DUNPHY CARE EVALUATION TEST ANSWERS AND
QUESTIONS SET A+
✔✔Marty, age 52, notices a bulge in his midline every time he rises from bed in the
morning. You tell him that it is a ventral hernia, also known as an:
1.
Inguinal hernia.
2.
Epigastric hernia.
3.
Umbilical hernia.
4.
Incisional hernia. - ✔✔Epigastric hernia.
✔✔You elicit costovertebral angle tenderness in Gordon, age 29. Which condition do
you suspect?
1.
Cirrhosis.
2.
Inflammation of the kidney.
3.
Inflammation of the spleen.
4.
Peritonitis. - ✔✔Inflammation of the kidney.
✔✔Marvin, a known alcoholic with cirrhosis, is frequently admitted for coagulopathies
and occasionally receives blood transfusions. His wife asks you why he has bleeding
problems. How do you respond?
1.
"Occasionally he accumulates blood in the gut."
2.
"There is an interruption of the normal clotting mechanism."
3.
"Long-term alcohol abuse has made his vessels very friable."
4.
,"His bone marrow has been affected." - ✔✔"There is an interruption of the normal
clotting mechanism."
✔✔Shelby has recently been diagnosed with pancreatitis. Of the following objective
findings that can result from the pancreatic inflammatory process, which is known as
Grey Turner sign?
1.
Left-sided pleural effusion.
2.
Bluish discoloration over the flanks.
3.
Bluish discoloration around the umbilicus.
4.
Jaundice. - ✔✔Bluish discoloration over the flanks.
✔✔Bobby, age 6, has constant periumbilical pain shifting to the right lower quadrant,
vomiting, a small volume of diarrhea, absence of headache, a mild elevation of the
white blood cell count with an early left shift, and white blood cells in the urine. You
suspect:
1.
Appendicitis.
2.
Gastroenteritis.
3.
Acute pancreatitis.
4.
Rocky Mountain spotted fever. - ✔✔Appendicitis.
✔✔Melva, age 63, presents with an acute exacerbation of pancreatitis, and you are
going to admit her to the hospital. Which is the most important factor in determining a
negative long-term outcome for her?
1.
Age.
2.
Infection.
3.
Pain.
4.
Length of time between exacerbations. - ✔✔Infection.
✔✔Marian, age 52, is obese. She complains of a rapid onset of severe right upper
quadrant abdominal cramping pain, nausea, and vomiting. Your differential diagnosis
might be:
1.
Appendicitis.
,2.
Crohn's disease.
3.
Cholecystitis.
4.
Irritable bowel syndrome. - ✔✔Cholecystitis.
✔✔You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter pylori
and plan to treat her empirically. What medications should you order?
1.
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole
(Flagyl).
2.
Bismuth subsalicylate (Pepto-Bismol) and omeprazole (Prilosec).
3.
Amoxicillin (Amoxil) and omeprazole (Prilosec).
4.
Clarithromycin (Biaxin) and metronidazole (Flagyl). - ✔✔A proton pump inhibitor
(omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl).
✔✔An 83-year-old female presents to the urgent care clinic for diarrhea. The patient
was just discharged from the hospital 1 week ago following treatment for pneumonia.
The patient states she has diarrhea, described as diffuse and watery, with mucus in it at
times. She has approximately 10 episodes per day. What is the recommended
treatment for this patient?
1.
Fecal transplant.
2.
Intravenous (IV) metronidazole.
3.
Oral vancomycin.
4.
Gastrointestinal rest. - ✔✔Oral vancomycin.
✔✔What is the most common bacterial cause of traveler's diarrhea?
1.
Escherichia coli.
2.
Campylobacter jejuni.
3.
Salmonella.
4.
Shigella. - ✔✔Escherichia coli.
, ✔✔A 7-year-old male presents with his mother to the urgent care clinic complaining of
abdominal pain. He started to complain of pain prior to going to bed; however, it has
gotten progressively worse and is now preventing him from sleeping. He is nauseous
but hasn't vomited and didn't eat dinner due to the pain. The patient appears pale and is
complaining of right-sided abdominal pain. His vitals are as follows: blood pressure
130/85, pulse 120, temperature 100.5°F, pulse oximetry 98% on room air. On physical
exam he is tender in the right lower quadrant. His complete blood count (CBC) shows a
white blood cell count (WBC) of 17.0. What is the patient's likely diagnosis?
1.
Appendicitis.
2.
Cholecystitis.
3.
Constipation.
4.
Gastroenteritis. - ✔✔Appendicitis.
✔✔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. - ✔✔Internal hemorrhoid.
✔✔The screening guidelines for colon cancer recommend which of the following for the
general population?
1.
Colonoscopy starting at age 50.
2.
Colonoscopy starting at age 45.
3.
Fecal occult blood test (FOBT) and rectal exam starting at age 50.
4.
Fecal occult blood test (FOBT) and rectal exam starting at age 45. - ✔✔Colonoscopy
starting at age 50.
