Baseline Exam Questions with 100% Correct Answers

A 65-year-old man is seen for loose stools 3 times per day for 1 week. Two weeks prior he began a 6-week course of ciprofloxacin for prostatitis. There is no blood in his stool. His past medical history is notable for atrial fibrillation, hypertension, and gout. He takes atenolol, warfarin, hydrochlorothiazide, and allopurinol. He smoked 2 packs per day for 30 years but quit 10 years ago. He no longer drinks, but he drank heavily until 10 years ago. He does not use drugs. He works as a plumber. His mother and father both died of heart attacks in their 80s. He has not noted any bruising, epistaxis, or bleeding gums. His temperature is 36.7, heart rate 89, blood pressure 115/84, respiratory rate 16, and oxygen saturation 98% on room air. He weighs 70kg. He is alert and oriented and in no acute distress. His physical examination is normal, and he has no ecchymoses. His WBC count is 7,800/microliter, hemoglobin 14.6 g/ 4. hold warfarin and recheck INR in 2-3 days A 22-year-old man presents for a pre-marital evaluation. He is asymptomatic and feels well. His past medical history is notable for sickle cell trait. He takes a multivitamin and has no allergies. He does not smoke, drink, or use drugs. He is a card dealer at a casino. His ROS and exam are negative. His fiancée is also asymptomatic and has been diagnosed with alpha-thalassemia trait based on hemoglobin electrophoresis. She is an immigrant from Kenya and works in public relations. What is the chance they will have a child with sickle cell disease? 1. 0% 2. 25% 3. 50% 4. 67% 5. 100% 1. 0% A 64-year-old African American man presents with fatigue. His thyroid-stimulating hormone level is normal, but he was found to have a normocytic anemia with a hemoglobin level of 9 g/dL. He has a reticulocyte count of 4%, and his ferritin level is normal. His lactate dehydrogenase level is modestly elevated, as is his indirect bilirubin level. Haptoglobin levels are low. His history is significant for mechanical mitral valve replacement in his 40s when he had severe mitral regurgitation due to endocarditis. A Coombs test is done and is negative. The hemoglobin electrophoresis is negative. A peripheral blood smear shows numerous irregularly shaped, jagged, asymmetric red blood cells. Which of the following is the most likely cause of this patient's anemia? 1. microangiopathic hemolytic anemia 2. immune hemolysis 3. thalassemia 4. sickle cell anemia 5. hereditary spherocytosis 1. microangiopathic hemolytic anemia A 61-year-old man with a history of hypertension complains of nocturia for the past several months. He also describes symptoms of urinary urgency, hesitancy, and dribbling during the same time period. He denies polyuria, polydipsia, and hematuria. He has no other complaints. DRE reveals a prostate of approximately 3 fingerbreadths wide. The prostate is soft, nontender, and there are no nodules. The rest of the physical examination is unremarkable. What is the next best step in the treatment of this patient? 1. order UA, urine culture, and PSA tests 2. order transurethral ultrasonography of the prostate 3. start alpha-1-receptor blockade 4. start 5-alpha-reductase inhibitor 5. expectant management with DRE and PSA annually 1. order UA, urine culture, and PSA tests A 32-year-old man complains of painful penile lesions. Physical examination reveals tender, soft, putty-like ulcers (see image). The patient also has a tender inguinal bubo. You suspect chancroid. Which of the following clinical characteristics or diagnostic tests for chancroid is 1. biopsy needed for a pathologic confirmation of the diagnosis 2. presents as tender lymphadenopathy and genital ulcers 3. Chlamydia trachomatis on lesion smear 4. diagnosis is clinical with no need for culture 5. Serologic testing for herpes simplex virus 2. presents as tender lymphadenopathy and genital ulcers A 21-year-old female presents with urinary retention, tender inguinal adenopathy, and lesions as shown. Which of the following is the most likely diagnosis? 1. herpes simplex virus primary infection 2. herpes simplex virus recurrent infection 3. Erosive lichen planus 4. recurrent treponema pallidum infection 5. primary treponema pallidum infection 1. herpes simplex virus primary infection A 35-year-old woman presents to your office with abnormal laboratory results. She admits to only mild fatigue and denies any nausea, vomiting, and diarrhea. There is no history of any abdominal pathology. On physical examination, her vital signs are stable and there is no abdominal or flank tenderness noted. Laboratory results show a sodium level of 140 mEq/L, a potassium level of 2.9 mEq/L, and a carbon dioxide level of 17 mEq/L. The serum creatinine level is 0.4 mEq/L and blood glucose is 68 mg/dL. The results are similar to blood work obtained 3 months ago. Urinalysis is positive for 2+ blood on urine dipstick. The microscopic examination shows 30-50 red blood cells/HPF. Urine pH is 6.0 on urine dip. Given the history and laboratory findings, which of the following would you expect to find? 1. calcium oxalate stones 2. magnesium ammonium phosphate stones 3. calcium phosphate stones 4. uric acid stones 5. cys 3. calcium phosphate stones