Name: Score:
120 Multiple choice questions
Term 1 of 120
A 65-year-old woman presents for her annual physical to her primary care physician. She has a
history of recurrent urinary tract infections and has a 30 pack-year smoking history. She has
worked in a textile factory for 40 years. With her increased risk, what is the most common
symptom of bladder cancer that would necessitate further investigation?
Weight Loss
Dysuria
Melena
Hematuria
Term 2 of 120
Which of the following is the first-line therapy for a typical anal fissure?
Fat
Minerals
Protein
Fiber
,Term 3 of 120
A 63-year-old right-handed man presents to the emergency department with a sudden onset of
numbness on the right side of his face, arm, and leg, as well as right arm and leg weakness. His
symptoms started fifteen minutes prior to presentation. On exam, the patient has mild aphasia,
mild dysarthria, a pronator drift of his right arm, diminished strength of his right arm and leg, and
diminished sensation on the right side. Computed tomography of the brain and computed
tomography angiography of his brain and neck were performed and by the time the scans were
finished the patient had complete resolution of his symptoms. The computed tomography
angiography of the neck revealed a 90% stenotic atherosclerotic lesion of the left internal carotid
artery. Carotid endarterectomy was scheduled. The most appropriate next step is administration
of which of the following?
Epigastric tenderness (peptic ulcer disease)
Hypovolemic shock
Aspirin (transient ischemic attack)
Albuterol (bronchospasm)
Term 4 of 120
An obese 68-year-old woman with hypertension is admitted to the hospital due to acute hypoxia.
She is a lifelong nonsmoker with no history of lung disease. A chest radiograph reveals a
moderate pleural effusion. Which of the following is the best next step in the management of this
patient?
Thoracentesis (pleural effusion, decreased breath sounds, dullness to percussion,
decreased tactile fremitus)
Venous stasis ulcer
Ecchymosis of the flanks (grey turner sign)
Upper endoscopy (esophageal strictures)
,Term 5 of 120
A 65-year-old man with hypertension presents to the clinic complaining of worsening shortness
of breath with physical exertion for the past two weeks. He has no history of chronic lung disease.
He denies chest discomfort and palpitations. Vital signs include heart rate 78 beats per minute,
blood pressure 134/84 mm Hg, temperature 98.8°F, pulse oxygenation 93%, and 20 respirations
per minute. Exam reveals an obese man, bibasilar lung crackles, normal heart sounds, and 1+
pitting edema in both ankles. Which of the following interventions is the best next step?
Complete Blood Count
Echocardiogram
Cardiac Catheterization
Chest Radiograph
Term 6 of 120
A 66-year-old woman with a past medical history of uncontrolled diabetes mellitus, obesity, and
rheumatoid arthritis who is on methotrexate presents to the emergency department complaining
of redness, drainage, and pain at her incision site. She had an umbilical hernia repair
approximately six days prior. On exam, you note the patient has a fever of 100.6°F and the incision
site is erythematous and warm with a small amount of purulent drainage noted. There are no signs
of wound dehiscence and no areas of fluctuance noted. Which of the following is the most likely
diagnosis?
Urticaria
Dermatitis
Cellulitis
Nephrolithiasis
, Term 7 of 120
A 52-year-old man with COPD who is a current cigarette smoker presents for preoperative
consultation. He reports worsening shortness of breath and productive cough over the past
month. He reports no chest pain or dependent edema. Vital signs include a resting room air pulse
oximetry of 97%. Physical exam reveals expiratory wheezing bilaterally. Which of the following
diagnostic studies is indicated?
Complete blood count
Chest radiograph
Echocardiogram
Pulmonary function test
Term 8 of 120
A 35-year-old woman presents to the clinic with palpitations, tremors, and diffuse sweating.
Which of the following is used in the diagnosis of hyperthyroidism?
