18 Oct Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?

Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?

 

A favorable prognostic trend Disease progression

 

The need to be more aggressive with Reuben’s medications

 

Drug resistance mutations

 

Which medication is used as a first-line treatment in the management of bipolar disorder?

 

Gabapentin

 

Lamotrigine

 

Carbamazepine

 

Topiramate  Carbamazepine

 

What is the essential feature of bipolar-I? Hyperactivity

 

 Mania Depression

 

Anxiety

 

 Which treatment would the clinician recommend for a patient who has relative polycythemia?

 

Rehydration

 

Antihistamines

 

Weekly phlebotomies

 

Rehydration

 

Referral to hematologist

 

 Which phrase describes rheumatoid arthritis (RA)?

 

Localized synovial joint destruction

 

Chronic exocrine dysfunction

 

Systemic inflammatory disease

 

Antibody-mediated cellular cytotoxicity response

 

 Which blood cell is excessively elevated in a person who has polycythemia?

 

Platelets

 

Neutrophils

 

Red blood cells

 

 All types of blood cells

 

 The stooped posture, motor slowness, and minor cognitive impairments of patients with major depressive disorders are similar to the signs of disorders of the basal ganglia, such as:

 

Parkinson’s disease Stevens-Johnson syndrome

 

Neurological disease

 

Huntington’s disease

 

 It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is

 

the most common long-term effect of sexual assault?

 

Depression

 

Obsessive-compulsive disorder

 

Substance abuse

 

PTSD

 

The clinician is educating a patient about the effects of marijuana. The patient stated that she has been smoking for years and believes the use does not interfere with her life. What is the potential long- term sequelae of marijuana use that the clinician should educate this patient about?

 

Memory impairment Sexual dysfunction

 

Dry mouth

 

There are no long-term consequences of marijuana use

 

 Which symptom is the cardinal subjective symptom of sickle cell crisis?

 

 Pain Nausea

 

Light-headedness

 

Palpitations

 

What is the health impact of low-dose alcohol consumption?

 

Increased risk of developing alcohol addiction

 

Increased risk of coronary artery disease

 

Increased high-density lipoproteins

 

Increased excitation of critical ion channels

 

Increased high-density lipoproteins

 

Which classic rash should the clinician assess for in a patient with SLE?

 

Butterfly Bulls-eye

 

Ringworm

 

 

 

“Slapped” cheeks

 

Which finding from the bone marrow aspiration is typical in a patient with CML?

 

Schistocytes

 

Howell-Jolly bodies

 

Philadelphia chromosome

 

Hemoglobin S gene

 

Philadelphia chromosome

 

Each of the following antidepressants does NOT have significant liver CYP P450 interaction effects?

 

Paroxetine

 

Fluoxetine

 

Fluvoxamine

 

Olanzapine

 

Bipolar disorder requires differential diagnosis from all of the following except?

 

Substance abuse and medication effects

 

Medical and neurological disorders

 

Cluster B personality disorders and depression

 

Obsessive-compulsive disorder

 

After returning from visiting his grandchildren in Connecticut, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. Which disease should the clinician be considering?

 

Rubella

 

Lyme disease

 

Fibromyalgia syndrome

 

Shingles  Lyme disease

 

Spontaneous bruising may be seen with platelet counts below what level?

 

100,000 cells/mL

 

75,000 cells/mL

 

50,000 cells/mL

 

30,000 cells/mL Results for item 18. 18

 

All benzodiazepines are associated with:

 

Potential anterograde amnesia Dopamine-related movement disorders

 

Serotonin syndrome

 

Xerostomia and agitation

 

 Which of the following disease-modifying antirheumatic drugs is a folic acid antagonist?

 

Methotrexate (Rheumatrex)

 

 Etanercept (Enbrel)

 

Rituximab (Rituxan)

 

Anakinra (Kineret)

 

Which test should the clinician use to initially screen for HIV?

