DETAILED VERIFIED SOLUTIONS|GRADED A+|NEWEST 2026/2027
You are educating a patient that has just been advised that he has "polyps" in his colon.
Which of the following statements is FALSE?
A. The larger the colonic polyp, the greater the risk of malignant transformation
B. Villous adenomas have a 30-70% risk of malignant transformation.
C. The greater the number of concomitant colonic polyps, the greater the risk of malignant
transformatio
D. The majority of colonic polyps are hyperplastic in origin
E. The majority of colonic polyps are > 3 cm in size. - ANSWER Answer: E, The majority of
colonic polyps are > 3 cm in size.
Most polyps are, in fact, quite small. All the rest of these statements are true
A 52 year-old male presents complaining of urinary frequency, with hesitancy, and nocturia
for the past few months. During his physical examination, you note a nontender, non-
enlarged prostate with an isolated right posterior lobe nodule. Which of the following
options is most appropriate?
*A.* order a serum acid phosphatase level
*B.* initiate prazosin and schedule a follow-up appointment in 6 weeks
*C.* refer the patient for an ultrasound of the prostate and order a PSA level
*D.* reassure the patient and schedule a follow-up appointment in six months
*E.* initiate norfloxacin therapy for 7 days and schedule follow-up in two weeks -
ANSWER *Answer: C*
1
,This patient has an isolated nodule of the prostate gland — cancer until proven otherwise.
You should order an ultrasound and a PSA. BPH will present as diffuse enlargement, and not
a discrete nodule.
Which of the following is NOT a characteristic feature of the nephrotic syndrome?
A. proteinuria
B. hematuria
C. hypoalbuminemia
D. hyperlipidemia
E. generalized edema - ANSWER *Answer: B. Hematuria*
Hematuria is present in NEPHRITIC syndrome. Nephrotic syndrome characteristically
includes proteinuria (>3.5 gm/day), with resulting low serum albumin, hyperlipidemia,
hypertension, hypercoagulability, and generalized edema (from oncotic third-spacing)
A patient describes a history of recurrent bouts of uveitis. Her chemistry panel reveals
elevated serum calcium and uric acid levels. Her anergy screen is negative. Her chest x-ray
demonstrates bilateral hilar adenopathy. Which diagnosis is most likely?
A. Silicosis
B. Sarcoidosis
C. Alpha-1 antitrypsin deficiency
D. Histoplasmosis
E. Tuberculosis - ANSWER *Answer: B. Sarcoidosis*
Sarcoid typically presents with hilar lvmphadenopathy and noncaseating granulomas of the
lungs (and other organs). In addition, patients may get eye involvement (uveitis). Elevations
of ACE, Calcium and uric acid are frequently seen.
2
, Which term is used to describe the characteristic concave or "spoon-shaped" nails of iron
deficiency anemia?
A. leukonychia
B. koilonychias
C. clubbing
D. onycholysis
E. paronychia - ANSWER *Answer: B. Koilonychia*
Koilonychia is a spoon-shaping of the nail itself. It is usually a result of iron deficiency
anemia. Leukonychia is often associated with hypoalbuminaemia that causes partial or
complete white discoloration of the nails. Leukonychia may also appear as a rare side effect
of systemic chemotherapy in some oncological patients but may also be present with arsenic
poisoning, renal failure pneumonia, or heart disease. Clubbing of the nails is an actual
thickening or elevation of the nail bed - it is a sign of release of TNF associated with
pulmonary disorders (tissue necrosis factor) typically found in bronchiectasis, lung cancers
and cystic fibrosis (the nails are NOT necessarily cyanotic.) Onycholysis is a painless
separation of the nail from the nail bed. Several or all nails are usually affected - there are
many causes. Paronychia is an infection of the nail bed and nail margin, usually from trauma
or more commonly, nail-biting.
A 34-old female presents complaining of symmetrical redness and swelling of the small
joints of her hands (PIPs and MCPs). She has noted that the symptoms are worst in the
morning. Her erythrocyte sedimentation rate is elevated and her rheumatoid factor is
negative. Which of the following diagnosis is most likely?
A. progressive systemic sclerosis
B. CREST syndrome
C. osteoarthritis
D. rheumatoid arthritis
E. ankylosing spondylitis - ANSWER *Answer: D Rheumatoid Arthritis*
3
You are educating a patient that has just been advised that he has "polyps" in his colon.
