NMS Q&A Family Medicine

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68 NMS Q&A Family Medicine(A) 100/50(B) 139/89(C) 130/80(D) 125/75(E) 100/607 Regarding a patient to be placed on a diuretic to controlBP, which of the following has the most specialsignificance in ancillary studies to obtain before startingthe patient on the chosen drug therapy?(A) Electrocardiogram (EKG)(B) BUN, creatinine(C) Electrolytes(D) Complete blood count(E) Liver function battery8 Hypertension is the most potent risk factor for whichone of the following conditions?(A) Myocardial infarction(B) Peripheral vascular disease(C) Stroke(D) Lung cancer(E) Renal failure9 A 75-year-old woman is seeing you for the first time;it is the first time she has seen any doctor for the past30 years. She had three random, consecutive BPdeterminations over a 1-week period, which weremeasured at 180/80, 170/75, and 183/85. You decidethat her isolated systolic hypertension should be treatedwith a pharmaceutical agent. Which of the followingwould be the best first-line drug?(A) Hydrochlorthiazide(B) Lisinopril (an ACEI)(C) Propranolol (beta-adrenergic blocker)(D) ACE receptor blocking agent(E) Verapamil (CCB)10 A 52-year-old obese man has a BP of 160/100; he hasbeen under treatment for the past 25 years, presentlyconsisting of an ACEI and a CCB, and he has a creatininelevel of 2 mg/dL and a BUN level of 38 mg/dL.Although he has a brother with diabetes mellitus typeII, his 2-hour postprandial blood sugar is 90 mg/dL.You ordered a C-peptide test and find that the level iselevated. In discussion of his renal function, you mustteach the patient what he must do to retard the acceleratedreduction of renal function. You begin by tellinghim that which of the following diseases is theleading cause of end-stage renal disease (ESRD)?(A) Diabetes(B) Pyelonephritis(C) Hypertension(D) Chronic glomerulonephritis(E) Polycystic kidney disease11 A 45-year-old white man with a multiple family historyof hypertension weighs 180 lb (81.54 kg) at aheight of 5 ft 10 in. (1.77 m) and presents with a BPof 145/95. You place the patient on a no-salt-addeddiet with a resultant fall in BP to 130/85, that is, consistentfor the next 6 months. The BP then rises againas the patient gains weight to 195 lb (88.33 kg) andlapses on the low-salt diet. This time the BP respondsdramatically to hydrochlorthiazide 25 mg/triamterene37.5 mg once daily. As first-line drugs for therapyin essential hypertension, thiazide diuretics areeffective in approximately what percentage of casesof hypertension in white individuals?(A) 10% to 20%(B) 20% to 30%(C) 30% to 40%(D) 40% to 50%(E) 60% to 70%12 A 35-year-old woman presents to you with BP readingsof 150/100, 145/98, and 160/95 on three successive days.A routine metabolic profile shows normal BUN, creatinine,blood sugar, sodium, chloride, and bicarbonate,but a potassium level of 2.8 mEq/L. She denies diarrhea,vomiting, past or present fistulae or enterostomy,or taking any prescription medications. Which of thefollowing types of hypertension is most likely present?(A) Essential hypertension of the vasoconstrictive type(B) Essential hypertension of the salt-retentive type(C) Pheochromocytoma(D) Primary aldosteronism(E) Renovascular hypertension13 Which of the following may be an important part ofmaking the diagnosis in the case of Question 12?(A) 24-hour urine catecholamine levels(B) 24-hour urine vanillylmandelic acid (VMA) levels(C) 8 am supine overnight and 12 pm upright serumaldosterone levels(D) BP levels sitting followed by BP levels standingevery 15 seconds for 2 minutes(E) Urinary metanephrine levels14 Each of the following statements regarding pheochromocytomais true except which one?(A) Patients with paroxysms of anxiety are oftentested for pheochromocytoma(B) Ten percent of cases are bilateral (found in bothadrenals)(C) Familial cases tend to be bilateral(D) Sensitivity and specificity for 24-hour urinemetanephrine, free catecholamine, and VMAlevels are sufficient to diagnosepheochromocytoma alone(E) Virtually all cases are curable through surgery
Hypertension 6915 In hypertensive patients with no other risk factors(e.g., diabetes) and who are not ethnically African-Americans, which of the following is the therapeutictarget for BP levels?(A) 120/80(B) 130/85(C) 130 to 140/ 89(D) 140 to 159/90 to 99(E) 210/ 12016 A 29-year-old woman has become hypertensive andBP levels are difficult to control. You have her on10 mg lisinopril twice daily, hydrochlorthiazide/triamterene once daily, and 80 mg verapamil 3 timesdaily. BP levels run 160/105 despite the foregoing.Serum potassium was normal before therapy wasstarted. The 24-hour urine studies for VMA, metanephrine,and free catecholamines were within normallimits. Which of the following may be helpful infurther elucidating the diagnosis?(A) EKG(B) Liver function profile(C) Lipid screen(D) Abdominal examination(E) Complete blood count
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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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Page 57 and 58: SECTION IIICardiovascular Diseasesi
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 73 and 74: chap ter 8Cerebrovascular DiseaseEx
Page 75 and 76: Cerebrovascular Disease 57(A) A non
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Page 85: 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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Page 107 and 108: SECTION VIThe Gastrointestinal Trac
Page 109 and 110: Medical Problems of the Gastrointes
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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
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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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122 NMS Q&A Family MedicineExaminat
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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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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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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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264 NMS Q&A Family Medicine(D) Pulm
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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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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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