NMS Q&A Family Medicine

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284 NMS Q&A Family Medicine9 Regarding the patient in Question 8, which of the followingmeasures would be most reasonable and beneficial,assuming descent is not a practical solutionand relief seems necessary at this time?(A) Acetazolamide (Diamox) administration(B) Dexamethasone in a tapering course(C) Oxygen administration(D) Pressure tent(E) Diltiazem10 The most serious symptoms that may occur withhigh-altitude sickness (HAI) are pulmonary edema,that is, high-altitude pulmonary edema (HAPE), andcerebral edema, that is, high-altitude cerebral edema(HACE). At what altitude do they become significantpossibilities for travelers who are unaccommodatedto altitude?(A) 2,000 ft (610 m)(B) 6,500 ft (1,981 m)(C) 8,000 ft (2,438 m)(D) 12,500 ft (3,810 m)(E) 15,000 ft (4,572 m)11 An 18-year-old man, who lives on the east coast, fliesto Cuzco, Peru (11,152 ft, or 3,399 m) and immediatelypursues his plan to hike to 2,000 ft (610 m)above the town, joining a group of high-altitude hikers.On the morning of the 2nd day, the group hasreached 12,000 ft (3,658 m) of altitude en route to theFortress of Sacsayhuaman. He begins to complain ofcoughing and shortness of breath, eventually producinga frothy pink sputum. Each of the followingwould be appropriate except for (which) one?(A) Rapid descent of 500 ft (152 m), if possible(B) Furosemide(C) Oxygen 1 to 2 L/minute(D) Acetazolamide(E) Hyperbaric tent12 A 45-year-old female patient reveals that a friend hasoffered to take her on a transcontinental flight in hisprivate unpressurized aircraft. The patient has a historyof HAI at 13,500 ft (4,114 m) during a mountainhiking expedition. She has had numerous benignexperiences at altitudes of 10,000 ft (3,048 m) orlower. Otherwise, she is healthy. Which of the followingis appropriate advice for her regarding the prospectiveflight and her health?(A) She should not make the flight because of herhistory of HAI.(B) She should postpone the trip until she hasundergone blood gas studies.(C) She may take the trip and will require no specialpreparations or treatments compared withother people on the plane.(D) She is safe but should undergoelectrocardiogram testing before making thefinal decision.(E) She may go on the trip as long as she takesoxygen throughout the flight.13 What cabin altitudes (terrestrial altitudes equivalent inatmospheric pressure to pressures in cabins of pressurizedaircraft) would the patient in Question 11 expectto encounter in pressurized commercial jet aircraft?(A) Sea level (cabin pressure encountered at sea level)(B) 500 ft (152 m)(C) 2,000 ft (610 m)(D) Up to 5,000 ft (1,524 m)(E) Up to 10,000 ft (3,048 m)14 Many immunizations are recommended before travelsimply for the general principle of the travelerremaining current for all routine immunizations.Others are recommended for reasons more specificto the country to be visited. Which of the followingimmunizations is recommended in the period of 1 to3 months before travel to any developing country?(A) A tetanus booster with an attenuated dose ofdiphtheria (Td)(B) Influenza(C) Polio(D) Rabies(E) Japanese encephalitis15 A 36-year-old woman with a history of atopic diseasesconsisting of seasonal rhinitis (in the springand fall), but without asthma, consults you in Augustafter a week of rhinitis symptoms because she is planninga trip by commercial air travel to Nova Scotia.Once, while recovering from a cold, she had sufferedsevere ear pain. Which of the following statements istrue regarding secretory otitis media of flight (“barotitis”or “aerotitis”)?(A) It occurs most frequently during ascent in flight.(B) The proximate cause of barotitis media isStreptococcus pneumoniae.(C) It can be prevented if the patient is able to forceair into the middle ears through the Eustachiantube during descent by means of the modifiedValsalva maneuver.(D) The physical evidence of this form of secretoryotitis media is a bulging tympanic membraneseen at otoscopy.(E) The same problem may occur during scubadiving, requiring the diver to delay ascent tocontrol symptoms and to “clear the ears.”
Travel Medicine 28516 Your patient consults you regarding travel abroad.Eventually, you introduce the topic of typhoidbecause you know he is planning a trip into a countryfor which typhoid vaccination is recommended. Towhich of the following regions is he planning totravel?(A) Canada(B) Indian subcontinent(C) Europe(D) Australia(E) New Zealand17 Which of the following is true regarding “jet lag”?(A) Rapid west-to-east travel across time zonesoften results in somnolence that isinappropriate to local time at the destination.(B) Rapid east-to-west travel often results indifficulty in sleep onset relative to local time atthe destination.(C) Anti-jetlag diets have proven effective inpreventing jetlag symptoms.(D) Paradoxical hypovolemia in the face of fluidretention plays a significant part in thepathophysiology of jetlag.(E) Cabin altitudes of 5,000 ft (1,524 m) play asignificant part in the pathophysiology of jetlag.18 An emerging concept in travel medicine is that ofpost-travel evaluation. Which of the following wouldbe checked for logically in an asymptomatic returningtraveler who had been to a tropical location?(A) Giardiasis(B) Tuberculosis skin testing(C) Hepatitis screen(D) Sigmoidoscopy for schistosomiasis(E) Malarial smear19 Which of the following patients should be deniedmedical approval for travel?(A) A 55-year-old white man with stable anginapectoris(B) A 62-year-old African-American man withnocturnal dyspnea and orthopnea(C) A 58-year-old white woman whose status is5 weeks after uncomplicated myocardialinfarction(D) A 57-year-old man with chronic lung diseasewho is unable to climb two flights of stairs or towalk for two blocks(E) A 35-year-old woman who is 7 months into anuncomplicated pregnancy
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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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Rheumatology in Primary Care 165(D)
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Rheumatology in Primary Care 16710.
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170 NMS Q&A Family Medicineof 5 ft,
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172 NMS Q&A Family Medicinepresent.
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174 NMS Q&A Family Medicinenodules.
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178 NMS Q&A Family MedicineReferenc
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180 NMS Q&A Family Medicineperipher
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182 NMS Q&A Family Medicineconditio
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184 NMS Q&A Family Medicine(D) Pneu
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chap ter 31Other Infectious Disease
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Other Infectious Diseases in Primar
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Other Infectious Diseases in Primar
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SECTION XIEndocrinology inPrimary C
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Diabetes Mellitus 197normal saline
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Diabetes Mellitus 199Examination An
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Diabetes Mellitus 20116. The answer
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204 NMS Q&A Family Medicine(A) Seru
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208 NMS Q&A Family Medicine16. The
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210 NMS Q&A Family Medicine(E) Hypo
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214 NMS Q&A Family Medicinelikeliho
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216 NMS Q&A Family Medicine(A) Prad
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SECTION XIIAllergieschapter 36Atopi
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Atopic, Food, and Contact Allergies
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Atopic, Food, and Contact Allergies
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SECTION XIIIPreventive HealthCarech
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Preoperative Clearance 229180 to 22
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Preoperative Clearance 23121 Prophy
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Page 265 and 266: Exercise and Health 247Examination
Page 267 and 268: chapter 41Concepts in Epidemiologya
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Page 331 and 332: chapter 54GeriatricsExamination que
Page 333 and 334: Geriatrics 315Examination Answers1.
Page 335 and 336: chapter 55HematologyExamination que
Page 337 and 338: Hematology 31915 A 45-year-old busy
Page 339 and 340: Hematology 321Mean cell hemoglobin
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