Question 1 2 / 2 points
A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?
Question options:
a) Pancreatitis
b) Peptic ulcer disease
c) Diverticulitis
d) All of the above
Question 2 2 / 2 points
Which of the following would be an appropriate treatment for a patient with mild BPH?
Question options:
a) Refer to a urologist for surgery.
b) Prescribe a trial of tamsulosin.
c) Recommend cranberry supplements.
d) Reevaluate symptoms in 1 to 3 months.
Question 3 2 / 2 points
The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?
Question options:
a) Repeat the test.
b) Refer to a nephrologist.
c) Measure the serum protein.
d) Obtain a blood urea nitrogen (BUN) and creatinine.
Question 4 2 / 2 points
Which is the most potent and irritating dose of tretinoin?
Question options:
a) 0.05% liquid formulation
b) 0.1% cream
c) 1% foam
d) 0.02% cream
Question 5 2 / 2 points
Which of the following clinical manifestations are consistent with a patient in ARF?
Question options:
a) Pruritis
b) Glycosuria
c) Irritability
Question 6 2 / 2 points
Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?
Question options:
a) Keratosis pilaris
b) Dennie’s sign
c) Keratoconus
d) Pityriasis alba
Question 7 2 / 2 points
The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?
Question options:
a) Erectile dysfunction
b) Glaucoma
c) Hypotension
d) Headache
Question 8 2 / 2 points
When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?
Question options:
a) A piece of hair or a thread
b) Hyphae
c) Leukocytes
d) Spores
Question 9 2 / 2 points
Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?
Question options:
a) Vagistat vaginal cream
b) Monistat combination pack
c) Terazol vaginal cream
d) Diflucan, 150 mg
Question 10 2 / 2 points
A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
Question options:
a) NSAIDs
b) Beets
c) Vitamin A
d) Red meat
Question 11 2 / 2 points
Which of the following tests is most useful in determining renal function in a patient suspected of CRF?
Question options:
a) BUN and creatinine
b) Electrolytes
c) Creatinine clearance
d) Urinalysis
Question 12 2 / 2 points
Eighty percent of men have noticeable hair loss by what age?
Question options:
a) 35
b) 50
c) 70
d) 85
Question 13 0 / 2 points
When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes.What do you suspect they are?
Question options:
a) Spores
b) Leukocytes
c) Pseudohyphae
d) Epithelial cells
Question 14 2 / 2 points
Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI?
Question options:
a) Last menstrual period
b) Method of birth control
c) Last unprotected sexual contact
d) All of the above
Question 15 2 / 2 points
What is the treatment of choice for a patient diagnosed with testicular cancer?
Question options:
a) Radical orchidectomy
b) Lumpectomy
c) Radiation implants
d) All of the above
Question 16 2 / 2 points
Which test is used to confirm a diagnosis of epididymitis?
Question options:
a) Urinalysis
b) Gram stain of urethral discharge
c) Complete blood cell count with differential
d) Ultrasound of the scrotum
Question 17 2 / 2 points
Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?
Question options:
a) Bullous impetigo
b) Staphylococcal scalded skin syndrome (SSSS)
c) Nonbullous impetigo
d) Ecthyma
Question 18 2 / 2 points
An example of ecchymosis is:
Question options:
a) A hematoma
b) A keloid
c) A bruise
d) A patch
Question 19 2 / 2 points
An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?
Question options:
a) Benign prostatic hyperplasia (BPH)
b) Parkinson’s disease
c) Prostate cancer
d) All of the above
Question 20 0 / 2 points
A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?
Question options:
a) Testosterone level
b) Prostate-specific antigen
c) Nocturnal penile tumescence and rigidity
d) Prolactin level
Question 21 2 / 2 points
A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?
Question options:
a) Peyronie’s disease
b) Damage to the pudendal artery
c) Scarring of the cavernosa
d) All of the above
Question 22 2 / 2 points
A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?
Question options:
a) The cancer involves the seminal vesicles.
b) There is metastatic disease to regional lymph nodes.
c) The cancer is confined to the capsule.
d) There is metastasis to distant organs.
Question 23 0 / 2 points
During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?
Question options:
a) An enlarged rubbery gland
b) A hard irregular gland
c) A tender gland
d) A boggy gland
Question 24 2 / 2 points
Tinea unguium is also known as:
Question options:
a) Onychomycosis
b) Tinea versicolor
c) Tinea manuum
d) Tinea corporis
Question 25 2 / 2 points
The patient is diagnosed with acute renal failure (ARF).Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia?
Question options:
a) Recent heat stroke
b) Nephrolithiasis
c) Recent infection where gentamicin was used in treatment
d) All of the above
Question 26 2 / 2 points
Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?
Question options:
a) Do not use lidocaine as it may potentiate bleeding.
b) Pinch the skin taut together.
c) Use gel foam to control bleeding.
d) This should be performed by a dermatologist only.
