the iron deficiency is from a GI bleed) |
Question 35 |
From the list of disorders (A-E), choose the one that BEST matches the descriptions of classic hematologic changes associated with it. Each choice is to be used once, more than once, or not at all.
Hematologic change: No reticulocytosis; High MCV
A | Thalassemia Hint: Thalassemia is a microcytic anemia, with no reticulocytosis (no cell lysis), and a negative guaiac. |
B | Lead poisoning Hint: Lead poisoning would cause a microcytosis with basophilic stippling and sideroblasts. |
C | Folate deficiency |
D | Malignant hypertension Hint: Malignant hypertension causes a hemolysis (so an elevated retic, increased LDH and negative guaiac) |
E | Late iron deficiency Hint: Late iron deficiency anemia, treated with iron would be a microcytic anemia with an elevated reticulocytosis and a positive guaiac (presumably the iron deficiency is from a GI bleed) |
Question 36 |
From the list of disorders (A-E), choose the one that BEST matches the descriptions of classic hematologic changes associated with it. Each choice is to be used once, more than once, or not at all.
Hematologic change: Elevated reticulocyte count; Low MCV; Positive guiac test
A | Thalassemia Hint: Thalassemia is a microcytic anemia, with no reticulocytosis (no cell lysis), and a negative guaiac |
B | Lead poisoning Hint: Lead poisoning would cause a microcytosis with basophilic stippling and sideroblasts. |
C | Folate deficiency Hint: Folate deficiency is a macrocytic anemia with no reticulocytosis (until you give folate) |
D | Malignant hypertension Hint: Malignant hypertension causes a hemolysis (so an elevated retic, increased LDH and negative guaiac) |
E | Late iron deficiency |
Question 37 |
From the list of disorders (A-E), choose the one that BEST matches the descriptions of classic hematologic changes associated with it. Each choice is to be used once, more than once, or not at all.
Hematologic change: No reticulocytosis; Low MCV
A | Thalassemia |
B | Lead poisoning Hint: Lead poisoning would cause a microcytosis with basophilic stippling and sideroblasts. |
C | Folate deficiency Hint: Folate deficiency is a macrocytic anemia with no reticulocytosis (until you give folate) |
D | Malignant hypertension Hint: Malignant hypertension causes a hemolysis (so an elevated retic, increased LDH and negative guaiac) |
E | Late iron deficiency Hint: Late iron deficiency anemia, treated with iron would be a microcytic anemia with an elevated reticulocytosis and a positive guaiac (presumably the iron deficiency is from a GI bleed) |
Question 38 |
A | primary hypothyroidism Hint: Primary hypothyroidism (Hashimoto's) is low T4 with a high TSH. |
B | secondary hypothyroidism Hint: Secondary hypothyroidism (from pituitary disease) is a low T4 with a low TSH. |
C | T3 thyrotoxicosis |
D | Graves disease |
E | chronic Hashimoto's thyroiditis |
Question 39 |
A | Barretts esophagus. Hint: Barrett's causes GERD symptoms and dysplasia of the esophageal mucosa. |
B | achalasia. |
C | Plummer-Vinson syndrome. |
D | Dresslers syndrome. |
E | Ogilvies syndrome. |
Question 40 |
A | epinephrine Hint: Ritodrine and epinephrine cause beta sympathetic stimulation |
B | albuterol Hint: Albuterol is a beta agonist. |
C | propranolol Hint: Propranolol is a beta blocker. |
D | prazosin |
E | ritodrine Hint: Ritodrine and epinephrine cause beta sympathetic stimulation |
Question 41 |
A | cubitus valgus |
B | cubitus varus |
C | genu valgus Hint: Valgus deformity forms an "L" in the knock-kneed child, and has an "L" in the middle of it (try it, it works) |
