CEA Prep: Full Practice Exam
1st line treatment for generalized anxiety disorder:
*buspar
*zoloft
*wellbutrin
*remeron - ANS-zoloft
Rationale: SSRIs increase serotonin levels in the brain, which helps improve mood and
reduce anxiety. Serotonin is a neurotransmitter associated with mood regulation and anxiety
reduction. By blocking the reabsorption (reuptake) of serotonin into neurons, Zoloft allows
more serotonin to be available in the brain, which can help improve mood and reduce
anxiety.
A "code blue" is called on your patient in the waiting room of your urgent care. When you
arrive, cardiac monitoring is applied and their rhythm appears to be normal sinus rhythm with
a rate of 80. On palpation over the carotid artery, you do not feel a pulse. What is the name
of this cardiac rhythm?
*Idioventricular rhythm
*Junctional Tachycardia
*Wandering Atrial Pacemaker (WAP)
*Pulseless Electrical Activity (PEA) - ANS-Pulseless Electrical Activity (PEA)
Rationale: PEA appears as a normal rhythm without a pulse. Idioventricular rhythm is very
slow (20-40), Junctional tachycardia and WAP both without pulses are considered PEA also.
A 13 year old female who is diagnosed with iron deficiency anemia is being treated with
ferrous sulfate. Proper treatment typically leads to the resolution of anemia within:
*3 months.
*4 weeks.
*8 months.
*2 weeks. - ANS-3 months.
Rationale: Due to the time it takes for the underlying deficit to be corrected as well as the
growth of new red blood cells to mature, 3 months are typically needed to show recovery
with treatment for iron deficiency.
A 13-year-old patient returns to the office complaining of intermittent headache for the past
couple of years. Which would be the most concerning symptom? - ANS-Stiff neck
Rationale: Inflammation of the membranes (meninges) surrounding the brain and spinal
cord, often caused by a viral or bacterial infection. This can cause severe headache, stiff
neck, fever, and sensitivity to light.
A 14-year-old with sickle cell anemia has recently experienced a sickle cell crisis and
presents for a follow-up examination after a recent hospitalization. It is most important to
continue monitoring growth, development, and: - ANS-hemoglobin levels.
Rationale: Chronic monitoring for patients with sickle cell disease includes monitoring of
hemoglobin and hematocrit.
,A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
spotting. She has not missed any doses and uses no other medication. Which of the
following is appropriate?
*Double dosing for 2 days
*Modifying use
*Changing to Ortho-Novum 1/35
*Providing reassurance - ANS-Providing reassurance
Rationale: Ortho-Novum 7/7/7 is a combination oral contraceptive pill that contains varying
doses of estrogen and progestin (norethindrone) throughout the cycle. It is a triphasic pill,
meaning that the hormone levels change every seven days to mimic the natural menstrual
cycle more closely. Mid-cycle spotting can occur for several reasons while using this
contraceptive.
A 19-year-old patient who has used oral contraceptives for 3 years plans to discontinue the
pill at the end of her current cycle to become pregnant. Which of the following daily
supplements would receive the highest priority?
*Ferrous sulfate
*Folic acid
*Multivitamin
*Calcium carbonate - ANS-Folic acid
Rationale: Folic acid, a B-vitamin (B9), plays a crucial role in ensuring a healthy pregnancy
and reducing the risk of birth defects. Folic acid is crucial in the early development of the
neural tube, which forms the brain and spinal cord. Adequate folic acid intake can
significantly reduce the risk of neural tube defects such as spina bifida (incomplete closure of
the spinal cord) and anencephaly (underdevelopment of the brain). The neural tube forms
very early in pregnancy, often before a woman knows she is pregnant. Therefore, it is
essential to have adequate folic acid levels before and during early pregnancy.
A 19-year-old presents with a sore throat and anterior cervical adenopathy. Which causative
agent would be suspected?
