Ann M. Aring, MD, Curtis Gingrich, MD, ABFM, Riverside Methodist Family Medicine Residency, Columbus, Ohio, and Samuel Sandowski, MD, South Nassau Communities, Oceanside, NY
Published Online: May 17, 2007 - 11:48:20 PM (CDT)
Ann M. Aring, MD Assistant Program Director Riverside Methodist Family Medicine Residency Columbus, Ohio
Curtis Gingrich, MD, ABFM Associate Program Director Riverside Methodist Family Medicine Residency Columbus, Ohio
Samuel Sandowski, MD Director of Medical Education and Family Medicine Residency Program Director South Nassau Communities, Oceanside, NY
1. Medications that can trigger or exacerbate acne include all the following, except: A. Beta-blockers B. Phenytoin (Dilantin) C. Prednisone (eg, Meticorten, Orasone, Panasol-S) D. Lithium (Eskalith, Lithobid)
Questions 2?4: Match each of the following statements about the treatment of attention-deficit/hyper?activity disorder (ADHD) with the correct medication(s) from the 4 choices listed below (A?D). Each choice may be used once, more than once, or not at all:
2. Contraindicated with clinical anxiety.
3. Side effects include appetite suppression and weight loss.
4. Not indicated for use in children.
A. Methylphenidate/dexmethylphenidate (eg, Rita?lin, Concerta, Focalin) B. Dextroamphetamine (Adderall, Dexedrine, Dextro- Stat) C. Atomoxetine (Strattera) D. Bupropion (Wellbutrin)
5. Which of the following conditions is the most common cause of carpal tunnel syndrome? A. Connective tissue disease B. Anomalous flexor tendons C. Nonspecific flexor tenosynovitis D. Obesity
6. Which of the following characteristics is NOT a risk factor for preeclampsia? A. Maternal age older than 35 or younger than 20 years B. Asian race C. Nulliparity D. Preeclampsia in a previous pregnancy E. Fetal chromosomal abnormalities
7. Which of the following laboratory tests is NOT indicated for the evaluation of HELLP (hemolysis, elevated liver enzymes, and a low platelet count) syndrome? A. Liver function B. 24-Hour urine collection C. Platelet count D. Peripheral blood smear
8. Which one of the following statements about breast milk is true? A. Breast milk that has separated and has fat floating on top is unsafe to use B. Breast milk should not be stored in plastic bottles C. Frozen breast milk can be thawed in a microwave oven D. Once thawed, breast milk should be used within 1 to 2 days
9. Which of these statements about the management of corneal abrasions are true, and which are false? A. Topical mydriatics aid healing B. Eye patching is always recommended C. Contact lenses should not be worn until the abrasion has resolved D. There is no strong evidence to support the use of topical antibiotics
10. A 54-year-old white woman presents with vertigo associated with a sense of fullness in her ear, tinnitus with a roaring or blowing noise, and fluctuating low-tone hearing loss. What is the most likely diagnosis? A. Labyrinthitis B. M?ni?re?s disease C. Benign positional vertigo D. Vascular migraine E. Otitis media
11. A 21-year-old white woman gave birth to a full-term boy by an uncomplicated spontaneous vaginal delivery about 4 hours ago. The baby?s Apgar scores were 81, 95. The prenatal course of this first pregnancy was unremarkable, except for a maternal group-B streptococcal (GBS)-positive culture. The membranes ruptured spontaneously, and she passed clear fluid 8 hours before birth. She received 2 doses of penicillin at least 4 hours before delivery. Which of the following options is appropriate management for GBS in a newborn? A. A limited evaluation, including observation for 48 hours, complete blood cell (CBC) count, and blood culture B. A full diagnostic evaluation, including CBC count, blood culture, and lumbar puncture C. Since the newborn received several doses of penicillin more than 4 hours before delivery, no evaluation or therapy is needed other than 24 hours of observation D. The newborn must be observed for at least 72 hours in the hospital, regardless of intrapartum antibiotic administration
12. Which of the following steps is NOT part of the active management of the third stage of labor? A. Administering an intravenous uterotonic agent upon delivery of the infant B. Clamping and cutting the umbilical cord early after delivery of the infant C. Leaving the umbilical cord unclamped until pulsations cease D. Controlled traction on the umbilical cord while awaiting placental separation and delivery
