A 42-year-old woman presents to the primary care clinic for a 1-day history of muscle
pain in her calves, weakness, and brown-colored urine. Her calves are tender to the
touch and mildly edematous. She was recently started on high-intensity statin therapy
and reports that she is also taking a fibrate medication that she was prescribed by
another provider. What laboratory test should be ordered to diagnose the suspected
condition?
AAST
BCRP
CESR
DSerum CK - D
A 32-year-old woman with a history of Graves' disease presents to your office with a
question about her medication. She just found out she is pregnant and wants to know if
any changes need to be made to her treatment regimen during her pregnancy. Which of
the following is the most appropriate therapy?
ACarbimazole
BLevothyroxineYour Answer
CMethimazole
DPropylthiouracil - D
A 7-year-old boy who is otherwise healthy presents to the clinic and is accompanied by
his concerned caregiver who reports that the child seems to have begun pubertal
development. On the physical assessment, there is symmetrical testicular growth and
sparse hair growth at the base of the penis. The clinician will formulate a plan of care
based on which of the following most probable causes for the suspected condition?
ACentral nervous system lesionCorrect Answer
BCryptorchidismYour Answer
CExogenous sex steroids
DKlinefelter syndrome - A
A 32-year-old man presents to the clinic for weight management. Considering his
elevated BMI, elevated blood pressure, increased waist circumference, and elevated
fasting blood glucose, the clinician diagnoses him with metabolic syndrome. In addition
to blood pressure control, the clinician recommends a low-calorie diet of 1,500 kcal/day
and an exercise regimen. What is the recommended weight reduction for this patient?
A10% decrease in body weight within 12 months
B10% decrease in body weight within 2 months
C10% decrease in body weight within 6 monthsCorrect Answer
D20% decrease in body weight within 3 months - C
A 30-year-old man with a history of type 2 diabetes mellitus and untreated
hypertriglyceridemia with triglycerides between 1,000-1,500 mg/dL presents to the clinic
,for a routine follow-up. What is an expected physical exam finding due to
hypertriglyceridemia?
AAcanthosis nigricans
BEruptive xanthomasCorrect Answer
CThyroid nodule
DVision impairment - B
A 37-year-old woman presents to the clinic to establish care. She has no current
concerns and no significant medical history. She is not currently employed, drinks
alcohol socially, eats a high-carbohydrate diet, and is physically inactive. On exam, you
note obesity, a high level of abdominal fat distribution, and acanthosis nigricans. Which
of the following is most likely to confirm the diagnosis of the suspected condition?
AA1C level of 7.5%Correct Answer
BBlood pressure reading of 172/91 mm Hg
CLow-density lipoprotein level of 185 mg/dL
DThyroid-stimulating hormone level of 0.2 U/mL - A
A 41-year-old man presents to the clinic for an annual check-up. He has no previous
medical history. Which of the following results in this patient's fasting lipid panel
indicates an increased risk of atherosclerotic cardiovascular disease?
AHDL-C of 62 mg/dL
BLDL-C of 100 mg/dL
CTotal cholesterol of 182 mg/dL
DTriglycerides of 192 mg/dL - D
A new thyroid nodule is found in an 82-year-old man. He questions the risk of this
nodule being malignant. You perform a detailed history and discover that his maternal
uncle worked as a nuclear energy technologist and had "some kind" of head and neck
cancer. As a child, the patient received radiation treatments for severe acne. He has
had 6 CT scans throughout his life. He is retired, but worked as a plumber in a
hydroelectric plant for 35 years. Which of the following risk factors places him at highest
risk for a malignant thyroid nodule?
AChildhood acne treatmentCorrect Answer
BExposure to CT scans
CFamily history
DOccupational exposure - A
Which of the following patients is at greatest risk for renal artery stenosis?
AA 30-year-old with hypertension
BA 48-year-old with kidney disease
CA 60-year-old with hepatitis
DA 68-year-old smoker - D
A 61-year-old woman presents to the clinic for a reevaluation after 6 months of diet and
lifestyle interventions for dyslipidemia. She is not diabetic, has no family history of
premature atherosclerotic cardiovascular disease, and medications include omeprazole
, and levothyroxine. At her initial exam 6 months ago, findings included total cholesterol
276 mg/dL, HDL 64 mg/dL, LDL-C 176 mg/dL, triglys unsure about starting a
medication. What is the best next step for this patient?
AAdvise a high-intensity statinYour Answer
BConsider a coronary artery calciumCorrect Answer
CInitiate a blood pressure lowering medication
DStart ezetimibe to lower LDL-C - B
A 29-year-old G1 woman at 11 weeks gestation with a family history of hypothyroidism
not currently on medication has baseline TSH levels 0.2 mU/L below the normal
reference range. What is the best next step in management?
AInitiate levothyroxine therapy
BInitiate methimazole therapy
CInitiate propylthiouracil therapy
DTherapy is not indicated - D
You are chart auditing the records of a 70-year-old woman with an unknown medical
history. During her previous visit, she was prescribed rosuvastatin 20 mg daily. Which of
the diagnoses and corresponding low-density lipoprotein values would be most
appropriate to warrant this medication during the previous visit?
ADiabetes mellitus with low-density lipoprotein 60 mg/dL
BHypertension with low-density lipoprotein 130 mg/dL
CObesity with low-density lipoprotein 140 mg/dLYour Answer
DPeripheral artery disease with LDL 90 - D
Which of the following labs should be ordered first when a patient has suspected
acromegaly?
AGrowth hormoneYour Answer
BHemoglobin A1C
CInsulin-like growth factor 1Correct Answer
DThyroid stimulating hormone - C
Which of the following is considered first-line pharmacotherapy for children 10 years of
age or older who fail to reach the targeted low-density lipoprotein cholesterol with
lifestyle counseling over a period of six months?
ACholestyramine
BEzetimibeYour Answer
CGemfibrozil
DLovastatin - D
A 16-year-old boy presents to the clinic with increased thirst and increased urination for
six months. He reports feeling thirsty once an hour and needing to use the bathroom
once every two hours. He also reports frequent nocturia, and on one occasion he had
an episode of enuresis after having an exhausting and stressful day. He notes that he
has been more tired lately. He reports no painful or burning urination, abdominal pain,
headache, confusion, palpitations, blurred vision, recent weight changes, or feelings of
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