EOC REVIEW QUESTIONS & ANSWERS
A 56-year-old woman with a 20-pack-year smoking history presents to the clinic
complaining of epigastric discomfort and nausea when walking or climbing stairs. The
pain is not present at rest and has no relation to meals. Her vital signs are within normal
limits, she is not taking any medications on a daily basis, and has no past surgical
history. Physical exam and ECG are normal. Which of the following is the most likely
diagnosis?
AAngina pectoris
BChronic obstructive pulmonary disease
CCostochondritis
DPeptic ulcer disease - Answers :A Angina pectoris
Which of the following is the best treatment for retinal detachment?
AEye drops
BIntraocular injection
CPatching of the eye
DSurgical repair - Answers :DSurgical repair
Which of the following is the most appropriate treatment for an episode of acute lower
back pain?
ANonsteroidal anti-inflammatory medication and bedrest for 10 to 14 days
BNonsteroidal anti-inflammatory medication and early resumption of activity
CTapering course of oral glucocorticoids
DUse of a lumbosacral orthosis - Answers :BNonsteroidal anti-inflammatory medication
and early resumption of activity
A 27-year-old previously healthy man presents to your office with a complaint of painful
"lumps" in his groin. He tells you that about a month ago he had a small lesion on his
penis that resolved on its own and he has been asymptomatic until now. His sexual
history is significant for having sexual encounters with multiple male partners. Which of
the following is the most appropriate therapy?
Doxycycline
Fluconazole
Metronidazole
Penicillin - Answers :Doxycycline
You are rounding on a 24-year-old patient in the hospital who just vaginally delivered a
healthy infant a few hours ago. You perform a routine abdominal exam. Where would
you normally expect to find the height of the fundus?
AAt the height of the symphysis pubis
BAt the height of the umbilicus
CIn the substernal area
DMidway between the umbilicus and symphysis pubis - Answers :BAt the height of the
umbilicus
,Parents present in clinic with their eight-year old son for a dry cough that he's had for
two months. He seems fine during the day, but the coughing starts again throughout the
night. Parents mention that he doesn't seem ill, but the coughing is interfering with his
sleep. Over-the-counter cough syrups have not helped. He has needed to do breathing
treatments for some early childhood illnesses but doesn't do breathing treatments or
use inhalers now. He has seasonal allergies, and his only medication is a daily
antihistamine. Vital signs are all within normal limits. Physical exam reveals a slight
expiratory wheeze bilaterally. Which of the following is the most likely diagnosis?
AAsthma
BCystic fibrosis
CObstructive sleep apnea
DRespiratory syncytial virus - Answers :AAsthma
A high school soccer player suffered a head injury while running into another player a
couple of weeks ago. He complained of dizziness and disruptions in consciousness
during the injury but the MRI of the head revealed the absence of a hemorrhage. The
athlete improved within 24 hours of the injury and was able to return to school. He
presents to the emergency room today because he has been complaining of a
headache and dizziness for the past 2 days that has not resolved with over the counter
pain medications. He has noticed problems in his concentration lately and he has
become more irritable. He described the headache as a band-like pressure around his
head. Bright light makes the headache worse. Which of the following is the most likely
diagnosis?
AMigraine headache
BPost-concussion syndrome
CSubdural hematoma
DTension headache - Answers :BPost-concussion syndrome
A 20-year-old man presents to his primary care physician concerned about his
persistent acne. He has been using a benzoyl peroxide 2.5% gel for the past month with
little improvement. Before beginning a systemic therapy, combination topical therapy is
considered. Which of the following would only be used as part of a combination therapy
with either benzoyl peroxide 2.5% gel or topical retinoid?
Clindamycin 2% gel
Dapsone 7.5% gel
Tazarotene 0.05% cream
Tretinoin 0.01% gel - Answers :Clindamycin 2% gel
A 24-year-old graduate student presents to the clinic complaining of depressed mood
most of the day, every day for three consecutive weeks. She also complains of thoughts
of worthlessness, decreased sleep, and decreased ability to concentrate on her studies.
Which of the following additional history or physical exam findings would be most
consistent with a diagnosis of major depressive disorder?
