48yo female presents for annual exam. A1C is 6.2%. You interpret this result as:
a. Prediabetes
b. T2DM
c. T1DM
d. Normal Ans✓✓✓ a. Prediabetes
55yo post-menopausal woman with h/o HTN c/o jaw pain on heavy exertion.
There were no c/o CP. Her EKG indicates NSR w/out ST segment abnormalities.
Your plan may include: Ans✓✓✓ Exercise stress test
55yo woman w/BMI of 28, has 20yr h/o primary HTN, has been on HCTZ 25mg for
years w/excellent response. During this follow up visit, she reports that for the
last 6mo she has felt thirsty all of the time even though she drinks at least 10
glasses of water/day. Previous fasting BGL was 136. No further testing was done
at that time. You check random BGL now, is 210. What is the next appropriate
step?
a. Order 3hr OGTT
b. Order another random BGL in 2wks
c. Order A1C
d. Prescribe metformin XR 500mg PO Ans✓✓✓ d. Prescribe metformin XR 500mg
PO
59yo female c/o pain when she urinates. She has been seen three times for this in
the last 3mo. Each time, dx'd with UTI, given abx. She carefully followed
instructions, but has no relief of symptoms. Last UA:WBC: 2-3RBC: 0-2Epithelial
cells: few Nitrite: neg Leuk: neg Which should be done next?
,a. Perform pelvic exam
b. Reassure the pt. that she has asymptomatic bacteriuria and does not need abx
c. Obtain clean catch urine for UA and C&S
d. Order pelvic ultrasound Ans✓✓✓ a. Perform pelvic exam
60yo obese male has T2DM and lipid panel of TC 250, HDL 32, LDL 165. You teach
the pt. about his modifiable cardiac risk factors, which include? Ans✓✓✓ DM,
obesity, hyperlipidemia
66yo dx with acute prostatitis, afebrile w/out severe pain, deemed appropriate to
be managed output. An appropriate initial treatment option for mild case is:
a. Septra x6wks
b. Cipro x10-14 days
c. Bactrim x14 days
d. Levaquin x3wks Ans✓✓✓ b. Cipro x10-14 days
68yo male, retired Air Force pilot, has been dx'd w/prostate ca in the past wk.
He's never had surgery and seeks clarification on availability of tx's for prostate
ca. He asks you to tell him the SE of radical prostatectomy. Which of the following
is NOT a potential SE of this procedure? Ans✓✓✓ Selected low back pain
76yo man seen for c/o UI. You should explore which of these causes of UI in men?
a. UTI
b. Sildenafil
c. Urethral polyps
d. All of the above Ans✓✓✓ a. UTI
,77yo Caucasian female has h/o breast ca. She's been in remission for 6yrs. As her
PCP, you are seeing her for follow up of her recent c/o intermittent abd pain
x3mo and general malaise. Given the hx above, what will you direct your
assessment at during the exam? Ans✓✓✓ Thorough abd and gyn exam to rule
out masses and ID any tenderness
79yo man is being eval'd for frequent urinary dribbling w/out burning. Physical
exam reveals smooth but slightly enlarged prostate. His PSA is 3.3. He undergoes
formal urodynamic studies and findings are as follows: decreased bladder
capacity of 370mL, few involuntary detrusor contractions at a low bladder volume
of 246mL, increased postvoid residual urine volume of 225mL, and slightly
decreased urinary flow rate. Which of the following is not consistent with normal
age-associated change? Ans✓✓✓ Increased postvoid residual urine volume
A 48 year old male patient screened for diabetes has a fasting plasma glucose
level of 120mg/dl (6.7mmol/L). The nurse practitioner plan includes:
a. prescribe metformin 500mg po BID
b. educate the patient on lifestyle changes to lower blood glucose
c. initiate self monitoring of blood glucose
d. review the effects of oral hypoglycemic medications Ans✓✓✓ b. educate the
patient on lifestyle changes to lower blood glucose
A 52 year old female patient screened for diabetes has a fasting plasma glucose
level of 123 mg/dl. The nurse practitioners plan includes:
a. repeat fasting glucose in 1 month
b. prescribe metformin 500mg BID po
c. repeat fasting plasma glucose in one year
, d. repeat fasting glucose in three years Ans✓✓✓ c. repeat fasting plasma glucose
in one year
A 56 year old man is diagnosed with acute prostatitis, he is afebrile without
severe pain and will be managed outpatient. He should initially be treated with
antibiotics for how long?
a. 6-12 weeks
b. 14-21 days
c. 3-6 weeks
d. 10-14 days Ans✓✓✓ d. 10-14 days
A 56-year old male patient screened for diabetes has a fasting plasma glucose
level of 96mg/dl. The nurse practitioner management plan includes:
a. repeat fasting plasma glucose in three years
b. prescribe Metformin 500mg po BID
c. repeat fasting plasma glucose in one year
d. refer to ophthalmology for eye exam Ans✓✓✓ a. repeat fasting plasma
glucose in three years
A 58 year old Caucasian mane with type 2 diabetes mellitus presents to the clinic
as a new patient. He takes metformin 500mg twice a day. His last Hgb A1c was
7%. He is up to date on eye and foot examinations. His BP is 142/96. According to
ACC 2017 guidelines for high blood pressure in adults, what is the most
appropriate first line medication?
a. lisinopril
b. furosemide
c. amlodipine