1. A 28-year-old student is seen in the school health clinic with complaints
of a hacking cough that is productive of small amounts of sputum and a runny
nose. He does not take any medications, denies any allergies, and has no
significant medical history. Physical examination reveals a low-grade
temperature of 99.9 degrees Fahrenheit, respirations of 16/min, a pulse of
90 beats per minute, and diffuse fine crackles in the base of the lungs. A chest
radiograph (x-ray) shows diffuse infiltrates on the lower lobe of the right lung.
The total white blood cell count is 10,500/uL. What is the most likely diagnosis?
A) Streptococcal pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
D) Legionnaires disease
Answer> Mycoplasma pneumonia
Mycoplasma pneumonia is the organism most commonly seen in children and
young adults. It is easily spread from droplets, from sneezing and coughing, in
close proximity. Diagnosis is based on symptoms and x-ray results of infiltrates in
lower lobes.
2. Which of the following antihypertensive medications has beneficial effects
for an elderly White female with osteoporosis?
A) Calcium channel blocker
B) Angiotensin-converting enzyme (ACE) inhibitor
,and the blood vessels, thereby keeping more calcium in the bones.
3. All of the following are false statements regarding acute gastritis except:
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause
the disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy
Answer> The screen- ing test for the disorder is the barium swallow test
The gold standard for diagnosing gastric disease is biopsy of gastric and/or duode-
,nal tissue by upper endoscopy. Chronic use of NSAIDs disrupts the production of
prostaglandins, which decreases blood supply and then breaks down the
protective layer of the mucosa, which leads to gastric disease.
4. Epidemiologic studies show that Hashimoto's disease occurs most com-
monly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men
Answer> Middle-aged to older women
Hashimoto's disease commonly occurs in middle-aged to older women.
5. A 63-year-old patient with a 10-year history of poorly controlled hyperten-
sion presents with a cluster of physical exam findings. Which of the following
indicate target organ damage commonly seen in hypertensive patients?
A) Pedal edema, hepatomegaly, and enlarged kidneys
B) Hepatomegaly, AV nicking, bibasilar crackles
C) Renal infection, S3, neuromuscular abnormalities
D) Glaucoma, jugular vein atrophy, heart failure
Answer> Hepatomegaly, AV nicking, bibasilar crackles
With long-term, uncontrolled hypertension, organ damage may occur. Organs
, flat white skin lesions that are irregularly shaped are found on the patient's
labia. The patient reports that the lesions are extremely itchy and have been
present for several years without much change. Which condition is best de-
scribed?
A) Chronic scabies infection
B) Lichen sclerosus
C) Chronic candidal vaginitis
D) A physiologic variant found in some older women
Answer> Lichen sclerosus Lichen sclerosus is a disease of the skin, in which white
spots appear on the skin and
of a hacking cough that is productive of small amounts of sputum and a runny
nose. He does not take any medications, denies any allergies, and has no
significant medical history. Physical examination reveals a low-grade
temperature of 99.9 degrees Fahrenheit, respirations of 16/min, a pulse of
90 beats per minute, and diffuse fine crackles in the base of the lungs. A chest
radiograph (x-ray) shows diffuse infiltrates on the lower lobe of the right lung.
The total white blood cell count is 10,500/uL. What is the most likely diagnosis?
A) Streptococcal pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
D) Legionnaires disease
Answer> Mycoplasma pneumonia
Mycoplasma pneumonia is the organism most commonly seen in children and
young adults. It is easily spread from droplets, from sneezing and coughing, in
close proximity. Diagnosis is based on symptoms and x-ray results of infiltrates in
lower lobes.
2. Which of the following antihypertensive medications has beneficial effects
for an elderly White female with osteoporosis?
A) Calcium channel blocker
B) Angiotensin-converting enzyme (ACE) inhibitor
,and the blood vessels, thereby keeping more calcium in the bones.
3. All of the following are false statements regarding acute gastritis except:
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause
the disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy
Answer> The screen- ing test for the disorder is the barium swallow test
The gold standard for diagnosing gastric disease is biopsy of gastric and/or duode-
,nal tissue by upper endoscopy. Chronic use of NSAIDs disrupts the production of
prostaglandins, which decreases blood supply and then breaks down the
protective layer of the mucosa, which leads to gastric disease.
4. Epidemiologic studies show that Hashimoto's disease occurs most com-
monly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men
Answer> Middle-aged to older women
Hashimoto's disease commonly occurs in middle-aged to older women.
5. A 63-year-old patient with a 10-year history of poorly controlled hyperten-
sion presents with a cluster of physical exam findings. Which of the following
indicate target organ damage commonly seen in hypertensive patients?
A) Pedal edema, hepatomegaly, and enlarged kidneys
B) Hepatomegaly, AV nicking, bibasilar crackles
C) Renal infection, S3, neuromuscular abnormalities
D) Glaucoma, jugular vein atrophy, heart failure
Answer> Hepatomegaly, AV nicking, bibasilar crackles
With long-term, uncontrolled hypertension, organ damage may occur. Organs
, flat white skin lesions that are irregularly shaped are found on the patient's
labia. The patient reports that the lesions are extremely itchy and have been
present for several years without much change. Which condition is best de-
scribed?
A) Chronic scabies infection
B) Lichen sclerosus
C) Chronic candidal vaginitis
D) A physiologic variant found in some older women
Answer> Lichen sclerosus Lichen sclerosus is a disease of the skin, in which white
spots appear on the skin and
