Neurology
A 62-year-old man with complaints of tremor with insidious onset and gradual worsening during the past year. The tremor is worse at rest and affects his fingers and wrist on the left side. Symptoms have become more noticeable in the past 3 months but not disabling. There is a vague family history of tremor. Which of the following examination findings is necessary to make a diagnosis of Parkinson's disease in this patient?
A 62-year-old man with complaints of tremor with insidious onset and gradual worsening during the past year. The tremor is worse at rest and affects his fingers and wrist on the left side. Symptoms have become more noticeable in the past 3 months but not disabling. There is a vague family history of tremor. Which of the following examination findings is necessary to make a diagnosis of Parkinson's disease in this patient?
Postural instability
Bradykinesia
Rigidity
Micrographia
Dysdiadochokinesis
Bradykinesia
When was the twitter account @_FloridaMan started?
2013
Which culture is generally credited with first celebrating Halloween?
The Romans
The Celts
The Ming Dynasty
The Holy Roman Empire
The Ottomans
The Celts
Which one of the following medications is most appropriate for a 25-year-old man with constipation predominant irritable bowel syndrome whose constipation is not improving with 34 g of polyethylene glycol daily?
Dicyclomine
Linaclotide
Metoclopramide
Amitriptyline
Loperamide
Linaclotide
Which one of the following tests is most likely to establish the diagnosis in a patient with episodes of spontaneously resolving chest pain, irritability, insomnia and nasal septum perforation?
Urine drug testing
In addition to empiric antibiotic therapy, which with the following treatments should be started in a previously healthy 52-year-old man with a 2-day history of altered mental status, and aphasia, tonic-clonic seizure that terminated without intervention, a temperature of 39.2 degress centigrade and a lymphocytic clear cytosis and normal glucose in CSF?
IVIG
Acyclovir
Amphotericin
Fosphenytoin
Dexamethasone
Acyclovir
Who is the current governor of Florida?
Ron DeSantis
What is America's favorite candy?
Candy apples
Candy corn
Skittles
M&M's
Snickers
Skittles
Which one of the following management approaches is most appropriate for a patient with asymptomatic hereditary hemochromatosis who has elevated iron stores with ferritin level at 859 ng/mL (30-300 range), but normal liver enzymes?
Repeat ferritin level
Begin penicillamine
Begin deferoxamine
Initiate therapeutic phlebotomy
Vitamin C supplementation
Initiate therapeutic phlebotomy
What is the best next step in managing a 56-year-old woman with depression who has been taking fluoxetine 20mg daily for 4 weeks with only partial improvement in symptoms and continued subjective distress?
Continue Fluoxetine, Add Mirtazapine
Stop Fluoxetine, Start Duloxetine
Continue Fluoxetine
Continue Fluoxetine, Add Lithium
Increase Dose of Fluoxetine
Increase Dose of Fluoxetine
Which one of the following diagnoses is most likely in a 55-year-old man with numbness of his right hand, a shooting pain from the right shoulder and along the medial side of the right forearm, diminished grip strength and finger extension, limited sensation in the right fourth and fifth fingers and medial forearm and no Tinel sign at the elbow?
Carpal tunnel syndrome
Brachioplexopathy
Ulnar neuropathy
Lacunar stroke
C8 radiculopathy
C8 radiculopathy
On which flag is the flag of Florida based on? (please be specific)
The Spanish Empire
What is the highest grossing Halloween film?
Hocus Pocus
Friday the 13th
Saw
It
Halloween
IT
A 66-year-old woman is admitted to the ICU with septic shock secondary to a UTI. She has a history of alcohol use disorder and cognitive impairment. Her liver function, INR and CBC remain normal. An abdominal US performed 3 months ago showed no evidence of cirrhosis. She has been insulated and ventilated for less than 24 hours. Patient is currently requiring norepinephrine and is on antibiotic therapy with piperacillin-tazobactam. Which one of the following strategies is most appropriate to prevent GI bleeding in this patient?
