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Neurology
Infectious disease
Women's Health
Geriatrics
100
B. Parkinsons disease Thallomotomy and pallidotomy, contralateral to the side of the body that is most affected, are most effective for the treatmment of disabling unilateral tremor and dyskinesis from Parkinson,s disease.
Pallidotomy is surgical therapy for 1. Alzeimers disease 2. Pakinson,s disease 3. Huntington,s chorea 4. Vascular dementia 5. Temporal lobe epilepsy
100
An intensely pruritic, vesicular rash that is localized to the upper extremity is most likely A) Herpes zoster B) Poison ivy C) Staphylococcus infection D) Atopic dermatitis E) Varicella
What is B) Poison ivy ?
100
Symptoms that present the greatest concern in pregnant women include A) Visual disturbances B) Nausea C) Heartburn D) Abnormal cravings E) Mild edema
What is A) Visual disturbances?
100
Which of the following is not considered in deciding to screen for conditions in the elderly? A) The exact age of the patient B) The risk of dying from the condition C) The potential benefits of screening D) The direct and indirect harms of screening E) The patient’s values and preferences
What is A) The exact age of the patient?
200
B. Parkinson,s Disease Resting tremor is the most common presentation of Parkinson,s disease. It is rare in progressive supranuclear palsy and multisystem atrophy, and less common in drug induced parkinsonism.
17.In differentiating early Parkinson’s disease from variants such as drug-induced parkinsonism, progressive supranuclear palsy, and multiple system atrophy, which one of the following is the most important clue? (check one) A. A resting tremor B. Bradykinesia C. Rigidity D. Gait difficulty E. Loss of postural reflexes
200
Which of the following infections is least likely in a patient with COPD? A) Streptococcus pneumoniae B) Haemophilus influenzae C) Moraxella catarrhalis D) Mycoplasma pneumoniae
What is D) Mycoplasma pneumoniae ?
200
A 24-year-old female is noted to have the presence of trichmonas found on a routine pap smear that is perform at the student health center. Although the center diagnoses a number of cases each year, she is entirely asymptomatic. Appropriate management should be to A) Reassure patient that no treatment is necessary B) Repeat cultures after the next menstrual cycle and treat if the organism is present C) Treat only if the patient is pregnant D) Treat regardless of symptoms E) Treat only if symptoms are present
What is D) Treat regardless of symptoms?
200
A 75 year old gentleman is brought in to your office by his wife. She complains that he is not the same over the last six months. His memory is failing him, he has difficulty with walking (especially when he initiates walking) and he is incontinent of urine. Which of the following is the most likely diagnosis based on his history? A) Alzheimer’s disease B) Parkinson’s disease C) Normal pressure hydrocephalus D) Pick’s disease E) Progressive supranuclear palsy
What is C) Normal pressure hydrocephalus?
300
B. Riboflavin A daily oral dose of 400 mg of riboflavin has been shown to be superior to placebo for migraine prophylaxis. The effect of riboflavin begins after 1 month of treatment and is maximal after 3 months of treatment. Its effect is most pronounced on attack frequency and the number of days patients have a headache. Ref: Schoenen J, Jacquy J, Lenaerts M: Effectiveness of high-dose riboflavin in migraine prophylaxis: A randomized controlled trial. Neurology 1998;50(2):
.Which one of the following is useful in migraine prophylaxis? (check one) A. Cyanocobalamin (vitamin B12) B. Riboflavin (vitamin B2) C. Ascorbic acid (vitamin C) D. Cholecalciferol (vitamin D) E. Tocopherol (vitamin E)
300
A 46year-old homosexual patient presents to your office with a violaceous skin lesion. Further examination shows generalized lymphadenopathy. Microscopic examination of a skin punch biopsy shows spindle cells mixed with vascular tissue. The most likely diagnosis is A) Malignant melanoma B) Kaposi’s sarcoma C) Tinea corpora D) Cherry hemangioma E) Cryptococcal granuloma
What is B) Kaposi’s sarcoma ?
300
Which of the following bacterial infections is not generally associated with preterm labor? A) Ureaplasma urealyticum B) Mycoplasma hominis C) Gardnerella vaginalis D) Bacteroides species E) All are associated with preterm labor
What is E) All are associated with preterm labor?
300
An 85 year old gentleman complains of chronic insomnia. Based on study results you know that A) Insomnia is relatively rare in the elderly B) Insomnia is a natural progression of aging and has little effect on the well-being of elderly patients C) Chronic insomnia is an independent risk factor for cognitive decline in elderly men D) Insomnia has no impact on the risk of falls E) Insomnia does not lead to nursing home placement
What is C) Chronic insomnia is an independent risk factor for cognitive decline in elderly men?
400
A 28-year-old homosexual man presents to your office complaining of a nonproductive cough, shortness of breath, fever, and chills. A chest radiograph shows bilateral interstitial infiltrates. The best treatment is A) oral azithromycin B) intravenous penicillin C) intravenous TMP-SMX D) intravenous amphotericin E) observation only
What is C) intravenous TMP-SMX?
400
Third-generation cephalosporins differ from first-generation cephalosporins in their increased effectiveness against A) Gram-positive organisms B) Gram-negative organisms C) Anaerobic organisms D) Parasites E) Fungi
What is B) Gram-negative organisms ?
400
A 27-year-old asymptomatic pregnant woman is found to have hyperthyroidism. Which of the following medications is the drug of choice for treatment? A) Propylthiouracil B) Radioactive iodine C) Methimazole D) Propranolol E) Levothyroxine
What is A) Propylthiouracil?
400
Which of the following is true regarding respiratory rate in the elderly? A) Subtle differences in age adjusted respiratory rate are present and should be adjusted for in the evaluation of the elderly patient B) Respiratory rates in the elderly are 5% higher than age adjusted controls C) Respiratory rates and patterns do not change as the patient ages D) Elevated respiratory rates do not represent concern in the elderly patients E) Respiratory rates do not correlate with disease in elderly patients
What is D) Elevated respiratory rates do not represent concern in the elderly patients?
500
Inflammation and necrosis of the muscular tissue supplied by small- and medium-sized arteries is known as A) Polyarteritis nodosa B) Pyoderma gangrenosum C) Polymyositis D) Giant cell arteritis E) Germatomyositis
What is A) Polyarteritis nodosa?
500
The most common cause of bacterial conjunctivitis in American adults is A) Streptococcus pneumoniae B) Haemophilus influenzae C) Chlamydia trachomatis D) Staphylococcus aureus E) Klebsiella
What is D) Staphylococcus aureus ?
500
Which of the following statements about molar pregnancy is true? A) Malignant transformation is monitored by serial alpha-fetoprotein levels. B) Further pregnancies should be discouraged after a molar pregnancy. C) It is usually associated with hyperemesis gravidarum. D) Risk for recurrent molar pregnancy is not increased in women who have had previous molar pregnancies. E) The majority of molar pregnancies result in malignant transformation.
What is C) It is usually associated with hyperemesis gravidarum?
500
Which one of the following statements about rehabilitation after a stroke is true? A) Physical therapy should be instituted for stretching and strengthening once supporting muscles are strong enough to support appropriate loads B) Tennis ball exercises can be used to strengthen the hand muscles C) Most motor function improvement occurs more than 6 months after a cerebral vascular accident D) A walking cane used on the side affected can help with ambulation and balance E) Bladder or bowel incontinence has no effect on prognosis after stroke
What is A) Physical therapy should be instituted for stretching and strengthening once supporting muscles are strong enough to support appropriate?