ACatatonia
BRacing thoughts
CResting tremor
,DWeight loss - Answers :DWeight loss
A 64-year-old man presents to the emergency department with crushing chest pain,
dyspnea, and diaphoresis that began approximately 30 minutes prior to arrival. An ECG
is performed and shows ST elevation in leads I and AVL with reciprocal ST changes in
leads III and AVF. He is prepped for immediate cardiac catheterization after
stabilization. Which coronary vessel is most likely occluded?
ACircumflex artery
BLeft anterior descending artery
CPosterior descending artery
DProximal right coronary artery - Answers :ACircumflex artery
A 79-year-old woman presents to the emergency department with altered mental status,
confusion, and stupor. She lives with her son who thought he heard her fall last night;
however, this morning he found her in her bed. A computed tomography scan of the
brain without contrast is ordered and shows a high-density crescentic collection across
the hemispheric convexity. Which of the following is the most likely diagnosis?
Dural metastases
Epidural hematoma
Meningioma
Subdural hematoma - Answers :Subdural hematoma
Parents of a type 1 diabetic child call the on-call clinic provider because the child feels
dizzy and sweaty. An oral temperature at home is 98.8°F, pulse is 84, and a self-
monitored blood glucose level is 62 mg/dL. The parents should be instructed to help the
child with which of the following interventions?
ADrink a glass of fruit juice
BGive an additional bolus insulin dose
CPerform the Valsalva maneuver
DTake acetaminophen - Answers :ADrink a glass of fruit juice
A 46-year-old woman with history of traumatic brain injury secondary to motor vehicle
collision 11 months ago is brought to the emergency room due to a period of transient
loss of awareness. Accompanying family member notes that while at home today, there
was a two-minute period where she was found to have a blank stare and was not
responding to verbal stimuli. The family member notes lip smacking occurred
throughout episode. After the episode, patient was drowsy and unaware of what had
occurred. While currently fatigued, patient is now back at her baseline cognitive status.
Magnetic resonance imaging shows evidence of left temporal gliosis and
encephalomalacia from previous head injury. Electroencephalography demonstrates
sharp waves in the temporal lobe. Which of the following is the most likely diagnosis?
Absence seizure
Atonic seizure
Complex partial seizure
Simple partial seizure - Answers :Complex partial seizure
, A 25-year-old woman presents with the complaint of vaginal discharge that has a bad
smell since the end of her last menstruation. On physical exam, the vulva appears
normal without edema or erythema. There is a thin, grey discharge. Vaginal pH is 4.7. A
slide is prepared for microscopy. When potassium hydroxide is added to the slide there
is a fishy, amine odor. What would be the most likely finding under the microscope?
Buds and hyphae
Epithelial cells with adherent coccobacilli
Motile trichomonads
Squamous epithelial cells - Answers :Epithelial cells with adherent coccobacilli (clue
cell)
Which of the following is most commonly seen in viral croup?
ADrooling
BInspiratory stridor
CSputum production
DWheezin - Answers :BInspiratory stridor
A 45-year-old man presents to his primary care physician with a three-month history of
fatigue, muscle aches, abdominal pain, intermittent nausea, and salt craving. Physical
exam reveals hyperpigmentation of his neck and knees. Which of the following
diagnostic studies would assist in confirming the diagnosis?
ACorticotropin-releasing hormone test
BMetyrapone test
CShort adrenocorticotropic hormone stimulation test
DUrinary cortisol level - Answers :CShort adrenocorticotropic hormone stimulation test
A 55-year-old man with aortic stenosis will have which of the following auscultation
findings?
AContinuous murmur heard at the left sternal border
BHolosystolic murmur heard at the apex of the heart
CLate diastolic murmur heard over the apex
DMid-systolic ejection murmur heard over the base of the heart - Answers :DMid-
systolic ejection murmur heard over the base of the heart
A 4-year-old girl presents to clinic brought in by her mother. She has had difficulty
walking in the last two weeks, and her mother is concerned that she may have had
some vision loss. The mother also reports increasingly foul-smelling stools and diarrhea
over the last month. Physical exam reveals truncal ataxia and decreased reflexes.
Peripheral blood smear reveals a hemolytic anemia. Which of the following is the most
likely diagnosis?