Parathyroid hormone
Melatonin
Thyroid-stimulating hormone
Growth hormone
120 Multiple choice questions
Term 1 of 120
A 65-year-old woman presents for her annual physical to her primary care physician. She has a
history of recurrent urinary tract infections and has a 30 pack-year smoking history. She has
worked in a textile factory for 40 years. With her increased risk, what is the most common
symptom of bladder cancer that would necessitate further investigation?
Weight Loss
Dysuria
Melena
Hematuria
Term 2 of 120
Which of the following is the first-line therapy for a typical anal fissure?
Fat
Minerals
Protein
Fiber
,Term 3 of 120
A 63-year-old right-handed man presents to the emergency department with a sudden onset of
numbness on the right side of his face, arm, and leg, as well as right arm and leg weakness. His
symptoms started fifteen minutes prior to presentation. On exam, the patient has mild aphasia,
mild dysarthria, a pronator drift of his right arm, diminished strength of his right arm and leg, and
diminished sensation on the right side. Computed tomography of the brain and computed
tomography angiography of his brain and neck were performed and by the time the scans were
finished the patient had complete resolution of his symptoms. The computed tomography
angiography of the neck revealed a 90% stenotic atherosclerotic lesion of the left internal carotid
artery. Carotid endarterectomy was scheduled. The most appropriate next step is administration
of which of the following?
Epigastric tenderness (peptic ulcer disease)
Hypovolemic shock
Aspirin (transient ischemic attack)
Albuterol (bronchospasm)
Term 4 of 120
An obese 68-year-old woman with hypertension is admitted to the hospital due to acute hypoxia.
She is a lifelong nonsmoker with no history of lung disease. A chest radiograph reveals a
moderate pleural effusion. Which of the following is the best next step in the management of this
patient?
Thoracentesis (pleural effusion, decreased breath sounds, dullness to percussion,
decreased tactile fremitus)
Venous stasis ulcer
Ecchymosis of the flanks (grey turner sign)
Upper endoscopy (esophageal strictures)
,Term 5 of 120
A 65-year-old man with hypertension presents to the clinic complaining of worsening shortness
of breath with physical exertion for the past two weeks. He has no history of chronic lung disease.
He denies chest discomfort and palpitations. Vital signs include heart rate 78 beats per minute,
blood pressure 134/84 mm Hg, temperature 98.8°F, pulse oxygenation 93%, and 20 respirations
per minute. Exam reveals an obese man, bibasilar lung crackles, normal heart sounds, and 1+
pitting edema in both ankles. Which of the following interventions is the best next step?
Complete Blood Count
Echocardiogram
Cardiac Catheterization
Chest Radiograph
Term 6 of 120
A 66-year-old woman with a past medical history of uncontrolled diabetes mellitus, obesity, and
rheumatoid arthritis who is on methotrexate presents to the emergency department complaining
of redness, drainage, and pain at her incision site. She had an umbilical hernia repair
approximately six days prior. On exam, you note the patient has a fever of 100.6°F and the incision
site is erythematous and warm with a small amount of purulent drainage noted. There are no signs
of wound dehiscence and no areas of fluctuance noted. Which of the following is the most likely
diagnosis?
Urticaria
Dermatitis
Cellulitis
Nephrolithiasis
, Term 7 of 120
A 52-year-old man with COPD who is a current cigarette smoker presents for preoperative
consultation. He reports worsening shortness of breath and productive cough over the past
month. He reports no chest pain or dependent edema. Vital signs include a resting room air pulse
oximetry of 97%. Physical exam reveals expiratory wheezing bilaterally. Which of the following
diagnostic studies is indicated?
Complete blood count
Chest radiograph
Echocardiogram
Pulmonary function test
Term 8 of 120
A 35-year-old woman presents to the clinic with palpitations, tremors, and diffuse sweating.
Which of the following is used in the diagnosis of hyperthyroidism?
Parathyroid hormone
Melatonin
Thyroid-stimulating hormone
Growth hormone