D | genu varum |
E | Legg-Calve-Perthes disease |
Question 42 |
A | Gonorrhea |
B | Chlamydia |
C | Candidiasis |
D | bacterial vaginosis |
E | Trichomoniasis |
Question 43 |
A | Auspitz sign Hint: Auspitz sign is also present in psoriasis where the scales bleed when removed. |
B | Koebner's phenomenon |
C | Darier's sign Hint: Darier's sign is in allergic patients who develop urticaria when the skin is rubbed. |
D | Gorlin's sign Hint: Gorlin's sign is seen in Ehlers-danlos when a patient can touch the tip of the nose with his tongue (I learn something new every day!!) |
E | Gottron's papules Hint: Gottron's papules are purple papules on the fingers seen in dermatomyositis. |
Question 44 |
A | acute otitis media Hint: OM would not cause periauricular nodes and tragal tenderness. |
B | acute otitis externa |
C | eustachian tube dysfunction Hint: Eustachian tube dysfn would cause middle ear pain (like when you're up in a plane). |
D | Ramsey-Hunt syndrome Hint: Ramsey- Hunt is herpes zoster of the ear canal and would be visible. |
E | perforated tympanic membrane Hint: A perforated TM would cause middle ear, not external ear pain (typically). |
Question 45 |
A | hydrochlorothiazide-triamterene |
B | prazosin |
C | nifedipine |
D | verapamil |
E | furosemide |
Question 46 |
A | tricyclic antidepressants |
B | barbiturates |
C | benzodiazepines |
D | monoamine oxidase inhibitors |
E | phenothiazines |
Question 47 |
A | lovastatin |
B | hydrochlorothiazide. |
C | dexamethasone |
D | phenytoin |
E | ampicillin |
Question 48 |
A | XO |
B | XXY Hint: XXY is the genotype for Klinefelter's (which is a tall, mildly retarded male). |
C | XXX Hint: Trisomy 21 is Down's.
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D | XXXY |
E | Trisomy 21 |
Question 49 |
A | repeat the chest x-ray in six months |
B | ultrasound of the left hemithorax |
C | bone scan |
D | CT scan of the chest |
E | proceed directly to bronchoscopy with biopsy |
Question 50 |
A | Streptococcal pneumoniae. |
B | Chlamydia. |
C | Hemophilus influenzae. |
D | Staphylococcus aureus. |
E | Legionella pneumophila. |
Question 51 |
A | Simple pneumothorax Hint: The "normal CXR" is what rules out the pneumothorax - another common problem in a stabbing injury.) |
B | Tension pneumothorax Hint: The "normal CXR" is what rules out the pneumothorax - another common problem in a stabbing injury. |
C | Pericardial Tamponade |
D | aortic laceration distal to the origin of the left common carotid artery |
E | inferior vena cava laceration |
Question 52 |
A | esophageal spasm |
B | hiatal hernia |
C | acute lateral wall subendocardial myocardial ischemia |
D | acute inferior wall myocardial subendocardial ischemia Hint: Inferior AMI is leads II, III, avF |
E | acute anterior wall myocardial transmural ischemia Hint: Anterior wall AMI is leads +- VI, with V2-V4, and maybe V5& V6. |
Question 53 |
A | shingles. |
B | Ramsey-Hunt syndrome. |
C | erythema infectiosum. |
D | herpes simplex, |
E | varicella |
Question 54 |
A | flourescein staining of the ey Hint: Flouroscein staining is for a corneal abrasion - it should not be done if the globe is penetrated |
B | pressing on the globe to assess intraocular pressure |
C | an X-ray of the orbits |
D | testing the extra-ocular eye muscles |
E | having the patient finger count |
Question 55 |
A | aspirin |
B | acetaminophen |
C | acyclovir |
D | phenytoin |
E | valproic acid |
Question 56 |
A | bowel obstruction |
B | peeling of the infant's skin |