*Epstein-Barr virus
*Adenovirus
*Haemophilus influenzae
*Group A beta-hemolytic Streptococcus - ANS-Group A beta-hemolytic Streptococcus
Rationale: While this patient could easily represent strep or EBV, the differentiating factor is
the location of the affected lymphadenopathy. As a generalization, posterior cervical
lymphadenopathy is common of Epstein-Barr virus (EBV) and anterior cervical
lymphadenopathy is more common with Group A beta-hemolytic streptococcus.
A 2-day old newborn has purulent discharge of the eyes and erythema. History includes a
vaginal birth at term delivered at home. What is the most likely culprit?
*Chlamydia trachomatis infection
*E-coli infection
*Staph infection
*Viral infection - ANS-Chlamydia trachomatis infection
Rationale: Chlamydia conjunctivitis is usually spread through direct contact with discharge
from the eyes or genital secretions of someone infected with Chlamydia trachomatis. It can
,occur in newborns during childbirth (neonatal conjunctivitis) or in adults through sexual
contact (adult inclusion conjunctivitis).
Symptoms: The symptoms can include:
Redness in the eye(s).
Watery or mucopurulent discharge (yellow or green discharge from the eyes).
Swelling of the eyelids.
Sensitivity to light (photophobia).
Itching or burning sensation in the eyes.
A 22-year-old has ASCAS on Pap smear and negative for HPV. The next step is:
*No follow up is needed.
*Repeat HPV in 3 months
*Colposcopy
*Repeat Pap in 6 months - ANS-Repeat Pap in 6 months
Rationale: For a 22-year-old with ASC-US on Pap smear and a negative HPV test, the next
appropriate step is to repeat the cytology in six months. This approach minimizes
unnecessary interventions while ensuring ongoing monitoring for any potential progression
of cervical cell abnormalities.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by bladder
emptying. The patient has been evaluated by urology and urogynecology. Review of
laboratory reports reveal negative urinalysis and cultures, negative results for sexually
transmitted infections, and an unremarkable cystoscopy. Which of the following is an
appropriate plan of care?
*Amitriptyline (Elavil) 25 mg oral once daily
*Referral to psychiatry
*Propranolol (Inderal) 10 mg oral once daily
*Nitrofurantoin (Macrodantin) 100 mg oral once daily - ANS-Amitriptyline (Elavil) 25 mg oral
once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by bladder
emptying. The patient has been evaluated by urology and urogynecology. Review of
laboratory reports reveal negative urinalysis and cultures, negative results for sexually
transmitted infections, and an unremarkable cystoscopy. Which of the following is an
appropriate plan of care? - ANS-Amitriptyline (Elavil) 25 mg oral once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old sexually active woman presents with lower abdominal pain, fever, and purulent
cervical discharge. On pelvic examination, cervical motion tenderness is noted. What is the
most likely diagnosis? - ANS-Pelvic inflammatory disease (PID)
Rationale: Cervical motion tenderness is a clinical finding characterized by pain elicited
when the cervix is moved or manipulated during a pelvic examination. This tenderness can
indicate underlying pelvic pathology. Lower abdominal pain, fever, abnormal vaginal
, discharge, pain during intercourse, and irregular menstrual bleeding and cervical motion
tenderness are present with Pelvic Inflammatory Disease (PID).
A 25-year-old athlete presents with shoulder pain and difficulty with overhead activities.
Physical examination suggests impingement syndrome. What is the most appropriate initial
treatment? - ANS-Physical therapy focusing on rotator cuff strengthening
Rationale: Exercises to improve shoulder strength and flexibility, focusing on the rotator cuff
and scapular stabilizers is an important initial treatment. Physical therapy may include
stretching and strengthening exercises, as well as techniques to improve shoulder
mechanics.
A 25-year-old woman presents with a 2-year history of fluctuating mood states, including
periods of mild depression and hypomania. These symptoms have not been severe enough
to meet the criteria for major depressive or manic episodes. What is the most likely
diagnosis? - ANS-Cyclothymic disorder
Rationale: Cyclothymic Disorder involves chronic mood fluctuations that include periods of
hypomanic and depressive symptoms. These symptoms are less severe than those in
Bipolar I or II disorders but can significantly impact daily functioning. Early diagnosis and
appropriate treatment, including psychotherapy, medications, and lifestyle changes, can help
manage symptoms and improve quality of life.
