NMS Q&A Family Medicine

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54 NMS Q&A Family Medicine21. The answer is E. A streptokinase infusion has noplace in the treatment of an established plaque, whereas itmay be employed in treatment of an acute thrombosis.ReferencesChestnut M , Prendergast TJ . Lung disorders of the pulmonarycirculation . In: Tierney LM , McPhee SJ , Papadakis MA , eds.Current Medical Diagnosis and Treatment , 43rd ed . New York :McGraw-Hill/Appleton & Lange ; 2004 : 212 – 305 .Ebell MH . Evidence-based initiation of warfarin (Coumadin).Am Fam Physician . 2005 ; 71 : 763 – 770 .Executive Committee for Asymptomatic Carotid AtherosclerosisStudy . Endarterectomy for asymptomatic carotid arterystenosis . JAMA . 1995 ; 273 : 1421 – 1428 .Family Medicine Board Review 2009. May 3–9, 2009 .Formon JJ , Kurzweg FT , Broadway RK . Aneurysms of the aorta:A review . Ann Surg . 1967 ; 165 : 557 – 563 .Kurowski K . Peripheral vascular disease. In: Rudy DR , KurowskiK , eds. Family Medicine: House Officer Series . Baltimore, MD :Williams & Wilkins ; 1997 : 97 – 122 .
chap ter 8Cerebrovascular DiseaseExamination questions : Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 65-year-old man with a history of poorly controlledhypertension and a 45 pack-year smoking history fallsdown returning to the bedroom from the bathroom.His wife finds him to be unable to move his right arm,and his face is drooping on the right. His speech isgarbled. She calls 911, and the man is taken to anemergency department where he arrives 45 minutesafter the onset of his symptoms. A decision was madeto consider thrombolysis. Which of the following isnot a satisfied criterion for going forward with theprocess of thrombolysis to interrupt a thromboticstroke?(A) Treatment with thrombolysis within 3 hours(B) Computed tomography (CT) scan of the headnegative for signs of hemorrhage(C) Neurologic defect neither too small nor toolarge(D) Blood pressure (BP) of 185/105(E) Patient underwent herniorraphy 10 days ago2 A 67-year-old female reports a bout of apparentparalysis of the right upper extremity, a feeling of“totally dead” right arm, unable to be moved, thatlasted for about 2 minutes. Which of the following istrue regarding this attack?(A) The majority of people who suffer such anattack will manifest infarction on MRI.(B) If such an attack resolves within 1 hour, the riskof stroke is minimal in the foreseeable future.(C) Anticoagulation therapy should beginforthwith.(D) The involvement of the upper extremityindicates anterior cerebral artery pathology.(E) A carotid duplex scan is indicated.3 Regarding hypercoagulable states in cerebrovasculardisease, which of the following is true?(A) Testing for protein C should be carried out assoon as possible.(B) Testing for protein S should be accomplishedbut not until 2 months after the stroke onset.(C) Testing for antithrombin III is not relevant inthe clinical setting of acute stroke.(D) Warfarin therapy should always beginimmediately after hemorrhage has beenruled out.(E) Prothrombin gene mutation is an indication forimmediate anticoagulation therapy, oncehemorrhage has been ruled out.4 A 65-year-old man successfully underwent carotidendarterectomy after discovery of a carotid bruit anda duplex ultrasound. His family physician decides toprescribe clopidogrel (Plavix). Which of the followingdrugs would decrease the platelet deaggravationeffectiveness of clopidogrel?(A) Motrin (Ibuprofen)(B) Protonix (pantoprozole)(C) Naprosyn (naproxen)(D) Prilosic (omeprozole)(E) Coumadin (warfarin)5 A 45-year-old white man comes to you for the firsttime for a “complete physical.” He is concerned thatboth his father and paternal grandfather died in theirfifties of stroke; further, a paternal uncle recently hada stroke leaving him left hemiparetic but functional.After a complete review of systems and examinationof all sectors, he returns to review the results, includingthose of comprehensive laboratory testing. Youhave found that he has a BP of 155/98 averaged overthree determinations. His total cholesterol (TC) is240 mg/dL, his high-density lipoprotein cholesterol(HDL-C) is 35 mg/dL, and his low-density lipoproteincholesterol (LDL-C) is 140 mg/dL. He has smokeda pack of cigarettes per day for the past 25 years. He isemployed in a high-tension occupation, that of stocktrader, in which his income depends on his successon behalf of his clients. Which of the following riskfactors are most prevalent in cerebrovascular (stroke)disease?(A) Elevated LDL-C(B) Reduced HDL-C(C) Elevated TC(D) Cigarette smoking(E) Hypertension55
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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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Page 59 and 60: Cardiology 41(A) Systolic crescendo
Page 61 and 62: Cardiology 43Examination Answers1.
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Page 85 and 86: chap ter 10HypertensionExamination
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Page 95 and 96: Neurology 778. The answer is A. The
Page 97 and 98: SECTION VRespiratory Diseasesin Pri
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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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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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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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288 NMS Q&A Family Medicinedenied a
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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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