Initiate early enteral feeding and treatment with omeprazole
Initiate treatment with omeprazole
Initiate treatment with sucralfate
No prophylaxis is indicated
Initiate early enteral feeding and treatment with H2 receptor antagonist
No prophylaxis is indicated
A 35-year old man presents after an argument with his wife. He reports that his modd was fine until she told him that she was going to dinner with some friends without him. He became angry, and his temper escalated to a point where he reportedly broke a window.
He begged his wife to stay home and said he would kill himself if she went out. He then went into the bathroom and superficially lacerated the skin on his forearms and inner thighs with a razor blade.
Diagnosis:
Narcissistic
Borderline
Antisocial
Intermittent explosive
Bipolar
Borderline
A 38-year-old woman presents with low back pain and pain that radiates down the right leg to the top of the right foot. The pain worsens with coughing, sneezing and physical activity. Which one of the physical examination maneuvers is sensitive for the most likely diagnosis?
Straight leg raise
Plantar reflex
Patellar reflex
Obturator sign
Contralateral straight leg raise
Straight leg raise
What is the largest community in Citrus Country per the US census bureau?
Homosassa Springs
What was the original title of Disney's Hocus Pocus?
Halloween House
Witching Hour
The 3 Witches
Monster Mash
Halloween House
Which one of the following next steps is most appropriate for a 25-year-old man with a BMI of 22.5 who has had uncomplicated heartburn for 1 year and no other symptoms, relevant family history or history of cigarette smoking?
Trial of PPI
Esophageal mononitrate
Ambulatory pH monitoring
EGD
Barium swallow study
Trial of PPI
What form of purging is most likely being used by a patient with a history of bulimia nervosa who has laboratory evidence of hypokalemia, metabolic alkalosis, and elevated urine levels of sodium, potassium and chloride?
Ipecac
Laxative
Enema
Self-induced vomiting
Diuretic
Diuretic
A 73-year-old woman reports headaches that occur almost daily when she wakes in the morning. The headaches, which are bilateral and throbbing but not associated with photophobia or phonophobia, last an average of 30 minutes. The patient also had difficulty remaining asleep and reports daytime fatigue and irritability. The only trigger she can identify her stress, alcohol use and sleep deprivation. Her medical history is significant only for hypertension.
Which one of the following diagnoses is most likely in this case?
Migraine headache
Sleep apnea headache
Tension type headache
Meningioma
Cluster headache
Sleep apnea headache
Which European explorer was the first to "find" Florida for his nation?
Juan Ponce de Leon
Rank these Halloween costumes by popularity
Dinosaur
Witch
Spider-man
Cruella de Vil
Harley Quinn
2. Dinosaur
3. Spider-man
4. Cruella de Vil
5. Harley Quinn
A 30-year-old woman reports a 6-month history of loose, nonbloody stools with associated bloating and cramping. She has not traveled outside the United States. She has limited dairy foods from her diet but this did not improve symptoms. On physical exam her abdomen is soft and nontender to palpation. Skin exam shows no rashes. Lab testing reveals a hematocrit of 32% (36-46 range). Stool culture test for ova and parasites are negative. Which one of the following test should be ordered at this time to evaluate for celiac disease?
Human leukocyte antigen DQ 2 and DQ 8
EGD with duodenal biopsies
Endomysial IgA antibody
Deamidated gliadin peptide antibody IgG
Measurement of tTg IgA antibody and total IgA
Measurement of tTg IgA antibody and total IgA
A 36-year old man reports recent-onset ED characterized by diminished libido and difficulty obtaining an erection. He has a history of insulin-treated diabetes and depress, for which he sees a psychiatrist and therapist regularly. Three months ago, he started taking fluoxetine for his depression. He had surgery to repair a left inguinal hernia one year ago.
What would be most consistent with hypogonadism?
Is your libido intact?
Do you lose your erection during intercourse?
Have you needed to shave less often? (48%)
Do you have morning erections?
Are you able to generate an erection?
Have you needed to shave less often?