Family Medicine EOR Questions and
answer
A 54-year-old man presents with chest pain. He has a past medical history of hypertension
and diabetes mellitus. The pain is located in the middle of his chest and radiates to his jaw.
The pain began about 20 minutes ago, and he rates the pain as a 10 on a 0 - 10 point scale,
with 10 being the worst pain he has ever felt. He has had 3 similar episodes, but they have
always resolved after 5 minutes or so of rest. He has smoked 1 pack of cigarettes a day for
the past 36 years. He drinks 2 or 3 beers on Friday nights. Review of systems (ROS) is
positive for diaphoresis, acute dyspnea, and impending doom. ROS negative for fever, chills,
and malaise. Physical exam shows an obese, middle-aged man in moderate distress. BP
126/80, pulse 100, respirations 26. Heart and lung exams are normal, except for tachycardia
and tachypnea. He has no pedal edema. What aspect of the patient's history is the largest
risk factor for an acute myocardial infarction?
A. alcohol use
B. cigarette smoking
C. diabetes mellitus
D. hypertension
E. obesity
C. Diabetes mellitus
(DM) is an independent risk factor for atherosclerosis. The risk of myocardial infarction (MI)
in a patient with diabetes is the same risk as someone without diabetes who has had a
previous MI. The risk of death from cardiac events is also the same between the 2 groups.
Patients with diabetes mellitus should be advised to stop smoking and aggressively control
other risk factors, such as glucose, hypertension, and dyslipidemia, in order to reduce the
risk of ischemic heart disease.
Absorption of vitamin B12 requires intrinsic factor that is secreted by which cell type?
parietal cells
Brainpower
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A 65-year-old woman presents with glossitis, weight loss, paresthesias, and diarrhea.
Laboratory tests show a macrocytic anemia. The most likely cause is
A Iron-deficiency anemia
B Thalassemia
C Pernicious anemia
D Multiple myeloma
E Colon cancer
C Pernicious anemia
A 45-year-old woman with a no significant past medical history presents with a 4-month
history of dull, aching heaviness sensation in her proximal right leg. She notes that this
sensation is provoked by extended periods of standing and walking, and is relieved when
she lies in a recumbent position. Her past medical history is remarkable for pregnancy 4
times, the most recent being approximately 2 years ago. She denies a history of smoking,
trauma, injuries, fever, chills, chest pain, shortness of breath, hemoptysis, cough, skin
changes and coolness, and peripheral edema. Her physical exam reveals several dilated,
tortuous, elongated veins along the medial right thigh, which are especially pronounced upon
standing. The remainder of the physical exam is normal. What will be the most appropriate
therapeutic approach for this patient at this time?
Warfarin (Coumadin)
Hint:
Warfarin is indicated for myocardial infarction or cerebrovascular accident prevention and in
patients with atrial fibrillation, mechanical heart valves, or deep venous thrombosis.
A Warfarin
B Clopidogrel (Plavix)
C Sclerotherapy
D Furosemide (Lasix)
E Cilostazol (Pletal)
This patient's diagnosis is varicose veins. Sclerotherapy can be used to treat varicose veins.
It involves the injection of an irritating solution into the varicose vein to promote an
inflammatory response, scarring, and obliteration of the lumen
A 62-year-old woman with a long-standing history of hypertension presents with a severe
headache; it started this morning and is rapidly worsening. During the interview, she
suddenly collapses. Your brief examination shows that she responds with extensor posturing
on external stimuli. Her deep tendon reflexes are 3, and you elicit Babinski bilaterally. You
also notice that her breathing has a peculiar pattern: deep inspiration with a pause at full
inspiration, followed by a brief insufficient release and the end-inspiration pause. How do you
best describe her respiratory pattern?
A Cheyne-Stokes
B Apneusis
C Ataxic
D Cluster
E Kussmaul
, Deficiency of what factor may predispose a person to recurrent thrombosis?
A Platelet deficiency
B Factor VIIIC deficiency
C Protein C deficiency
D von Willebrand factor deficiency
E Factor VII deficiency
C Protein C deficiency
A 15-year-old girl presents with a 1-hour history of rapid heartbeat, faintness, sweating, and
nervousness. She is also experiencing shortness of breath and chest pain. The patient has
no significant past medical history. There is no history of similar episodes. The patient is on
no medications, and she denies illicit drug use. On exam, her vital signs are BP70/60 mmHg;
pulse 200 bpm; RR 22/min, temperature afebrile. She looks pale, and her palms are slightly
sweaty. She is not comfortable sitting up, so she prefers lying down. She looks slightly
apprehensive. Her heart and lung exam are negative except for the tachycardia; except for
cool sweaty hands, a brief abdominal and extremity exam are non-revealing. The physician
quickly places the paddles on the patient's chest to record the rhythm; this shows a
narrow-complex regular tachycardia at 210 bpm. He requests oxygen, IV line, and
continuous monitoring. An EKG is in the process of being completed. At this point, what
should be done?
synchronized cardioversion
which cancers is the AFP tumor marker associated with?
hepatocellular carcinoma
germ cell tumors
50-year-old man presents with a 3-month history of weakness, fatigue, and abdominal
discomfort. Upon further questioning, he acknowledges a lack of sexual desire. He denies
any photosensitivity. On physical examination, his liver is enlarged, and his spleen is
palpable. He has abnormal skin pigmentation on his face, neck and his elbows and which
gives his skin a metallic gray hue. His laboratory results are in the chart.
TESTRESULTS
TIBC275 (250 - 350)
Plasma iron 220 (80 - 160)
Transferring saturation 90% (16 - 57%)
What serious complication is associated with the patient's condition?
answer
A 54-year-old man presents with chest pain. He has a past medical history of hypertension
and diabetes mellitus. The pain is located in the middle of his chest and radiates to his jaw.
