3P PRACTICE QUESTIONS AND
ANSWERS
Thezgroovezofzthezmetacarpophalangealzjointzcanzbezpalpatedzbyzhavingzthe
patient:z-zans--flexzhiszhand
Whenzauscultatingzbreathzsoundszinzazpatientzwhozhaszleftzsidedzheartzfailure,zthezbreathzs
oundszare:z-zans--
vesicularzwithzlatezinspiratoryzcrackleszinzthezdependentzportionszofzthezlungszandzresonant
zonzpercussionz(looseszabilityztozpumpzoutzblood)
Youzarezevaluatingzaz15zyearzoldzpatientzforzbipolarzdisorder.zHiszparentsztellzyouzthatzhezha
szseverezmoodzswings,ziszeasilyzdistracted,zandzconstantlyzcorrectszhiszteachers.zYouzhav
ezthezhighzsuspicionzforzbipolarzifzwhichzsymptomzwaszpresent?z-zans--
hezsleepszlesszthanz4zhoursznightly
UsingzGTPALznomenclature,zhowzwouldzdocumentzazpatientzcurrentlyzpregnantzwithzazhxz
ofzuncomplicatedztermzvaginalzdelivery,zpretermzdeliveryzofzlivebornztwins,zandzanz8zweekz
electivezabortion?z-zans--G4zT1zP1zA1zL3z(multzbirthszcountzasz1zpregnancyzandz1zbirth)
Whatziszthezmostzlikelyzpresentingzsymptomzinzazpediatriczpatientzwithzcroup?z-zans--
barkingzcough
47zyearzoldzwomanzpostztotalzhysterectomyzandzestrogenzhormoneztherapy.zWhichziszcontr
aindicated?z-zans--Heartzdisease
Severezaorticzregurgitationzsymptomszwithzdyspneaz-zans--
dryzcough,zangina,zhypotension,zsystoliczmurmur
Unipolarzdepression.zWhatzmedicationszareznotzconsidered?z-zans--
TCAz(tricycliczantidepressants);zBuspar,zSSR,zwellbutinzarezallzokay
WhichzofzthezfollowingzstatementsziszmostzaccuratezaboutzcoughzassociatedzwithzACEI?z-
zans--Asthma
ConductivezHearingzlossz-zans--Externalzear,zmiddlezear,zorzbothzproblem
Whichzofzthezfollowingziszazriskzfactorzforzthezdevelopmentzofzprostatezenlargement?z-zans--
Diabetes;zObesity,zheartzandzcirculatoryzdisease,zDM2
, PatientszwithzsuspectedzPADzmayzbezasymptomaticzorzmayzcomplainzofzwhichzsymptomzin
zthezlowerzextremity?z-zans--Painzduringzactivity
Azpatientzwhozpresentszwithznocturia,zdyspneazonzexertion,zandzperipheralzedemazandziszf
oundztozhavezasciteszandzJVDzshouldzbezevaluatedzfor:z-zans--heartzfailure
23zyearzoldzwomanziszhavingzfrequentzmigraineszandzneedszazprophylacticzmedication.zSh
ezalsozhaszasthma.zThezmedicationzshouldzbezavoidedzinzthiszpatient:z-zans--
Propranololz(inderal);zcanzcausezincreasezbronchospasm
45zyearzoldzwomanzwithzfirstzepisodezofzDVTziszbeingztreatedzforzCAP,zwhichzantibioticziszsa
feztozusezwithzwarfarin?z-zans--Clarithromycinz(PCNzandzcephalosporinszarezokay)
OnzPAzofz50zyearzoldzwomanzwhozhaszcomplainszofzjointzpain,zthezNPzfindszswanzneckzandz
boutonierezdeformitieszwhichzshezknowszarezrelatedztozthezdiagnosiszofz-zans--
rheumatoidzarthritis
28zyearzoldzwomanzhaszsymptomszofzasthmazdailyzandzseveralznightszazweek.zShezuseszaz
SABAzandzwillzbezstartingzfluticasone/salmeterolz(Advair).zAdvair:z-zans--
isznotzeffectivezduringzanzacutezasthmazattack
Thezmainzlymphaticzchannelzthatzdrainszlymphzbackztozthezsystemiczcirculationzfromzthezen
tirezbody,zwithzthezexceptionzofzthezRTzarm,zthorax,zheadzandzneckziszthez-zans--
thoraciczduct
Intrauterinezgrowthzrestrictionziszsuspectedzinzanz18zyearzoldzpregnantzpatientzatz35zweeksz
gestationzifzthezfundalzheightzmeasurementzisz-zans--32
Az22zyearzoldzpatientzpresentszwithzcomplaintszofzheadacheszwithzassociatedznauseazandz
vomitting.zThezLEASTzlikelyzdifferentialzdiagnosiszforzthiszpatientzisz-zans--
tensionzheadaches
Thezsymptomszthatzwillzhelpzdifferentiatezacutezpyelonephritiszfromzacuteznephrolithiasiszis
zthezpresencezofz-zans--costovertebral zpain
Whilezassessingzanz80zyearzoldzman,zthezNPzconsiderszthezneedztozevaluatezforzdepressio
nzbasedzonzthezpatient'sz-zans--poorzmotivationztozparticipatezinzcare
Acutezgoutzattack.zWhatzshouldznotzbezinitiated?z-zans--Probenecid
Serotoninzsyndromeziszsuspected.zWhatzsymptoms?z-zans--
rapidzheartzratezandzhighzbloodzpressure
Whichzmedicationzclasszisznotzrecommendedzinzthezoutpatientztreatmentzofzazpediatriczpati
entzwithzacutezbacterialzrhinosinusitisz(ABRS)z-zans--Antihistamines
