NR 509 Final Exam Study Guide
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam with correct answers ||\\||\\ ||\\||\\ ||\\||\\
Chapter 19: Abdomen ||\\||\\ ||\\||\\
...
An overweight 26-year-old public servant presents to the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Emergency Department with 12 hours of intense ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
abdominal pain, light-headedness, and a fainting episode ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
that finally prompted her to seek medical attention. She
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
has a strong family history of gallstones and is concerned
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
about this possibility. She has not had any vomiting or ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
diarrhea. She had a normal bowel movement this ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
morning. Her β-human chorionic gonadotropin (β-hCG) is ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
positive at triage. She reports that her last period was 10 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
weeks ago. Her vital signs at triage are pulse, 118; blood ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
pressure, 86/68; respiratory rate, 20/min; oxygen ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
saturation, 99%; and temperature, 37.3ºC orally. The ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
clinician performs an abdominal exam prior to her pelvic ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam and, on palpation of her abdomen, finds involuntary
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
rigidity and rebound tenderness. What is the most likely
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
diagnosis?
,a. Ruptured tubal (or ectopic) pregnancy
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
b. Acute cholecystitis ||\\||\\ ||\\||\\
c. Ruptured appendix
||\\||\\ ||\\||\\
d. Perforated bowel wall
||\\||\\ ||\\||\\ ||\\||\\
e. Ruptured ovarian cyst
||\\||\\ ||\\||\\ ||\\||\\
A 63-year-old janitor with a history of adenomatous
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
colonic polyps presents for a well visit. Basic labs are
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
performed to screen for diabetes mellitus and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
dyslipidemia. Electrolytes and liver enzymes were also ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
measured. His labs are all normal expect for moderate ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
elevations of aspartate aminotransferase, alanine ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
aminotransferase, γ-glutamyl transferase, and alkaline ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
phosphatase as well as a mildly elevated total bilirubin. He ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
presents for a follow-up appointment and the clinician
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
performs an abdominal exam to assess his liver. Which of ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the following findings would be most consistent with
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hepatomegaly?
a. Liver span of 11 cm at the midclavicular line
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
b. Liver span of 8 cm at the midsternal line
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,c. Dullness to percussion over a span of 11 cm at the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
midclavicular line ||\\||\\
d. Dullness to percussion over a span of 8 cm at the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
midsternal line ||\\||\\
e. Liver palpable 3 cm below the right costal margin, mid
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
clavicular line, on expiration
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A 63-year-old underweight administrative clerk with a 50-
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
pack-year smoking history presents with a several month ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
history of recurrent epigastric abdominal discomfort. She ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
feels fairly well otherwise and denies any nausea, ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
vomiting, diarrhea, or constipation. She reports that a first ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cousin died from a ruptured aneurysm at age 68 years.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Her vital signs are pulse, 86; blood pressure, 148/92;
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
respiratory rate, 16; oxygen saturation, 95%; and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
temperature, 36.2ºC. Her body mass index is 17.6. On ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam, her abdominal aorta is prominent, which is ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
concerning for an abdominal aortic aneurysm (AAA). ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Which of the following is her most significant risk factor ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
for an AAA? ||\\||\\ ||\\||\\
a. Female gender ||\\||\\ ||\\||\\
b. History of smoking ||\\||\\ ||\\||\\ ||\\||\\
, c. Underweight
||\\||\\
d. Family history of ruptured aneurysm
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
e. Hypertension
||\\||\\
A 76-year-old retired man with a history of prostate
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cancer and hypertension has been screened annually for ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
colon cancer using high sensitivity fecal occult blood
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
testing (FOBT). He presents for follow-up of his ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hypertension, during which the clinician scans his chart to ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
ensure he is up to date with his preventive health care. He ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
has a positive FOBT on one occasion at age 66 years and
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
subsequently went for a colonoscopy. Internal ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hemorrhoids and sigmoid diverticuli were found on ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
colonoscopy. He has no first-degree relatives with a ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
history of colorectal cancer or adenomatous polyps. What ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
are the U.S. Preventive Services Task Force (USPSTF)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
screening recommendations for this patient? ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
a. Do not screen routinely
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
b. Continue annual FOBT screening until age 80 years
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
c. Continue annual FOBT screening until age 85 years
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
d. Repeat colonoscopy this year
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam with correct answers ||\\||\\ ||\\||\\ ||\\||\\
Chapter 19: Abdomen ||\\||\\ ||\\||\\
...
