N502 H/A Exam 1 Questions With
Correct Answers
info gathering order - CORRECT ANSWER✔✔-establish the agenda
| | | | | | |
invite pt story | | |
gather info about pts perspective of illness
| | | | | |
ID and respond to pts cues
| | | | | |
gather info by exploring biomedical perspective
| | | | |
gather important background info
| | |
social determinants of health - CORRECT ANSWER✔✔-neighborhood & built
| | | | | | | | |
environment
economic stability (food, employment, poverty)
| | | |
education
social and community context
| | | |
health and health care| | |
Gingivitis - CORRECT ANSWER✔✔-inflammation of the gingiva without
| | | | | | | |
destruction of the periodontal ligament or bone, which distinguishes it from
| | | | | | | | | | |
periodontitis.
Mrs. Pederson is a 74 year old who presents for a routine blood pressure follow
| | | | | | | | | | | | | | |
up visit. Her blood pressure is well controlled, but on review of systems she
| | | | | | | | | | | | | |
,reports dry mouth of several years duration that has acutely worsened over the
| | | | | | | | | | | | |
past 2 months. She quit smoking after she developed thyroid cancer that required
| | | | | | | | | | | |
surgery and neck radiation for cure. She has been drinking more water than
| | | | | | | | | | | | | |
usual, but it only improves her symptoms for a few minutes. She drinks wine with
| | | | | | | | | | | | | |
dinner and sometimes before bed for insomnia. On physical examination this is
| | | | | | | | | | | | |
the appearance of her tongue (Pic: normal, dry).
| | | | | | |
All of the following are likely contributing to Mrs. Pederson's xerostomia (the
| | | | | | | | | | | |
sensation of dry mouth) except: | | | |
A. Aging process
| |
B. antiHTN meds
| |
C. alcohol use
| | |
D. head/neck radiation
| |
E. sedative medications - CORRECT ANSWER✔✔-A. Aging process
| | | | | | |
aging alone is not a predisposing factor to xerostomia(dry mouth)
| | | | | | | | |
Mrs. Pederson's active medical problems include Hypertension, Type 2 Diabetes
| | | | | | | | | |
Mellitus, and Glaucoma. Her past history is remarkable for treated thyroid cancer,
| | | | | | | | | | |
seasonal allergies, and intermittent insomnia. She smoked when she was
| | | | | | | | | | |
younger, but quit 30 years ago. She is widowed and a retired administrative
| | | | | | | | | | | | |
assistant. She enjoys a glass of wine about five times a week with dinner and
| | | | | | | | | | | | | | |
walks daily for exercise.
| | |
Her medications include:
| |
lisinopril/HCTZ 10/25 mg orally once daily | | | | |
metformin 1000 mg orally twice daily | | | | |
,aspirin 81 mg orally once daily
| | | | |
zolpidem 10 mg orally at bedtime approximately twice per week
| | | | | | | | |
diphenhydramine 25 mg orally as needed for allergy symptoms in the spring and | | | | | | | | | | | | |
fall
latanoprost ophthalmic drops daily (topical prostaglandin analog for closed angle
| | | | | | | | | |
glaucoma treatment) |
Based on the information provided above, which of the following scenarios would
| | | | | | | | | | |
most likely contribute to Mrs. Pederson's xerostomia - CORRECT ANSWER✔✔-B.
| | | | | | | | | | |
zolpidem is a sedative which can worsen xerostomia
| | | | | | |
Mrs. Pederson reduces her alcohol intake and stops taking diphenhydramine and
| | | | | | | | | | |
zolpidem. She understands the need for her antihypertensive and diabetic
| | | | | | | | | |
medications and will continue to take those as directed. After these changes her
| | | | | | | | | | | | |
dry mouth improves to some degree, but is still symptomatic. She inquires what
| | | | | | | | | | | | |
else she can do to improve her symptoms.
| | | | | | |
Which of the following interventions would be contraindicated for Mrs.
| | | | | | | | | |
Pederson?
