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A 7-year-old male presents with his mother to the urgent care clinic complaining of
abdominal pain. He started to complain of pain prior to going to bed; however, it has
gotten progressively worse and is now preventing him from sleeping. He is nauseous
but hasn't vomited and didn't eat dinner due to the pain.
The patient appears pale and is complaining of right-sided abdominal pain. His
vitals are as follows: blood pressure 130/85, pulse 120, temperature 100.5°F, pulse
oximetry 98% on room air. On physical exam he is tender in the right lower
quadrant. His complete blood count (CBC) shows a white blood cell count (WBC) of
17.0. What is the patient's likely diagnosis?
1.Appendicitis.
2.Cholecystitis.
3.Constipation.
4.Gastroenteritis . - correct answer✔✔ appendicitis
rationale: This is the clinical scenario typical for appendicitis
What is the recommended treatment to eradicate a Helicobacter pylori infection?
1.Ranitidine, amoxicillin, and clarithromycin for 2 weeks.
2.Amoxicillin, clarithromycin, and omeprazole for 2 weeks.
3.Bismuth, amoxicillin, and clarithromycin for 2 weeks.
4.Bismuth, doxycycline, metronidazole, and ranitidine. . - correct answer✔✔
Amoxicillin, clarithromycin, and omeprazole for 2 weeks
,rationale: This is the recommended treatment to eradicate H pylori.
A 50-year-old female presents to the urgent care clinic complaining of left lower
quadrant pain. She has associated nausea and vomiting, and her vital signs are as
follows: temperature 102.5°F, pulse 110, blood pressure 150/90, pulse oximetry
99% on room air. What is the best test to evaluate this patient?
1.Sigmoidoscopy.
2.Abdominal series.
3.Computed tomography (CT) scan with oral contrast.
4.Abdominal ultrasound. . - correct answer✔✔ Computed tomography (CT)
scan with oral contrast
rationale: This is the best diagnostic choice. While diverticulitis is likely the cause of
the patient's symptoms, a CT of the abdomen would show if the patient has any
gynecologic etiology (such as ovarian cyst or tumor) of this pain
Which gastrointestinal disease below could theoretically be completely eradicated
with a total colectomy?
1.Crohn's disease.
2.Irritable bowel syndrome.
,3.Ulcerative colitis.
4.Celiac disease . - correct answer✔✔ Ulcerative Colitis
rationale: Ulcerative colitis is a disease only of the colon. While it is not the first
treatment choice, total colectomy is a treatment option that can completely resolve
this problem
The screening guidelines for colon cancer recommend which of the following for
the general population?
1.Colonoscopy starting at age 50.
2.Colonoscopy starting at age 45.
3.Fecal occult blood test (FOBT) and rectal exam starting at age 50.
4.Fecal occult blood test (FOBT) and rectal exam starting at age 45. . - correct
answer✔✔ Colonoscopy after age 50
rationale: This is the recommended age to start colonoscopic examination in someone
with a low risk for colon cancer
, Which of the following is not a risk factor for cholecystitis?
1.Female gender.
2.Obesity.
3.Sickle cell anemia.
4.Younger age . - correct answer✔✔ Younger age
rationale: The risk of cholecystitis actually increases with age
A 54-year-old female presents to your primary care office for routine reevaluation
for gastroesophageal reflux disease (GERD). She has been treated with diet
modifications and 6 weeks of omeprazole without improvement of her symptoms.
What is the next step in management of this patient's GERD?
1.Order an endoscopy.
2.Order a Helicobacter pylori blood test.
3.Try adding ranitidine to the patient's regimen.
4.Try adding bismuth to the patient's regimen. . - correct answer✔✔ Order
an endoscopy
rationale: This is the next step in treatment in order to evaluate the etiology of the
patient's GERD and consider biopsy if necessary
A 25-year-old male presents with "bleeding in my eye" for 1 day. He awoke this
morning with a dark area of redness in his eye. He has no visual loss or changes.
He denies constitutional symptoms, pruritus, drainage, or recent trauma. The
redness presents on physical exam as a dark red area in the patient's sclera of the
right eye only and takes up less than 50% of the eye. The patient's remaining