C | aspiration pneumonitis and respiratory distress syndrome |
D | infection with E. coli |
E | intrauterine cataract formation and sensorineural hearing loss |
Question 57 |
A | cerebral contusion |
B | subarachnoid hemorrhage |
C | epidural hematoma |
D | diabetes insipidus |
E | renal contusion |
Question 58 |
A | The larger the colonic polyp, the greater the risk of malignant transformation |
B | Villous adenomas have a 30-70% risk of malignant transformation. |
C | The greater the number of concomitant colonic polyps, the greater the risk of malignant transformatio |
D | The majority of colonic polyps are hyperplastic in origin |
E | The majority of colonic polyps are > 3 cm in size. |
Question 59 |
A | left ventricular dysfunction. |
B | a shortened PR interval. |
C | the presence of delta waves. |
D | large pericardial effusions. |
E | marked left ventricular hypertrophy. |
Question 60 |
A | first (thumb) |
B | second (index) |
C | third (long) |
D | fourth (ring) |
E | fifth (pinky) |
Question 61 |
A | cervicitis. |
B | pelvic inflammatory disease. |
C | dysfunctional uterine bleeding. |
D | an ectopic pregnancy. |
E | vaginitis. |
Question 62 |
A | acute case of balanitis |
B | varicocele. |
C | hydrocele. Hint: Hydrocele is just a water collection in the scrotum. |
D | spermatocele. Hint: Spermatocele is just a fluid collection which happens to contain sperm (sperm are not palpable). |
E | paraphimosis. |
Question 63 |
A | hypochondriasis |
B | sialolithiasis |
C | parotitis. Hint: Parotitis would be inflammation and infection of the parotid gland (usually due to a stone that is stuck in the duct). A parotitis patient would be acutely ill with redness of the gland and fever. |
D | an abscessed tooth. |
E | conjunctivitis manibularis. |
Question 64 |
A | proteinuria |
B | a progressive decline in the creatinine clearance |
C | an elevated serum haptoglobin |
D | renal insufficiency |
E | microalbuminuria |
Question 65 |
A | loculated effusion |
B | chylothorax. Hint: Chylo thorax suggest a transudative effusion (not purulent). |
C | empyema. |
D | hydrothorax. Hint: hydro thorax suggest a transudative effusion (not purulent). |
E | hemothorax. Hint: hemothorax is blood. |
Question 66 |
A | chest x-ray |
B | echocardiogram |
C | aortic angiogram |
D | abdominal flat plate |
E | aortic ultrasound |
Question 67 |
A | anal abseess Hint: Abscess would be constant |
B | perianal fistula Hint: fistula would drain |
C | proctalgia fugax |
D | ulcerative colitis Hint: UC would cause bloody mucousy diarrhea |
E | internal hemorrhoids. Hint: hemorrhoids would cause no pain, but bleeding. |
Question 68 |
A | chronic emphysema |
B | chronic bronchitis |
C | chronic bronchitis with hypersensitive airways (asthmatic bronchitis) |
D | cor pulmonale |
E | bronchiectasis |
Question 69 |
A | rifampin |
B | isoniazid |
C | streptomycin |
D | ethambutol |
E | para-aminosalicylic acid |
Question 70 |
A | Salter Harris Type I Hint: Salter I = slight increase in Space between epiphyseal plate and metaphysic |
B | Salter Harris Type II |
C | Salter Harris Type III Hint: Salter III = fx Lower (in the epiphyseal plate) |
D | Salter Harris Type IV Hint: Salter IV = fit Through (both the metaphysic and epiphysis) |
E | Salter Harris Type V Hint: Salter V = Really bad (comminuted fx compressing the epiphysis) This spells SALTR and may help you remember. |
Question 71 |
A | a hiatal hernia visualized on chest x-ray |
B | a normal erythrocyte sedimentation rate |
C | calcified "popcorn" lesions in the lung fields bilaterally |
