Family Medicine EOR
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1. A 54-year-old man presents with chest pain. He has C. Diabetes mellitus
a past medical history of hypertension and diabetes
mellitus. The pain is located in the middle of his chest (DM) is an independent
and radiates to his jaw. The pain began about 20 min- risk factor for atheroscle-
utes ago, and he rates the pain as a 10 on a 0 - 10 point rosis. The risk of myocar-
scale, with 10 being the worst pain he has ever felt. dial infarction (MI) in a
He has had 3 similar episodes, but they have always patient with diabetes is
resolved after 5 minutes or so of rest. He has smoked the same risk as some-
1 pack of cigarettes a day for the past 36 years. He one without diabetes who
drinks 2 or 3 beers on Friday nights. Review of systems has had a previous MI. The
(ROS) is positive for diaphoresis, acute dyspnea, and risk of death from cardiac
impending doom. ROS negative for fever, chills, and events is also the same
malaise. Physical exam shows an obese, middle-aged between the 2 groups. Pa-
man in moderate distress. BP 126/80, pulse 100, respi- tients with diabetes melli-
rations 26. Heart and lung exams are normal, except tus should be advised to
for tachycardia and tachypnea. He has no pedal ede- stop smoking and aggres-
ma. What aspect of the patient's history is the largest sively control other risk
risk factor for an acute myocardial infarction? factors, such as glucose,
hypertension, and dyslipi-
A. alcohol use demia, in order to reduce
B. cigarette smoking the risk of ischemic heart
C. diabetes mellitus disease.
D. hypertension
E. obesity
2. Absorption of vitamin B12 requires intrinsic factor parietal cells
that is secreted by which cell type?
3. A 65-year-old woman presents with glossitis, weight C Pernicious anemia
loss, paresthesias, and diarrhea. Laboratory tests
show a macrocytic anemia. The most likely cause is
A Iron-deficiency anemia
, Family Medicine EOR
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B Thalassemia
C Pernicious anemia
D Multiple myeloma
E Colon cancer
4. A 45-year-old woman with a no significant past med- This patient's diagnosis
ical history presents with a 4-month history of dull, is varicose veins. Scle-
aching heaviness sensation in her proximal right leg. rotherapy can be used
She notes that this sensation is provoked by extended to treat varicose veins.
periods of standing and walking, and is relieved when It involves the injection
she lies in a recumbent position. Her past medical of an irritating solution
history is remarkable for pregnancy 4 times, the most into the varicose vein to
recent being approximately 2 years ago. She denies a promote an inflammato-
history of smoking, trauma, injuries, fever, chills, chest ry response, scarring, and
pain, shortness of breath, hemoptysis, cough, skin obliteration of the lumen
changes and coolness, and peripheral edema. Her
physical exam reveals several dilated, tortuous, elon-
gated veins along the medial right thigh, which are
especially pronounced upon standing. The remainder
of the physical exam is normal. What will be the most
appropriate therapeutic approach for this patient at
this time?
Warfarin (Coumadin)
Hint:
Warfarin is indicated for myocardial infarction or cere-
brovascular accident prevention and in patients with
atrial fibrillation, mechanical heart valves, or deep ve-
nous thrombosis.
A Warfarin
B Clopidogrel (Plavix)
C Sclerotherapy
, Family Medicine EOR
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D Furosemide (Lasix)
E Cilostazol (Pletal)
5. A 62-year-old woman with a long-standing history
of hypertension presents with a severe headache; it
started this morning and is rapidly worsening. Dur-
ing the interview, she suddenly collapses. Your brief
examination shows that she responds with extensor
posturing on external stimuli. Her deep tendon reflex-
es are 3, and you elicit Babinski bilaterally. You also
notice that her breathing has a peculiar pattern: deep
inspiration with a pause at full inspiration, followed
by a brief insufficient release and the end-inspiration
pause. How do you best describe her respiratory pat-
tern?
A Cheyne-Stokes
B Apneusis
C Ataxic
D Cluster
E Kussmaul
6. Deficiency of what factor may predispose a person to C Protein C deficiency
recurrent thrombosis?
A Platelet deficiency
B Factor VIIIC deficiency
C Protein C deficiency
D von Willebrand factor deficiency
E Factor VII deficiency
7. A 15-year-old girl presents with a 1-hour history of synchronized cardiover-
rapid heartbeat, faintness, sweating, and nervous- sion
ness. She is also experiencing shortness of breath and
, Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
chest pain. The patient has no significant past medical
history. There is no history of similar episodes. The
patient is on no medications, and she denies illicit
drug use. On exam, her vital signs are BP70/60 mmHg;
pulse 200 bpm; RR 22/min, temperature afebrile. She
looks pale, and her palms are slightly sweaty. She is
not comfortable sitting up, so she prefers lying down.
She looks slightly apprehensive. Her heart and lung
exam are negative except for the tachycardia; except
for cool sweaty hands, a brief abdominal and ex-
tremity exam are non-revealing. The physician quickly
places the paddles on the patient's chest to record the
rhythm; this shows a narrow-complex regular tachy-
cardia at 210 bpm. He requests oxygen, IV line, and
continuous monitoring. An EKG is in the process of
being completed. At this point, what should be done?
8. which cancers is the AFP tumor marker associated hepatocellular carcinoma
with?
germ cell tumors
9. 50-year-old man presents with a 3-month history of A Hepatocellular carcino-
weakness, fatigue, and abdominal discomfort. Upon ma
further questioning, he acknowledges a lack of sexual
desire. He denies any photosensitivity. On physical
examination, his liver is enlarged, and his spleen is
palpable. He has abnormal skin pigmentation on his
face, neck and his elbows and which gives his skin
a metallic gray hue. His laboratory results are in the
chart.
