Name: Score:
58 Multiple choice questions
,Term 1 of 58
Which of the following are risk factors for osteoporosis? Select all that apply.
A. Early menopause
B. BMI > 30
C. Sedentary lifestyle
D. African American people
E. History of previous fracture as an adult
The correct answers are A, B, D, E.
Medical screening should be considered for conditions that are important health
problems that can be treated and have a latent phase of a disease enabling early
detection and more timely treatment, impacting the outcome of the disease. The
screening test should be acceptable to patients at reasonable cost.
Since patients without symptoms are being screened, the overall prevalence of the
condition in the population will be low. The goal is to identify cases at an early stage;
thus, an effective screening test should have very good sensitivity (identify most or all
potential cases) and high specificity (label incorrectly as few as possible as potential
cases). Remember that even a test with a specificity of 95% will lead to many false
positives when the prevalence of the condition is very low.
The correct answers are A, C, E.
Risk factors for osteoporosis are mainly due to low estrogen states.
Low estrogen states may be caused by early menopause (i.e., before age 45 years),
prolonged premenopausal amenorrhea, and low weight and body mass index.
Lack of physical activity and inadequate calcium intake (which could be attributable to
poor nutrition or alcoholism) are also associated with osteoporosis.
Other risk factors include:
Family history of osteoporotic fracture
Personal history of previous fracture as an adult
Cigarette smoking
White race
Obesity (BMI >30) is associated with a high estrogen level and can be protective against
menopausal symptoms and osteoporosis.
The correct answers are A, D, E.
,The most common manifestations of Graves ophthalmopathy (eye problems) are eyelid
retraction and exophthalmos.
Primary symptoms of the eye manifestations of Graves disease are related to corneal
irritation from eyelid retraction.
While most of the time the eye signs and symptoms are bilateral, they can be unilateral.
While 50% of patients with Graves have some eye involvement by MRI, only about 20% to
30% of those are clinically relevant. In up to 10% the eye manifestations can happen when
the patient is euthyroid or even hypothyroid. Treatment of hyperthyroidism does not
affect the eye manifestations. In fact, some patients who get radioactive iodine will
experience worsening symptomatology.
The correct answers are A, B, C, D, E, F.
Compartment syndrome is a serious life- and limb-threatening complication of extremity
trauma that occurs when rising pressure in a muscle compartment impairs perfusion to
that same muscle compartment. Fractures, crush injuries, burns, and arterial injuries all
can result in an acute compartment syndrome. You must have a high clinical suspicion for
compartment syndrome, as delay in diagnosis or treatment can ultimately lead to
compromised blood supply, nerve damage, and muscle death. Treatment is emergent
decompression via fasciotomy.
The 6 P's (Signs of limb threatening Injury)
Pain (Disproportionate pain = earliest sign)
Pallor
Pulselessness
Paresthesia (A skin sensation, such as burning, prickling, itching, or tingling.= most
reliable sign)
Perishing cold (The inability to regulate one's body temperature.)
Paralysis
, Term 2 of 58
A 47-year-old woman comes into your office for a health care maintenance exam. She has
hypertension and type 2 diabetes. She is not sexually active and has not yet experienced
menopause. There is no family history of cancer. Her blood pressure is 118/78, her BMI is 34 and
the remainder of her physical exam is within normal limits. Her vaccinations are up-to-date, she
has a PAP smear today and will have labs drawn. According to USPSTF, which of the following
is the best recommendation to give her concerning mammography?
Should have started at age 40 and every year thereafter
Should have started at age 40 and every 2 years thereafter
Start at age 50 and every year thereafter
Start at age 50 and every 2 years thereafter
Should have started at age 45 and every year thereafter
Term 3 of 58
Ms. Anderson is a 60-year-old woman who comes in to clinic as a walk in appointment. She is
tearful and is carrying a box of tissues in her hand. She says she doesn't know why but she has
been very sad of late. She reports trouble falling asleep and staying asleep. She used to be the
head of her Bridge club, but quit two weeks ago and doesn't feel like going out anymore. She
also says she has lost interest in walking her dog, and now just allows him to use the doggie
door to let himself out. She also says she feels weak and fatigued and no longer has the energy
to do her gardening or shopping. She spends most of her day on the sofa crying while watching
TV. She also reports a greatly diminished appetite. She denies suicidal or homicidal ideation, but
she does have a history of a previous suicide attempt following her divorce seven years ago
for which she was hospitalized. A recent CBC, CMP, CXR, TSH, U/A and CT of the head were all
within normal limits. How long do the above symptoms need to be present in order to make the
diagnosis of Major Depressive Disorder?
