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WorksheetsAAFP Part 2 56
Total questions: 5
Worksheet time: 3mins
A 35-year-old female presents with fatigue. She has been falling asleep at work for the past 6 weeks. She is married with two children and works as a nurse at the community hospital. Since she returned to work 12 weeks ago after maternity leave, her infant has had multiple respiratory infections and has not slept well through the night. Her menstrual cycle has been irregular and heavy for the past several months. A CBC and TSH level are normal.
Which one of the following laboratory tests would be appropriate at this visit? (check one)
25-Hydroxyvitamin D
β-hCG
D-dimer
A serum antibody test for Lyme disease
In a patient presenting with truncal obesity, hypertension, type 2 diabetes mellitus, hirsutism, osteopenia, and skin fragility, which one of the following tests is needed to confirm the diagnosis of Cushing syndrome? (check one)
A dexamethasone suppression test
Inferior petrosal sinus sampling
Plasma corticotropin
Plasma free cortisol
Urinary free cortisol
A 42-year-old female presents with shortness of breath that has slowly worsened over the past 6 months. She can now walk only 10 feet without becoming short of breath. She does not have a cough or chest pain. Her history is significant only for obesity. She smoked one pack of cigarettes per day for 20 years and quit smoking 6 years ago. Her blood pressure is 138/88 mm Hg, pulse rate 92 beats/min, respiratory rate 18/min, and oxygen saturation 92% on room air. Her BMI is 42 kg/m2.Her heart has a regular rate and rhythm with no murmurs and her lungs are clear to auscultation. Her lower extremities have bilateral 1+ edema. A chest radiograph is normal. Spirometry reveals a decreased FVC with a normal FEV1/FVC ratio. A CBC, a TSH level, and a basic metabolic panel are all normal except for a serum bicarbonate level of 35 mEq/L (N 22–29).
These findings are most consistent with (check one)
asthma
COPD
obstructive sleep apnea
obesity hypoventilation syndrome
pulmonary fibrosis
You see a 58-year-old female who received a drug-eluting stent 10 days ago during a hospitalization for acute coronary syndrome and coronary artery disease. She asks for recommendations about anticoagulation. You determine that she is not at high risk for bleeding.
Which one of the following would you recommend? (check one)
Long-term aspirin use
Clopidogrel (Plavix) and aspirin for 30 days and then aspirin alone
Clopidogrel alone for 1 year and then aspirin alone
Clopidogrel and aspirin for 1 year and then aspirin alone
Prasugrel (Effient) for 1 year with no anticoagulation after that
A 45-year-old female presents with throbbing right-sided heel pain that started a few weeks ago. She says the pain is worst in the morning and seems to improve during the day but will return after a long day on her feet. She does not have a history of trauma, change in exercise, unexplained fever, or unintended weight loss.On examination the patient’s vital signs are normal. You note pain on palpation of the right medial calcaneal tuberosity and along the plantar fascia, and pain with passive dorsiflexion of the right foot. The skin over the foot reveals no sign of trauma, lesions, or masses.
Which one of the following is the most likely cause of this patient’s heel pain? (check one)
The heel spur
A calcaneal stress fracture
Heel pad syndrome
Plantar fasciitis
Sever’s disease
