A 17-year-old male student presents for a pre-sports physical examination.
When taking his history, you discover that his uncle and older brother both
died suddenly while playing sports. The patient has a holosystolic murmur
at the apex of the heart that radiates to the axilla. What is the
most likely cause?
A. Aortic stenosis
B. Brain aneurysm
C. Hypertrophic obstructive cardiomyopathy (HOCM) *Yes
D. Ventricular septal defect (VSD)
16 year-old female is evaluated for the first time by a nurse practitioner. She
reports no significant past medical history, chronic medical conditions, does
not take medication, and denies drug or alcohol use. Her last menstrual
cycle was 18 months ago. Today, she weighs 90 kg and she is 155 cm tall.
She has had a weight increase of more than 10 kg by her recollection. Her
blood pressure is 142/88 mm Hg. Examination reveals chin hair and some
dark hair on the upper lip. Which of the following is the best intervention by
the nurse practitioner?
A. Begin weight loss supplements
B. Refer the patient to a nutritionist to provide a very low-calorie diet
C. Evaluate the patient for secondary causes of obesity *Yes
D. Advise the patient to exercise daily
A child presents with concerns about their school performance from their
caregiver. The child is sleeping poorly, their grades are deteriorating, and
their teachers have observed a decrease in their attention span. On physical
examination, the patient exhibits lid lag, tremors, and an increased heart
rate. Which of the following additional findings supports the suspected
diagnosis of Graves' disease?
A. Diffuse goiter *Yes
B. Precocious puberty
, C. Pretibial myxedema
When taking his history, you discover that his uncle and older brother both
died suddenly while playing sports. The patient has a holosystolic murmur
at the apex of the heart that radiates to the axilla. What is the
most likely cause?
A. Aortic stenosis
B. Brain aneurysm
C. Hypertrophic obstructive cardiomyopathy (HOCM) *Yes
D. Ventricular septal defect (VSD)
16 year-old female is evaluated for the first time by a nurse practitioner. She
reports no significant past medical history, chronic medical conditions, does
not take medication, and denies drug or alcohol use. Her last menstrual
cycle was 18 months ago. Today, she weighs 90 kg and she is 155 cm tall.
She has had a weight increase of more than 10 kg by her recollection. Her
blood pressure is 142/88 mm Hg. Examination reveals chin hair and some
dark hair on the upper lip. Which of the following is the best intervention by
the nurse practitioner?
A. Begin weight loss supplements
B. Refer the patient to a nutritionist to provide a very low-calorie diet
C. Evaluate the patient for secondary causes of obesity *Yes
D. Advise the patient to exercise daily
A child presents with concerns about their school performance from their
caregiver. The child is sleeping poorly, their grades are deteriorating, and
their teachers have observed a decrease in their attention span. On physical
examination, the patient exhibits lid lag, tremors, and an increased heart
rate. Which of the following additional findings supports the suspected
diagnosis of Graves' disease?
A. Diffuse goiter *Yes
B. Precocious puberty
, C. Pretibial myxedema