A. Use of an over-the-counter saliva substitute
| | | | | |
B. Sucking sugarless candy during the day to promote saliva production
| | | | | | | | | |
C. Starting cevimeline in an effort to increase saliva production
| | | | | | | | |
D. Switching to an electric toothbrush from a traditional one
| | | | | | | | |
E. Avoiding sugary and caffeinated drinks - CORRECT ANSWER✔✔-C. Cevimeline
| | | | | | | | | |
and pilocarpine increases the flow of saliva through stimulation of muscarinic
| | | | | | | | | | |
cholinergic receptors, and are commonly used in patients with Sjogrens
| | | | | | | | | |
Syndrome. While potentially helpful, their use is contraindicated in patients such
| | | | | | | | | | |
, as Mrs. Pederson with angle closure Glaucoma. Other potential side effects of
| | | | | | | | | | | |
these agents include headache, nausea, diaphoresis, rhinitis, abdominal pain, and
| | | | | | | | |
vomiting.
|
Herpes labialis - CORRECT ANSWER✔✔-cold sores
| | | | | |
tx: topical antiviral
| |
Tanya is a 10 year old female who presents to your office with a painful mouth
| | | | | | | | | | | | | | | |
sore that has been present for three days. The sore developed spontaneously and
| | | | | | | | | | | |
has not changed since its appearance. Six months ago, she noticed similar sores
| | | | | | | | | | | | | |
that resolved spontaneously after two weeks. She denies fever or systemic
| | | | | | | | | | |
symptoms. Your oral exam reveals the following: | | | | | |
What is the most likely cause of Tanya's oral lesion?
| | | | | | | | |
A. Primary oral herpes
| | |
B. Gingival trauma
| |
C. Coxsackie virus
| |
D. Aphthous ulcer - CORRECT ANSWER✔✔-D
| | | | |
Which of the following is true regarding Recurrent Aphthous Ulcers (RAU)?
| | | | | | | | | |
A. These lesions commonly present as a single painful ulcer that resolves after
| | | | | | | | | | | | |
two months. |
B. RAUs have been associated with vitamin deficiencies.
| | | | | | |
Correct Answers
info gathering order - CORRECT ANSWER✔✔-establish the agenda
| | | | | | |
invite pt story | | |
gather info about pts perspective of illness
| | | | | |
ID and respond to pts cues
| | | | | |
gather info by exploring biomedical perspective
| | | | |
gather important background info
| | |
social determinants of health - CORRECT ANSWER✔✔-neighborhood & built
| | | | | | | | |
environment
economic stability (food, employment, poverty)
| | | |
education
social and community context
| | | |
health and health care| | |
Gingivitis - CORRECT ANSWER✔✔-inflammation of the gingiva without
| | | | | | | |
destruction of the periodontal ligament or bone, which distinguishes it from
| | | | | | | | | | |
periodontitis.
Mrs. Pederson is a 74 year old who presents for a routine blood pressure follow
| | | | | | | | | | | | | | |
up visit. Her blood pressure is well controlled, but on review of systems she
| | | | | | | | | | | | | |
,reports dry mouth of several years duration that has acutely worsened over the
| | | | | | | | | | | | |
past 2 months. She quit smoking after she developed thyroid cancer that required
| | | | | | | | | | | |
surgery and neck radiation for cure. She has been drinking more water than
| | | | | | | | | | | | | |
usual, but it only improves her symptoms for a few minutes. She drinks wine with
| | | | | | | | | | | | | |
dinner and sometimes before bed for insomnia. On physical examination this is
| | | | | | | | | | | | |
the appearance of her tongue (Pic: normal, dry).
