NMS Q&A Family Medicine

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216 NMS Q&A Family Medicine(A) Prader–Willi syndrome(B) Prolactinoma(C) Gonadal failure(D) Constitutional delay(E) Dramatic recent weight loss ( 20% of bodyweight)8 Regarding the patient featured in Question 7, thereare other possible causes not mentioned among thechoices given. Each of the following is an additionalpossible etiology for the disorder of the patientdescribed in Question 6, except for which one?(A) Polycystic ovary syndrome (PCOS)(B) Over 3,000 rads of radiation to the ovaries(C) Autoimmune gonadal failure(D) Alkylating agent chemotherapy(E) Turner syndrome9 During your examination of a 19-month-old femaleinfant, you note unilateral breast bud development inthe right breast. The child has otherwise been welland is on no medications. The vaginal mucosaappears as expected at 19 months. She remains atabout the 50th percentile for both height and weight.Which of the following do you recommend?(A) Reassure the parents(B) Order a right breast ultrasound(C) Order a bilateral mammogram(D) Suggest a breast surgeon consultation for surgicalexcision of lesion(E) Check estradiol, FSH, and LH levels10 You are evaluating a 14-year-old girl who is manifestingvirilization. She otherwise has no complaints andhas not been ill. She used to take an albuterol inhalerbut has not needed that in the past 2 years. She hasclitoral enlargement and facial hair, but motor andsensory examination, including deep tendon reflexes,are normal. Visual fields are intact to gross confrontation.You appreciate no masses on abdominalexamination. Which of the following would be partof your initial work-up?(A) Serum testosterone level(B) Serum progesterone level(C) Karyotype testing(D) Serum estrogen (total) level(E) A magnetic resonance imaging of the pituitarygland11 A 25-year-old man and his 23-year-old wife expresstheir concern regarding failure to achieve pregnancyafter 2 years of marriage and monthly attempts atconception. An initial screening sperm count showssignificant azospermia. The husband possesses anelongated lower body segment but otherwise is ofnormal weight for height. His education level washigh school. His testicles measure 3 cm and 3.5 cm,respectively. Otherwise, secondary sex characteristicsare normal except for a suggestion of gynecomastia.His past development was normal in regard to secondarysex characteristics and the timing of theironset. LH and FSH levels are within normal limits.Which of the following is the most likely diagnosis?(A) Kallmann syndrome(B) Prader–Willi syndrome(C) Klinefelter syndrome(D) Laurence–Moon syndrome(E) Bardet–Biedl syndrome12 A phenotypical male newborn shows no testicles inthe scrotum. Which of the following should be themost timely action to be taken in the newborn periodin regard to this finding?(A) Consult a surgeon for possible orchiopexy(B) Consult a surgeon for orchiectomy(C) Observation for likely descent of the testicleswithin the first 3 months(D) Ascertain the presence of testes in the abdomen(E) Early institution of hormonal therapy to bringabout descent of testes13 Which of the following statements is correct regardingthe prognosis of undescended testicles if they hadbeen brought into the scrotum within the first year?(A) Fertility can be expected to revert to normalwhen the child comes of age if correction ismade by time the child reaches the age of 1 year.(B) Potential for malignancy in an undescendedtesticle reverts to normal after medical orsurgical correction if accomplished by the timethe child reaches the age of 1 year.(C) Neither fertility nor potential for malignancycan be expected to be comparable with those inmales without the affliction, even if the conditionis corrected by the time the child reachesthe age of 1 year.(D) Both fertility and potential for malignancy willrevert to normal after correction if it is made bythe time the child reaches the age of 1 year.(E) Surgical or medical correction of cryptorchidismserves only a cosmetic function, as it has noeffect on the long-term course of the individualwho suffered from the condition.14 The parents of a 7-year-old boy bring him to you forevaluation. They have noted bilateral breast development.There is no history of exogenous estrogen use.His vital signs are normal, including a regular heartrhythm at a rate of 88. He has otherwise been welland is on no mediations. There is no history of
Growth and Development 217ambiguous genitalia at birth. On examination, thetestes are approximately 1 cm each bilaterally. Thepenis is small. Breast tissue is palpable bilaterally withdiscernible areola development. There are no abdominalmasses. The boy is 40th percentile for height andweight. Which of the following do you recommend?(A) Reassure parents that it is just benign gynecomastiaand is probably transient(B) Begin treatment with testosterone enanthate50 mg IU each month(C) Begin search for estrogen-secreting tumor(D) Obtain surgical consultation for excisionalbiopsy of breast masses(E) Review the family history for similaroccurrences15 An 8 1/2-year-old boy has deepening voice and earlygrowth of facial hair. His testicles measure 2.8 cmbilaterally. Bone age is advanced for his height andchronological age. FSH and LH are in the pubertalrange that is, above the low prepubertal levels. Truesexual precocity is diagnosed. Which of the followingmedications would be appropriate for treatment ofthis condition(A) Gonadotropin-releasing hormone (GnRH)agonist(B) Human chorionic gonadotropin(C) Cyproterone acetate(D) Medroxyprogesterone acetate(E) Spironolactone
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NMS Q&AFamily Medicine3rd EDITION
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Acquisitions Editor: Susan RhynerPr
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Foreword to the First EditionFamily
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AcknowledgmentsFor the contribution
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xivContentsChapter 15 Surgical Issu
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SECTION IUrgent Carechapter 1Urgent
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Urgent Care in Family Practice 3(A)
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Urgent Care in Family Practice 5Exa
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Urgent Care in Family Practice 7rem
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10 NMS Q&A Family Medicine(A) To pl
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12 NMS Q&A Family MedicineExaminati
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chapter 3Otolaryngology inPrimary C
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Otolaryngology in Primary Care 17tr
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Otolaryngology in Primary Care 1924
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Otolaryngology in Primary Care 21of
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Otolaryngology in Primary Care 23co
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26 NMS Q&A Family Medicine(A) Migra
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30 NMS Q&A Family MedicineQuestions
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32 NMS Q&A Family Medicine(A) Distu
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36 NMS Q&A Family Medicine80 mm Hg.
