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3,531 questions
A70-year-old man presents to urgent care complaining of a painful, swollen left knee. He previously has had no problems with this knee. Three days prior to onset, he went out dancing for 23 hours but recalls no specific injury. Examination of the knee reveals a moderatesized effusion and mild pain with any range of motion. Plain x-ray shows no fracture. Which of the following is the best next management?
A husband and wife, both aged 30, come to the community health center for advice and evaluation prior to a month-long mission trip to central Africa. Both are in good health. She takes oral contraceptive pills and he is on no prescription medication. Review of their records shows that they have had all of the appropriate vaccinations for their ages, have completed a three dose hepatitis B series and had dT boosters 2 years ago. Their mission will involve building a school and health clinic in a rural area of Cameroon. What advice would be the most appropriate to provide?
A 23-year-old woman presents with "skipped heartbeats" and on cardiac examination is found to have a midsystolic click followed by a late systolic murmur. Echocardiogram shows prolapse of the mitral valve. Which of the following is true about this condition? Mitral valve prolapse is present in up to 10% of the population.
A6-month-old boy is brought to the office for a routine check-up by his mother. They have recently moved to the area and are new to your practice. He is the product of an uncomplicated term pregnancy, has grown and developed appropriately for his age, and is up-to-date on his immunizations. He has had two cases of otitis media in his life. Neither of his parents has been diagnosed with any chronic medical conditions. Both of his parents smoke cigarettes, but "not in the same room" as the child. What information about secondhand smoke could you provide to the parents? The health risks of secondhand smoke are lower because it has a significantly different chemical
A6-month-old boy is brought to the office for a routine check-up by his mother. They have recently moved to the area and are new to your practice. He is the product of an uncomplicated term pregnancy, has grown and developed appropriately for his age, and is up-to-date on his immunizations. He has had two cases of otitis media in his life. Neither of his parents has been diagnosed with any chronic medical conditions. Both of his parents smoke cigarettes, but "not in the same room" as the child. Which of the following statements is true?
A 59-year-old woman had a left modified radical mastectomy for intraductal carcinoma 2 years previously. She presents with confusion, lethargy, and thigh pain. X-rays reveal a lytic lesion in the shaft of the femur. Which of the following blood abnormalities is most likely?
A 39-year-old woman presents to the office for the evaluation of a mole on her left arm. It has been present and enlarging over the past 6 months. It itches and occasionally bleeds. Which of the following attributes would be considered high risk for skin cancer?
A 26-year-old G2P1 female comes to your office for her initial obstetric visit. The first day of her last menstrual period was 6 weeks ago. Other than some mild morning sickness, she is feeling fine. Her first pregnancy was 40 weeks in gestation and uncomplicated. She has no significant medical history. Which of the following tests is recommended as screening for hepatitis B in pregnancy?
Otitis media occurring during the first 8 weeks of life deserves special consideration, because the bacteria responsible for infections during this time may be different from those that affect older infants and children. Which of the following organisms is the most likely to cause otitis media in these infants?
A 59-year-old woman had a left modified radical mastectomy for intraductal carcinoma 2 years previously. She presents with confusion, lethargy, and thigh pain. X-rays reveal a lytic lesion in the shaft of the femur. Which of the following is the most appropriate initial therapy?
A 39-year-old woman presents to the office for the evaluation of a mole on her left arm. It has been present and enlarging over the past 6 months. It itches and occasionally bleeds. Which of the following statements regarding skin cancer is true?
A55-year-old retired policeman has had hypertension for about 15 years for which he takes hydralazine. He has a 35 pack-year tobacco history and continues to smoke one pack a day. On his visit, he complains about the appearance of his nose and asks if something can be done to decrease the redness. Which of the following statements is correct? Hydralazine does not play a role in his nasal erythema.
A 39-year-old woman presents to the office for the evaluation of a mole on her left arm. It has been present and enlarging over the past 6 months. It itches and occasionally bleeds. How would you advise this patient regarding sun exposure?
A46-year-old attorney is noted to have normal cholesterol levels but a very high fasting triglyceride level of 1600. He is otherwise healthy and has no risk factors for CAD. Which of the following statements is correct?
A 25-year-old man was admitted to the intensive care unit with a severe head injury, with fracture of the base of the skull. Approximately 18 hours after the injury, he developed polyuria. Urine osmolality was 150 mOsm/L and serum osmolality was 350 mOsm/L. IV fluids were stopped, and 3 hours later, urine output and urine osmolality remained unchanged. Five units of vasopressin were intravenously administered. Urine osmolality increased to 300 mOsm/L. Which of the following is the most likely diagnosis?
A50-year old male presents to the office for prostate cancer screening because he saw a TV show recommending that men get tested. He has no significant medical history, takes no medications, and has no genitourinary symptoms. There is no family history of prostate cancer. What can you tell him about prostate cancer and the PSA test?
A70-year-old man with a 60 pack-year smoking history presents with cough and weight loss. He describes recent diffuse darkening of his skin and his CXR shows a mass suspicious for lung cancer in the left hilum. His laboratory tests reveal hypokalemia. Which of the following is the most likely histology of his lung cancer?
A50-year old male presents to the office for prostate cancer screening because he saw a TV show recommending that men get tested. He has no significant medical history, takes no medications, and has no genitourinary symptoms. There is no family history of prostate cancer. How would you advise him regarding prostate cancer screening?
A47-year-old man is postoperative day number 2 after an open cholecystectomy. He becomes short of breath and a medicine consultation is called to evaluate. Vital signs include a temperature of 100°F, pulse r ate of 110/min, blood pressure (BP) of 110/60 mmHg, and respiratory rate of 24/min. Blood gas shows a pH of 7.52, carbon dioxide of 28, PO2 of 58, and calculated bicarbonate of 20. What is the primary acid-base disorder in this patient?
A 49-year-old male postal worker presents to your office for the evaluation of a lesion on his left arm. The lesion started about a week ago as a red pustule but has grown and now has a thick black scab. The lesion is painless. A coworker showed the patient a similar appearing lesion that she developed on her arm for which her doctor prescribed an oral antibiotic. Examination reveals a 5 cm circular black eschar with some surrounding vesicles. A Gram stain of fluid drained from a vesicle reveals chains of gram-positive bacilli. What organism is most likely responsible for this lesion?