Multiple Choice Questions (MCQ)

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Category: Q&A Medicine--->Practice Examination
Page: 20

Question 96#Print Question

An 18-year-old boy with cystic fibrosis presents to the Emergency Department with a 4-day history of progressively worsening productive cough, fever, and malaise. His temperature is 38.8°C, blood pressure is 110/75 mmHg, heart rate is 104 beats per minute, and respiratory rate is 24 breaths per minute. Chest x-ray demonstrates a right lower lobe infiltrate.

Which antibiotic would be most beneficial for empiric treatment of this patient?

a. Vancomycin
b. Clindamycin
c. Azithromycin
d. Piperacillin–tazobactam
e. Ceftriaxone

Question 97#Print Question

A 62-year-old man presents with acute swelling of his left knee. He describes excruciating pain and swelling for the past 2 days. The patient presented with a similar episode 2 years ago, but is unable to recall what condition he was diagnosed with and what medication he was administered. He has a past medical history of diabetes, hyperlipidemia, hypertension, and chronic alcoholism. He drinks 5 to 6 beers per day. He has a temperature of 38.4°C, blood pressure of 120/80 mmHg, and heart rate of 75 beats per minute. Physical examination reveals a tender and erythematous left knee with significantly limited range of motion and marked swelling.

Which of the following is the best next step in management for this patient?

a. Indomethacin
b. Joint aspiration with synovial fluid analysis
c. Uric acid levels
d. Knee x-ray

Question 98#Print Question

A 55-year-old woman presents to the office with a 1-week history of dry cough, sore throat, and nasal congestion. She has a 5 pack-year smoking history but successfully quit over 15 years ago. She was diagnosed with asthma as a child and used an albuterol inhaler intermittently, but has not seen a physician or received an inhaler in the last 10 years. The patient’s temperature is 36.7°C, blood pressure is 120/80 mmHg, and heart rate is 72 beats per minute. Mild rhinorrhea is present but there are no other significant examination findings. A chest radiograph is obtained and shown below.

What is the best next step in management of this patient?

a. Albuterol inhaler
b. CT chest
c. Azithromycin
d. Reassurance
e. Rapid strep testing

Question 99#Print Question

A 45-year-old woman presents to her physician complaining of 3 weeks of fevers and pain in her knees and ankles. She also states that she often wakes up during the night drenched in sweat. On examination, her temperature is 38.1°C, blood pressure is 123/56 mmHg, heart rate is 78 beats per minute, and oxygen saturation is 98% on room air. She has 1+ radial pulses, 2+ dorsalis pedis pulses, and mild decreased range of motion in her bilateral knees secondary to pain.

Which of the following is the most appropriate next step in management? 

a. Methotrexate
b. Prednisone
c. Endovascular aortic stent placement
d. Ceftriaxone
e. Genetic screening

Question 100#Print Question

A 47-year-old woman presents to the clinic complaining of headache and nasal discharge. She says that this has happened to her many times before, and it goes away with antibiotics. She also mentions that her urine has been unusually dark for the past few days. On examination, a saddle nose deformity is noted. A urinalysis is performed and shows significant blood with red blood cell casts.

What is the most likely diagnosis?

a. Goodpasture syndrome
b. Poststreptococcal glomerulonephritis
c. Granulomatosis with polyangiitis
d. Congenital syphilis

Category: Q&A Medicine--->Practice Examination
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