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SECTION IIICardiovascular Diseasesi
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Cardiology 41(A) Systolic crescendo
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Cardiology 43Examination Answers1.
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Cardiology 4516. The answer is C. T
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chapter 7Peripheral Vascular Diseas
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Peripheral Vascular Disease 49would
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Peripheral Vascular Disease 51Exami
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Peripheral Vascular Disease 53right
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chap ter 8Cerebrovascular DiseaseEx
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Cerebrovascular Disease 57(A) A non
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Cerebrovascular Disease 59ventricul
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chap ter 9Pediatric CardiologyExami
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Pediatric Cardiology 6315 You hear
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Pediatric Cardiology 65by placing o
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chap ter 10HypertensionExamination
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Hypertension 6915 In hypertensive p
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Hypertension 71systolic hypertensio
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74 NMS Q&A Family Medicine(A) Right
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Neurology 778. The answer is A. The
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SECTION VRespiratory Diseasesin Pri
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Pneumonia and Bronchitides 81(C) Co
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Pneumonia and Bronchitides 836. The
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chapter 13Respiratory Diseasesin Ch
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Respiratory Diseases in Children 87
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SECTION VIThe Gastrointestinal Trac
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Medical Problems of the Gastrointes
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Medical Problems of the Gastrointes
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chap ter 15Surgical Issues of theGa
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Surgical Issues of the Gastrointest
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Surgical Issues of the Gastrointest
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chap ter 16Problems of the LiverExa
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Problems of the Liver 103level, whe
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Problems of the Liver 105been inves
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SECTION VIIUrology and Nephrologyin
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Problems of the Urinary Tract 10913
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Problems of the Urinary Tract 11110
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114 NMS Q&A Family Medicine7 Which
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116 NMS Q&A Family MedicineExaminat
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118 NMS Q&A Family Medicineof malig
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120 NMS Q&A Family Medicine(D) Sulf
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124 NMS Q&A Family MedicineReferenc
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126 NMS Q&A Family Medicinecycle. H
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chapter 21Gynecology in Mature Adul
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Gynecology in Mature Adults 133amen
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Gynecology in Mature Adults 1357. T
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chapter 22Diseases of the Female Br
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Diseases of the Female Breast 139Ex
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Diseases of the Female Breast 141Re
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144 NMS Q&A Family Medicine(B) Long
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146 NMS Q&A Family Medicine(D) PIP
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148 NMS Q&A Family Medicine6. The a
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chapter 24Musculoskeletal Problemso
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Musculoskeletal Problems of the Nec
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Musculoskeletal Problems of the Nec
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chapter 25Musculoskeletal Problemso
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Musculoskeletal Problems of the Low
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Musculoskeletal Problems of the Low
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chapter 26Rheumatology in Primary C
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Page 207 and 208: chap ter 31Other Infectious Disease
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Page 213 and 214: SECTION XIEndocrinology inPrimary C
Page 215 and 216: Diabetes Mellitus 197normal saline
Page 217 and 218: Diabetes Mellitus 199Examination An
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Page 239 and 240: SECTION XIIAllergieschapter 36Atopi
Page 241 and 242: Atopic, Food, and Contact Allergies
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Page 247 and 248: Preoperative Clearance 229180 to 22
Page 249 and 250: Preoperative Clearance 23121 Prophy
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Page 253 and 254: chap ter 38Obesity and Dyslipidemia
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Page 261 and 262: Smoking Cessation 243Examination An
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Page 265 and 266: Exercise and Health 247Examination
Page 267 and 268: chapter 41Concepts in Epidemiologya
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268 NMS Q&A Family Medicinebeing se
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270 NMS Q&A Family Medicineis exace
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272 NMS Q&A Family Medicine8 What a
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274 NMS Q&A Family Medicine12. Hepa
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276 NMS Q&A Family Medicine(D) Ever
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278 NMS Q&A Family MedicineAlthough
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280 NMS Q&A Family Medicine5 Of the
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282 NMS Q&A Family Medicineclinicia
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284 NMS Q&A Family Medicine9 Regard
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288 NMS Q&A Family Medicinedenied a
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290 NMS Q&A Family Medicinewithout
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chapter 51Anxiety and PhobiasExamin
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Anxiety and Phobias 297Examination
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chapter 52Somatic Symptoms withoutO
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Somatic Symptoms without Organic Ba
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Somatic Symptoms without Organic Ba
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306 NMS Q&A Family Medicine5 A 25-y
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308 NMS Q&A Family Medicineperiorbi
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310 NMS Q&A Family Medicineand loti
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chapter 54GeriatricsExamination que
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Geriatrics 315Examination Answers1.
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chapter 55HematologyExamination que
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Hematology 31915 A 45-year-old busy
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Hematology 321Mean cell hemoglobin
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Hematology 323whereas in multiple m
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326 NMS Q&A Family Medicine7 A 45-y
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