MN568 Midterm Exam REVIEW Questions AND Correct
Answers
12. Mary has HTN and previously had a stroke. Which of these HTN medications would you order?
A. ACEI
B. ARB
C. Beta blocker - ✔✔beta blocker
24. Rayburn is a healthy 47 yr old male. Diagnosed with community acquired pneumonia. What is the
best choice of outpatient treatment?
A. Keflex
B. Augmentin
C. Azithromycin - ✔✔Azithromycin
A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in
appendicitis?
A. Very early
B. 3 to 4 hours after perforation
C. Late in inflammation
D. Appendicitis never presents with vague pain - ✔✔Very early
A 25yo pt presents to the clinic with fatigue, cold intolerance, wt gain, and constipation for the past
3mo. On physical exam, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair;
and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?
-Serum calcium
,-TSH
-Electrolytes
-Urine specific gravity - ✔✔TSH
A 28-year-old patient is seen with complaints of diarrhea. Which of the following responses to the
history questions would help the primary-care provider (PCP) establish the diagnosis of irritable bowel
syndrome (IBS)?
A. Feels relief after urination
B. Pain wakes up patient from sleep
C. Defecates in the middle of the night
D. Pain is precipitated by eating - ✔✔Pain is precipitated by eating
A 35yo woman presents w/symptoms of hypoglycemia. There is no h/o DM. Which of the following
should be included in the differential dx?
-Anxiety disorder
-Pheochromocytoma
-Psychosis
-All of the above - ✔✔Pheochromocytoma
A 45-year-old male presents with throbbing podagral pain and tophi in the ear pinnae. Which
medication should the clinician prescribe for this acute attack?
A. Colchicine (Colcrys)
B. Probenecid (Benemid)
C. Allopurinol (Zyloprim)
D. Pegloticase (Krystexxa) - ✔✔Colchicine (Colcrys)
,A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical
examination is remarkable for left lower quadrant tenderness. At this time, which of the following
should be considered in the differential diagnosis?A. EndometriosisB. Yersinia enterocolitica infectionC.
AppendicitisD. GERD - ✔✔Endometriosis
A 55-year-old African American man with newly diagnosed hypertension presents to your primary care
clinic for medication management. Today his blood pressure reads 145/95. He denies headache, blurred
vision, chest pain, and shortness of breath. Which medication would you start him on? - ✔✔amlodipine
A 60-year-old male presents to your primary care office after being discharged from the hospital. He was
at a Christmas work party and started to notice heart palpitations. He was drinking alcohol at the party.
He went to the emergency department, where he was admitted. His electrocardiogram (EKG) showed
tachycardia, with a normal ST segment, and he did not have any obvious P waves. The patient has not
felt any palpitations since that one incident, which was 2 weeks ago. If he were sent home on Coumadin
for blood thinning, at what level should you try to keep his international normalized ratio (INR)? -
✔✔2.0-3.0
A 64yo man with T2DM presents to the clinic with the complaint of "my feet feel like they're on fire." He
has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the
following would be an appropriate treatment?
-Tricyclic antidepressants
-Capsaicin cream
-Vitamin B12 injections
-Insulin - ✔✔Tricyclic antidepressants
A 65-year-old obese, diabetic female presents to your urgent care clinic complaining of 2 days of
progressively worsening epigastric pain, fatigue, nausea, and dizziness. Her vitals are as follows:
temperature (T) 98.8°F, pulse (P) 110, pulse oximetry 93%, blood pressure (BP) 160/100. The patient has
a family history of diabetes, breast cancer, paternal heart attack, hypertension, and hyperlipidemia. Her
complete blood count (CBC), comprehensive metabolic panel (CMP), and urinalysis show a patient with
stage 2 chronic kidney disease (CKD) and a glucose of 150. The patient has no diarrhea and no other
gastrointestinal symptoms. How would you proceed next? - ✔✔Order a rapid troponin and EKG
, A 7-year-old male presents with his mother to the urgent care clinic complaining of abdominal pain. He
started to complain of pain prior to going to bed; however, it has gotten progressively worse and is now
preventing him from sleeping. He is nauseous but hasn't vomited and didn't eat dinner due to the pain.
The patient appears pale and is complaining of right-sided abdominal pain. His vitals are as follows:
blood pressure 130/85, pulse 120, temperature 100.5°F, pulse oximetry 98% on room air. On physical
exam he is tender in the right lower quadrant. His complete blood count (CBC) shows a white blood cell
count (WBC) of 17.0. What is the patient's likely
diagnosis?1.Appendicitis.2.Cholecystitis.3.Constipation.4.Gastroenteritis.
Appendicitis. - ✔✔Appendicitis
A 70-year-old female presents to your urgent care clinic with chest pain for 24 hours, progressive
dyspnea, and fatigue and is found to have elevated troponins and an electrocardiogram (EKG) with ST
elevations. Which of the following is not a recommended treatment? - ✔✔Administration of fibrinolytics
stat
A 70-year-old patient presents to your office following an acute hospital stay for atrial fibrillation. The
patient has the following past medical and surgical history: diabetes, hypertension, gout, rheumatoid
arthritis, hyperlipidemia, and multiple joint replacements. Which of the following medications is
appropriate for their outpatient deep venous thrombosis (DVT) prophylaxis? - ✔✔Coumadin 5 mg daily
A blood pressure (BP) of 142/92 is considered:
a. Normal.
b. Stage 1 hypertension.
c. Prehypertension.
d. Stage 2 hypertension. - ✔✔Stage 1 hypertension
A blood pressure (BP) of 150/90 is considered:A. Stage 2 hypertensionB. HypertensiveC. Normal in
healthy older adultsD. Acceptable if the patient has diabetes mellitus (DM) - ✔✔Normal in healthy older
adults
Answers
12. Mary has HTN and previously had a stroke. Which of these HTN medications would you order?
A. ACEI
B. ARB
C. Beta blocker - ✔✔beta blocker
24. Rayburn is a healthy 47 yr old male. Diagnosed with community acquired pneumonia. What is the
best choice of outpatient treatment?
