NMS Q&A Family Medicine

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326 NMS Q&A Family Medicine7 A 45-year-old man has been treated for hypertensionwith clonidine (e.g., Catapres), titrated to 0.2 mgdaily. However, he has begun to complain of fatigue,and the primary care doctor makes a decision tochange the antihypertensive medication to the beta-1selective blocking agent, atenolol. Which of the followingis the wisest method for making the change?(A) Start the atenolol as 50 mg daily 2 days beforediscontinuation of the clonidine.(B) Start atenolol 4 days before the discontinuanceof clonidine as 25 mg daily and increase it to50 mg daily 2 days before the change.(C) Start the atenolol at the maintenance dosage of50 mg on the day after the last dose of clonidine.(D) Discontinue clonidine and wait 2 days beforestarting atenolol at a prudent beginning dosage.(E) Taper the clonidine off as the atenolol is startedlow and accelerates, with the two drugsoverlapping in their subtherapeutic levels over a4-day period.8 Besides the manifestations of Cushing syndrome, whichof the following may be a complication of systemic glucocorticoidadministration over several weeks?(A) Decreased insulin requirements in diabetics(B) Lymphoproliferative disorder(C) Atrophic gastritis(D) Premature closure of epiphyses in growingchildren(E) Glaucoma9 A 33-year-old woman is brought to an emergencydepartment in stupor with a history of attemptingsuicide with a prescribed benzodiazepine. Which ofthe following is the specifically indicated drug for thisemergency?(A) Naloxone(B) Buprenorphine(C) Flumazenil(D) Dextroamphetamine(E) Phenobarbital10 Fluoxetine (Prozac, an SSRI antidepressant) has beenprescribed for a 35-year-old woman with depression.Which of the following side effects would be morelikely, given this combination, if she is to be giventolterodine (Detrol) for her recurrent trigonitis thatis causing urinary frequency (Detrol, urinary antispasmodicagent)?(A) Bradycardia(B) Gastritis(C) Gastroesophageal reflux disease (GERD)(D) Dry mouth(E) Decreased near point of visual focus11 A 34-year-old male patient is seen by a physician forthe first time; he presents himself as depressed andtaking tranylcypromine (Parnate) prescribed by adoctor in another city for the past 4 months. Thepatient expressed doubt, insecurity, and frustrationwith the current regimen because of the necessity toavoid aged cheeses, wines, and other foods to avoidthe risk of serious behavioral and neurological sideeffects. The adopting physician conducts her owninterview and is satisfied that the man is indeeddepressed and still in need of completing a 1-yearcourse of medication. The new doctor is consideringa change to fluoxetine (Prozac, an SSRI) for thepatient’s depression. Which of the following is thebest technique for effecting the transition from tranylcypromineto fluoxetine?(A) Continue tranylcypromine and start fluoxetine.Discontinue tranylcypromine after 2 days.(B) Continue tranylcypromine and start fluoxetine.Discontinue tranylcypromine after 2 weeks.(C) Discontinue tranylcypromine and startfluoxetine the next day.(D) Discontinue tranylcypromine and wait 2 weeksbefore starting fluoxetine.(E) Discontinue tranylcypromine and wait 4 weeksbefore starting fluoxetine.12 Risperidone (Risperdal), an antipsychotic agent, iscontraindicated in which of the following groups ofpeople?(A) Teenaged patients(B) Elderly patients(C) Schizophrenic patients(D) Patients with pneumonia(E) Patients with urinary tract infections13 A 37-year-old male patient with schizophrenia hasbeen treated with pimozide (Orap) with satisfactorycontrol. He now has developed a communityacquiredpneumonia. Which of the following antibioticsis contraindicated?(A) Clarithromycin(B) Ampicillin(C) Amoxicillin(D) Sulfamethoxazole(E) Doxycycline14 The high-potency topical glucocorticoid, betamethasone,is indicated for certain inflammatory skinconditions on a temporary basis. Each of the followingside effects is known to be caused by prolonged applicationof this preparation, except for which one?(A) Cushing syndrome(B) Adrenocorticotropin suppression
Drug Interactions, Caveats, and Primary Care 327(C) Systemic effects passed through breast milk(D) Atrophy of the treated area of the skin(E) Precipitation of diabetes15 If a pregnant woman has been treated for dyslipidemia,which of the following drugs would be safe tocontinue throughout the period of gestation?(A) Cholestyramine(B) Gemfibrozil(C) Simvastatin(D) Atorvastatin(E) Fenofibrate16 Atorvastatin (Lipitor) will have its blood levelsincreased when given in combination with each ofthe following, except for which drug?(A) Ketoconazole(B) Diltiazem(C) Gemfibrozil(D) Grapefruit juice(E) Beta-adrenergic blocking agents17 The anticoagulant warfarin interacts with manymedications to increase its blood level, risking bleedingcomplications. Which of the following drugs incombination with warfarin acts to decrease warfarinblood levels?(A) Dextrophenydate(B) Rifampin(C) Amiodarone(D) Fluconazole(E) Metronidazole
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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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Preoperative Clearance 233example,
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chap ter 38Obesity and Dyslipidemia
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Obesity and Dyslipidemia 23713 A 45
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Obesity and Dyslipidemia 239attriti
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chapter 39Smoking CessationExaminat
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Smoking Cessation 243Examination An
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chapter 40Exercise and HealthExamin
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Exercise and Health 247Examination
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chapter 41Concepts in Epidemiologya
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Concepts in Epidemiology and Resear
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Concepts in Epidemiology and Resear
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256 NMS Q&A Family Medicine7 What i
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258 NMS Q&A Family Medicineantigen
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260 NMS Q&A Family Medicine(B) Arra
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262 NMS Q&A Family Medicineinfectio
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264 NMS Q&A Family Medicine(D) Pulm
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266 NMS Q&A Family Medicinemay occu
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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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Page 313 and 314: chapter 51Anxiety and PhobiasExamin
Page 315 and 316: Anxiety and Phobias 297Examination
Page 317 and 318: chapter 52Somatic Symptoms withoutO
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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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