NMS Q&A Family Medicine

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62 NMS Q&A Family Medicine(C) Shunt reversal(D) Clubbing of the fingernails(E) Left ventricular CHF7 A 15-year-old girl complains of chest pains and palpitations.Her mother is concerned that the girl mayhave mitral valve prolapse (MVP). In what position(s)is a click that is attendant to MVP most likely to beheard upon auscultation?(A) Supine(B) Sedentary(C) Standing(D) Prone(E) Reverse Trendelenburg position8 You are examining a 4-year-old boy for routine wellchild care. You hear a soft grade I/II murmur loudestin the left second intercostal space. Which of the followingwould most reassure you and the parents thatthis is a venous hum and not the murmur of pulmonicvalvular stenosis?(A) A venous hum has only a diastolic component.(B) A venous hum has a coarse, harsh sound.(C) The murmur stops with compression of softtissue.(D) With PS, cyanosis is present.(E) In venous hum, S 2 is normal.9 While examining a 3-week-old male infant for hisfirst well child visit, you notice that he has a harsh,pansystolic loud murmur at the lower left sternalborder. There is also a heave over the left precordium.The child has been eating normally and the familyhas not observed any episodes of cyanosis or dyspnea.You find no cyanosis. You had examined thischild at birth and before his discharge from the newbornnursery and did not discern any murmurs duringthese examinations. S 2 is normally split (increaseswith inspiration). Which of the following lesions isthe most likely to account for the murmur?(A) Tetralogy of Fallot(B) ASD(C) PDA(D) VSD(E) Venous hum10 Regarding the child in Question 9, for which of thefollowing complications is the child at risk?(A) Heart failure(B) Eisenmenger syndrome(C) Bacterial endocarditis(D) Failure of the defect to spontaneously close(E) All of the above11 You detect a grade III/VI harsh murmur over the leftsternal border and second right intercostal space in a13-year-old adolescent boy. He has no dyspnea,orthopnea, syncope, or chest pains. You suspect hehas congenital aortic stenosis. Each of the followingfindings on physical examination correlates with thatdiagnosis, except which one?(A) There is radiation of the murmur to the neck.(B) There is presence of an ejection click.(C) The murmur is loud and harsh both at the baseand left sternal border.(D) There is radiation of murmur to the left axilla.(E) There is presence of a palpable thrill in thesuprasternal notch.12 On a routine examination of a new patient, diminishedblood pressure readings are found in an adolescent’slegs, relative to that found in the upperextremities. You suspect coarctation of the aorta.Each of the following may be associated with coarctationexcept for which factor?(A) This may be an XO female patient.(B) There may be notching of the ribs seen on x-ray.(C) A delay in the femoral pulse may be found.(D) Cyanosis of the lips and clubbing of thefingernails may be observed.(E) The patient is more likely to be male than female.13 A 16-year-old boy is brought to you for the first timeby his parents, complaining of increasing fatigability.Auscultation of the heart reveals a grade III/VI systolicejection murmur and thrills at the right secondintercostal space and in the suprasternal notch. S 2 isnot split, either in inspiration or in expiration. Themurmur is heard neither over the carotid arteries norin the left axilla. Which of the following lesionsexplains these findings?(A) PS(B) Aortic stenosis (AS)(C) ASD(D) VSD(E) Mitral valve prolapse (MVP)14 A baby is born prematurely, at a weight of 3.64 lb(1.65 kg). What is the treatment of choice for a hemodynamicallysignificant PDA in this infant that persistsfor longer than 48 hours?(A) Observation for clinical deterioration(B) Thrombosing the patent ductus through cardiaccatheterization(C) Surgical ligation(D) Vasodilators(E) Indomethacin
Pediatric Cardiology 6315 You hear a carotid bruit in a 3-year-old girl who hasotherwise been healthy and has been growing anddeveloping appropriately for her age. She is on nomedications. Which of the following would you recommend?(A) Aspirin 325 mg by mouth daily(B) Persantine by mouth three times daily(C) A carotid Doppler study(D) A cerebral angiogram(E) Observation only16 You see a newborn boy after a few hours of birth. Hisweight is 8.5 lb (3.85 kg). You hear a loud murmuralong the lower left sternal border. You delay his dischargehome with the mother, pending evaluation ofthe cardiac status. On day 3 the nursery reports thatthe baby manifests cyanosis. Which of the followingmost likely accounts for this picture?(A) PDA(B) Transposition of the great vessels(C) Coarctation of the aorta(D) ASD
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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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Page 59 and 60: Cardiology 41(A) Systolic crescendo
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Page 69 and 70: Peripheral Vascular Disease 51Exami
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Page 85 and 86: chap ter 10HypertensionExamination
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Page 121 and 122: Problems of the Liver 103level, whe
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Page 125 and 126: SECTION VIIUrology and Nephrologyin
Page 127 and 128: Problems of the Urinary Tract 10913
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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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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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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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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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260 NMS Q&A Family Medicine(B) Arra
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264 NMS Q&A Family Medicine(D) Pulm
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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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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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