Your-Doctor
Multiple Choice Questions (MCQ)


Quiz Categories Click to expand

Category: Medicine--->General Medicine and Prevention
Page: 5

Question 21# Print Question

A 92-year-old woman with type 2 diabetes mellitus has developed cellulitis and gangrene of her left foot. She requires a lifesaving amputation, but refuses to give consent for the surgery. She has been ambulatory in her nursing home but states that she would be so dependent after surgery that life would not be worth living for her. She has no living relatives; she enjoys walks and gardening. She is competent and of clear mind.

Which of the following is the most appropriate course of action?

A. Perform emergency surgery
B. Consult a psychiatrist
C. Request permission for surgery from a friend of the patient
D. Follow the patient’s wishes
E. Obtain a court order to override the patient’s wishes


Question 22# Print Question

A 42-year-old man sees you because of obesity. He played football in high school and at age 18 weighed 250 lb. He has gradually gained weight since. Many previous attempts at dieting have resulted in transient weight loss of 10 to 15 lb, which he then rapidly regains. He has been attending weight watchers for the last 3 months and has successfully lost 4 lb. Recent attempts at exercise have been limited because of bilateral knee pain and swelling. On examination height is 6 ft 0 in, weight 340 lb, BMI 46. Blood pressure with a large cuff is 150/95. Baseline laboratory studies including CBC, biochemical profile, thyroid-stimulating hormone, and lipids are normal with the exception of fasting serum glucose, which is 145 mg/dL.

What is the best next step? 

A. Discuss bariatric surgery with the patient
B. Refer to a commercial weight-loss program
C. Recommend a 1000-calorie per day diet
D. Prescribe phentermine
E. Recommend a low-fat diet


Question 23# Print Question

A 54-year-old man sees you for follow-up of hypertension and a seizure disorder that is well controlled. He established as a new patient 2 months ago and is back for his second office visit with you. At the time of his initial visit he admitted to a 35-year history of smoking 2 packs of cigarettes per day. At that time he indicated that he was not interested in stopping smoking and seemed irritated when you suggested that he quit. Today his blood pressure is well controlled and there are no new medical issues.

With regard to discussing cessation of cigarette smoking during today’s visit, what is the best next step? 

A. Do not discuss cessation of cigarette smoking because it will likely upset him again
B. Do not discuss cessation of cigarette smoking, because there is no real benefit to cessation of cigarette smoking after smoking this long
C. Ask him if he is still smoking, and, if so, advise him to quit and assess his willingness to do so
D. Recommend bupropion
E. Recommend that he switch to smokeless tobacco


Question 24# Print Question

A 70-year-old man with unresectable carcinoma of the lung meta-static to liver and bone has developed progressive weight loss, anorexia, and shortness of breath. The patient has executed a valid living will that prohibits the use of feeding tube in the setting of terminal illness. The patient becomes lethargic and stops eating altogether. The patient’s wife of 30 years now insists on enteral feeding for her husband.

Which of the following is the most appropriate course of action? 

A. Respect the wife’s wishes as a reliable surrogate decision maker
B. Resist the placement of a feeding tube in accordance with the living will
C. Ask the daughter to make the decision
D. Place a feeding tube until such time as the matter can be discussed with the patient
E. Request a court order to place a feeding tube


Question 25# Print Question

A 32-year-old, overweight, diabetic woman is found to have a triglyceride level greater than 1000 mg/dL. Family history is positive for diabetes, pancreatitis, and premature coronary artery disease. TSH is normal. You advise the patient to follow a low-fat diabetic diet, to exercise regularly and to avoid alcohol.

What medication would be most appropriate to start at this time?

A. High-dose rosuvastatin
B. Nicotinic acid
C. Low-dose atorvastatin
D. High-dose fenofibrate
E. Over-the-counter fish oil




Category: Medicine--->General Medicine and Prevention
Page: 5 of 6