TESTRESULTS
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1. A 54-year-old man presents with chest pain. He has C. Diabetes mellitus
a past medical history of hypertension and diabetes
mellitus. The pain is located in the middle of his chest (DM) is an independent
and radiates to his jaw. The pain began about 20 min- risk factor for atheroscle-
utes ago, and he rates the pain as a 10 on a 0 - 10 point rosis. The risk of myocar-
scale, with 10 being the worst pain he has ever felt. dial infarction (MI) in a
He has had 3 similar episodes, but they have always patient with diabetes is
resolved after 5 minutes or so of rest. He has smoked the same risk as some-
1 pack of cigarettes a day for the past 36 years. He one without diabetes who
drinks 2 or 3 beers on Friday nights. Review of systems has had a previous MI. The
(ROS) is positive for diaphoresis, acute dyspnea, and risk of death from cardiac
impending doom. ROS negative for fever, chills, and events is also the same
malaise. Physical exam shows an obese, middle-aged between the 2 groups. Pa-
man in moderate distress. BP 126/80, pulse 100, respi- tients with diabetes melli-
rations 26. Heart and lung exams are normal, except tus should be advised to
for tachycardia and tachypnea. He has no pedal ede- stop smoking and aggres-
ma. What aspect of the patient's history is the largest sively control other risk
risk factor for an acute myocardial infarction? factors, such as glucose,
hypertension, and dyslipi-
A. alcohol use demia, in order to reduce
B. cigarette smoking the risk of ischemic heart
C. diabetes mellitus disease.
D. hypertension
E. obesity
2. Absorption of vitamin B12 requires intrinsic factor parietal cells
that is secreted by which cell type?
3. A 65-year-old woman presents with glossitis, weight C Pernicious anemia
loss, paresthesias, and diarrhea. Laboratory tests
show a macrocytic anemia. The most likely cause is
A Iron-deficiency anemia
, Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
B Thalassemia
C Pernicious anemia
D Multiple myeloma
E Colon cancer
4. A 45-year-old woman with a no significant past med- This patient's diagnosis
ical history presents with a 4-month history of dull, is varicose veins. Scle-
aching heaviness sensation in her proximal right leg. rotherapy can be used
She notes that this sensation is provoked by extended to treat varicose veins.
periods of standing and walking, and is relieved when It involves the injection
she lies in a recumbent position. Her past medical of an irritating solution
history is remarkable for pregnancy 4 times, the most into the varicose vein to
recent being approximately 2 years ago. She denies a promote an inflammato-
history of smoking, trauma, injuries, fever, chills, chest ry response, scarring, and
pain, shortness of breath, hemoptysis, cough, skin obliteration of the lumen
changes and coolness, and peripheral edema. Her
physical exam reveals several dilated, tortuous, elon-
gated veins along the medial right thigh, which are
especially pronounced upon standing. The remainder
of the physical exam is normal. What will be the most
appropriate therapeutic approach for this patient at
this time?
Warfarin (Coumadin)
Hint:
Warfarin is indicated for myocardial infarction or cere-
brovascular accident prevention and in patients with
atrial fibrillation, mechanical heart valves, or deep ve-
nous thrombosis.
A Warfarin
B Clopidogrel (Plavix)
C Sclerotherapy
, Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
D Furosemide (Lasix)
E Cilostazol (Pletal)
5. A 62-year-old woman with a long-standing history
of hypertension presents with a severe headache; it
started this morning and is rapidly worsening. Dur-
ing the interview, she suddenly collapses. Your brief
examination shows that she responds with extensor
posturing on external stimuli. Her deep tendon reflex-
es are 3, and you elicit Babinski bilaterally. You also
notice that her breathing has a peculiar pattern: deep
inspiration with a pause at full inspiration, followed
by a brief insufficient release and the end-inspiration
pause. How do you best describe her respiratory pat-
tern?
A Cheyne-Stokes
B Apneusis
C Ataxic
D Cluster
E Kussmaul
6. Deficiency of what factor may predispose a person to C Protein C deficiency
recurrent thrombosis?
A Platelet deficiency
B Factor VIIIC deficiency
C Protein C deficiency
D von Willebrand factor deficiency
E Factor VII deficiency
7. A 15-year-old girl presents with a 1-hour history of synchronized cardiover-
rapid heartbeat, faintness, sweating, and nervous- sion
ness. She is also experiencing shortness of breath and
, Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
chest pain. The patient has no significant past medical
history. There is no history of similar episodes. The
patient is on no medications, and she denies illicit
drug use. On exam, her vital signs are BP70/60 mmHg;
pulse 200 bpm; RR 22/min, temperature afebrile. She
looks pale, and her palms are slightly sweaty. She is
not comfortable sitting up, so she prefers lying down.
She looks slightly apprehensive. Her heart and lung
exam are negative except for the tachycardia; except
for cool sweaty hands, a brief abdominal and ex-
tremity exam are non-revealing. The physician quickly
places the paddles on the patient's chest to record the
rhythm; this shows a narrow-complex regular tachy-
cardia at 210 bpm. He requests oxygen, IV line, and
continuous monitoring. An EKG is in the process of
being completed. At this point, what should be done?
8. which cancers is the AFP tumor marker associated hepatocellular carcinoma
with?
germ cell tumors
9. 50-year-old man presents with a 3-month history of A Hepatocellular carcino-
weakness, fatigue, and abdominal discomfort. Upon ma
further questioning, he acknowledges a lack of sexual
desire. He denies any photosensitivity. On physical
examination, his liver is enlarged, and his spleen is
palpable. He has abnormal skin pigmentation on his
face, neck and his elbows and which gives his skin
a metallic gray hue. His laboratory results are in the
chart.
TESTRESULTS
