Ambulatory Care Test Ambulatory Care Clinical Data Interpretation 4

Question 1

An ambulatory patient's spirometry shows FEV1/FVC ratio of 0.62 with FEV1 of 58% predicted. How is this classified?

Accepted Answer

Obstructive pattern, moderate

Answer

An FEV1/FVC ratio below 0.70 confirms obstruction, and an FEV1 between 50-80% predicted classifies severity as moderate per GOLD criteria.

Question 2

A patient's random urine albumin-to-creatinine ratio (UACR) is 180 mg/g. What category of albuminuria does this represent?

Accepted Answer

Moderately increased (A2)

Answer

A UACR of 30-300 mg/g is classified as moderately increased albuminuria (A2), indicating early diabetic or hypertensive nephropathy.

Question 3

A patient's CBC shows MCV of 110 fL and hypersegmented neutrophils. Which finding would most confirm the underlying cause?

Accepted Answer

Low serum vitamin B12 or folate level

Answer

Macrocytosis (elevated MCV) with hypersegmented neutrophils is a classic presentation of megaloblastic anemia caused by B12 or folate deficiency.

Question 4

A patient with hypertension has a morning home blood pressure reading averaging 148/92 mmHg over 7 days despite being well-controlled in the office. What phenomenon does this suggest?

Accepted Answer

Masked hypertension

Answer

Masked hypertension refers to normal office blood pressure with elevated out-of-office readings, which carries significant cardiovascular risk and requires treatment adjustment.

Question 5

A hemoglobin electrophoresis shows HbS 40%, HbA 55%, HbF 5%, HbA2 2%. How should this pattern be interpreted?

Accepted Answer

Sickle cell trait (HbAS)

Answer

The presence of both HbA and HbS with HbS around 40% is characteristic of sickle cell trait (HbAS), a carrier state not typically causing sickling crises.

Ambulatory Care Test Practice Test

Ambulatory Care Test Practice Test

Ambulatory Care Test Ambulatory Care Clinical Data Interpretation 4