One week
Two weeks
Four weeks
Five weeks
Eight weeks
58 Multiple choice questions
,Term 1 of 58
Which of the following are risk factors for osteoporosis? Select all that apply.
A. Early menopause
B. BMI > 30
C. Sedentary lifestyle
D. African American people
E. History of previous fracture as an adult
The correct answers are A, B, D, E.
Medical screening should be considered for conditions that are important health
problems that can be treated and have a latent phase of a disease enabling early
detection and more timely treatment, impacting the outcome of the disease. The
screening test should be acceptable to patients at reasonable cost.
Since patients without symptoms are being screened, the overall prevalence of the
condition in the population will be low. The goal is to identify cases at an early stage;
thus, an effective screening test should have very good sensitivity (identify most or all
potential cases) and high specificity (label incorrectly as few as possible as potential
cases). Remember that even a test with a specificity of 95% will lead to many false
positives when the prevalence of the condition is very low.
The correct answers are A, C, E.
Risk factors for osteoporosis are mainly due to low estrogen states.
Low estrogen states may be caused by early menopause (i.e., before age 45 years),
prolonged premenopausal amenorrhea, and low weight and body mass index.
Lack of physical activity and inadequate calcium intake (which could be attributable to
poor nutrition or alcoholism) are also associated with osteoporosis.
Other risk factors include:
Family history of osteoporotic fracture
Personal history of previous fracture as an adult
Cigarette smoking
White race
Obesity (BMI >30) is associated with a high estrogen level and can be protective against
menopausal symptoms and osteoporosis.
The correct answers are A, D, E.
,The most common manifestations of Graves ophthalmopathy (eye problems) are eyelid
retraction and exophthalmos.
Primary symptoms of the eye manifestations of Graves disease are related to corneal
irritation from eyelid retraction.
While most of the time the eye signs and symptoms are bilateral, they can be unilateral.
While 50% of patients with Graves have some eye involvement by MRI, only about 20% to
30% of those are clinically relevant. In up to 10% the eye manifestations can happen when
the patient is euthyroid or even hypothyroid. Treatment of hyperthyroidism does not
affect the eye manifestations. In fact, some patients who get radioactive iodine will
experience worsening symptomatology.
The correct answers are A, B, C, D, E, F.
Compartment syndrome is a serious life- and limb-threatening complication of extremity
trauma that occurs when rising pressure in a muscle compartment impairs perfusion to
that same muscle compartment. Fractures, crush injuries, burns, and arterial injuries all
can result in an acute compartment syndrome. You must have a high clinical suspicion for
compartment syndrome, as delay in diagnosis or treatment can ultimately lead to
compromised blood supply, nerve damage, and muscle death. Treatment is emergent
decompression via fasciotomy.
The 6 P's (Signs of limb threatening Injury)
Pain (Disproportionate pain = earliest sign)
Pallor
Pulselessness
Paresthesia (A skin sensation, such as burning, prickling, itching, or tingling.= most
reliable sign)
Perishing cold (The inability to regulate one's body temperature.)
Paralysis
, Term 2 of 58
A 47-year-old woman comes into your office for a health care maintenance exam. She has
hypertension and type 2 diabetes. She is not sexually active and has not yet experienced
menopause. There is no family history of cancer. Her blood pressure is 118/78, her BMI is 34 and
the remainder of her physical exam is within normal limits. Her vaccinations are up-to-date, she
has a PAP smear today and will have labs drawn. According to USPSTF, which of the following
is the best recommendation to give her concerning mammography?
Should have started at age 40 and every year thereafter
Should have started at age 40 and every 2 years thereafter
Start at age 50 and every year thereafter
Start at age 50 and every 2 years thereafter
Should have started at age 45 and every year thereafter
Term 3 of 58
Ms. Anderson is a 60-year-old woman who comes in to clinic as a walk in appointment. She is
tearful and is carrying a box of tissues in her hand. She says she doesn't know why but she has
been very sad of late. She reports trouble falling asleep and staying asleep. She used to be the
head of her Bridge club, but quit two weeks ago and doesn't feel like going out anymore. She
also says she has lost interest in walking her dog, and now just allows him to use the doggie
door to let himself out. She also says she feels weak and fatigued and no longer has the energy
to do her gardening or shopping. She spends most of her day on the sofa crying while watching
TV. She also reports a greatly diminished appetite. She denies suicidal or homicidal ideation, but
she does have a history of a previous suicide attempt following her divorce seven years ago
for which she was hospitalized. A recent CBC, CMP, CXR, TSH, U/A and CT of the head were all
within normal limits. How long do the above symptoms need to be present in order to make the
diagnosis of Major Depressive Disorder?
One week
Two weeks
Four weeks
Five weeks
Eight weeks