A 25-year-old woman presents with a sudden onset of shortness of breath and pleuritic
chest pain. She has no significant past medical history and takes no medications. On
physical examination, her heart rate is 110 beats per minute, respiratory rate is 24 breaths
per minute, and oxygen saturation is 90% on room air. What is the most likely diagnosis? -
ANS-Pulmonary embolism
Rationale: Pulmonary embolism (PE) is a serious medical condition that occurs when a
blood clot (usually from the legs or other parts of the body) travels to the lungs and obstructs
one of the pulmonary arteries. The primary symptoms of a PE can vary depending on the
size of the clot and the location within the lung, but the most common symptoms include:
Sudden onset of difficulty breathing, which may occur at rest or with exertion and sharp,
stabbing pain that may worsen with deep breathing (pleuritic pain). The pain may also feel
like pressure, fullness, or a squeezing sensation.
A 25-year-old woman presents with a urinary tract infection (UTI) confirmed by urinalysis.
She has no allergies. What is the most appropriate first-line antibiotic treatment?
*Amoxicillin
*Trimethoprim-sulfamethoxazole
*Ciprofloxacin
*Nitrofurantoin - ANS-Nitrofurantoin
Rationale: Overall, Nitrofurantoin is a preferred choice for treating uncomplicated UTIs,
especially in otherwise healthy individuals where local resistance patterns support its
efficacy.
A 25-year-old woman presents with dysuria, frequency, and urgency. Urinalysis shows pyuria
and bacteriuria. What is the most likely diagnosis? - ANS-Cystitis
Rationale: Symptoms of cystitis include frequent urges to urinate, which may be
accompanied by pain or burning during urination. The urine may appear bloody or cloudy,
1st line treatment for generalized anxiety disorder:
*buspar
*zoloft
*wellbutrin
*remeron - ANS-zoloft
Rationale: SSRIs increase serotonin levels in the brain, which helps improve mood and
reduce anxiety. Serotonin is a neurotransmitter associated with mood regulation and anxiety
reduction. By blocking the reabsorption (reuptake) of serotonin into neurons, Zoloft allows
more serotonin to be available in the brain, which can help improve mood and reduce
anxiety.
A "code blue" is called on your patient in the waiting room of your urgent care. When you
arrive, cardiac monitoring is applied and their rhythm appears to be normal sinus rhythm with
a rate of 80. On palpation over the carotid artery, you do not feel a pulse. What is the name
of this cardiac rhythm?
*Idioventricular rhythm
*Junctional Tachycardia
*Wandering Atrial Pacemaker (WAP)
*Pulseless Electrical Activity (PEA) - ANS-Pulseless Electrical Activity (PEA)
Rationale: PEA appears as a normal rhythm without a pulse. Idioventricular rhythm is very
slow (20-40), Junctional tachycardia and WAP both without pulses are considered PEA also.
A 13 year old female who is diagnosed with iron deficiency anemia is being treated with
ferrous sulfate. Proper treatment typically leads to the resolution of anemia within:
*3 months.
*4 weeks.
*8 months.
*2 weeks. - ANS-3 months.
Rationale: Due to the time it takes for the underlying deficit to be corrected as well as the
growth of new red blood cells to mature, 3 months are typically needed to show recovery
with treatment for iron deficiency.
A 13-year-old patient returns to the office complaining of intermittent headache for the past
couple of years. Which would be the most concerning symptom? - ANS-Stiff neck
Rationale: Inflammation of the membranes (meninges) surrounding the brain and spinal
cord, often caused by a viral or bacterial infection. This can cause severe headache, stiff
neck, fever, and sensitivity to light.