D | diffuse ST segment elevation on his electrocardiograph |
E | a widened Aa gradient on his arterial blood gas |
Question 72 |
A | white blood count and differentia |
B | urinalysis |
C | CSF analysis |
D | serum glucose |
E | chest X-ray (CXR) |
Question 73 |
A | conjunctivitis |
B | glaucoma |
C | iritis |
D | Herpes keratitis |
E | blepharitis |
Question 74 |
A | multiple sclerosis Hint: MS may have dysarthria, but reflexes are normal, sensation is impaired and bladder function is frequently affected |
B | Alzheimer's disease Hint: Alzheimer's has normal neuro exam with cognitive disability. |
C | Huntington's chorea Hint: Huntington's causes a movement disorder with writhing choreiform movements of the body |
D | amyotrophic lateral sclerosis |
E | myasthenia gravis Hint: Myasthenia causes fatigue of the ocular muscles typically worsening at the end of the day. |
Question 75 |
A | elevated serum calcium |
B | osteoporosis |
C | "punched out" osseous lesions |
D | plasma cell infiltration of bone marrow |
E | hypogammaglobulinemia |
Question 76 |
A | low testosterone levels in men |
B | low levels of physical activity |
C | inadequate dietary protein |
D | cigarette smoking |
E | chronic corticosteroid use |
Question 77 |
A | mesenteric ischemia |
B | diverticulitis |
C | mesenteric adenitis |
D | cholecystitis |
E | proctitis |
Question 78 |
A | atenolol |
B | metoprolol |
C | nadfilol |
D | propranolol |
E | pindolol |
Question 79 |
A | rheumatoid arthritis |
B | septic arthritis |
C | pseudogout gout Hint: Calcium Pyrophosphate (pseudogout) is Prism-shaped crystals with Positive |
D | aseptic arthritis |
E | gout |
Question 80 |
A | tetracycline Hint: Tetracyclines (A & E) should be avoided. |
B | penicillin Hint: PCN does not work for Chlamydia. |
C | norfloxacin Hint: Quinolones (norfloxacin) are contraindicated. |
D | erythromycin |
E | doxycycline |
Question 81 |
A | brown recluse spider |
B | black widow spider |
C | scorpion
|
D | Dermacentor andersoni tick |
E | the centipede |
Question 82 |
A | prerenal cause Hint: In pre-renal ARF, the sodium content of the urine would be decreased (because the patient is volume depleted, so the kidneys try to retain Na - less is in the urine) |
B | intrarenal — glomerulonephritis |
C | intrarenal — acute tubular necrosis Hint: In intrarenal disease, the urine would contain casts. |
D | intrarenal — interstitial nephritis |
E | postrenal cause |
Question 83 |
A | naloxone. |
B | pentazocine. |
C | nalbuphine. |
D | methadone. |
E | buprenorphine. |
Question 84 |
A | the intensity of the murmur increases during a valsalva maneuver |
B | the intensity of the murmur decreases during standing |
C | the murmur does not change while the patient squat |
D | the intensity of the murmur decreases during exercise |
E | elevation of the legs while the patient is supine increases the intensity of the
murmur |
Question 85 |
A | pleural fluid:serum LDH ratio >0.6 |
B | pleural fluid specific gravity < 1.006 |
C | pleural fluid without protein |
D | pleural fluid without LDH |
E | pleural fluid:serum protein ratio <0.5 |
Question 86 |
A | periumbilical pain early |
B | localized RLQ pain late |
C | WBC>22,000 |
D | Rebound tenderness |
E | Low grade fever |
Question 87 |
A patient presents with severe diarrhea described as watery and bloody. He states he ate some chicken at a farm and wasn't sure if it was cooked well enough. His stool demonstrates many WBC's and S-shaped gram-neg rods. Which of the following antimicrobial agent of choice should be used to treat this patient?
