CEA Comprehensive Exam Prep Solved
100% Correct (Verified)
A "code blue" is called on your patient in the waiting room of your urgent care. When
you arrive, cardiac monitoring is applied and their rhythm appears to be normal sinus
rhythm with a rate of 80. On palpation over the carotid artery, you do not feel a pulse.
What is the name of this cardiac rhythm?
*Idioventricular rhythm
*Junctional Tachycardia
*Wandering Atrial Pacemaker (WAP)
*Pulseless Electrical Activity (PEA) - ANSWER-Pulseless Electrical Activity (PEA)
Rationale: PEA appears as a normal rhythm without a pulse. Idioventricular rhythm is
very slow (20-40), Junctional tachycardia and WAP both without pulses are considered
PEA also.
A 13 year old female who is diagnosed with iron deficiency anemia is being treated with
ferrous sulfate. Proper treatment typically leads to the resolution of anemia within:
*3 months.
*4 weeks.
*8 months.
*2 weeks. - ANSWER-3 months.
Rationale: Due to the time it takes for the underlying deficit to be corrected as well as
the growth of new red blood cells to mature, 3 months are typically needed to show
recovery with treatment for iron deficiency.
A 13-year-old patient returns to the office complaining of intermittent headache for the
past couple of years. Which would be the most concerning symptom? - ANSWER-Stiff
neck
Rationale: Inflammation of the membranes (meninges) surrounding the brain and spinal
cord, often caused by a viral or bacterial infection. This can cause severe headache,
stiff neck, fever, and sensitivity to light.
A 14-year-old with sickle cell anemia has recently experienced a sickle cell crisis and
presents for a follow-up examination after a recent hospitalization. It is most important to
continue monitoring growth, development, and: - ANSWER-hemoglobin levels.
Rationale: Chronic monitoring for patients with sickle cell disease includes monitoring of
hemoglobin and hematocrit.
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of
midcycle spotting. She has not missed any doses and uses no other medication. Which
of the following is appropriate?
*Double dosing for 2 days
*Modifying use
*Changing to Ortho-Novum 1/35
,*Providing reassurance - ANSWER-Providing reassurance
Rationale: Ortho-Novum 7/7/7 is a combination oral contraceptive pill that contains
varying doses of estrogen and progestin (norethindrone) throughout the cycle. It is a
triphasic pill, meaning that the hormone levels change every seven days to mimic the
natural menstrual cycle more closely. Mid-cycle spotting can occur for several reasons
while using this contraceptive.
A 19-year-old patient who has used oral contraceptives for 3 years plans to discontinue
the pill at the end of her current cycle to become pregnant. Which of the following daily
supplements would receive the highest priority?
*Ferrous sulfate
*Folic acid
*Multivitamin
*Calcium carbonate - ANSWER-Folic acid
Rationale: Folic acid, a B-vitamin (B9), plays a crucial role in ensuring a healthy
pregnancy and reducing the risk of birth defects. Folic acid is crucial in the early
development of the neural tube, which forms the brain and spinal cord. Adequate folic
acid intake can significantly reduce the risk of neural tube defects such as spina bifida
(incomplete closure of the spinal cord) and anencephaly (underdevelopment of the
brain). The neural tube forms very early in pregnancy, often before a woman knows she
is pregnant. Therefore, it is essential to have adequate folic acid levels before and
during early pregnancy.
A 19-year-old presents with a sore throat and anterior cervical adenopathy. Which
causative agent would be suspected?
*Epstein-Barr virus
*Adenovirus
*Haemophilus influenzae
*Group A beta-hemolytic Streptococcus - ANSWER-Group A beta-hemolytic
Streptococcus
Rationale: While this patient could easily represent strep or EBV, the differentiating
factor is the location of the affected lymphadenopathy. As a generalization, posterior
cervical lymphadenopathy is common of Epstein-Barr virus (EBV) and anterior cervical
lymphadenopathy is more common with Group A beta-hemolytic streptococcus.
A 2-day old newborn has purulent discharge of the eyes and erythema. History includes
a vaginal birth at term delivered at home. What is the most likely culprit?
*Chlamydia trachomatis infection
*E-coli infection
*Staph infection
*Viral infection - ANSWER-Chlamydia trachomatis infection
Rationale: Chlamydia conjunctivitis is usually spread through direct contact with
discharge from the eyes or genital secretions of someone infected with Chlamydia
trachomatis. It can occur in newborns during childbirth (neonatal conjunctivitis) or in
adults through sexual contact (adult inclusion conjunctivitis).
Symptoms: The symptoms can include:
,Redness in the eye(s).
Watery or mucopurulent discharge (yellow or green discharge from the eyes).