A. Keflex
B. Augmentin
C. Azithromycin - ✔✔Azithromycin
A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in
appendicitis?
A. Very early
B. 3 to 4 hours after perforation
C. Late in inflammation
D. Appendicitis never presents with vague pain - ✔✔Very early
A 25yo pt presents to the clinic with fatigue, cold intolerance, wt gain, and constipation for the past
3mo. On physical exam, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair;
and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?
-Serum calcium
,-TSH
-Electrolytes
-Urine specific gravity - ✔✔TSH
A 28-year-old patient is seen with complaints of diarrhea. Which of the following responses to the
history questions would help the primary-care provider (PCP) establish the diagnosis of irritable bowel
syndrome (IBS)?
A. Feels relief after urination
B. Pain wakes up patient from sleep
C. Defecates in the middle of the night
D. Pain is precipitated by eating - ✔✔Pain is precipitated by eating
A 35yo woman presents w/symptoms of hypoglycemia. There is no h/o DM. Which of the following
should be included in the differential dx?
-Anxiety disorder
-Pheochromocytoma
-Psychosis
-All of the above - ✔✔Pheochromocytoma
A 45-year-old male presents with throbbing podagral pain and tophi in the ear pinnae. Which
medication should the clinician prescribe for this acute attack?
A. Colchicine (Colcrys)
B. Probenecid (Benemid)
C. Allopurinol (Zyloprim)
D. Pegloticase (Krystexxa) - ✔✔Colchicine (Colcrys)
,A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical
examination is remarkable for left lower quadrant tenderness. At this time, which of the following
should be considered in the differential diagnosis?A. EndometriosisB. Yersinia enterocolitica infectionC.
AppendicitisD. GERD - ✔✔Endometriosis
A 55-year-old African American man with newly diagnosed hypertension presents to your primary care
clinic for medication management. Today his blood pressure reads 145/95. He denies headache, blurred
vision, chest pain, and shortness of breath. Which medication would you start him on? - ✔✔amlodipine
A 60-year-old male presents to your primary care office after being discharged from the hospital. He was
at a Christmas work party and started to notice heart palpitations. He was drinking alcohol at the party.
He went to the emergency department, where he was admitted. His electrocardiogram (EKG) showed
tachycardia, with a normal ST segment, and he did not have any obvious P waves. The patient has not
felt any palpitations since that one incident, which was 2 weeks ago. If he were sent home on Coumadin
for blood thinning, at what level should you try to keep his international normalized ratio (INR)? -
✔✔2.0-3.0
A 64yo man with T2DM presents to the clinic with the complaint of "my feet feel like they're on fire." He
has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the
following would be an appropriate treatment?
-Tricyclic antidepressants
-Capsaicin cream
-Vitamin B12 injections
-Insulin - ✔✔Tricyclic antidepressants
A 65-year-old obese, diabetic female presents to your urgent care clinic complaining of 2 days of
progressively worsening epigastric pain, fatigue, nausea, and dizziness. Her vitals are as follows:
temperature (T) 98.8°F, pulse (P) 110, pulse oximetry 93%, blood pressure (BP) 160/100. The patient has
a family history of diabetes, breast cancer, paternal heart attack, hypertension, and hyperlipidemia. Her
complete blood count (CBC), comprehensive metabolic panel (CMP), and urinalysis show a patient with
stage 2 chronic kidney disease (CKD) and a glucose of 150. The patient has no diarrhea and no other
gastrointestinal symptoms. How would you proceed next? - ✔✔Order a rapid troponin and EKG
, A 7-year-old male presents with his mother to the urgent care clinic complaining of abdominal pain. He
started to complain of pain prior to going to bed; however, it has gotten progressively worse and is now
preventing him from sleeping. He is nauseous but hasn't vomited and didn't eat dinner due to the pain.
The patient appears pale and is complaining of right-sided abdominal pain. His vitals are as follows:
blood pressure 130/85, pulse 120, temperature 100.5°F, pulse oximetry 98% on room air. On physical
exam he is tender in the right lower quadrant. His complete blood count (CBC) shows a white blood cell
count (WBC) of 17.0. What is the patient's likely
diagnosis?1.Appendicitis.2.Cholecystitis.3.Constipation.4.Gastroenteritis.
Appendicitis. - ✔✔Appendicitis
A 70-year-old female presents to your urgent care clinic with chest pain for 24 hours, progressive
dyspnea, and fatigue and is found to have elevated troponins and an electrocardiogram (EKG) with ST
elevations. Which of the following is not a recommended treatment? - ✔✔Administration of fibrinolytics
stat
A 70-year-old patient presents to your office following an acute hospital stay for atrial fibrillation. The
patient has the following past medical and surgical history: diabetes, hypertension, gout, rheumatoid
arthritis, hyperlipidemia, and multiple joint replacements. Which of the following medications is
appropriate for their outpatient deep venous thrombosis (DVT) prophylaxis? - ✔✔Coumadin 5 mg daily
A blood pressure (BP) of 142/92 is considered:
a. Normal.
b. Stage 1 hypertension.
c. Prehypertension.
d. Stage 2 hypertension. - ✔✔Stage 1 hypertension
A blood pressure (BP) of 150/90 is considered:A. Stage 2 hypertensionB. HypertensiveC. Normal in
healthy older adultsD. Acceptable if the patient has diabetes mellitus (DM) - ✔✔Normal in healthy older
adults
