AAFP Part 2 #18

A 52-year-old female with morbid obesity is incidentally noted to have mildly elevated AST (SGOT) levels. She does not consume alcohol and denies using recreational drugs. A workup for chronic viral hepatitis and hemochromatosis is negative.Which one of the following is most likely to improve her hepatic condition?

• Pentoxifylline

• Simvastatin

• L-Carnitine

• Vitamin E

• Weight loss

A 44-year-old male with papulopustular rosacea sees you for follow-up. You have been treating his condition with topical azelaic acid (Finacea), and although his condition is improved he is not satisfied with the results. You suggest adding which one of the following oral medications?  

• Clarithromycin

• Clindamycin

• Doxycycline

• Erythromycin

• Metronidazole

A 52-year-old male has a skin lesion removed from his arm with appropriate sterile precautions. Which one of the following would be most appropriate to use on this surgical wound?  

• Petrolatum

• Silver sulfadiazine (Silvadene) cream

• Mupirocin (Bactroban) ointment

• Polymyxin B/bacitracin ointment (Polysporin)

• Triple-antibiotic (neomycin/polymyxin B/bacitracin) ointment

A 15-year-old male is brought to the office for a well child visit. His parents report that he has had a nighttime cough and wheezing for the past several months. He is otherwise healthy and up-to-date on all of his immunizations. You suspect that he has asthma. Which one of the following would be most appropriate at this point?  

• Treat empirically with a short-acting β-agonist

• Perform spirometry

• Order radiologic testing

• Start an inhaled corticosteroid

• Start a leukotriene inhibitor

A 36-year-old female presents with a several-week history of polyuria and intense thirst. She currently takes no medications. On examination her blood pressure and pulse rate are normal, and she is clinically euvolemic. Laboratory tests, including serum electrolyte levels, renal function tests, and plasma glucose, are all normal. A urinalysis is significant only for low specific gravity. Her 24-hour urine output is >5 L with low urine osmolality. The most likely cause of this patient’s condition is a deficiency of?  

• angiotensin II

• aldosterone

• renin

• insulin

• arginine vasopressin

A 39-year-old female presents with lower abdominal/pelvic pain. On examination, with the patient in a supine position, you palpate the tender area of her lower abdomen. When you have her raise both legs off the table while you palpate the abdomen, her pain intensifies. Which one of the following is the most likely diagnosis?

• Appendicitis

• A hematoma within the abdominal wall musculature

• Diverticulitis

• Pelvic inflammatory disease

• An ovarian cyst

Which one of the following is one of the five basic principles of the patient-centered medical home?

• Utilizing the latest research and advances in treatment and diagnosis

• Coordinating a patient’s care across all elements of the health care system

• Acting as a gatekeeper to limit access to specialist care

• Serving as the base of a pyramid in support of a complex health care system

• Transitioning away from delivering care in an office, and focusing on meeting patients in their own homes

Mild cognitive impairment is characterized by which one of the following?  

• Localized motor dysfunction

• Impairment in at least one activity of daily living

• Impairment in at least one instrumental activity of daily living

• The presence of the APO E4 allele

• Objective evidence of memory decline

A healthy 24-year-old male presents with a sore throat of 2 days’ duration. He reports mild congestion and a dry cough. On examination his temperature is 37.2°C (99.0°F). His pharynx is red without exudates, and there are no anterior cervical nodes. His tympanic membranes are normal, and his chest is clear. Which one of the following would be most appropriate at this point?  

• Analgesics and supportive care only

• A rapid strep test

• A throat culture and empiric treatment with penicillin

• Azithromycin (Zithromax)

Routine vaccination against which one of the following organisms has significantly reduced the risk of bacterial meningitis among young children?

• Borrelia burgdorferi

• Escherichia coli

• Haemophilus influenzae

• Listeria monocytogenes

• Mycoplasma pneumoniae