Swelling of the eyelids.
Sensitivity to light (photophobia).
Itching or burning sensation in the eyes.
A 22-year-old has ASCAS on Pap smear and negative for HPV. The next step is:
*No follow up is needed.
*Repeat HPV in 3 months
*Colposcopy
*Repeat Pap in 6 months - ANSWER-Repeat Pap in 6 months
Rationale: For a 22-year-old with ASC-US on Pap smear and a negative HPV test, the
next appropriate step is to repeat the cytology in six months. This approach minimizes
unnecessary interventions while ensuring ongoing monitoring for any potential
progression of cervical cell abnormalities.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by
bladder emptying. The patient has been evaluated by urology and urogynecology.
Review of laboratory reports reveal negative urinalysis and cultures, negative results for
sexually transmitted infections, and an unremarkable cystoscopy. Which of the following
is an appropriate plan of care?
*Amitriptyline (Elavil) 25 mg oral once daily
*Referral to psychiatry
*Propranolol (Inderal) 10 mg oral once daily
*Nitrofurantoin (Macrodantin) 100 mg oral once daily - ANSWER-Amitriptyline (Elavil) 25
mg oral once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by
bladder emptying. The patient has been evaluated by urology and urogynecology.
Review of laboratory reports reveal negative urinalysis and cultures, negative results for
sexually transmitted infections, and an unremarkable cystoscopy. Which of the following
is an appropriate plan of care? - ANSWER-Amitriptyline (Elavil) 25 mg oral once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old sexually active woman presents with lower abdominal pain, fever, and
purulent cervical discharge. On pelvic examination, cervical motion tenderness is noted.
What is the most likely diagnosis? - ANSWER-Pelvic inflammatory disease (PID)
Rationale: Cervical motion tenderness is a clinical finding characterized by pain elicited
when the cervix is moved or manipulated during a pelvic examination. This tenderness
can indicate underlying pelvic pathology. Lower abdominal pain, fever, abnormal vaginal
, discharge, pain during intercourse, and irregular menstrual bleeding and cervical motion
tenderness are present with Pelvic Inflammatory Disease (PID).
A 25-year-old athlete presents with shoulder pain and difficulty with overhead activities.
Physical examination suggests impingement syndrome. What is the most appropriate
initial treatment? - ANSWER-Physical therapy focusing on rotator cuff strengthening
Rationale: Exercises to improve shoulder strength and flexibility, focusing on the rotator
cuff and scapular stabilizers is an important initial treatment. Physical therapy may
include stretching and strengthening exercises, as well as techniques to improve
shoulder mechanics.
A 25-year-old woman presents with a 2-year history of fluctuating mood states,
including periods of mild depression and hypomania. These symptoms have not been
severe enough to meet the criteria for major depressive or manic episodes. What is the
most likely diagnosis? - ANSWER-Cyclothymic disorder
Rationale: Cyclothymic Disorder involves chronic mood fluctuations that include periods
of hypomanic and depressive symptoms. These symptoms are less severe than those
in Bipolar I or II disorders but can significantly impact daily functioning. Early diagnosis
and appropriate treatment, including psychotherapy, medications, and lifestyle changes,
can help manage symptoms and improve quality of life.
A 25-year-old woman presents with a sudden onset of shortness of breath and pleuritic
chest pain. She has no significant past medical history and takes no medications. On
physical examination, her heart rate is 110 beats per minute, respiratory rate is 24
breaths per minute, and oxygen saturation is 90% on room air. What is the most likely
diagnosis? - ANSWER-Pulmonary embolism
Rationale: Pulmonary embolism (PE) is a serious medical condition that occurs when a
blood clot (usually from the legs or other parts of the body) travels to the lungs and
obstructs one of the pulmonary arteries. The primary symptoms of a PE can vary
depending on the size of the clot and the location within the lung, but the most common
symptoms include: Sudden onset of difficulty breathing, which may occur at rest or with
exertion and sharp, stabbing pain that may worsen with deep breathing (pleuritic pain).
The pain may also feel like pressure, fullness, or a squeezing sensation.
A 25-year-old woman presents with a urinary tract infection (UTI) confirmed by
urinalysis. She has no allergies. What is the most appropriate first-line antibiotic
treatment?
*Amoxicillin
*Trimethoprim-sulfamethoxazole
*Ciprofloxacin
*Nitrofurantoin - ANSWER-Nitrofurantoin
Rationale: Overall, Nitrofurantoin is a preferred choice for treating uncomplicated UTIs,
especially in otherwise healthy individuals where local resistance patterns support its
efficacy.