Friedreich's ataxia
Vitamin A deficiency
Vitamin B12 deficiency
Vitamin E deficiency - Answers :Vitamin E deficiency
A 56-year-old woman with a 20-pack-year smoking history presents to the clinic
complaining of epigastric discomfort and nausea when walking or climbing stairs. The
pain is not present at rest and has no relation to meals. Her vital signs are within normal
limits, she is not taking any medications on a daily basis, and has no past surgical
history. Physical exam and ECG are normal. Which of the following is the most likely
diagnosis?
AAngina pectoris
BChronic obstructive pulmonary disease
CCostochondritis
DPeptic ulcer disease - Answers :A Angina pectoris
Which of the following is the best treatment for retinal detachment?
AEye drops
BIntraocular injection
CPatching of the eye
DSurgical repair - Answers :DSurgical repair
Which of the following is the most appropriate treatment for an episode of acute lower
back pain?
ANonsteroidal anti-inflammatory medication and bedrest for 10 to 14 days
BNonsteroidal anti-inflammatory medication and early resumption of activity
CTapering course of oral glucocorticoids
DUse of a lumbosacral orthosis - Answers :BNonsteroidal anti-inflammatory medication
and early resumption of activity
A 27-year-old previously healthy man presents to your office with a complaint of painful
"lumps" in his groin. He tells you that about a month ago he had a small lesion on his
penis that resolved on its own and he has been asymptomatic until now. His sexual
history is significant for having sexual encounters with multiple male partners. Which of
the following is the most appropriate therapy?
Doxycycline
Fluconazole
Metronidazole
Penicillin - Answers :Doxycycline
You are rounding on a 24-year-old patient in the hospital who just vaginally delivered a
healthy infant a few hours ago. You perform a routine abdominal exam. Where would
you normally expect to find the height of the fundus?
AAt the height of the symphysis pubis
BAt the height of the umbilicus
CIn the substernal area
DMidway between the umbilicus and symphysis pubis - Answers :BAt the height of the
umbilicus
,Parents present in clinic with their eight-year old son for a dry cough that he's had for
two months. He seems fine during the day, but the coughing starts again throughout the
night. Parents mention that he doesn't seem ill, but the coughing is interfering with his
sleep. Over-the-counter cough syrups have not helped. He has needed to do breathing
treatments for some early childhood illnesses but doesn't do breathing treatments or
use inhalers now. He has seasonal allergies, and his only medication is a daily
antihistamine. Vital signs are all within normal limits. Physical exam reveals a slight
expiratory wheeze bilaterally. Which of the following is the most likely diagnosis?
AAsthma
BCystic fibrosis
CObstructive sleep apnea
DRespiratory syncytial virus - Answers :AAsthma
A high school soccer player suffered a head injury while running into another player a
couple of weeks ago. He complained of dizziness and disruptions in consciousness
during the injury but the MRI of the head revealed the absence of a hemorrhage. The
athlete improved within 24 hours of the injury and was able to return to school. He
presents to the emergency room today because he has been complaining of a
headache and dizziness for the past 2 days that has not resolved with over the counter
pain medications. He has noticed problems in his concentration lately and he has
become more irritable. He described the headache as a band-like pressure around his
head. Bright light makes the headache worse. Which of the following is the most likely
diagnosis?
AMigraine headache
BPost-concussion syndrome
CSubdural hematoma
DTension headache - Answers :BPost-concussion syndrome
A 20-year-old man presents to his primary care physician concerned about his
persistent acne. He has been using a benzoyl peroxide 2.5% gel for the past month with
little improvement. Before beginning a systemic therapy, combination topical therapy is
considered. Which of the following would only be used as part of a combination therapy
with either benzoyl peroxide 2.5% gel or topical retinoid?
Clindamycin 2% gel
Dapsone 7.5% gel
Tazarotene 0.05% cream
Tretinoin 0.01% gel - Answers :Clindamycin 2% gel
A 24-year-old graduate student presents to the clinic complaining of depressed mood
most of the day, every day for three consecutive weeks. She also complains of thoughts
of worthlessness, decreased sleep, and decreased ability to concentrate on her studies.
Which of the following additional history or physical exam findings would be most
consistent with a diagnosis of major depressive disorder?