A 14-year-old with sickle cell anemia has recently experienced a sickle cell crisis and
presents for a follow-up examination after a recent hospitalization. It is most important to
continue monitoring growth, development, and: - ANS-hemoglobin levels.
Rationale: Chronic monitoring for patients with sickle cell disease includes monitoring of
hemoglobin and hematocrit.
,A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
spotting. She has not missed any doses and uses no other medication. Which of the
following is appropriate?
*Double dosing for 2 days
*Modifying use
*Changing to Ortho-Novum 1/35
*Providing reassurance - ANS-Providing reassurance
Rationale: Ortho-Novum 7/7/7 is a combination oral contraceptive pill that contains varying
doses of estrogen and progestin (norethindrone) throughout the cycle. It is a triphasic pill,
meaning that the hormone levels change every seven days to mimic the natural menstrual
cycle more closely. Mid-cycle spotting can occur for several reasons while using this
contraceptive.
A 19-year-old patient who has used oral contraceptives for 3 years plans to discontinue the
pill at the end of her current cycle to become pregnant. Which of the following daily
supplements would receive the highest priority?
*Ferrous sulfate
*Folic acid
*Multivitamin
*Calcium carbonate - ANS-Folic acid
Rationale: Folic acid, a B-vitamin (B9), plays a crucial role in ensuring a healthy pregnancy
and reducing the risk of birth defects. Folic acid is crucial in the early development of the
neural tube, which forms the brain and spinal cord. Adequate folic acid intake can
significantly reduce the risk of neural tube defects such as spina bifida (incomplete closure of
the spinal cord) and anencephaly (underdevelopment of the brain). The neural tube forms
very early in pregnancy, often before a woman knows she is pregnant. Therefore, it is
essential to have adequate folic acid levels before and during early pregnancy.
A 19-year-old presents with a sore throat and anterior cervical adenopathy. Which causative
agent would be suspected?
*Epstein-Barr virus
*Adenovirus
*Haemophilus influenzae
*Group A beta-hemolytic Streptococcus - ANS-Group A beta-hemolytic Streptococcus
Rationale: While this patient could easily represent strep or EBV, the differentiating factor is
the location of the affected lymphadenopathy. As a generalization, posterior cervical
lymphadenopathy is common of Epstein-Barr virus (EBV) and anterior cervical
lymphadenopathy is more common with Group A beta-hemolytic streptococcus.
A 2-day old newborn has purulent discharge of the eyes and erythema. History includes a
vaginal birth at term delivered at home. What is the most likely culprit?
*Chlamydia trachomatis infection
*E-coli infection
*Staph infection
*Viral infection - ANS-Chlamydia trachomatis infection
Rationale: Chlamydia conjunctivitis is usually spread through direct contact with discharge
from the eyes or genital secretions of someone infected with Chlamydia trachomatis. It can
,occur in newborns during childbirth (neonatal conjunctivitis) or in adults through sexual
contact (adult inclusion conjunctivitis).
Symptoms: The symptoms can include:
Redness in the eye(s).
Watery or mucopurulent discharge (yellow or green discharge from the eyes).
Swelling of the eyelids.
Sensitivity to light (photophobia).
Itching or burning sensation in the eyes.
A 22-year-old has ASCAS on Pap smear and negative for HPV. The next step is:
*No follow up is needed.
*Repeat HPV in 3 months
*Colposcopy
*Repeat Pap in 6 months - ANS-Repeat Pap in 6 months
Rationale: For a 22-year-old with ASC-US on Pap smear and a negative HPV test, the next
appropriate step is to repeat the cytology in six months. This approach minimizes
unnecessary interventions while ensuring ongoing monitoring for any potential progression
of cervical cell abnormalities.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by bladder
emptying. The patient has been evaluated by urology and urogynecology. Review of
laboratory reports reveal negative urinalysis and cultures, negative results for sexually
transmitted infections, and an unremarkable cystoscopy. Which of the following is an
appropriate plan of care?