100% Correct (Verified)
A "code blue" is called on your patient in the waiting room of your urgent care. When
you arrive, cardiac monitoring is applied and their rhythm appears to be normal sinus
rhythm with a rate of 80. On palpation over the carotid artery, you do not feel a pulse.
What is the name of this cardiac rhythm?
*Idioventricular rhythm
*Junctional Tachycardia
*Wandering Atrial Pacemaker (WAP)
*Pulseless Electrical Activity (PEA) - ANSWER-Pulseless Electrical Activity (PEA)
Rationale: PEA appears as a normal rhythm without a pulse. Idioventricular rhythm is
very slow (20-40), Junctional tachycardia and WAP both without pulses are considered
PEA also.
A 13 year old female who is diagnosed with iron deficiency anemia is being treated with
ferrous sulfate. Proper treatment typically leads to the resolution of anemia within:
*3 months.
*4 weeks.
*8 months.
*2 weeks. - ANSWER-3 months.
Rationale: Due to the time it takes for the underlying deficit to be corrected as well as
the growth of new red blood cells to mature, 3 months are typically needed to show
recovery with treatment for iron deficiency.
A 13-year-old patient returns to the office complaining of intermittent headache for the
past couple of years. Which would be the most concerning symptom? - ANSWER-Stiff
neck
Rationale: Inflammation of the membranes (meninges) surrounding the brain and spinal
cord, often caused by a viral or bacterial infection. This can cause severe headache,
stiff neck, fever, and sensitivity to light.
A 14-year-old with sickle cell anemia has recently experienced a sickle cell crisis and
presents for a follow-up examination after a recent hospitalization. It is most important to
continue monitoring growth, development, and: - ANSWER-hemoglobin levels.
Rationale: Chronic monitoring for patients with sickle cell disease includes monitoring of
hemoglobin and hematocrit.
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of
midcycle spotting. She has not missed any doses and uses no other medication. Which
of the following is appropriate?
*Double dosing for 2 days
*Modifying use
*Changing to Ortho-Novum 1/35
,*Providing reassurance - ANSWER-Providing reassurance
Rationale: Ortho-Novum 7/7/7 is a combination oral contraceptive pill that contains
varying doses of estrogen and progestin (norethindrone) throughout the cycle. It is a
triphasic pill, meaning that the hormone levels change every seven days to mimic the
natural menstrual cycle more closely. Mid-cycle spotting can occur for several reasons
while using this contraceptive.
A 19-year-old patient who has used oral contraceptives for 3 years plans to discontinue
the pill at the end of her current cycle to become pregnant. Which of the following daily
supplements would receive the highest priority?
*Ferrous sulfate
*Folic acid
*Multivitamin
*Calcium carbonate - ANSWER-Folic acid
Rationale: Folic acid, a B-vitamin (B9), plays a crucial role in ensuring a healthy
pregnancy and reducing the risk of birth defects. Folic acid is crucial in the early
development of the neural tube, which forms the brain and spinal cord. Adequate folic
acid intake can significantly reduce the risk of neural tube defects such as spina bifida
(incomplete closure of the spinal cord) and anencephaly (underdevelopment of the
brain). The neural tube forms very early in pregnancy, often before a woman knows she
is pregnant. Therefore, it is essential to have adequate folic acid levels before and
during early pregnancy.
A 19-year-old presents with a sore throat and anterior cervical adenopathy. Which
causative agent would be suspected?
*Epstein-Barr virus
*Adenovirus
*Haemophilus influenzae
*Group A beta-hemolytic Streptococcus - ANSWER-Group A beta-hemolytic
Streptococcus
Rationale: While this patient could easily represent strep or EBV, the differentiating
factor is the location of the affected lymphadenopathy. As a generalization, posterior
cervical lymphadenopathy is common of Epstein-Barr virus (EBV) and anterior cervical
lymphadenopathy is more common with Group A beta-hemolytic streptococcus.
A 2-day old newborn has purulent discharge of the eyes and erythema. History includes
a vaginal birth at term delivered at home. What is the most likely culprit?
*Chlamydia trachomatis infection
*E-coli infection
*Staph infection
*Viral infection - ANSWER-Chlamydia trachomatis infection
Rationale: Chlamydia conjunctivitis is usually spread through direct contact with
discharge from the eyes or genital secretions of someone infected with Chlamydia
trachomatis. It can occur in newborns during childbirth (neonatal conjunctivitis) or in
adults through sexual contact (adult inclusion conjunctivitis).
Symptoms: The symptoms can include:
,Redness in the eye(s).
Watery or mucopurulent discharge (yellow or green discharge from the eyes).
Swelling of the eyelids.
Sensitivity to light (photophobia).
Itching or burning sensation in the eyes.