Question 27 2 / 2 points
A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication?
Question options:
a) Diarrhea
b) Parkinson’s disease
c) Closed-angle glaucoma
d) Breast cancer
Question 28 2 / 2 points
Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
Question options:
a) “You must be under a lot of stress lately.”
b) “It is hereditary. Did your father experience this also?”
c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d) “We’ll have to do some tests.”
Question 29 2 / 2 points
A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?
Question options:
a) Risk of osteoporosis
b) May have hot flushes
c) May have impotence
d) All of the above
Question 30 2 / 2 points
Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?
Question options:
a) There are round, hypopigmented macules on his back.
b) Josh has red papules on his face.
c) There are crusted plaques in Josh’s groin area.
d) There are white streaks on his neck.
Question 31 2 / 2 points
The most common precancerous skin lesion found in Caucasians is:
Question options:
a) A skin tag
b) Actinic keratosis
c) A melanoma
d) A basal cell lesion
Question 32 2 / 2 points
Which scalp problem can be caused by a fever and certain drugs?
Question options:
a) Telogen effluvium (TE)
b) Trichotillomania
c) Psoriasis
d) Alopecia areata
Question 33 2 / 2 points
A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?
Question options:
a) Terazosin 2 mg PO once a day
b) Ice pack to the scrotal area
c) Saw palmetto 320 mg per day
d) All of the above
Question 34 2 / 2 points
A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?
Question options:
a) Lower urinary tract infection
b) Chlamydia infection
c) Candidiasis
d) Pyelonephritis
Question 35 2 / 2 points
Which of the following foods should be limited in a patient with CRF?
Question options:
a) Milk
b) Bananas
c) Soy sauce
d) All of the above
Question 36 2 / 2 points
An example of a primary skin lesion is a/an:
Question options:
a) Bulla
b) Scale
c) Excoriation
d) Fissure
Question 37 2 / 2 points
A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?
Question options:
a) Urethral polyps
b) Urinary tract infection (UTI)
c) Anticholinergic medication
d) All of the above
Question 38 2 / 2 points
A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked?
Question options:
a) “Do you have a history of liver disease?”
b) “What medications are you currently taking?”
c) “Have you noticed swelling in your ankles?”
d) All of the above
Question 39 2 / 2 points
A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means. Which is the best response?
Question options:
a) “There is no such thing as Stage D cancer.”
b) “You have cancer that has spread to the surrounding tissue.”
c) “Your cancer has spread to other organs.”
d) “Your cancer can be cured by removing your bladder.”
Question 40 2 / 2 points
Treatment for epididymitis includes which of the following?
Question options:
a) Warm sitz baths
b) Scrotal elevation
c) Masturbation
d) All of the above
Question 41 2 / 2 points
A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for which risk factor for kidney stones?
Question options:
a) Hypertension
b) Constipation
c) Tubal ligation
d) Diabetes
Question 42 2 / 2 points
A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis?
Question options:
a) Psychogenic nocturia
b) Urethral polyp
c) Irritative posterior urethral lesion
d) Benign prostatic hypertrophy
Question 43 0 / 2 points
A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?
Question options:
a) Every month
b) Every 3 to 4 months
c) Every 6 to 12 months
d) Every year
Question 44 2 / 2 points
Mark has necrotizing fasciitis of his left lower extremity.Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?
Question options:
a) Staphylococcal aureus
b) Clostridium perfringens
c) S. pyrogenes
d) Streptococcus
Question 45 2 / 2 points
Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation.There is some edema involved. You suspect:
Question options:
a) Necrotizing fasciitis
b) Kaposi’s sarcoma
c) Cellulitis
d) A diabetic ulcer
Question 46 2 / 2 points
Why do people of African descent have a lower incidence of non-melanoma skin cancer?
Question options:
a) They have an increased number of melanocytes.
b) Their darker skin protects from ultraviolet radiation.
c) Their skin is thicker.
d) Their immune system is stronger.
Question 47 2 / 2 points
A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis.In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?
Question options:
a) Escherichia coli
b) Staphylococcus aureus
c) Chlamydia trachomatis
d) Pseudomonas aeruginosa
Question 48 2 / 2 points
When instructing your elderly client about treating her xerosis, what do you tell her?
Question options:
a) A daily hot bath may help the associated pruritus.
b) Rub the skin briskly to make sure it is completely dry after bathing.
c) Only take short tepid showers.
d) Use a gel that is alcohol-based after bathing to soften the skin.
Question 49 2 / 2 points
Which of the following instructions should be given to the patient with nephrolithiasis?
Question options:
a) Take ibuprofen, 600 mg every 8 hours.
b) Take Tums? for stomach upset.
c) Drink more black tea.
d) Increase intake of vegetables, like spinach.
Question 50 2 / 2 points
The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?
Question options:
a) 3 to 7 days
b) 14 to 21 days
c) 3 to 6 weeks
d) 6 to 12 weeks