Week 4 Midterm Exam Version 1, 2, 3 & 5

Question 37: The most common etiologic organism for community-acquired pneumonia is:
 

A. Streptococcus pneumoniae
B. Beta hemolytic streptococcus
C. Mycoplasma
D. Methicillin resistant staphylococcus 

Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?

a. Serum calcium

b. Electrocardiogram (ECG)

c. Thyroid-stimulating hormone test

d. Complete blood cell count

Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above

Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis

Question 42: Marci has a wart on her hand. She says she  heard something about “silver duct tape therapy.” What do you tell her about his?

a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.

Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin

b. Quinolone

c. Cephalosporin
d. Macrolide

Question 44: Which of the following is an example of sensorineural hearing loss?

a. Perforation of the tympanic membrane

b. Otosclerosis

c. Cholesteatoma
d. Presbycusis

Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”

a. An ulcer

b. A fissure

c. Lichenification
d. An excoriation

Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

a. IgA

b. IgE

c. IgG
d. IgM

Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses?

a. Pancreatitis

b. Peptic ulcer disease

c. Diverticulitis

d. All of the above

Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?

a. B-type natriuretic peptide

b. C-reactive protein

c. Serum albumin

d. Erythrocyte sedimentation rate

Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?

a. Baker phenomenon

b. Arnold reflex

c. cough reflex

d. Tragus reflex

Version 2

Question 1: Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

2 weeks

1 month

3 months

6 months

Question 2: CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components.

a. Clinician education loans
b. Clinician practice liability and malpractice expense
c. Clinician reported cost reduction efforts
d. Clinician volume of patients treated

Question 3: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks

Question 4: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 6: Most adult poisonings are:

a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 7: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

a. The scrotum will be dark.
b. The scrotum will appear light pink or yellow.
c. The scrotum will appear milky white.
d. The internal structures will be clearly visible.

Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?What is the normal number for the Glascow Coma Scale?

a. 7

b. 9

c. 10
d. 15

Question 9: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?

a. Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)

Question 10: Which solution should be used when irrigating lacerated tissue over a wound on the arm?

a. Dilute povidone-iodine solution
b. Hydrogen peroxide (H2O2)
c. Saline solution infused with an antibiotic
d. Saline irrigation or soapy water

Question 11: Which ethical principle reflects respect for all persons and their self-determination?

a. Autonomy

b. Beneficence

c. Justice
d. Veracity

Question 12: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
d. A boggy gland