A 22-year-old has ASCAS on Pap smear and negative for HPV. The next step is:
*No follow up is needed.
*Repeat HPV in 3 months
*Colposcopy
*Repeat Pap in 6 months - ANSWER-Repeat Pap in 6 months
Rationale: For a 22-year-old with ASC-US on Pap smear and a negative HPV test, the
next appropriate step is to repeat the cytology in six months. This approach minimizes
unnecessary interventions while ensuring ongoing monitoring for any potential
progression of cervical cell abnormalities.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by
bladder emptying. The patient has been evaluated by urology and urogynecology.
Review of laboratory reports reveal negative urinalysis and cultures, negative results for
sexually transmitted infections, and an unremarkable cystoscopy. Which of the following
is an appropriate plan of care?
*Amitriptyline (Elavil) 25 mg oral once daily
*Referral to psychiatry
*Propranolol (Inderal) 10 mg oral once daily
*Nitrofurantoin (Macrodantin) 100 mg oral once daily - ANSWER-Amitriptyline (Elavil) 25
mg oral once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by
bladder emptying. The patient has been evaluated by urology and urogynecology.
Review of laboratory reports reveal negative urinalysis and cultures, negative results for
sexually transmitted infections, and an unremarkable cystoscopy. Which of the following
is an appropriate plan of care? - ANSWER-Amitriptyline (Elavil) 25 mg oral once daily
Rationale: Amitriptyline (Elavil) is a tricyclic antidepressant medication that is sometimes
used off-label for various conditions, including the management of urinary urgency and
overactive bladder symptoms.
A 24-year-old sexually active woman presents with lower abdominal pain, fever, and
purulent cervical discharge. On pelvic examination, cervical motion tenderness is noted.
What is the most likely diagnosis? - ANSWER-Pelvic inflammatory disease (PID)
Rationale: Cervical motion tenderness is a clinical finding characterized by pain elicited
when the cervix is moved or manipulated during a pelvic examination. This tenderness
can indicate underlying pelvic pathology. Lower abdominal pain, fever, abnormal vaginal
, discharge, pain during intercourse, and irregular menstrual bleeding and cervical motion
tenderness are present with Pelvic Inflammatory Disease (PID).
A 25-year-old athlete presents with shoulder pain and difficulty with overhead activities.
Physical examination suggests impingement syndrome. What is the most appropriate
initial treatment? - ANSWER-Physical therapy focusing on rotator cuff strengthening
Rationale: Exercises to improve shoulder strength and flexibility, focusing on the rotator
cuff and scapular stabilizers is an important initial treatment. Physical therapy may
include stretching and strengthening exercises, as well as techniques to improve
shoulder mechanics.
A 25-year-old woman presents with a 2-year history of fluctuating mood states,
including periods of mild depression and hypomania. These symptoms have not been
severe enough to meet the criteria for major depressive or manic episodes. What is the
most likely diagnosis? - ANSWER-Cyclothymic disorder
Rationale: Cyclothymic Disorder involves chronic mood fluctuations that include periods
of hypomanic and depressive symptoms. These symptoms are less severe than those
in Bipolar I or II disorders but can significantly impact daily functioning. Early diagnosis
and appropriate treatment, including psychotherapy, medications, and lifestyle changes,
can help manage symptoms and improve quality of life.
A 25-year-old woman presents with a sudden onset of shortness of breath and pleuritic
chest pain. She has no significant past medical history and takes no medications. On
physical examination, her heart rate is 110 beats per minute, respiratory rate is 24
breaths per minute, and oxygen saturation is 90% on room air. What is the most likely
diagnosis? - ANSWER-Pulmonary embolism
Rationale: Pulmonary embolism (PE) is a serious medical condition that occurs when a
blood clot (usually from the legs or other parts of the body) travels to the lungs and
obstructs one of the pulmonary arteries. The primary symptoms of a PE can vary
depending on the size of the clot and the location within the lung, but the most common
symptoms include: Sudden onset of difficulty breathing, which may occur at rest or with
exertion and sharp, stabbing pain that may worsen with deep breathing (pleuritic pain).
The pain may also feel like pressure, fullness, or a squeezing sensation.
A 25-year-old woman presents with a urinary tract infection (UTI) confirmed by
urinalysis. She has no allergies. What is the most appropriate first-line antibiotic
treatment?
*Amoxicillin
*Trimethoprim-sulfamethoxazole
*Ciprofloxacin
*Nitrofurantoin - ANSWER-Nitrofurantoin
Rationale: Overall, Nitrofurantoin is a preferred choice for treating uncomplicated UTIs,
especially in otherwise healthy individuals where local resistance patterns support its
efficacy.