An overweight 26-year-old public servant presents to the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Emergency Department with 12 hours of intense ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
abdominal pain, light-headedness, and a fainting episode ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
that finally prompted her to seek medical attention. She
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
has a strong family history of gallstones and is concerned
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
about this possibility. She has not had any vomiting or ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
diarrhea. She had a normal bowel movement this ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
morning. Her β-human chorionic gonadotropin (β-hCG) is ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
positive at triage. She reports that her last period was 10 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
weeks ago. Her vital signs at triage are pulse, 118; blood ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
pressure, 86/68; respiratory rate, 20/min; oxygen ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
saturation, 99%; and temperature, 37.3ºC orally. The ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
clinician performs an abdominal exam prior to her pelvic ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam and, on palpation of her abdomen, finds involuntary
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
rigidity and rebound tenderness. What is the most likely
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
diagnosis?
,a. Ruptured tubal (or ectopic) pregnancy
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
b. Acute cholecystitis ||\\||\\ ||\\||\\
c. Ruptured appendix
||\\||\\ ||\\||\\
d. Perforated bowel wall
||\\||\\ ||\\||\\ ||\\||\\
e. Ruptured ovarian cyst
||\\||\\ ||\\||\\ ||\\||\\
A 63-year-old janitor with a history of adenomatous
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
colonic polyps presents for a well visit. Basic labs are
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
performed to screen for diabetes mellitus and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
dyslipidemia. Electrolytes and liver enzymes were also ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
measured. His labs are all normal expect for moderate ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
elevations of aspartate aminotransferase, alanine ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
aminotransferase, γ-glutamyl transferase, and alkaline ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
phosphatase as well as a mildly elevated total bilirubin. He ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
presents for a follow-up appointment and the clinician
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
performs an abdominal exam to assess his liver. Which of ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the following findings would be most consistent with
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hepatomegaly?
a. Liver span of 11 cm at the midclavicular line
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
b. Liver span of 8 cm at the midsternal line
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,c. Dullness to percussion over a span of 11 cm at the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
midclavicular line ||\\||\\
d. Dullness to percussion over a span of 8 cm at the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
midsternal line ||\\||\\
e. Liver palpable 3 cm below the right costal margin, mid
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
clavicular line, on expiration
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A 63-year-old underweight administrative clerk with a 50-
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
pack-year smoking history presents with a several month ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
history of recurrent epigastric abdominal discomfort. She ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
feels fairly well otherwise and denies any nausea, ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
vomiting, diarrhea, or constipation. She reports that a first ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cousin died from a ruptured aneurysm at age 68 years.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Her vital signs are pulse, 86; blood pressure, 148/92;
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
respiratory rate, 16; oxygen saturation, 95%; and ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
temperature, 36.2ºC. Her body mass index is 17.6. On ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
exam, her abdominal aorta is prominent, which is ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
concerning for an abdominal aortic aneurysm (AAA). ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Which of the following is her most significant risk factor ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
for an AAA? ||\\||\\ ||\\||\\
a. Female gender ||\\||\\ ||\\||\\
b. History of smoking ||\\||\\ ||\\||\\ ||\\||\\
, c. Underweight
||\\||\\
d. Family history of ruptured aneurysm
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
e. Hypertension
||\\||\\
A 76-year-old retired man with a history of prostate
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cancer and hypertension has been screened annually for ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
colon cancer using high sensitivity fecal occult blood
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
testing (FOBT). He presents for follow-up of his ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hypertension, during which the clinician scans his chart to ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
ensure he is up to date with his preventive health care. He ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
has a positive FOBT on one occasion at age 66 years and
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
subsequently went for a colonoscopy. Internal ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
hemorrhoids and sigmoid diverticuli were found on ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
colonoscopy. He has no first-degree relatives with a ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
history of colorectal cancer or adenomatous polyps. What ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
are the U.S. Preventive Services Task Force (USPSTF)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
screening recommendations for this patient? ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
a. Do not screen routinely
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
b. Continue annual FOBT screening until age 80 years
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
c. Continue annual FOBT screening until age 85 years
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
d. Repeat colonoscopy this year
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
