CCS CASES EXAM QUESTIONS WITH CORRECT ANSWERS

CCS CASES EXAM QUESTIONS WITH
CORRECT ANSWERS



Case 1: Uncomplicated acute cystitis and pregnancy - Answers --DDx: pyelo, PID,
urethritis, cervicitis, vaginitis
-Emergency orders: None.
-Exam
-What to order 1st: B-HCG, UA -> advance to get the results -> +HCG, +UA
-What to order 2nd: Nitrofurantoin (oral, continuous), UCx, prenatal vitamins (oral,
continuous), counseling (pregnancy, smoking cessation, alcohol cessation)
-Location/Follow-up: Office -> Home, 2wks

Case 2: Pregnancy - Answers --DDx: R/o GTD.
-Emergency orders: None.
-Exam
-What to order 1st: B-HCG qualitative (stat) -> advance to obtain result -> +B-HCG
-What to order 2nd: TVUS pelvis, prenatal labs (Blood type and Rh, atypical antibody,
CBC with diff, BMP, UA, urine cx, Pap smear, Rubella antibodies, RPR, HBs antigen,
HIV ELISA, Chlamydia, gonorrhea), prenatal vitamins, iron sulfate, folic acid (all
routine).
-Location/Follow-up: Office -> Home, 4wks

Case 3: Ulcerative colitis - Answers --DDx: Crohn's, diverticulosis, angiodysplasia,
hemorrhoids, anal fissure, infectious colitis, ischemic colitis, colonic polyps/cancer, brisk
UGIB.
-Emergency orders: None.
-Exam
-What to order 1st: CBC with diff, BMP, LFTs, PT/INR/PTT, stool WBCs, stool cx, stool
O+P, ESR
-Location: Office -> home, 1 week -> advance to obtain lab results -> +ESR
-What to order 2nd: Sigmoidoscopy, rectal biopsy -> advance to obtain results -> UC
confirmed -> Bring pt back to the office.
-What to order 3rd: Meselamine suppository, loperamide, dicyclomine, dietary consult,
counseling
-Location/Follow-Up: Office -> Home, 2wks.

Case 4: Ectopic pregnancy - Answers --DDx: spontaneous abortion, molar pregnancy,
degenerating leiomyoma, adnexal torsion, ruptured corpus luteum, PID, acute
appendicitis, pyelonephritis.