Question 1: Which of the following symptoms is common with acute otitis media?
Bulging tympanic membrane
Bright light reflex of tympanic membrane
Increased tympanic membrane mobility
All of the above
Question 2. The cytochrome p system involves enzymes that are generally:
Inhibited by drugs
Induced by drugs
Inhibited or induced by drugs
Associated with decreased liver perfusion
Question 3. In AR disorders, carriers have:
Two mutated genes; one from each parent that cause disease
A mutation on a sex chromosome that causes a disease
A single gene mutation that causes the disease
One copy of a gene mutation but not the disease
,Question 4. A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue,
and unintentional weight loss. At times he is constipated and other times he has episodes of
diarrhea. His physical examination is unremarkable. It is important for the clinician to recognize
the importance of:
CBC with differential
Stool culture and sensitivity
Abdominal X-ray
Colonoscopy
Question 5. Which of the following findings should trigger an urgent referral to a cardiologist or
neurologist?
History of bright flash of light followed by significantly blurred vision
History of transient and painless monocular loss of vision
History of monocular severe eye pain, blurred vision, and ciliary flush
All of the above
Question 6. In examination of the nose, the clinician observes gray, pale mucous membranes
with clear, serous discharge. This is most likely indicative of:
Bacterial sinusitis
Allergic rhinitis
Drug abuse
,Skull fracture
Question 7. An 82-year-old female presents to the emergency department with epigastric pain
and weakness. She admits to having dark, tarry stools for the last few days. She reports a long
history of pain due to osteoarthritis. She self-medicates daily with ibuprofen, naprosyn, and
aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal
occult blood test is positive. A likely etiology of the patient’s problem is:
Mallory-Weiss tear
Esophageal varices
Gastric ulcer
Colon cancer
Question 8. Your patient is a 78-year-old female with a smoking history of 120-pack years. She
complains of hoarseness that has developed over the last few months. It is important to exclude
the possibility of:
Thrush
Laryngeal cancer
Carotidynia
Thyroiditis
Question 9. Your patient has been using chewing tobacco for 10 years. On physical examination,
you observe a white ulceration surrounded by erythematous base on the side of his tongue. The
clinician should recognize that very often this is:
, Malignant melanoma
Squamous cell carcinoma
Aphthous ulceration
Behcet’s syndrome
Question 10. The best way to diagnose structural heart disease/dysfunction non-invasively is:
Chest X-ray
EKG
Echocardiogram
Heart catheterization
Question 11. (*There are multiple questions on this exam related to this scenario. Be sure to read
the whole way through to the question.) Mr.Keenan is a 42-year-old man with a mild history of
GERD and a remote history of an appendectomy, presenting with an acute onset of significant
right upper-quadrant abdominal pain and vomiting. His pain began after a large meal, was
unrelieved by a proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon
questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain seems to
radiate to his back. Despite a family history of cardiac disease, he reports no classic anginal signs
or chest pain. He furthermore denies respiratory or pleuritic signs and denies fever, night sweats,
and unintended weight loss. Finally, there are no dermatologic signs, nor genitourinary
symptoms.
Of the following lab studies, which would provide little help in determining your differential
diagnosis?
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