PACKRAT 16; Questions and Answers 100% Correct
1. Health Maintenance/Obstetrics/Gynecology
Which of the following portends the greatest risk for the development of breast cancer?
A. Nulliparity
B. Early menarche
C. BRCA 1 positivity
D. Maternal family history of breast cancer CORRECT ANSWER-(...
PACKRAT 16; Questions and Answers 100% Correct
1. Health Maintenance/Obstetrics/Gynecology
Which of the following portends the greatest risk for the development of breast cancer?
A. Nulliparity
B. Early menarche
C. BRCA 1 positivity
D. Maternal family history of breast cancer CORRECT ANSWER-(u) A. See C for
explanation.
(u) B. See C for explanation.
(c) C. BRCA1 positivity is associated with half of the early onset breast cancers and 90% of the
hereditary ovarian
cancers.
(u) D. See C for explanation.
2. Clinical Therapeutics/Urology/Renal
In order to help delay the progression to kidney disease in a diabetic patient with proteinuria,
which of the following would you consider using to treat the patient's concomitant
hypertension?
A. Atenolol (Tenormin)
B. Amlodipine (Norvasc)
C. Accupril (Quinapril)
D. Amiloride (Midamor) CORRECT ANSWER-(u) A. Atenolol is a beta blocker. Beta
blockers are not first line therapy for hypertensive diabetics.
, PACKRAT 16; Questions and Answers 100% Correct
(u) B. Amlodipine is a calcium channel blocker. Calcium channel blockers are not first line
therapy for hypertensive diabetics.
(c) C. Accupril is an ACE inhibitor. Because of their beneficial effects in diabetic neuropathy, ACE
inhibitors (and ARBs) should be part of the initial treatment regimen for hypertension in
diabetics.
(u) D. Amiloride is a potassium-sparing diuretic. An ACE inhibitor is the standard first line
therapy for hypertensive diabetics.
:
3. Diagnosis/Pulmonology
A 58 year-old with a 20 pack-year history of tobacco use presents to the emergency department
with sudden onset of
severe, progressive right-sided chest pain and shortness of breath. She denies fever, nausea and
productive cough
but reports returning from a mission trip to South Africa yesterday. Her exam reveals
tachycardia, tachypnea, clear
lung fields and 3+ edema and erythema of the left leg. Her chest radiograph is normal. Which of
the following is the
most likely diagnosis?
A. Pulmonary embolism
B. Pneumothorax
, PACKRAT 16; Questions and Answers 100% Correct
C. Pneumonia
D. Pleurisy CORRECT ANSWER-(c) A. The patient's risk factors, acutely progressive
presentation and normal chest radiograph make a pulmonary
embolism the most likely and most worrisome diagnosis.
(u) B. See A for explanation.
(u) C. See A for explanation.
(u) D. See A for explanation.
: (8)
4. History & Physical/Dermatology
A 46 year-old male is brought to the emergency department after sustaining burns to his entire
right arm and leg in a
house fire. Which of the following percentages best classifies the extent of his burns?
A. 12
B. 18
C. 27
D. 36 CORRECT ANSWER-(u) A. See C for explanation.
(u) B. See C for explanation.
(c) C. According to the "rule of nines" the percentages can be calculated as follows: entire arm =
9% of body surface
area (BSA). Anterior surface of each leg = 9% BSA, posterior surface of each leg = 9% BSA. The
patient has a
, PACKRAT 16; Questions and Answers 100% Correct
total of 27% BSA with burns.
(u) D. See C for explanation.
: (8)
5. Diagnostic Studies/ENT/Ophthalmology
Which of the following imaging modalities is most appropriate in the evaluation of chronic
sinusitis?
A. Coronal CT
B. Sinus MRI
C. Panorex
D. Sinus radiographs CORRECT ANSWER-(c) A. Coronal CT is the most effective imaging to
determine the anatomy of the sinuses as well as the presence and
extent of sinusitis.
(u) B. MRI is of limited value due to less than optimal visualization of bony structures.
(u) C. Panorex imaging provides limited viusalization of the sinus structures.
(u) D. Sinus radiographs are rarely used due to limited visualization of soft tissues.
: (8)
6. Clinical Therapeutics/Orthopedics/Rheumatology
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