Graded Answers Latest Updated 2026\2027
3 month old infant with down syndrome, due to milk intolerance, mom started on goats milk;
now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would you
order?
Iron, TIBC
3 months of synthroid, TSH increased, T4 normal, what do you do?
increase medication
3 ways to assess cognitive function in patient with signs/symptoms of memory loss
MMSE
4 month old with strabismus, mom is worried
tell her it is normal
4 month old wont keep anything down, what is the main thing you look at?
growth chart
6 month old closed anterior fontanel
XRAY
88/yr. old patient in for follow up secondary. She's been treated with Tylenol for Joint arthritis.
Her SED rate was checked after 6 weeks of treatment and it was 28. Normal range is from
something to 25. How would you treat the pt
change to NSAID, SED rate is a sign of inflammation
a pregnant female at slightly above symphysis pubic and Fundal height is 32cm (above the
umbilical). What should be done
order Ultrasound
If A1C > 9 on two oral meds what do you order
If you are already on TWO oral drugs for diabetes and A1c is 9 or higher, start BASAL insulin.
If you cannot tolerate metformin and your A1c is 9 or higher start BASAL insulin. ON EXAM
Intermediate-acting- NPH (Humulin N, Novolin N)
,Long-acting-Levimir/Basalgar/Lantus
Ultra-long-acting-Degludec (Tresiba) and glargine u-300 (Toujeo)
Abnormal cells on PAP, what do you do next?
refer for Colposcopy
ACE/ARB contraindications
pregnancy
Renal failure
Renal Stenosis
Condition when ACE is contraindicated
pregnancy
Acne Rosacea
chronic small acne like papules/pustules around nose mouth chin
TREATMENT- Metrogel, Azelex. Low dose tetracycline. Clindamycin. EXAM
Acne Vulgaris
common acne
TREATMENT-Retin-A, acne worsens 4-6 weeks if no improvement in 8-12 weeks increase dose or
add erythromycin, benzoyl peroxide.
actinic keratoses
Precursor to squamous cell carcinoma. "numerous dry round and pink to red lesions" with a
rough and scaly texture. Does not heal. Slow growing in sun exposed areas.
Diagnosis: BIOPSY Golden Standard.
Treatment: Small area- liquid nitrogen or (cryotherapy), Large area (5-FU cream)- which causes
skin to ooze, crust, scab, redness EXAM
Acute Angle Closure Glaucoma
acute/severe halos, cupping optic nerve, cloudy cornea, mid-dilated oval pupil.
ER STAT. EXAM
Acute Bacterial Pneumonia CXR
,middle lobe. ON EXAM
Acute Closed Angle Glaucoma Vs Open Angle
Acute-Sudden pain, halos, cupping, dilated, cloudy , intraocular pressure, HA, refer ED
Open Angle Glaucoma (primary)
CN 2, gradual loss peripheral vision first
TX-laser trabeculoplasty
Eye drops (prostaglandin analogues)-latanoprost , bimatoprost ,travoprost
Treatment of Initial Genital Herpes
Acyclovir 200mg 5 x day
Addison's disease
Addison's- deficient in cortisol (pt have low sodium, blood sugar, but Increased K.)
You must give cortisol.
(Diagnosis Plasma Cortisol <5 mcg/dl @ 0800.) EXAM
ADHD
A behavioral problem characterized by short attention span, restless movement, and impaired
learning capacity.
Which murmurs are pathological
all diastolic murmurs
Murmur grading
I-barely
II-audible
III- clearly audible.
IV- first time thrill
V-Steth edge
VI-entire steth. EXAM
Allergic Conjunctivitis
, "stringy; increased tearing" Type I sensitivity. Typically bilateral. Rhinitis and allergic shiner.
TX=PO antihistamines
allergic rhinitis
blue pale turbinate clear drainage
Tx=inhaled corticosteroids
Aphthous stomatitis AKA canker sores are?
painful shallow ulcers heal 7-10 days
TX=Magic mouthwash
Abd assessment on patient with ascites will be
Dull to percussion
Atopic Dermatitis (eczema)
Inherited. Extremely itchy. On flexural folds, neck, hands. Inc. IgE. "small vesicles that rupture
leaving painful, bright-red, weepy lesions" they become lichenified from itching.
tx=First line: Topical steroids. Avoid hot water/soaps. PO antihistamines. EXAM
AV nicking (Arterioles pressing on vein of the eye)
HTN retinopathy
Basal cell cancer
Waxy, pearly, telangiectasia, ulcer center lesion -most common type of skin cancer caused by
UV exposure. Metastatic is rare
When prescribing lithium what lab do you monitor?
monitor TSH, toxicity bind to TH cause hypothyroidism.
What are the B/P ranges
Normal in elderly
Normal is <120/80
Elevated Blood Pressure: A reading ranging from 120-129/80