Which of the following statements is FALSE?
A. The larger the colonic polyp, the greater the risk of malignant transformation
B. Villous adenomas have a 30-70% risk of malignant transformation.
C. The greater the number of concomitant colonic polyps, the greater the risk of malignant
transformatio
D. The majority of colonic polyps are hyperplastic in origin
E. The majority of colonic polyps are > 3 cm in size. - ANSWER Answer: E, The majority of
colonic polyps are > 3 cm in size.
Most polyps are, in fact, quite small. All the rest of these statements are true
A 52 year-old male presents complaining of urinary frequency, with hesitancy, and nocturia
for the past few months. During his physical examination, you note a nontender, non-
enlarged prostate with an isolated right posterior lobe nodule. Which of the following
options is most appropriate?
*A.* order a serum acid phosphatase level
*B.* initiate prazosin and schedule a follow-up appointment in 6 weeks
*C.* refer the patient for an ultrasound of the prostate and order a PSA level
*D.* reassure the patient and schedule a follow-up appointment in six months
*E.* initiate norfloxacin therapy for 7 days and schedule follow-up in two weeks -
ANSWER *Answer: C*
1
,This patient has an isolated nodule of the prostate gland — cancer until proven otherwise.
You should order an ultrasound and a PSA. BPH will present as diffuse enlargement, and not
a discrete nodule.
Which of the following is NOT a characteristic feature of the nephrotic syndrome?
A. proteinuria
B. hematuria
C. hypoalbuminemia
D. hyperlipidemia
E. generalized edema - ANSWER *Answer: B. Hematuria*
Hematuria is present in NEPHRITIC syndrome. Nephrotic syndrome characteristically
includes proteinuria (>3.5 gm/day), with resulting low serum albumin, hyperlipidemia,
hypertension, hypercoagulability, and generalized edema (from oncotic third-spacing)
A patient describes a history of recurrent bouts of uveitis. Her chemistry panel reveals
elevated serum calcium and uric acid levels. Her anergy screen is negative. Her chest x-ray
demonstrates bilateral hilar adenopathy. Which diagnosis is most likely?
A. Silicosis
B. Sarcoidosis
C. Alpha-1 antitrypsin deficiency
D. Histoplasmosis
E. Tuberculosis - ANSWER *Answer: B. Sarcoidosis*
Sarcoid typically presents with hilar lvmphadenopathy and noncaseating granulomas of the
lungs (and other organs). In addition, patients may get eye involvement (uveitis). Elevations
of ACE, Calcium and uric acid are frequently seen.
2
, Which term is used to describe the characteristic concave or "spoon-shaped" nails of iron
deficiency anemia?
A. leukonychia
B. koilonychias
C. clubbing
D. onycholysis
E. paronychia - ANSWER *Answer: B. Koilonychia*
Koilonychia is a spoon-shaping of the nail itself. It is usually a result of iron deficiency
anemia. Leukonychia is often associated with hypoalbuminaemia that causes partial or
complete white discoloration of the nails. Leukonychia may also appear as a rare side effect
of systemic chemotherapy in some oncological patients but may also be present with arsenic
poisoning, renal failure pneumonia, or heart disease. Clubbing of the nails is an actual
thickening or elevation of the nail bed - it is a sign of release of TNF associated with
pulmonary disorders (tissue necrosis factor) typically found in bronchiectasis, lung cancers
and cystic fibrosis (the nails are NOT necessarily cyanotic.) Onycholysis is a painless
separation of the nail from the nail bed. Several or all nails are usually affected - there are
many causes. Paronychia is an infection of the nail bed and nail margin, usually from trauma
or more commonly, nail-biting.
A 34-old female presents complaining of symmetrical redness and swelling of the small
joints of her hands (PIPs and MCPs). She has noted that the symptoms are worst in the
morning. Her erythrocyte sedimentation rate is elevated and her rheumatoid factor is
negative. Which of the following diagnosis is most likely?
A. progressive systemic sclerosis
B. CREST syndrome
C. osteoarthritis
D. rheumatoid arthritis
E. ankylosing spondylitis - ANSWER *Answer: D Rheumatoid Arthritis*
3
