FREE Family Practice Exam Question and Answers

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The fasting lipid profile of a 46-year-old male reveals a total cholesterol level of 238 mg/dL and an HDL-C level of 185. He has smoked for 100 pack-years. He falls into the moderately high risk category (10-year risk = 10-20%), according to the Framingham Coronary Risk Calculator. Less LDL cholesterol is the desired value for this patient.

Correct! Wrong!

Explanation:
For patients with high risk, the target LDL cholesterol level is under 100 mg/dL (under 70 is optimal); for those with moderate-to-high risk, it is under 130 mg/dL (under 100 is optimal); for those with moderate risk, it is under 130 mg/dL; and for those with one to one coronary risk factor, it is under 160 mg/dL.

A patient with severe right upper quadrant (RUQ) pain presents. Which imaging test should be used to evaluate this patient?

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Explanation:
Depending on where the discomfort is, the American College of Radiology has suggested several imaging tests. While CT with contrast is the best for evaluating pain in the right lower and left lower quadrants, US is advised to measure RUQ discomfort (RLQ and LLQ). Pain in the left upper quadrant (LUQ) is suggested for CT without contrast.

A 44-year-old patient with hypertension has an electrocardiogram (ECG) ordered by the doctor. Left ventricular hypertrophy is visible on the ECG (LVH). Which of these results might the doctor be anticipating from this ECG?

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If a patient with low back pain exhibits any of the following symptoms:

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Explanation:
Only upper respiratory infections are encountered more frequently in primary care than low back pain (LBP). This is a serious health issue that can result in long-term impairment. As a result, it's critical to spot warning signs and figure out when a patient needs to be referred. Cancer, infection, acute abdominal aneurysm, fracture, cauda equina syndrome, trauma history, and neurologic deficiency are all warning signs. Patients should be directed to a program that will assist them in returning to normal function if there are no abnormal findings on examination, radiography, or laboratory tests, and after receiving conservative treatment for 4-6 weeks, particularly if the condition is recurring or persistent. Individuals with inflammatory arthropathy, fibromyalgia, or metabolic bone disease should be referred to a rheumatologist.

With a patient with stage 3 chronic renal disease, how should hypertension be treated?

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Explanation:
A moderate decline in glomerular filtration rate (GFR) of 30 to 59 is considered stage 3 of chronic renal disease. In these individuals, the objectives are to prevent cardiovascular disease, maintain blood pressure below 130/80, and halt the decline in renal function. Several studies have demonstrated that using ACEIs, ARBs, and loop diuretics together can protect renal function while treating hypertension in individuals. Although dietary modifications are crucial, they are insufficient in these patients to maintain renal function.

A patient is admitted with whiplash. The patient exhibits paresthesia along the spine when the neck is flexed, according to the examination. This is advantageous:

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Explanation:
The patient exhibits the Lhermitte sign when the head flexes anteriorly and paraesthesias occur along the spine or upper extremities. This can be a sign of myelopathy, spondylosis, or MS. The ability to anteriorly move the tibia distinguishes the Lachman test, which looks for anterior cruciate ligament damage in the knee. A positive Spurling test indicates pain in the ipsilateral downward pressure on the head radiating to the posterior shoulder or arm. The specificity of this test for cervical radiculopathy is excellent. The cervical roots' motor innervations can be recalled using the mnemonics Blocker (C5), Beggar (C6), Kisser (C7), Grabber (C8), and Spock (T1).

Symptoms of mild acne in a 17-year-old girl include papules, pustules, and a few nodules. Benzoyl peroxide purchased over the counter, which she had been using, is no longer effective. Which line treatment works the best?

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Explanation:
Topical antibiotics are the preferred treatment for moderate acne, and they work best when combined with benzoyl peroxide. In cases of severe nodulocystic acne, isotretinoin is reversed.

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