Leik Board Questions (with rationale
on most)
An elderly patient with a productive cough and fever is diagnosed with pneumonia. All of the following
organisms are capable of causing community-acquired pneumonia except:
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Treponema pallidum
D) Streptococcus pneumoniae - Answer-C) Treponema pallidum
Treponema pallidum is a gram-negative spirochete bacterium that causes syphilis.
Human chorionic gonadotropin (hCG) is produced by the:
A) Placenta
B) Hypothalamus
C) Anterior pituitary
D) Ovaries - Answer-A) Placenta
Human chorionic gonadotropin (hCG) is a hormone produced by the placenta after implantation. It can
also be produced in gestational trophoblastic disease or hydatidiform mole (molar pregnancy).
The majority of serum alpha fetoprotein is produced by the:
A) Fetal liver
,B) Maternal liver
C) Placenta
D) Fetal neural tube - Answer-A) Fetal liver
Alpha fetoprotein (AFP) is produced mainly by the growing fetal liver. A small amount comes from the
mother's liver, but by the end of the first trimester, most of the AFP is produced by the fetal liver.
A middle-aged woman who works in the housekeeping department of a hospital presents to the
employee health clinic with a complaint of a needle stick to her left thumb. The needle was in one of the
garbage bags from the emergency department.The patient had a little bleeding that stopped
spontaneously. Which of the following is the next step?
A) Order an enzyme-linked immunosorbent assay (ELISA) test as soon as possible
B) Recommend a tetanus booster in 1 week
C) Offer the patient hepatitis B immunoglobulin
D) Order a chest x-ray - Answer-A) Order an enzyme-linked immunosorbent assay (ELISA) test as soon as
possible
Employee health clinic protocols for needlesticks recommend ordering an ELISA test as soon as possible
to establish baseline blood work for the employee.
An elderly woman has been taking digoxin (Lanoxin) for 10 years. Her EKG is showing anew onset of
atrial fibrillation. Her pulse is 64 beats/min. She denies syncope and dizziness.Which of the following
interventions is most appropriate?
A) Order an electrolyte panel and a digoxin level
B) Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an electrolyte panel
C) Order a serum digoxin level and decrease her digoxin dose by half while waiting for results
D) Discontinue the digoxin and order another 12-lead EKG - Answer-B) Order a serum thyroid-
stimulating hormone (TSH), digoxin level, and an electrolyte panel
, Obtaining baseline blood work to evaluate for causes of new-onset atrial fibrillation is recommended
before decreasing or stopping medications. Thyroid disease is a common cause of new-onset atrial
fibrillation.
Koplik's spots are associated with:
A) Poxvirus infections
B) Rubeola
C) Kawasaki's disease
D) Rubella - Answer-B) Rubeola
Rubeola is the Latin name for measles. Signs and symptoms of measles infection include fever over
101°F, coryza, cough, conjunctivitis, rash, and Koplik's spots on the buccal mucosa. Do not confuse
rubeola with rubella (German measles or 3-day measles).
A 21-year-old new mother reports that she has been feeling irritable and jittery almost daily for the past
few months. She complains of frequent palpitations and more frequent bowel movements along with
weight loss. Her blood pressure is 160/70 mmHg, pulse is110 beats/min, and she is afebrile. All of the
following conditions should be considered in the differential diagnosis for this patient except:
A) Mitral regurgitation
B) Graves' disease
C) Generalized anxiety disorder
D) Illicit drug use - Answer-A) Mitral regurgitation
Signs and symptoms of mitral regurgitation do not include frequent bowel movements with weight loss.
A patient with a history of mitral valve prolapse (MVP) is requesting prophylaxis before her dental
surgery. Which of the following would you prescribe this patient?
A) Amoxicillin a half hour before and 2 hours after the procedure
on most)
An elderly patient with a productive cough and fever is diagnosed with pneumonia. All of the following
organisms are capable of causing community-acquired pneumonia except:
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Treponema pallidum
D) Streptococcus pneumoniae - Answer-C) Treponema pallidum
Treponema pallidum is a gram-negative spirochete bacterium that causes syphilis.
Human chorionic gonadotropin (hCG) is produced by the:
A) Placenta
B) Hypothalamus
C) Anterior pituitary
D) Ovaries - Answer-A) Placenta
Human chorionic gonadotropin (hCG) is a hormone produced by the placenta after implantation. It can
also be produced in gestational trophoblastic disease or hydatidiform mole (molar pregnancy).
The majority of serum alpha fetoprotein is produced by the:
A) Fetal liver
,B) Maternal liver
C) Placenta
D) Fetal neural tube - Answer-A) Fetal liver
Alpha fetoprotein (AFP) is produced mainly by the growing fetal liver. A small amount comes from the
mother's liver, but by the end of the first trimester, most of the AFP is produced by the fetal liver.
A middle-aged woman who works in the housekeeping department of a hospital presents to the
employee health clinic with a complaint of a needle stick to her left thumb. The needle was in one of the
garbage bags from the emergency department.The patient had a little bleeding that stopped
spontaneously. Which of the following is the next step?
A) Order an enzyme-linked immunosorbent assay (ELISA) test as soon as possible
B) Recommend a tetanus booster in 1 week
C) Offer the patient hepatitis B immunoglobulin
D) Order a chest x-ray - Answer-A) Order an enzyme-linked immunosorbent assay (ELISA) test as soon as
possible
Employee health clinic protocols for needlesticks recommend ordering an ELISA test as soon as possible
to establish baseline blood work for the employee.
An elderly woman has been taking digoxin (Lanoxin) for 10 years. Her EKG is showing anew onset of
atrial fibrillation. Her pulse is 64 beats/min. She denies syncope and dizziness.Which of the following
interventions is most appropriate?
A) Order an electrolyte panel and a digoxin level
B) Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an electrolyte panel
C) Order a serum digoxin level and decrease her digoxin dose by half while waiting for results
D) Discontinue the digoxin and order another 12-lead EKG - Answer-B) Order a serum thyroid-
stimulating hormone (TSH), digoxin level, and an electrolyte panel
, Obtaining baseline blood work to evaluate for causes of new-onset atrial fibrillation is recommended
before decreasing or stopping medications. Thyroid disease is a common cause of new-onset atrial
fibrillation.
Koplik's spots are associated with:
A) Poxvirus infections
B) Rubeola
C) Kawasaki's disease
D) Rubella - Answer-B) Rubeola
Rubeola is the Latin name for measles. Signs and symptoms of measles infection include fever over
101°F, coryza, cough, conjunctivitis, rash, and Koplik's spots on the buccal mucosa. Do not confuse
rubeola with rubella (German measles or 3-day measles).
A 21-year-old new mother reports that she has been feeling irritable and jittery almost daily for the past
few months. She complains of frequent palpitations and more frequent bowel movements along with
weight loss. Her blood pressure is 160/70 mmHg, pulse is110 beats/min, and she is afebrile. All of the
following conditions should be considered in the differential diagnosis for this patient except:
A) Mitral regurgitation
B) Graves' disease
C) Generalized anxiety disorder
D) Illicit drug use - Answer-A) Mitral regurgitation
Signs and symptoms of mitral regurgitation do not include frequent bowel movements with weight loss.
A patient with a history of mitral valve prolapse (MVP) is requesting prophylaxis before her dental
surgery. Which of the following would you prescribe this patient?
A) Amoxicillin a half hour before and 2 hours after the procedure