ANSWERS
Thezgroovezofzthezmetacarpophalangealzjointzcanzbezpalpatedzbyzhavingzthe
patient:z-zans--flexzhiszhand
Whenzauscultatingzbreathzsoundszinzazpatientzwhozhaszleftzsidedzheartzfailure,zthezbreathzs
oundszare:z-zans--
vesicularzwithzlatezinspiratoryzcrackleszinzthezdependentzportionszofzthezlungszandzresonant
zonzpercussionz(looseszabilityztozpumpzoutzblood)
Youzarezevaluatingzaz15zyearzoldzpatientzforzbipolarzdisorder.zHiszparentsztellzyouzthatzhezha
szseverezmoodzswings,ziszeasilyzdistracted,zandzconstantlyzcorrectszhiszteachers.zYouzhav
ezthezhighzsuspicionzforzbipolarzifzwhichzsymptomzwaszpresent?z-zans--
hezsleepszlesszthanz4zhoursznightly
UsingzGTPALznomenclature,zhowzwouldzdocumentzazpatientzcurrentlyzpregnantzwithzazhxz
ofzuncomplicatedztermzvaginalzdelivery,zpretermzdeliveryzofzlivebornztwins,zandzanz8zweekz
electivezabortion?z-zans--G4zT1zP1zA1zL3z(multzbirthszcountzasz1zpregnancyzandz1zbirth)
Whatziszthezmostzlikelyzpresentingzsymptomzinzazpediatriczpatientzwithzcroup?z-zans--
barkingzcough
47zyearzoldzwomanzpostztotalzhysterectomyzandzestrogenzhormoneztherapy.zWhichziszcontr
aindicated?z-zans--Heartzdisease
Severezaorticzregurgitationzsymptomszwithzdyspneaz-zans--
dryzcough,zangina,zhypotension,zsystoliczmurmur
Unipolarzdepression.zWhatzmedicationszareznotzconsidered?z-zans--
TCAz(tricycliczantidepressants);zBuspar,zSSR,zwellbutinzarezallzokay
WhichzofzthezfollowingzstatementsziszmostzaccuratezaboutzcoughzassociatedzwithzACEI?z-
zans--Asthma
ConductivezHearingzlossz-zans--Externalzear,zmiddlezear,zorzbothzproblem
Whichzofzthezfollowingziszazriskzfactorzforzthezdevelopmentzofzprostatezenlargement?z-zans--
Diabetes;zObesity,zheartzandzcirculatoryzdisease,zDM2
, PatientszwithzsuspectedzPADzmayzbezasymptomaticzorzmayzcomplainzofzwhichzsymptomzin
zthezlowerzextremity?z-zans--Painzduringzactivity
Azpatientzwhozpresentszwithznocturia,zdyspneazonzexertion,zandzperipheralzedemazandziszf
oundztozhavezasciteszandzJVDzshouldzbezevaluatedzfor:z-zans--heartzfailure
23zyearzoldzwomanziszhavingzfrequentzmigraineszandzneedszazprophylacticzmedication.zSh
ezalsozhaszasthma.zThezmedicationzshouldzbezavoidedzinzthiszpatient:z-zans--
Propranololz(inderal);zcanzcausezincreasezbronchospasm
45zyearzoldzwomanzwithzfirstzepisodezofzDVTziszbeingztreatedzforzCAP,zwhichzantibioticziszsa
feztozusezwithzwarfarin?z-zans--Clarithromycinz(PCNzandzcephalosporinszarezokay)
OnzPAzofz50zyearzoldzwomanzwhozhaszcomplainszofzjointzpain,zthezNPzfindszswanzneckzandz
boutonierezdeformitieszwhichzshezknowszarezrelatedztozthezdiagnosiszofz-zans--
rheumatoidzarthritis
28zyearzoldzwomanzhaszsymptomszofzasthmazdailyzandzseveralznightszazweek.zShezuseszaz
SABAzandzwillzbezstartingzfluticasone/salmeterolz(Advair).zAdvair:z-zans--
isznotzeffectivezduringzanzacutezasthmazattack
Thezmainzlymphaticzchannelzthatzdrainszlymphzbackztozthezsystemiczcirculationzfromzthezen
tirezbody,zwithzthezexceptionzofzthezRTzarm,zthorax,zheadzandzneckziszthez-zans--
thoraciczduct
Intrauterinezgrowthzrestrictionziszsuspectedzinzanz18zyearzoldzpregnantzpatientzatz35zweeksz
gestationzifzthezfundalzheightzmeasurementzisz-zans--32
Az22zyearzoldzpatientzpresentszwithzcomplaintszofzheadacheszwithzassociatedznauseazandz
vomitting.zThezLEASTzlikelyzdifferentialzdiagnosiszforzthiszpatientzisz-zans--
tensionzheadaches
Thezsymptomszthatzwillzhelpzdifferentiatezacutezpyelonephritiszfromzacuteznephrolithiasiszis
zthezpresencezofz-zans--costovertebral zpain
Whilezassessingzanz80zyearzoldzman,zthezNPzconsiderszthezneedztozevaluatezforzdepressio
nzbasedzonzthezpatient'sz-zans--poorzmotivationztozparticipatezinzcare
Acutezgoutzattack.zWhatzshouldznotzbezinitiated?z-zans--Probenecid
Serotoninzsyndromeziszsuspected.zWhatzsymptoms?z-zans--
rapidzheartzratezandzhighzbloodzpressure
Whichzmedicationzclasszisznotzrecommendedzinzthezoutpatientztreatmentzofzazpediatriczpati
entzwithzacutezbacterialzrhinosinusitisz(ABRS)z-zans--Antihistamines
