Dunphy Primary Care Midterm Review Questions and Solutions

Dunphy Primary Care Midterm Review Questions and Solutions A 23-year-old college student presents to your primary care clinic complaining of the following symptoms: fever for 4 days that is controlled with Tylenol, nonproductive cough, general malaise and fatigue, and minimal rhinorrhea. The patient did not get a flu shot this year and states his girlfriend was diagnosed with the flu 3 days ago. His rapid influenza test is positive. What is the best treatment? 1. Rest and hydration. 2. Oseltamivir. 3. Inpatient hospitalization for supportive care. 4. Azithromycin. - Answer Rest and hydration. A 25-year-old male presents complaining of hematochezia. The patient states he has noticed this for 2 days. He states there is a streak of bright blood along his stool every time he has a bowel movement. The patient has no pain with his bowel movements. He admits to eating a poor diet. The patient has no abdominal pain, nausea, or vomiting. On physical exam the patient has a positive fecal occult blood test but has no noticeable rectal bleeding or lesions. What is the likely diagnosis? 1. Internal hemorrhoid. 2. External hemorrhoid. 3. Bleeding peptic ulcer. 4. Rectal fissure. - Answer Internal hemorrhoid. A 28-year-old teacher presents to your primary care office in the winter complaining of severe hoarseness for 3 days. It is progressive, and the patient can no longer teach her classes because she can't talk for long periods of time. The patient's vital signs show a temperature of 97.9°F, pulse of 70 beats per minute (BPM), pulse oximetry of 97% on room air, and blood pressure (BP) of 135/82. The patient has erythematous nasal and pharyngeal membranes, no nasal drainage, erythematous tympanic membranes, and a very sore throat. Rapid streptococcal (strep) test is negative, and there is no cervical lymphadenopathy. What is the treatment of choice? 1. Azithromycin. 2. Vocal rest. 3. Oral methylprednisolone. 4. Codeine cough syrup. - Answer Vocal rest. A 35-year-old nurse presents to your employee health clinic for her annual purified protein derivative (PPD) skin test. Two days later she comes in for the recheck. She has a raised, erythematous lesion at the injection site. What diameter measu