D118 practice test questions WITH ANSWERS

D118 practice test questions WITH ANSWERS |\ |\ |\ |\ |\




1.1. A 55-year-old male with a 75 pack-year history of smoking presents to
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the clinic to establish primary care and discuss age-appropriate screening
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options for cancer. His pulse rate is 78/min, blood pressure is 140/80 mmHg,
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and saturation at room air is 96%. Air entry is decreased bilaterally with
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occasional rhonchi and crepitations on chest auscultation. He is advised by
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the primary care provider to undergo a low dose CT scan (LDCT) for screening.
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Which of the following are the criteria for undergoing this screening test for
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this patient? * |\ |\




1 point
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A. All adults between ages 55 and 80 years
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B. Adults more than 40 years of age with a 20 pack-year smoking history
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C. Adults aged 55 to 80 years with a 30 pack-year smoking history
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D. Adults less than 60 years of age who are active smokers and have no other
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risk factors: C. Adults aged 55 to 80 years with a 30 pack-year smoking
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history Feedback |\




A, B, D Rationale: All adults aged 55 to 80 years do not meet the criteria
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for a |\




high-risk population. As lung cancer screening involves exposure to
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possible harmful radiation, and there are potential other risks to
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screening, identifying a high-risk population is essential.According to the
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National Comprehensive Cancer Network (NCCN), there is a utility in
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screening patients with a 20 pack-year history of smoking. However,
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,recommendations are for patients more than 55 years of age with an |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




additional risk factor such as family history, occupational exposure to
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carcinogens, or personal history of chronic obstructive pulmonary |\ |\ |\ |\ |\ |\ |\ |\




disease (COPD).According to the National Lung Screening Trial, patients
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aged 55 to 80 years with a 30 pack-year history of smoking who are active
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smokers or quit within the last 15 years qualify for annual low-dose CT
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screening.Patients with a life-limiting condition should not be screened. |\ |\ |\ |\ |\ |\ |\ |\




2.2. A preventative medicine task force is trying to identify and combat
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peripheral arterial disease among the rural population they serve. They seek
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information regarding a rapid, low cost, and sensitive tool to detect this
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disease that can be used at health fairs scheduled to take place in the rural
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town centers. Which of the following would be the best screening tool for this
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situation? * |\




1 point
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A. Doppler ultrasound |\




B. 5-minute treadmill test |\ |\




C. Ankle-brachial pressure index (ABI) |\ |\ |\




D. Pedal pulse palpation: D. Pedal pulse palpation Rationale: In a study
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of over 18,000 men, the presence of bilateral dorsalis pedis and
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posterior tibial pulses |\ |\




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, ruled out peripheral arterial disease (PAD) with enough reliability for the
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authors to conclude it could be used as an appropriate initial screening too
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for PAD.In order for pedal pulse palpation (PPP) to effectively screen for PAD
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|\ if any of the 4 pedal pulses are absent, the patient should be referred to a
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primary care provider to receive ABI testing for PAD, which is a more |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




specific tool.ABI testing, which involves calculating a pressure ratio betwee
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|\ the ankle and arm blood pressure, involves specific training and
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equipment. Although it is often used as an initial test for PAD in the office |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




setting with one clinician and patient, at a health fair where rapid low
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cost, low equipment screening is needed, there is a better option.PAD is
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common at the population level, with estimates of around 10% prevalenc |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




|\ in adults over 55.
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3.3. A 35-year-old woman with a history of gestational diabetes at age 23 is
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seen for an annual physical exam. Based on the American Diabetes Associa-
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tion (ADA) recommendations for screening for type 2 diabetes in those with
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a prior history of gestational diabetes, what is the maximum recommended
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testing interval for screening this patient for diabetes? *
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0 points
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A. Annually
B. Biannually
C. When she turns 45 |\ |\ |\




D. Every three years: D. Every three years |\ |\ |\ |\ |\ |\




|\ Rationale: Women with a history of gestational diabetes should have life |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




long screening for the development of type 2 diabetes at least once every
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