*Amitriptyline (Elavil) 25 mg oral once daily
*Referral to psychiatry
*Propranolol (Inderal) 10 mg oral once daily
*Nitrofurantoin (Macrodantin) 100 mg oral once daily - ANS-Amitriptyline (Elavil) 25 mg oral
once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by bladder
emptying. The patient has been evaluated by urology and urogynecology. Review of
laboratory reports reveal negative urinalysis and cultures, negative results for sexually
transmitted infections, and an unremarkable cystoscopy. Which of the following is an
appropriate plan of care? - ANS-Amitriptyline (Elavil) 25 mg oral once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old sexually active woman presents with lower abdominal pain, fever, and purulent
cervical discharge. On pelvic examination, cervical motion tenderness is noted. What is the
most likely diagnosis? - ANS-Pelvic inflammatory disease (PID)
Rationale: Cervical motion tenderness is a clinical finding characterized by pain elicited
when the cervix is moved or manipulated during a pelvic examination. This tenderness can
indicate underlying pelvic pathology. Lower abdominal pain, fever, abnormal vaginal
, discharge, pain during intercourse, and irregular menstrual bleeding and cervical motion
tenderness are present with Pelvic Inflammatory Disease (PID).
A 25-year-old athlete presents with shoulder pain and difficulty with overhead activities.
Physical examination suggests impingement syndrome. What is the most appropriate initial
treatment? - ANS-Physical therapy focusing on rotator cuff strengthening
Rationale: Exercises to improve shoulder strength and flexibility, focusing on the rotator cuff
and scapular stabilizers is an important initial treatment. Physical therapy may include
stretching and strengthening exercises, as well as techniques to improve shoulder
mechanics.
A 25-year-old woman presents with a 2-year history of fluctuating mood states, including
periods of mild depression and hypomania. These symptoms have not been severe enough
to meet the criteria for major depressive or manic episodes. What is the most likely
diagnosis? - ANS-Cyclothymic disorder
Rationale: Cyclothymic Disorder involves chronic mood fluctuations that include periods of
hypomanic and depressive symptoms. These symptoms are less severe than those in
Bipolar I or II disorders but can significantly impact daily functioning. Early diagnosis and
appropriate treatment, including psychotherapy, medications, and lifestyle changes, can help
manage symptoms and improve quality of life.
A 25-year-old woman presents with a sudden onset of shortness of breath and pleuritic
chest pain. She has no significant past medical history and takes no medications. On
physical examination, her heart rate is 110 beats per minute, respiratory rate is 24 breaths
per minute, and oxygen saturation is 90% on room air. What is the most likely diagnosis? -
ANS-Pulmonary embolism
Rationale: Pulmonary embolism (PE) is a serious medical condition that occurs when a
blood clot (usually from the legs or other parts of the body) travels to the lungs and obstructs
one of the pulmonary arteries. The primary symptoms of a PE can vary depending on the
size of the clot and the location within the lung, but the most common symptoms include:
Sudden onset of difficulty breathing, which may occur at rest or with exertion and sharp,
stabbing pain that may worsen with deep breathing (pleuritic pain). The pain may also feel
like pressure, fullness, or a squeezing sensation.
A 25-year-old woman presents with a urinary tract infection (UTI) confirmed by urinalysis.
She has no allergies. What is the most appropriate first-line antibiotic treatment?
*Amoxicillin
*Trimethoprim-sulfamethoxazole
*Ciprofloxacin
*Nitrofurantoin - ANS-Nitrofurantoin
Rationale: Overall, Nitrofurantoin is a preferred choice for treating uncomplicated UTIs,
especially in otherwise healthy individuals where local resistance patterns support its
efficacy.
A 25-year-old woman presents with dysuria, frequency, and urgency. Urinalysis shows pyuria
and bacteriuria. What is the most likely diagnosis? - ANS-Cystitis
Rationale: Symptoms of cystitis include frequent urges to urinate, which may be
accompanied by pain or burning during urination. The urine may appear bloody or cloudy,