The pain began about 20 minutes ago, and he rates the pain as a 10 on a 0 - 10 point scale,
with 10 being the worst pain he has ever felt. He has had 3 similar episodes, but they have
always resolved after 5 minutes or so of rest. He has smoked 1 pack of cigarettes a day for
the past 36 years. He drinks 2 or 3 beers on Friday nights. Review of systems (ROS) is
positive for diaphoresis, acute dyspnea, and impending doom. ROS negative for fever, chills,
and malaise. Physical exam shows an obese, middle-aged man in moderate distress. BP
126/80, pulse 100, respirations 26. Heart and lung exams are normal, except for tachycardia
and tachypnea. He has no pedal edema. What aspect of the patient's history is the largest
risk factor for an acute myocardial infarction?
A. alcohol use
B. cigarette smoking
C. diabetes mellitus
D. hypertension
E. obesity
C. Diabetes mellitus
(DM) is an independent risk factor for atherosclerosis. The risk of myocardial infarction (MI)
in a patient with diabetes is the same risk as someone without diabetes who has had a
previous MI. The risk of death from cardiac events is also the same between the 2 groups.
Patients with diabetes mellitus should be advised to stop smoking and aggressively control
other risk factors, such as glucose, hypertension, and dyslipidemia, in order to reduce the
risk of ischemic heart disease.
Absorption of vitamin B12 requires intrinsic factor that is secreted by which cell type?
parietal cells
Brainpower
Read More
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
/
,0:15
Full screen
A 65-year-old woman presents with glossitis, weight loss, paresthesias, and diarrhea.
Laboratory tests show a macrocytic anemia. The most likely cause is
A Iron-deficiency anemia
B Thalassemia
C Pernicious anemia
D Multiple myeloma
E Colon cancer
C Pernicious anemia
A 45-year-old woman with a no significant past medical history presents with a 4-month
history of dull, aching heaviness sensation in her proximal right leg. She notes that this
sensation is provoked by extended periods of standing and walking, and is relieved when
she lies in a recumbent position. Her past medical history is remarkable for pregnancy 4
times, the most recent being approximately 2 years ago. She denies a history of smoking,
trauma, injuries, fever, chills, chest pain, shortness of breath, hemoptysis, cough, skin
changes and coolness, and peripheral edema. Her physical exam reveals several dilated,
tortuous, elongated veins along the medial right thigh, which are especially pronounced upon
standing. The remainder of the physical exam is normal. What will be the most appropriate
therapeutic approach for this patient at this time?
Warfarin (Coumadin)
Hint:
Warfarin is indicated for myocardial infarction or cerebrovascular accident prevention and in
patients with atrial fibrillation, mechanical heart valves, or deep venous thrombosis.
A Warfarin
B Clopidogrel (Plavix)
C Sclerotherapy
D Furosemide (Lasix)
E Cilostazol (Pletal)
This patient's diagnosis is varicose veins. Sclerotherapy can be used to treat varicose veins.
It involves the injection of an irritating solution into the varicose vein to promote an
inflammatory response, scarring, and obliteration of the lumen
A 62-year-old woman with a long-standing history of hypertension presents with a severe
headache; it started this morning and is rapidly worsening. During the interview, she
suddenly collapses. Your brief examination shows that she responds with extensor posturing
on external stimuli. Her deep tendon reflexes are 3, and you elicit Babinski bilaterally. You
also notice that her breathing has a peculiar pattern: deep inspiration with a pause at full
inspiration, followed by a brief insufficient release and the end-inspiration pause. How do you
best describe her respiratory pattern?
A Cheyne-Stokes
B Apneusis
C Ataxic
D Cluster
E Kussmaul
, Deficiency of what factor may predispose a person to recurrent thrombosis?
A Platelet deficiency
B Factor VIIIC deficiency
C Protein C deficiency
D von Willebrand factor deficiency
E Factor VII deficiency
C Protein C deficiency
A 15-year-old girl presents with a 1-hour history of rapid heartbeat, faintness, sweating, and
nervousness. She is also experiencing shortness of breath and chest pain. The patient has
no significant past medical history. There is no history of similar episodes. The patient is on
no medications, and she denies illicit drug use. On exam, her vital signs are BP70/60 mmHg;
pulse 200 bpm; RR 22/min, temperature afebrile. She looks pale, and her palms are slightly
sweaty. She is not comfortable sitting up, so she prefers lying down. She looks slightly
apprehensive. Her heart and lung exam are negative except for the tachycardia; except for
cool sweaty hands, a brief abdominal and extremity exam are non-revealing. The physician
quickly places the paddles on the patient's chest to record the rhythm; this shows a
narrow-complex regular tachycardia at 210 bpm. He requests oxygen, IV line, and
continuous monitoring. An EKG is in the process of being completed. At this point, what
should be done?
synchronized cardioversion
which cancers is the AFP tumor marker associated with?
hepatocellular carcinoma
germ cell tumors
50-year-old man presents with a 3-month history of weakness, fatigue, and abdominal
discomfort. Upon further questioning, he acknowledges a lack of sexual desire. He denies
any photosensitivity. On physical examination, his liver is enlarged, and his spleen is
palpable. He has abnormal skin pigmentation on his face, neck and his elbows and which
gives his skin a metallic gray hue. His laboratory results are in the chart.
TESTRESULTS
TIBC275 (250 - 350)
Plasma iron 220 (80 - 160)
Transferring saturation 90% (16 - 57%)
What serious complication is associated with the patient's condition?
