Clinical Case-Based Multiple Choice Questions

A 12-year-old boy reports to your office with his mother. The mother tells you that, 1 week ago, a rash formed that initially presented as an oval with a crinkled appearance. Upon today's examination, you find that the boy has a pruritic rash in the form of a Christmas tree pattern on his trunk. Which of the following is the most likely cause?

• Coxsackie virus

• Erythema infectiosum

• Lyme disease

• Pityriasis rosea

A 17-year-old male visits your office for a physical exam. He is tall in stature and has a long, narrow face, as well as thin extremities and fingers. During the physical examination, you confirm that his arm span exceeds his height. These physical characteristics are consistent with which of the following disorders?

• Marfan syndrome

• Martin-Bell syndrome

• Klinefelter syndrome

• Precocious puberty

A 20-year-old college student tells you that he developed an itch in his ear canal that is sometimes painful and is especially noticeable when he chews. Although he has not noticed any hearing loss, his ear is scaly and itchy. Upon physical exam, you notice swelling in the outer third of his ear canal. He claims that he regularly cleans his ears and has never swum or played any water sports in his life. Of the following, which is the most likely diagnosis for his condition?

• Cholesteatoma

• Otitis externa

• Serous otitis media

• Acute otitis media

A 21-year-old soccer player presents to your office with a swollen, painful knee. He recently sustained a painful injury during the game when, during a sprint, he quickly and sharply shifted directions. Which of the following would you use to test for an anterior/posterior cruciate ligament tear?

• Phalen's test

• Apley grind test

• Lachman's test

• McMurray's test

A 25-year-old woman comes into your practice complaining of recurring headaches, as well as fatigue and difficulty breathing during exercise. A physical examination reveals tachycardia and pallor, and lab results show low mean corpuscular volume, low mean corpuscular hemoglobin concentration, low serum ferritin, and high red cell distribution width. What is the best treatment for this patient's most likely condition?

• Folate

• Ferrous sulfate

• Hydroxyurea

• Cyanocobalamin

A 32-year-old man comes to you with raised, round, flesh-colored bumps covering part of his lower right abdomen and right inner thigh. A physical exam indicates the lesions are around 2-4 mm in diameter, are smooth, rounded, and firm; and vary from white to 'fleshy' color. Which of the following is the most popular method of treatment for the most likely condition?

• Cryoanesthesia

• Topical acyclovir

• Imiquimod

• Topical erythromycin

A 47-year-old man presents to your clinic with complaints of dizziness and vomiting. Upon checking his ears, you note a local inflammation in his left ear, erythema with diminished light reflexes, fluid in the middle ear, and a bulging tympanic membrane. You suspect a bacterial pathogen. Which of the following is the most likely cause?

• Enterococcus faecium

• Moraxella catarrhalis

• Haemophilus influenzae

• Streptococcus pneumoniae

A 55-year-old woman comes to your office and explains that she has been experiencing severe pain when moving her elbow, along with swelling and tenderness. She has been a secretary for more than 30 years and believes her signs and symptoms are the result of having to type for prolonged periods. Which of the following is the patient's most likely condition?

• Osteoporosis

• Polymyalgia rheumatica

• Bursitis

• Carpal tunnel syndrome

A 62-year-old male comes to your office with concerns about a general feeling of dizziness and lightheadedness. He states that he has been feeling a pulsating pain right below the back of his head; this pain often occurs early in the morning and resolves throughout the day. The patient's findings are most consistent with which of the following cardiovascular conditions?

• Hypertension

• Aortic stenosis

• Angina

• Myocardial infarction

A 62-year-old male presents to your office with complaints of serious joint pains that become worse as the day progresses. Specifically, the pain is in his wrists, knees, and hips; you infer that the patient's obesity may be exacerbating this pain. An X-ray reveals remodeling of the subchondral bone, juxta-articular sclerosis, osteophytes, and joint space narrowing. What is the most likely diagnosis for his condition?

• Carpal tunnel syndrome

• Bursitis

• Rheumatoid arthritis

• Osteoarthritis