A | metronidazole |
B | erythromycin |
C | ampicillin |
D | ciprofloxacin |
E | doxycycline |
Question 88 |
A | acute bacterial prostatitis |
B | spigelian hernia |
C | calyceal obstruction |
D | acute biliary colic |
E | dissecting aortic aneurysm |
Question 89 |
A | bretylium 500 mg intravenously |
B | verapamil 5 mg intravenously |
C | adenosine 6 mg intravenously |
D | digoxin 0.5 mg intravenously |
E | lidocaine 100 mg intravenously |
Question 90 |
A | the anterior aspect of the lung bases |
B | the lingual of the left lung |
C | the right middle lobe |
D | the posterior aspect of the lung bases |
E | the apices of the lungs |
Question 91 |
A | elliptical pupils |
B | a rounded head |
C | a double row of caudal plates |
D | the length of the snake |
E | the presence of a black band next to a red band |
Question 92 |
A | rubella vaccine |
B | rubeola vaccine |
C | hepatitis B vaccine |
D | influenza vaccine |
E | tetanus vaccine |
Question 93 |
A | verapamil |
B | digoxin |
C | captopril |
D | acetaminophen |
E | lovastatin |
Question 94 |
A | delivering the first child at an age greater than 40 years old |
B | a positive family history of ovarian cancer |
C | present age greater than 50 years old |
D | being nulliparous |
E | oral contraceptive use |
Question 95 |
A | promethazine |
B | metoclopramide |
C | sumitriptan |
D | trimethobenzamide |
E | ketorolac |
Question 96 |
A | thrombocytopenia |
B | malnutrition |
C | the presence of catheters or shunts for therapeutic intervention |
D | neutropenia |
E | splenectomy |
Question 97 |
A | Cushing's syndrome |
B | Cushing's disease |
C | Addison's disease |
D | acromegaly |
E | scarlet fever |
Question 98 |
A | reducable |
B | irreducible |
C | incarcerated Hint: Incarcerated means "not reducible" |
D | strangulated |
E | indirect |
Question 99 |
A | hypertensive emergency Hint: Hypertensive emergencies are severe elevations in blood pressure (BP) that are complicated by evidence of progressive target organ dysfunction, and will require immediate BP reduction (not necessarily to normal ranges) to prevent or limit target organ damage. Examples include: hypertensive encephalopathy, intracranial hemorrhage, unstable angina pectoris, or acute myocardial infarction, acute left ventricular failure with pulmonary edema, dissecting aneurysm, or eclampsia. While the level of BP at the time of presentation is usually very high (greater than 180/120 mm Hg), keep in mind that it is not the degree of BP elevation, but rather the clinical status ofthe patient that defines a hypertensive emergency. For example, a BP of 160/100 mm Hg in a 60-year-old patient who presents with acute pulmonary edema represents a true hypertensive emergency. |
B | hypertensive urgency |
C | malignant hypertension |
D | idiopathic hypertension |
E | hypertension of undetermined etiology |
Question 100 |
A | lateral epicondylitis. |
B | medial epicondylitis. |
C | olecranon bursitis. |
D | nursemaid's elbow. |
E | a dislocated elbow. |
Question 101 |
A | Sheehan's syndrome Hint: I would choose Sheehan's syndrome if the question stated that the patient had a postpartum hemorrhage |
B | prolactin - secreting adenoma |
C | Frohlich's syndrome |
D | Cushing's disease |
E | a basophilic adenoma of the pituitary |
Question 102 |
A | erythema multiforme |
B | erythem nodosum Hint: erythema nodosum causes PAINFUL purple nodules on the anterior shins. |
C | erysipelas |
D | pleurodynia |
E | erythema chronicum migrans |
Question 103 |
A | Infectious mononucleosis is caused by the Epstein-Barr virus. |
B | Most adults (>90%) have been infected with the Epstein-Barr virus |
C | Splenic rupture is a dreaded complication of infectious mononucleosis. |
D | Streptococcal pharyngitis and infectious mononucleosis never coexist. |
E | The usual mode of transmission of the viral etiology of infectious mononucleosis is through infected saliva. |