 

Western blot

 

Enzyme-linked immunosorbent assay

 

HIV-1/2 antigen/antibody combination immunoassay

 

HIV-1/2 antigen/antibody combination immunoassay

 

Nucleic acid amplification testing

 

Which of the following is considered first-line treatment for panic disorders?

 

Benzodiazepines

 

Selective serotonin reuptake inhibitors (SSRIs)

 

Cognitive behavioral therapy Tricyclic antidepressants

 

 Cognitive behavioral therapy

 

HITS is a validated instrument used to identifying intimate partner violence. What does HITS stand for?

 

Hit, Injured, Threatened, Scared

 

Hurt, Insult, Threaten, Scream Humiliated, Isolated, Tortured, Scarred

 

Harm, Injury, Terror, Shame

 

The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

 

1 month

 

3 months

 

6 months

 

 12 months

 

Which of the following is a laboratory finding commonly found in patients with anorexia nervosa?

 

Hypophosphatemia Hypermagnesmia

 

Leukocytosis

 

Decreased TRH

 

 Results for item 25. 25

 

Which of the following is the only drug used to treat bulimia that is approved by the U.S. Food and Drug Administration?

 

Sertraline

 

Fluoxetine Citalopram

 

Imipramine

 

A patient presents with symptoms of infectious mononucleosis. Which lab chemistry test should the clinician order?

 

Viral load

 

 Hemoglobin A1c

 

Western blot assay

 

Heterophile antibody test

 

After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?

 

2              weeks

 

3              weeks

 

4              weeks

 

5              weeks

 

How long would the clinician inform the patient to rest after onset of infectious mononucleosis?

 

4 days

 

10 days

 

2 weeks

 

4 weeks

 

What is the most common cause of microcytic anemia?

 

Anemia of chronic disease

 

Sideroblastic anemia

 

Iron-deficiency anemia Pernicious anemia

 

Dryness of the eyes and mouth is typical of which condition?

 

Sjögren’s syndrome Allergic reaction

 

Hypothyroidism

 

 

 

Sideroblastic anemia

 

Which condition is the most common cause of generalized musculoskeletal pain in women ages 20 to 55?

 

 Chronic fatigue syndrome

 

Anemia

 

Fibromyalgia syndrome Sports-related injuries

 

Which assessment finding presents with early rheumatoid disease?

 

Pain and swelling in both small and large peripheral joints

 

Joint swelling and immobility on rising

 

Rigid joints with diminished range of motion

 

Joint swelling and immobility on rising

 

A cardiac rub with pulmonary friction rub

 

 Which of the following may be used to evaluate a person’s suicide risk?

 

CAGE

 

SANE

 

SAD PERSONAS

 

SAD PERSONAS

 

DIGFAST

 

Suicide plans are assessed on all of the following, EXCEPT:

 

Specificity

 

Possibility Availability

 

Lethality

 

Infectious mononucleosis results from an acute infection with which of the following?

 

Epstein-Barr virus Acute HIV infection

 

Guillain-Barré

 

Hepatitis

 

A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?

 

Pheochromocytoma

 

Hyperthyroidism

 

Cardiac arrhythmias

 

All of the above

 

Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?

 

Erythrocyte sedimentation rate

 

White blood cell count

 

Polymorphonuclear cells

 

C-reactive protein (CRP)

 

A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects?

 

Give the patient a “drug holiday” until the symptoms resolve and then restart the medication.

 

Switch the patient to a different antipsychotic.

 

Treat the patient with anticholinergics. Treat the patient with anticonvulsants.

 

What is the likely result of the over-prescription, over-supply, and over-production of opioids?

 

Opioid use

 

Opioid abuse Opioid dependence

 

Opioid resistance

 

The clinician must differentiate chronic vitamin B12 deficiency anemia from folate deficiency anemia. Which action should the clinician take?

 

Obtain a complete blood count

 

 Assess for peripheral neuropathy

 

Inspect for smooth surface on tongue

 

Determine the size of the red blood cell

 

Assess for peripheral neuropathy