e
1. A 45-year-old male presents with acute onset of severe pain, redness, and swelling in his
right first metatarsophalangeal joint. Which of the following is the most appropriate initial
pharmacological treatment for this acute gouty flare?
A. Allopurinol 100mg daily
B. Indomethacin 50mg three times daily
C. Febuxostat 40mg daily
D. Probenecid 250mg twice daily
Correct Answer: B
Explanation: NSAIDs like indomethacin or naproxen are considered first-line therapy for
acute gout flares to reduce inflammation. Allopurinol and febuxostat are urate-lowering
therapies that should not be initiated during an acute attack as they can exacerbate
symptoms. The goal of acute management is rapid pain relief and resolution of the
inflammatory process.
2. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old patient
with no history of diabetes or chronic kidney disease?
A. < 120/80 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
,D. < 150/90 mmHg
Correct Answer: D
Explanation: JNC 8 guidelines specifically recommend a blood pressure target of less than
150/90 mmHg for individuals aged 60 years and older without comorbidities. For younger
patients or those with diabetes/CKD, the threshold for treatment and target remains lower.
This recommendation aimed to reduce the risk of polypharmacy and side effects in the
geriatric population while maintaining cardiovascular safety.
3. A 12-month-old infant is brought into the clinic for a well-child checkup. Which set of
immunizations is typically recommended at this age according to the CDC schedule?
A. MMR, Varicella, and Hepatitis A
B. DTaP, IPV, and PCV13 only
C. Rotavirus, Hib, and HepB
D. HPV, Meningococcal, and Tdap
Correct Answer: A
Explanation: The 12-to-15 month window is the standard time for the first doses of MMR
and Varicella vaccines. Hepatitis A is also initiated at the 12-month mark, with a second
dose required 6 months later. Clinicians must ensure that these live vaccines are
administered properly to provide long-term immunity against these pediatric illnesses.
, 4. A 32-year-old female presents with a ‘strawberry cervix’ and a thin, yellow-green,
malodorous vaginal discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
B. Vulvovaginal Candidiasis
C. Trichomoniasis
D. Chlamydia Trachomatis
Correct Answer: C
Explanation: Trichomoniasis is often characterized by a frothy, green-yellow discharge
and punctate hemorrhages on the cervix known as a strawberry cervix. Diagnosis is
typically confirmed via wet mount showing motile trichomonads or NAIT testing.
Treatment involves metronidazole for both the patient and their sexual partners to prevent
reinfection.
5. An 8-year-old child presents with a ‘honey-colored’ crusted lesion around the mouth. What
is the most appropriate topical treatment for this condition?
A. Hydrocortisone cream
B. Mupirocin ointment
C. Ketoconazole cream
D. Acyclovir ointment
Correct Answer: B
1. A 45-year-old male presents with acute onset of severe pain, redness, and swelling in his
right first metatarsophalangeal joint. Which of the following is the most appropriate initial
pharmacological treatment for this acute gouty flare?
A. Allopurinol 100mg daily
B. Indomethacin 50mg three times daily
C. Febuxostat 40mg daily
D. Probenecid 250mg twice daily
Correct Answer: B
Explanation: NSAIDs like indomethacin or naproxen are considered first-line therapy for
acute gout flares to reduce inflammation. Allopurinol and febuxostat are urate-lowering
therapies that should not be initiated during an acute attack as they can exacerbate
symptoms. The goal of acute management is rapid pain relief and resolution of the
inflammatory process.
2. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old patient
with no history of diabetes or chronic kidney disease?
A. < 120/80 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
,D. < 150/90 mmHg
Correct Answer: D
Explanation: JNC 8 guidelines specifically recommend a blood pressure target of less than
150/90 mmHg for individuals aged 60 years and older without comorbidities. For younger
patients or those with diabetes/CKD, the threshold for treatment and target remains lower.
This recommendation aimed to reduce the risk of polypharmacy and side effects in the
geriatric population while maintaining cardiovascular safety.
3. A 12-month-old infant is brought into the clinic for a well-child checkup. Which set of
immunizations is typically recommended at this age according to the CDC schedule?
A. MMR, Varicella, and Hepatitis A
B. DTaP, IPV, and PCV13 only
C. Rotavirus, Hib, and HepB
D. HPV, Meningococcal, and Tdap
Correct Answer: A
Explanation: The 12-to-15 month window is the standard time for the first doses of MMR
and Varicella vaccines. Hepatitis A is also initiated at the 12-month mark, with a second
dose required 6 months later. Clinicians must ensure that these live vaccines are
administered properly to provide long-term immunity against these pediatric illnesses.
, 4. A 32-year-old female presents with a ‘strawberry cervix’ and a thin, yellow-green,
malodorous vaginal discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
B. Vulvovaginal Candidiasis
C. Trichomoniasis
D. Chlamydia Trachomatis
Correct Answer: C
Explanation: Trichomoniasis is often characterized by a frothy, green-yellow discharge
and punctate hemorrhages on the cervix known as a strawberry cervix. Diagnosis is
typically confirmed via wet mount showing motile trichomonads or NAIT testing.
Treatment involves metronidazole for both the patient and their sexual partners to prevent
reinfection.
5. An 8-year-old child presents with a ‘honey-colored’ crusted lesion around the mouth. What
is the most appropriate topical treatment for this condition?
A. Hydrocortisone cream
B. Mupirocin ointment
C. Ketoconazole cream
D. Acyclovir ointment
Correct Answer: B