13. Which of the following statements regarding the management of active tuberculosis (TB) is true? A. The US Preventive Services Task Force recommends universal screening with a purified protein derivative skin test for all individuals every 5 years B. Culture of gastric aspirates is the recommended confirmatory test for all individuals suspected of having pulmonary TB C. Initial treatment should consist of a regimen of 4 antibiotics daily for 8 weeks until culture results are available D. Antibiotic dosing should be spread out during the day to decrease side effects
14. Which of the following drug therapies can cause osteoporosis? A. Long-term glucocorticoid use B. Depot medroxyprogesterone acetate (Depo-Provera) C. Anticoagulants, such as heparin or warfarin (Cou?madin, Jantoven) D. All the above
15. Which of the following tests have been endorsed by the American Medical Association (AMA) for the assessment and counseling of older adult drivers? A. Static visual acuity (Snellen chart) B. Timed gait C. The clock-drawing test D. All the above
16. Which of the following statements about mental health disorders is true? A. The prevalence is greater in higher-income populations because of increased access to care and a greater ability to establish a diagnosis B. Cost of medical care is lower, because patients with mental health disorders often do not seek help for such conditions C. Those with mental health disorders tend to have fewer chronic medical problems D. The majority of patients with mental health disorders are treated solely by a primary care provider E. Patients with mental health disorders tend to have fewer nonpsychiatric visits, because most of their medical attention is aimed at their mental health disorder
17. Which of the following statements about mitral valve prolapse is true? A. Patients with mitral valve prolapse depicted on echocardiogram but who have no leaflet redundancy or regurgitation are more likely to have panic disorder than patients who have mitral valve prolapse with regurgitation B. Patients with mitral valve prolapse and mitral regurgitation are at increased risk for panic disorder C. There is no association between mitral valve prolapse and panic disorder D. Surgery to correct a mitral valve with prolapse will also resolve panic disorder E. Mitral valve prolapse is always considered a risk factor for panic disorder regardless of its severity or clinical significance
18. A 37-year-old man tells you that he is excessively worried about his finances, his marriage, and his weekend baseball team making the finals. He has worried about these things almost daily for the past 3 months. He admits to waking up and thinking about these matters at night and not being able to concentrate at work. He states that his marriage is in trouble; his wife finds him persistently irritable, because he is always worried about their finances. Does this man have generalized anxiety disorder (GAD)? A. Yes, he meets all the criteria B. No, he has not met any of the criteria for GAD; he probably has depression C. Maybe, but it is too soon to tell D. Maybe, but GAD cannot be diagnosed without a computed tomography or magnetic resonance imaging scan of the brain
19. Which of the following symptoms is NOT typically associated with posttraumatic stress disorder (PTSD)? A. Decreased ability to concentrate B. Recurrent nightmares about the trauma C. Increased irritability D. Amnesia about certain aspects of the trauma E. Significant weight fluctuations
20. Which of the following statements about mental health disorders is true? A. Patients with depression and anxiety disorder have a higher suicide rate than those with anxiety disorder alone B. There is no correlation between depression and anxiety disorders C. About 30% of patients with panic disorder will develop major depression during their lifetime D. Duration of agoraphobia in patients with panic disorder does not increase in those who also have comorbid depression E. A patient cannot have anxiety disorder and major depression at the same time
21. A 37-year-old male veteran presents with disturbing flashbacks and nightmares about his time in Iraq. Which of the following medications would be least likely to help him? A. Imipramine (Tofranil) B. A monoamine oxidase inhibitor (MAOI) C. Clonidine (Catapres) D. Sertraline (Zoloft) E. Prazosin (Minipress)
