all are correct 2024-2025 graded A+
TypediPre-Predictor
1) Ai15iyearsioldihighischoolistudentiwithiaimildisoreithroatiandilow-
gradeifeverithatihasipersistediforiabouti3iweeks.iSheireportsigeneralimalaise,ifatigue,iandilossiof
iappetite.iTheiNPisuspectsimononucleosis.iWhichiofitheifollowingiisitheiLEASTiappropriateiin
tervention?
a. Palpateitheilymphinodesiandispleen
b. Examineitheiposteriorioropharynxiforipetechiae
c. ObtainiaiCBC,ithroaticulture,iandiheterophiliantibodyitest.
d. ObtainianiurinalysesiandiserumiforiLFTsiandiamylase
Explanation:imononucleosisiisiaisymptomaticiinfectionicausedibyitheiEpstein-
Barivirus.iCommoniisipeoplei15-
24iyearsiofiage.i Commonisignsiandisymptomsifollowingiincubationiperiodi(1-
2imonths)iincludeifatigue,ichills,imalaise,ianorexia,iwhiteitonsillariexudatesiandilymphadenopathy
ioriposterioricervicaliregion.iSplenomegalyicanibeipresent.iAimaculopapulariorioccasionallyiaipete
chialirashioccursiinilessithani15%iofipatients.iAidiagnosisiisiusuallyimadeiusingitheiMonospot.iInia
ddition,ineutropeniaiandilymphocytosisiareiusuallyidetectediinitheiCBC.
2) Ai32iyearsioldimaleipatienticomplaintiofiurinaryifrequencyiandiburningioniurinationifori3ida
ys.iUrinalysesirevealsibacteriuriaiandipositiveinitrites.iHeideniesianyipastihx.iOfiurinaryitractiinfe
ctions.iTheiinitialitreatmentishouldibe:
a. trimethoprim-sulfamethoxazolei(Bactrim,iSulfatrim)ifori7-10iday
b. ciprofloxacini(Cipro)ifori3-5idays
c. Trimethoprim-Sulfamethoxazoleifori3idays
d. 750imgiciprofloxaciniasiaione-timeidose
Explanation:itrimethoprim-
sulfamethoxazolei(TMPS)iisiusuallyiniappropriateimedicationitoitreatiurinaryitractiinfectionsiinim
ostipatients.i InitheicaseioficommunityiresistanceitoiTMPS
>20%^,ianotherimedicationishouldibeisubstituted.iInimen,itheiappropriateilengthiofitimeiisi7-
10idays.iWomenimayibeitreatedifori3idaysiforiuncomplicatediUTI
3) Whichiagentiisimostieffectiveiforitheitreatmentiofinodulocysticiacne?
a. Benzoyliperoxidei(Benzac)
b. Retinoiciacidi(RetiniA)
c. Topicalitetracycline
d. Isotretinoin)
Explanation:iIsotretinoini(Accutane)iisiaisystemiciagentiindicatediforitreatmentiwithisevereiinfla
mmatoryiacne.iGuidelinesiforiitsiuseimustibeiclearlyiunderstoodibyitheipatient.iAiwomaniofichildbe
aringiageimustiuseianieffectiveimethodioficontraceptionibecauseiisotretinoiniisiteratogenic.iThereia
reimanyirestrictionsiiniprescribingithisimedicationibecauseiofitheiteratogenicieffectsiisigiveniduring
ipregnancy.iTherefore,iitiisiaipregnancyicategoryiX.
1
,4) Ani18iy/oiwomaniisitakingiaicombinedihormonalioralicontraceptive.iSheishouldibe
,NSGi 6440i Predictori test
3
instructeditoiuseiaibackupimethodiforitheipreventioniofipregnancy
a. Throughoutitheiweekiofiplaceboipills
b. Ifiprescribeditopiramatei(Topamax)iforitheitreatmentiofimigraines.
3
, c. Ifiprescribediamoxicillin/clavulanatei(Augmentin)iforiaisinusiinfection
d. ifisheiforgetsitoitakeiaisingleidoseiofitheicontraceptive
Explanation:iAnticonvulsantiincludingiphenytoini(Dilantin),icarbamazepinei(Tegretol),iprimidon
ei(Mysoline),itopiramatei(Topamax)iandioxcarbazepinei(Trileptal)ireduceitheieffectivenessioficont
raceptives.iDepo-medroxyprogesteroneiacetatei injectionsiorilevonorgestrel-
ireleasingiintrauterineidevicesiwouldibeiaibetterimethodioficontraceptiveiforipatientsitakingianticon
vulsants.iMosticommonlyiusediantibioticsihaveinotibeeniprovenitoireduceitheieffectivenessioficont
raceptives.iRifampiniisianiexception,iandiadditionali….iBeiusedibyiwomenitakingithisidrugiandiusi
ngioralicontraceptives,itransdermal,iorivaginaliringipreparations.
Additionalibackupicontraceptionishouldibeiusediifitakingiantifungaliagents.iNoiadditionaliprotecti
oniisineededithoughtitheiweekiofiplaceboipills.iMissingioneisingleidoseioficontraceptiveidoesinotire
quireiadditionaliprotection,imissingimoreithanioneidosesidoes.
5) Ai44iyearsioldifemaleipatientihasidiabetes.iHeritotalicholesteroli(TC)iisi250img/dli(6.5immol
/L),iLDL=i190img/dLi(4.94immol/L),iHDL=i25img/dLi(65immol/L),ianditriglycerides=i344img/d
Li(8.94immol/L).iWhatiagentihaveitheigreatestieffectioniimprovingiherilipidiprofileiandireducingim
orbidityiandimortalityiassociatesiwithidyslipidemia?
a. Niacini(Niaspan)
b. Atorvastatin
c. Omegai3ifattyiacids
d. Fenofibrates
Explanation:iFirstiandiforemost,iitiisiessentialitoieducateiindividualsioniaiheart-
healthyilifestyle.iLDL-
Ciisioneiofitheimajoriculpritsiinitheidevelopmentiofiatheroscleroticiheartidisease.iTheitargetileveliof
iLDL-
Ciisibetweeni50itoi70mg/dlitoipreventiplaqueiformationiinitheibloodivessels.iGuidelinesistronglyir
ecommendistatinitherapyibecauseitheyiprimarilyiloweriLDL-
Cilevels,ibutitheyialsoihaveitheisecondaryieffectsiofiloweringitriglycerideiandiincreasingiHDL-
Cilevels.
6) Ai30iyearsioldifemaleicomesiintoiaicliniciwithiclassicisignsiandisymptomsiofiappendicitis.iT
heiNPifailsitoireferitheipatientitoiaisurgeon.iTheiappendixirupturesianditheiwomanidie.iThisiisianie
xampleiof
a. Failureiofidiligence
b. Professionaliliability
c. Negligence
d. Malpractice
Explanation:imalpractice,iainegligenceitort,ioccursiwheniaihealthicareiprofessional’siactionsifallib
ellowitheiappropriateistandardioficareiandihurtsitheipatient.iInithisicaseitheipatienticameiwithisingsi
andisymptomsiindicatingiappendicitisianditheiNPifaileditoireferitheipatient..
7) AiNPihasirecentlyibeenihireditoiworkiiniaifastitrackifacility.iTheiNPiemployeriaskediifish