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100

Which of the following statements regarding the reduction of stroke risk is true? ............................. . A) Vitamin E should be recommended to help reduce the risk of stroke B) Vitamin C has been shown to reduce the risk of stroke in multiple meta-analysis studies C) Dietary prevention of stroke should include increased intake of fruits and vegetables D) Risk factor modification has little impact on the risk for stroke

What is C) C) Dietary prevention of stroke should include increased intake of fruits and vegetables?

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
A two-year-old child is brought into your office. Mom reports the boy fell off his bed and has been limping for the last three days. He did hit his head but had no loss of consciousness and has been acting normally since his fall. You note retinal hemorrhages on exam. The most likely cause is A) Autism B) Abuse C) Hemophilia D) Leukemia E) Poor coordination
What is B) Abuse ?
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
A 36-year-old runner presents with pain associated with the anterior heel. The patient reports his symptoms are worse on awakening and improve as the day progresses. The most likely diagnosis is A) Achilles tendonitis B) plantar fasciitis C) calcaneal fracture D) calcaneal bone spur E) anterior talotibial impingement syndrome
What is B) plantar fasciitis?
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 17-month-old boy is seen in the emergency room. He has miosis, bronchoconstriction, and diarrhea. He is also sweating, excessively salivating, and vomiting. His breath has a garlic odor. The most likely diagnosis is A) Alcohol overdose B) Organophosphate poisoning C) Cyanide ingestion D) Diabetic ketoacidosis E) Cocaine overdose
What is B) Organophosphate poisoning?
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
Which of the following statements about lung cancer is true? A) Squamous cell and small cell tumors are rarely associated with smoking B) Squamous cell tumors typically arise in central bronchi and may be diagnosed with sputum cytology C) Large cell tumors are common, arise centrally, and typically metastasize locally D) Small cell carcinoma is usually located peripherally and rarely metastasizes E) Yearly chest x-rays are recommended for smokers over age 50
What is B) Squamous cell tumors typically arise in central bronchi and may be diagnosed with sputum cytology?
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

A 10-year-old jumped off the high dive at a local swimming pool and presents to your office complaining of severe right-sided ear pain after landing on that side when he hit the water. You have seen him for this problem for the last 12 weeks, but a small perforation remains in the tympanic membrane. There is no sign of infection. Appropriate treatment at this point consists of A) Continued observation B) An audiogram to document hearing C) Steroid otic drops D) Antibiotic ear drops and no water exposure E) Referral to an ear-nose-throat specialist

What is E) Referral to an ear-nose-throat specialist?

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 17-year-old surfer presents to your office complaining of an intensely pruritic, serpinginuos type rash that has formed on the sole of his foot. The rash appears to be spreading and is forming bullae at the affected site. The most likely diagnosis is A) Tinea pedis B) Bathing suit dermatitis C) Leshmaniasis D) Ascariasis E) Cutaneous larva migrans A) Alzheimer’s disease B) Parkinson’s disease C) Normal pressure hydrocephalus D) Pick’s disease E) Progressive supranuclear palsy

What is E) Cutaneous larva migrans?

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

You are covering the local high school football game on Friday night. An 16-year-old star running back goes down on the field after a hard tackle. When you arrive at his side, he is holding his knee. He describes a “pop” followed by severe pain. Which of the following would be most helpful in the initial diagnosis? A) Ability to walk B) Lachman’s test C) Anterior drawer test D) CT of the knee E) Arthrogram of the knee

What is B) Lachman’s test?

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?