ACatatonia
BRacing thoughts
CResting tremor
,DWeight loss - Answers :DWeight loss
A 64-year-old man presents to the emergency department with crushing chest pain,
dyspnea, and diaphoresis that began approximately 30 minutes prior to arrival. An ECG
is performed and shows ST elevation in leads I and AVL with reciprocal ST changes in
leads III and AVF. He is prepped for immediate cardiac catheterization after
stabilization. Which coronary vessel is most likely occluded?
ACircumflex artery
BLeft anterior descending artery
CPosterior descending artery
DProximal right coronary artery - Answers :ACircumflex artery
A 79-year-old woman presents to the emergency department with altered mental status,
confusion, and stupor. She lives with her son who thought he heard her fall last night;
however, this morning he found her in her bed. A computed tomography scan of the
brain without contrast is ordered and shows a high-density crescentic collection across
the hemispheric convexity. Which of the following is the most likely diagnosis?
Dural metastases
Epidural hematoma
Meningioma
Subdural hematoma - Answers :Subdural hematoma
Parents of a type 1 diabetic child call the on-call clinic provider because the child feels
dizzy and sweaty. An oral temperature at home is 98.8°F, pulse is 84, and a self-
monitored blood glucose level is 62 mg/dL. The parents should be instructed to help the
child with which of the following interventions?
ADrink a glass of fruit juice
BGive an additional bolus insulin dose
CPerform the Valsalva maneuver
DTake acetaminophen - Answers :ADrink a glass of fruit juice
A 46-year-old woman with history of traumatic brain injury secondary to motor vehicle
collision 11 months ago is brought to the emergency room due to a period of transient
loss of awareness. Accompanying family member notes that while at home today, there
was a two-minute period where she was found to have a blank stare and was not
responding to verbal stimuli. The family member notes lip smacking occurred
throughout episode. After the episode, patient was drowsy and unaware of what had
occurred. While currently fatigued, patient is now back at her baseline cognitive status.
Magnetic resonance imaging shows evidence of left temporal gliosis and
encephalomalacia from previous head injury. Electroencephalography demonstrates
sharp waves in the temporal lobe. Which of the following is the most likely diagnosis?
Absence seizure
Atonic seizure
Complex partial seizure
Simple partial seizure - Answers :Complex partial seizure
, A 25-year-old woman presents with the complaint of vaginal discharge that has a bad
smell since the end of her last menstruation. On physical exam, the vulva appears
normal without edema or erythema. There is a thin, grey discharge. Vaginal pH is 4.7. A
slide is prepared for microscopy. When potassium hydroxide is added to the slide there
is a fishy, amine odor. What would be the most likely finding under the microscope?
Buds and hyphae
Epithelial cells with adherent coccobacilli
Motile trichomonads
Squamous epithelial cells - Answers :Epithelial cells with adherent coccobacilli (clue
cell)
Which of the following is most commonly seen in viral croup?
ADrooling
BInspiratory stridor
CSputum production
DWheezin - Answers :BInspiratory stridor
A 45-year-old man presents to his primary care physician with a three-month history of
fatigue, muscle aches, abdominal pain, intermittent nausea, and salt craving. Physical
exam reveals hyperpigmentation of his neck and knees. Which of the following
diagnostic studies would assist in confirming the diagnosis?
ACorticotropin-releasing hormone test
BMetyrapone test
CShort adrenocorticotropic hormone stimulation test
DUrinary cortisol level - Answers :CShort adrenocorticotropic hormone stimulation test
A 55-year-old man with aortic stenosis will have which of the following auscultation
findings?
AContinuous murmur heard at the left sternal border
BHolosystolic murmur heard at the apex of the heart
CLate diastolic murmur heard over the apex
DMid-systolic ejection murmur heard over the base of the heart - Answers :DMid-
systolic ejection murmur heard over the base of the heart
A 4-year-old girl presents to clinic brought in by her mother. She has had difficulty
walking in the last two weeks, and her mother is concerned that she may have had
some vision loss. The mother also reports increasingly foul-smelling stools and diarrhea
over the last month. Physical exam reveals truncal ataxia and decreased reflexes.
Peripheral blood smear reveals a hemolytic anemia. Which of the following is the most
likely diagnosis?
Friedreich's ataxia
Vitamin A deficiency
Vitamin B12 deficiency
Vitamin E deficiency - Answers :Vitamin E deficiency
