Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
1. A 54-year-old man presents with chest pain. He has C. Diabetes melli-
a past medical history of hypertension and diabetes tus
mellitus. The pain is located in the middle of his
chest and radiates to his jaw. The pain began about (DM) is an inde-
20 minutes ago, and he rates the pain as a 10 on pendent risk fac-
a 0 - 10 point scale, with 10 being the worst pain tor for atheroscle-
he has ever felt. He has had 3 similar episodes, but rosis. The risk of
they have always resolved after 5 minutes or so of myocardial infarc-
rest. He has smoked 1 pack of cigarettes a day for tion (MI) in a pa-
the past 36 years. He drinks 2 or 3 beers on Fri- tient with diabetes
day nights. Review of systems (ROS) is positive for is the same risk
diaphoresis, acute dyspnea, and impending doom. as someone with-
ROS negative for fever, chills, and malaise. Physical out diabetes who
exam shows an obese, middle-aged man in moderate has had a previ-
distress. BP 126/80, pulse 100, respirations 26. Heart ous MI. The risk of
and lung exams are normal, except for tachycardia death from cardiac
and tachypnea. He has no pedal edema. What aspect events is also the
of the patient's history is the largest risk factor for an same between the
acute myocardial infarction? 2 groups. Patients
with diabetes mel-
A. alcohol use litus should be
B. cigarette smoking advised to stop
C. diabetes mellitus smoking and ag-
D. hypertension gressively control
E. obesity other risk fac-
tors, such as glu-
cose, hyperten-
sion, and dyslipi-
demia, in order
to reduce the risk
of ischemic heart
disease.
2. Absorption of vitamin B12 requires intrinsic factor parietal cells
that is secreted by which cell type?
3. A 65-year-old woman presents with glossitis, weight C Pernicious ane-
loss, paresthesias, and diarrhea. Laboratory tests mia
show a macrocytic anemia. The most likely cause is
, Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
A Iron-deficiency anemia
B Thalassemia
C Pernicious anemia
D Multiple myeloma
E Colon cancer
4. A 45-year-old woman with a no significant past med- This patient's di-
ical history presents with a 4-month history of dull, agnosis is vari-
aching heaviness sensation in her proximal right leg. cose veins. Scle-
She notes that this sensation is provoked by extend- rotherapy can be
ed periods of standing and walking, and is relieved used to treat vari-
when she lies in a recumbent position. Her past med- cose veins. It in-
ical history is remarkable for pregnancy 4 times, the volves the injec-
most recent being approximately 2 years ago. She tion of an irritat-
denies a history of smoking, trauma, injuries, fever, ing solution into
chills, chest pain, shortness of breath, hemoptysis, the varicose vein
cough, skin changes and coolness, and peripheral to promote an
edema. Her physical exam reveals several dilated, tor- inflammatory re-
tuous, elongated veins along the medial right thigh, sponse, scarring,
which are especially pronounced upon standing. The and obliteration of
remainder of the physical exam is normal. What will the lumen
be the most appropriate therapeutic approach for this
patient at this time?
Warfarin (Coumadin)
Hint:
Warfarin is indicated for myocardial infarction or
cerebrovascular accident prevention and in patients
with atrial fibrillation, mechanical heart valves, or
deep venous thrombosis.
A Warfarin
B Clopidogrel (Plavix)
C Sclerotherapy
D Furosemide (Lasix)
E Cilostazol (Pletal)
5. A 62-year-old woman with a long-standing history
of hypertension presents with a severe headache; it
started this morning and is rapidly worsening. Dur-
ing the interview, she suddenly collapses. Your brief
, Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
examination shows that she responds with extensor
posturing on external stimuli. Her deep tendon reflex-
es are 3, and you elicit Babinski bilaterally. You also
notice that her breathing has a peculiar pattern: deep
inspiration with a pause at full inspiration, followed
by a brief insufficient release and the end-inspiration
pause. How do you best describe her respiratory pat-
tern?
A Cheyne-Stokes
B Apneusis
C Ataxic
D Cluster
E Kussmaul
6. Deficiency of what factor may predispose a person to C Protein C defi-
recurrent thrombosis? ciency
A Platelet deficiency
B Factor VIIIC deficiency
C Protein C deficiency
D von Willebrand factor deficiency
E Factor VII deficiency
7. A 15-year-old girl presents with a 1-hour history synchronized car-
of rapid heartbeat, faintness, sweating, and ner- dioversion
vousness. She is also experiencing shortness of
breath and chest pain. The patient has no significant
past medical history. There is no history of similar
episodes. The patient is on no medications, and she
denies illicit drug use. On exam, her vital signs are
BP70/60 mmHg; pulse 200 bpm; RR 22/min, temper-
ature afebrile. She looks pale, and her palms are
slightly sweaty. She is not comfortable sitting up, so
she prefers lying down. She looks slightly apprehen-
sive. Her heart and lung exam are negative except
for the tachycardia; except for cool sweaty hands, a
brief abdominal and extremity exam are non-reveal-
ing. The physician quickly places the paddles on the
patient's chest to record the rhythm; this shows a
narrow-complex regular tachycardia at 210 bpm. He
, Family Medicine EOR
Study online at https://quizlet.com/_8yjd8h
requests oxygen, IV line, and continuous monitoring.
An EKG is in the process of being completed. At this
point, what should be done?
8. which cancers is the AFP tumor marker associated hepatocellular
with? carcinoma
germ cell tumors
9. 50-year-old man presents with a 3-month history of A Hepatocellular
weakness, fatigue, and abdominal discomfort. Upon carcinoma
further questioning, he acknowledges a lack of sexu-
al desire. He denies any photosensitivity. On physical
examination, his liver is enlarged, and his spleen is
palpable. He has abnormal skin pigmentation on his
face, neck and his elbows and which gives his skin
a metallic gray hue. His laboratory results are in the
chart.
TESTRESULTS
TIBC275 (250 - 350)
Plasma iron 220 (80 - 160)
Transferring saturation 90% (16 - 57%)
What serious complication is associated with the pa-
tient's condition?
A Hepatocellular carcinoma
B Bronchogenic carcinoma
C Pancreatic carcinoma
D Lymphoma
E Leukemia
10. classic triad of hemochromatosis cirrhosis
diabetes mellitus
skin pigmentation
11. name the serious complication associated with he- hepatocellular
mochromatosis carcinoma
12.