✔✔Which of the following is not a risk factor for cholecystitis?
QUESTIONS SET A+
✔✔Marty, age 52, notices a bulge in his midline every time he rises from bed in the
morning. You tell him that it is a ventral hernia, also known as an:
1.
Inguinal hernia.
2.
Epigastric hernia.
3.
Umbilical hernia.
4.
Incisional hernia. - ✔✔Epigastric hernia.
✔✔You elicit costovertebral angle tenderness in Gordon, age 29. Which condition do
you suspect?
1.
Cirrhosis.
2.
Inflammation of the kidney.
3.
Inflammation of the spleen.
4.
Peritonitis. - ✔✔Inflammation of the kidney.
✔✔Marvin, a known alcoholic with cirrhosis, is frequently admitted for coagulopathies
and occasionally receives blood transfusions. His wife asks you why he has bleeding
problems. How do you respond?
1.
"Occasionally he accumulates blood in the gut."
2.
"There is an interruption of the normal clotting mechanism."
3.
"Long-term alcohol abuse has made his vessels very friable."
4.
,"His bone marrow has been affected." - ✔✔"There is an interruption of the normal
clotting mechanism."
✔✔Shelby has recently been diagnosed with pancreatitis. Of the following objective
findings that can result from the pancreatic inflammatory process, which is known as
Grey Turner sign?
1.
Left-sided pleural effusion.
2.
Bluish discoloration over the flanks.
3.
Bluish discoloration around the umbilicus.
4.
Jaundice. - ✔✔Bluish discoloration over the flanks.
✔✔Bobby, age 6, has constant periumbilical pain shifting to the right lower quadrant,
vomiting, a small volume of diarrhea, absence of headache, a mild elevation of the
white blood cell count with an early left shift, and white blood cells in the urine. You
suspect:
1.
Appendicitis.
2.
Gastroenteritis.
3.
Acute pancreatitis.
4.
Rocky Mountain spotted fever. - ✔✔Appendicitis.
✔✔Melva, age 63, presents with an acute exacerbation of pancreatitis, and you are
going to admit her to the hospital. Which is the most important factor in determining a
negative long-term outcome for her?
1.
Age.
2.
Infection.
3.
Pain.
4.
Length of time between exacerbations. - ✔✔Infection.
✔✔Marian, age 52, is obese. She complains of a rapid onset of severe right upper
quadrant abdominal cramping pain, nausea, and vomiting. Your differential diagnosis
might be:
1.
Appendicitis.
,2.
Crohn's disease.
3.
Cholecystitis.
4.
Irritable bowel syndrome. - ✔✔Cholecystitis.
✔✔You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter pylori
and plan to treat her empirically. What medications should you order?
1.
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole
(Flagyl).
2.
Bismuth subsalicylate (Pepto-Bismol) and omeprazole (Prilosec).
3.
Amoxicillin (Amoxil) and omeprazole (Prilosec).
4.
Clarithromycin (Biaxin) and metronidazole (Flagyl). - ✔✔A proton pump inhibitor
(omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl).
✔✔An 83-year-old female presents to the urgent care clinic for diarrhea. The patient
was just discharged from the hospital 1 week ago following treatment for pneumonia.
The patient states she has diarrhea, described as diffuse and watery, with mucus in it at
times. She has approximately 10 episodes per day. What is the recommended
treatment for this patient?
1.
Fecal transplant.
2.
Intravenous (IV) metronidazole.
3.
Oral vancomycin.
4.
Gastrointestinal rest. - ✔✔Oral vancomycin.
✔✔What is the most common bacterial cause of traveler's diarrhea?
1.
Escherichia coli.
2.
Campylobacter jejuni.
3.
Salmonella.
4.
Shigella. - ✔✔Escherichia coli.
, ✔✔A 7-year-old male presents with his mother to the urgent care clinic complaining of
abdominal pain. He started to complain of pain prior to going to bed; however, it has
gotten progressively worse and is now preventing him from sleeping. He is nauseous
but hasn't vomited and didn't eat dinner due to the pain. The patient appears pale and is
complaining of right-sided abdominal pain. His vitals are as follows: blood pressure
130/85, pulse 120, temperature 100.5°F, pulse oximetry 98% on room air. On physical
exam he is tender in the right lower quadrant. His complete blood count (CBC) shows a
white blood cell count (WBC) of 17.0. What is the patient's likely diagnosis?
1.
Appendicitis.
2.
Cholecystitis.
3.
Constipation.
4.
Gastroenteritis. - ✔✔Appendicitis.
✔✔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. - ✔✔Internal hemorrhoid.
✔✔The screening guidelines for colon cancer recommend which of the following for the
general population?
1.
Colonoscopy starting at age 50.
2.
Colonoscopy starting at age 45.
3.
Fecal occult blood test (FOBT) and rectal exam starting at age 50.
4.
Fecal occult blood test (FOBT) and rectal exam starting at age 45. - ✔✔Colonoscopy
starting at age 50.
✔✔Which of the following is not a risk factor for cholecystitis?