| | | | | | |
All of the following are likely contributing to Mrs. Pederson's xerostomia (the
| | | | | | | | | | | |
sensation of dry mouth) except: | | | |
A. Aging process
| |
B. antiHTN meds
| |
C. alcohol use
| | |
D. head/neck radiation
| |
E. sedative medications - CORRECT ANSWER✔✔-A. Aging process
| | | | | | |
aging alone is not a predisposing factor to xerostomia(dry mouth)
| | | | | | | | |
Mrs. Pederson's active medical problems include Hypertension, Type 2 Diabetes
| | | | | | | | | |
Mellitus, and Glaucoma. Her past history is remarkable for treated thyroid cancer,
| | | | | | | | | | |
seasonal allergies, and intermittent insomnia. She smoked when she was
| | | | | | | | | | |
younger, but quit 30 years ago. She is widowed and a retired administrative
| | | | | | | | | | | | |
assistant. She enjoys a glass of wine about five times a week with dinner and
| | | | | | | | | | | | | | |
walks daily for exercise.
| | |
Her medications include:
| |
lisinopril/HCTZ 10/25 mg orally once daily | | | | |
metformin 1000 mg orally twice daily | | | | |
,aspirin 81 mg orally once daily
| | | | |
zolpidem 10 mg orally at bedtime approximately twice per week
| | | | | | | | |
diphenhydramine 25 mg orally as needed for allergy symptoms in the spring and | | | | | | | | | | | | |
fall
latanoprost ophthalmic drops daily (topical prostaglandin analog for closed angle
| | | | | | | | | |
glaucoma treatment) |
Based on the information provided above, which of the following scenarios would
| | | | | | | | | | |
most likely contribute to Mrs. Pederson's xerostomia - CORRECT ANSWER✔✔-B.
| | | | | | | | | | |
zolpidem is a sedative which can worsen xerostomia
| | | | | | |
Mrs. Pederson reduces her alcohol intake and stops taking diphenhydramine and
| | | | | | | | | | |
zolpidem. She understands the need for her antihypertensive and diabetic
| | | | | | | | | |
medications and will continue to take those as directed. After these changes her
| | | | | | | | | | | | |
dry mouth improves to some degree, but is still symptomatic. She inquires what
| | | | | | | | | | | | |
else she can do to improve her symptoms.
| | | | | | |
Which of the following interventions would be contraindicated for Mrs.
| | | | | | | | | |
Pederson?
A. Use of an over-the-counter saliva substitute
| | | | | |
B. Sucking sugarless candy during the day to promote saliva production
| | | | | | | | | |
C. Starting cevimeline in an effort to increase saliva production
| | | | | | | | |
D. Switching to an electric toothbrush from a traditional one
| | | | | | | | |
E. Avoiding sugary and caffeinated drinks - CORRECT ANSWER✔✔-C. Cevimeline
| | | | | | | | | |
and pilocarpine increases the flow of saliva through stimulation of muscarinic
| | | | | | | | | | |
cholinergic receptors, and are commonly used in patients with Sjogrens
| | | | | | | | | |
Syndrome. While potentially helpful, their use is contraindicated in patients such
| | | | | | | | | | |
, as Mrs. Pederson with angle closure Glaucoma. Other potential side effects of
| | | | | | | | | | | |
these agents include headache, nausea, diaphoresis, rhinitis, abdominal pain, and
| | | | | | | | |
vomiting.
|
Herpes labialis - CORRECT ANSWER✔✔-cold sores
| | | | | |
tx: topical antiviral
| |
Tanya is a 10 year old female who presents to your office with a painful mouth
| | | | | | | | | | | | | | | |
sore that has been present for three days. The sore developed spontaneously and
| | | | | | | | | | | |
has not changed since its appearance. Six months ago, she noticed similar sores
| | | | | | | | | | | | | |
that resolved spontaneously after two weeks. She denies fever or systemic
| | | | | | | | | | |
symptoms. Your oral exam reveals the following: | | | | | |
What is the most likely cause of Tanya's oral lesion?
| | | | | | | | |
A. Primary oral herpes
| | |
B. Gingival trauma
| |
C. Coxsackie virus
| |
D. Aphthous ulcer - CORRECT ANSWER✔✔-D
| | | | |
Which of the following is true regarding Recurrent Aphthous Ulcers (RAU)?
| | | | | | | | | |
A. These lesions commonly present as a single painful ulcer that resolves after
| | | | | | | | | | | | |
two months. |
B. RAUs have been associated with vitamin deficiencies.
| | | | | | |
