PACKRAT 13 # matches; Questions and Answers 100% Correct
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PACKRAT
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PACKRAT
PACKRAT 13 # matches; Questions and Answers 100%
Correct
Which of the following factors in patients with chronic venous insufficiency predisposes them to
development of skin ulcers?
A. Increased intravascular oncotic pressure
B. Leakage of fibrinogen and growth factors into the interstitial ...
PACKRAT 13 # matches; Questions and Answers 100%
Correct
Which of the following factors in patients with chronic venous insufficiency predisposes them to
development of skin ulcers?
A. Increased intravascular oncotic pressure
B. Leakage of fibrinogen and growth factors into the interstitial space
C. Decreased capillary leakage
D. Inherited deficiency of protein C CORRECT ANSWER-(u) A. Decreased intravascular
oncotic pressure can cause swelling
(c) B. Leakage of fibrinogen and growth factors into the interstitial space, leukocyte aggregation
and activation, and obliteration of the cutaneous lymphatic network can predispose a patient to
skin ulcers
(u) C. Increased capillary leakage causes venous insufficiency.
(u) D. Inherited deficiency of protein C predisposes patients to thrombosis.
A 26 year-old monogamous female presents with cyclic pelvic pain that has been increasing
over the last 6 months. She complains of significant dysmenorrhea and dyspareunia. She uses
condoms for birth control. On physical examination her uterus is retroverted and non-mobile,
and she has a palpable adnexal mass on the left side. Her serum pregnancy test is negative.
Which of the following is the most likely diagnosis?
A. Ovarian cancer
B. Endometriosis
C. Functional ovarian cyst
D. Pelvic inflammatory disease CORRECT ANSWER-(u) A. It is important to consider
ovarian cancer in a patient with a pelvic mass however, ovarian cancer usually occurs in older
women over age 55 and patients are often asymptomatic until the disease is more advanced
, PACKRAT 13 # matches; Questions and Answers 100%
Correct
(c) B. With endometriosis, the uterus is often fixed and retroflexed in the pelvis. The palpable
mass is an endometrioma or "chocolate cyst". The patient with endometriosis also often has
dysmenorrhea, dyspareunia, and dyschezia.
(u) C. Functional ovarian cysts occur from ovulation and usually are not symptomatic.
(u) D. With PID the patient will have abdominal tenderness, adnexal tenderness, cervical motion
tenderness and an elevated temperature.
At what age does the first tooth usually erupt in an infant?
A. 2-4 months
B. 6-8 months
C. 10-12 months
D. 14-16 months CORRECT ANSWER-(u) A. See B for explanation.
(c) B. The first tooth in an infant to erupt is the central incisor at the average age of 6-8 months.
(u) C. See B for explanation.
(u) D. See B for explanation.
A 7 year-old boy wets the bed on most nights. Which of the following is the preferred
pharmacological agent to decrease the incidence of bed wetting episodes?
A. Imipramine (Tofranil)
B. Phenytoin (Dilantin)
C. Pramipexole (Mirapex)
, PACKRAT 13 # matches; Questions and Answers 100%
Correct
D. Hyoscyamine (Urised) CORRECT ANSWER-(c) A. Imipramine is an anti-cholinergic and
when given before bedtime has been shown to decrease the incidence of bed wetting.
(u) B. Phenytoin is an anticonvulsant and is not used in enuresis.
(u) C. Pramipexole is a dopamine agonist used in the treatment of restless leg syndrome.
(u) D. Hyoscyamine is an anti-spasmodic used to treat overactive bladder.
A newborn is being evaluated for perioral cyanosis while feeding associated with sweating. Vital
signs are rectal temperature, 37.8 degrees C (100 degrees F), blood pressure 80/45 mmHg,
pulse 180/min, and respirations 40/min. A grade 3/6 harsh systolic ejection murmur with a
single loud S2 is heard at the left upper sternal border. Electrocardiogram (ECG) shows right
ventricular hypertrophy with right axis deviation. Chest x-ray shows a boot-shaped heart and
decreased pulmonary vascular markings. Which of the following is the most likely diagnosis?
A. Atrial septal defect
B. Total anomalous pulmonary venous return
C. Coarctation of the aorta
D. Tetralogy of Fallot CORRECT ANSWER-(u) A. Although the murmur may be consistent
with an ASD with pulmonary hypertension the chest x-ray would not show decreased
pulmonary vascular markings. With a large left to right shunt large pulmonary arteries and
increased vascularity would be seen.
(u) B. The murmur for TAPVR is a soft systolic murmur at the left upper sternal border with a
split S2 in addition to a short mid-diastolic murmur at the low left sternal border.
(u) C. Cyanosis is usually not the presenting sign for coarctation of the aorta. Infants may
present with heart failure, ECG will show evidence of LVH.
(c) D. This is a common presentation for tetralogy of fallot.
, PACKRAT 13 # matches; Questions and Answers 100%
Correct
Which of the following is considered to be the modality of choice for the identification of a
pituitary macroadenoma that is suspected on the basis of a visual field deficit?
A. Skull x-ray
B. PET scan
C. CT of the brain
D. MRI of the brain CORRECT ANSWER-(u) A. Skull x-ray is not the modality of choice for
the identification of pituitary macroadenoma.
(u) B. PET scan is not the modality of choice for the identification of pituitary macroadenoma.
(u) C. CT of the brain is not the optimal imaging technique for evaluation of the pituitary stalk.
(c) D. MRI of the brain provides the best visualization of pituitary tumors.
A 2 year-old male presents with a four day history of fever and general malaise. On examination
the vitals reveal an oral temperature of 102 degrees F. The child appears to have rubor on the
trunk which started one day prior to this visit. Physical examination reveals a maculopapular
rash with defervescence. Which of the following is the most appropriate management at this
time?
A. Ibuprofen (Motrin)
B. Aspirin
C. Amoxicillin
D. Valacyclovir (Valtrex) CORRECT ANSWER-(c) A. Motrin is indicated for management of
the fever in Roseola infantum caused by the herpesvirus.
(h) B. Aspirin is contraindicated in children for management of fever.
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