Question 104 |
A | an increase in daily water intake |
B | an increase in daily sodium chloride intake |
C | a reduction in daily sugar consumption |
D | a reduction in daily protein consumption |
E | "normal" daily dairy product consumption |
Question 105 |
A | dysthymic disorder |
B | narcissistic disorder |
C | borderline personality disorder |
D | somatization disorder |
E | anxiety |
Question 106 |
A | rheumatoid arthritis |
B | ankylosing spondylitis |
C | systemic lupus erythematosus |
D | scleroderma |
E | periarteritis nodosa |
Question 107 |
A | hepatitis A virus |
B | hepatitis B virus |
C | hepatitis C virus |
D | hepatitis D virus |
E | hepatitis E virus |
Question 108 |
A | chest x-ray Hint: CXR is not necessary unless you suspect the patient has pneumonia. |
B | white blood cell count |
C | serum theophylline level |
D | peak expiratory flow rate |
E | arterial blood gas analysis Hint: ABG's may be indicated in a severe asthma attack, but not typically. |
Question 109 |
A | bacitracin ointment |
B | mupirocin ointment |
C | erythromycin orally Hint: Erythromycin is not a bad choice, but choose dicloxacillin for staph aureus. |
D | amoxicillin orally |
E | dicloxacillin orally |
Question 110 |
A | complete blood count |
B | random blood sugar |
C | free T4 level |
D | liver function studies |
E | head CT scan |
Question 111 |
A | physiologic split second heart sound (split S2) |
B | crackles in both lungs that do not change with coughing |
C | chest tenderness with palpation of the costosternal junctions |
D | an S4 gallop that is not present when the patient is asymptomatic |
E | sinus bradycardia |
Question 112 |
A | choanal atresia |
B | respiratory distress syndrome |
C | polycystic kidney disease |
D | congenital heart disease |
E | tracheoesophageal fistula |
Question 113 |
A | tympanic membrane |
B | cornea |
C | nasal septum |
D | contralateral pinna |
E | ipsilateral epitrochlear node |
Question 114 |
A | to reduce the stenosis of the contralateral temporal artery |
B | to reduce the swelling of the patient's berry aneurysm |
C | because the patient is at risk for developing blindness |
D | because the patient most likely has pseudotumor cerebri |
E | because of the associated risk of angioedema developing in her oropharynx |
Question 115 |
A | Pancoast tumor |
B | Tuberculosis |
C | pneumothorax |
D | superior vena cava syndrome |
E | pneumonia |
Question 116 |
A | Biot's |
B | Cheyne-Stokes Hint: may be caused by damage to respiratory centers, or by physiological abnormalities in chronic heart failure, and is also seen in newborns with immature respiratory systems and in visitors new to high altitudes. |
C | Kussmaul's |
D | Apneustic |
E | Ataxic |
Question 117 |
A | epithelial cell carcinoma |
B | gastrinoma |
C | adenocarcinoma |
D | teratoma |
E | insulinoma |
Question 118 |
A | pericardial effusion Hint: Pericardial effusion would cause diastolic pressures. |
B | aortic regurgitation |
C | arteriovenous fistula Hint: AV fistula would cause increased systolic pressures with decreased diastolic pressures as well. |
D | thyrotoxicosis Hint: Thyrotoxicosis would cause high systolic, but low diastolic pressures (increased HR reduces filling time, so less EDV). |
E | patent ductus arteriosus Hint: PDA would cause increased systolic pressures with reduced diastolic pressures. |
Question 119 |
A | radial collateral ligament of the thumb |
B | ulnar collateral ligament of the thumb |
C | flexor tendons of the thumb |
D | extensor tendons of the thumb |
E | median nerve, causing thenar musculature hypotonicity |
Question 120 |
A | a fibroadenoma. |
B | carcinoma of the breast. |
C | fibrocystic breast changes. |
D | Bowen's disease. |
E | her mammogram to be normal. |
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