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WorksheetsRandom Board Review Questions 98
Total questions: 10
Worksheet time: 8mins
A 56-year-old male with diabetes mellitus, hypertension, and chronic renal insufficiency presents for follow-up of his chronic medical conditions. Results of his most recent metabolic panel included an estimated glomerular filtration rate of 30 mL/min/1.73 m2 (N >60) and a calcium level of 10.4 mg/dL (N 8.5–10.2). Medication reconciliation reveals he is not taking the sevelamer (Renagel, Renvela) prescribed by the consulting nephrologist. You explain to the patient that he should be taking sevelamer to lower his serum calcium.
The drug accomplishes this by? (check one)
Blocking the effect of parathyroid hormone
Blocking excessive Vitamin D levels, thereby decreasing intestinal calcium absorption and increasing renal calcium excretion
Blocking intestinal absorption of phosphate, which lowers parathyroid hormone secretion
Directly blocking excessive calcium absorption in the intestines
Directly increasing the renal excretion of both calcium and phosphate
A 16-year-old afebrile, otherwise healthy female presents with a 4-day history of right ear pain. She says she has spent a fair amount of time swimming recently. Traction on the pinna causes pain. The erythema and inflammation is limited to the ear canal but there is too much edema to easily visualize the tympanic membrane. Which one of the following would be the most appropriate treatment? (check one)
Amoxicillin
Amoxicillin/clavu-lanate (Augmentin)
Augmentin plus acetic acid 2% topically
Ciprofloxacin 0.3%/dexameth-asone 0.1% (Ciprodex) topically
An obese 10-year-old male with tonsillar hypertrophy is brought to your office because of snoring. There is no history of recent or past visits for tonsillitis. Polysomnography shows moderate obstructive sleep apnea syndrome. Which one of the following is the treatment of choice for this patient? (check one)
Continuous positive airway pressure
Intranasal corticosteroids
Extended antibiotic therapy
Adenotonsillec-tomy
For which type of renal calculus is acidification of the urine indicated? (check one)
Cystine
Uric acid C
Calcium oxalate
Calcium phosphate
An 11-year-old male is brought to your office for evaluation of bilateral posterior heel pain that has occurred for the past few months. He plays basketball and soccer several times a week and the pain begins several minutes into each of these activities. There is no pain at rest or with walking. The patient has not noticed any numbness, tingling, or weakness. On examination you find no swelling or tenderness of the heel or Achilles tendon. Reflexes, strength, and range of motion at the ankle are intact, but he does have bilateral posterior heel pain when you passively dorsiflex the ankles. Which one of the following is the most likely diagnosis? (check one)
Achilles Tendinopathy
Calcaneal apophysitis
Plantar fasciitis
Heel pad syndrome
Tarsal tunnel syndrome
For most patients, which one of the following is the most effective treatment for anemia of chronic disease? (check one)
Elemental iron
Erythropoietin
Prednisone
Optimal management of underlying disorder
Combined therapy with oral iron, vitamin B12, folic acid, and erythropoietin
A 30-year-old female complains of dysmenorrhea, pelvic pain, and dyspareunia. Which one of the following would be appropriate to detect endometriosis? (check one)
A CA-125 assay
Transvaginal ultrasonography
CT of the pelvis
MRI of the pelvis
Colonoscopy
A 4-week-old white male is brought to your office with a 2-week history of increasing dyspnea,cough, and poor feeding. The child appears nontoxic and is afebrile. On examination you note conjunctivitis, and a chest examination reveals tachypnea and crackles. A chest film shows hyperinflation and diffuse interstitial infiltrates and a WBC count reveals eosinophilia. What is the most likely etiologic agent? (check one)
Staphylococcus species
Chlamydia trachomatis
Respiratory syncytial virus
Parainfluenza virus
A 14-year-old male has open and closed comedones without evidence of surrounding inflammation on his face and upper back. Which one of the following is the most appropriate initial treatment? (check one)
Topical antibiotics
Topical retinoids
Oral antibiotics
Oral isotretinoin
A 13-year-old African-American male is brought to your office by his mother for a limp that she has noticed for about 1 week. The patient admits to vague right-sided hip and knee pain present only with activity. He says the pain has never awakened him from sleep and is never present at rest. Neither the mother nor the patient has noticed any systemic symptoms such as fever, night sweats, weight loss, or appetite changes. There is no recent history of trauma. On examination the patient’s weight is in the 90th percentile and his height is in the 50th percentile. He has an antalgic gait. Examination of the left hip is normal. Examination of the right hip is significant for decreased internal rotation. The right hip externally rotates involuntarily with passive flexion. There is no external deformity and no skin changes are noted. He has a negative FABER test. Palpation of the bursa and bone does not elicit pain. Examination of both knees is normal. Plain radiographs confirm your clinical impression.
Which one of the following is the most appropriate next step in the management of this patient? (check one)
Reassurance with close follow up
Physical therapy
Injection of the sacroiliac joint
Hospital admission for tests
Surgery
