Packrat Exam Questions & Answers

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Packrat Exam Questions & Answers 23 yo male with recent URI sxs presents c/o chest pain. His pain is worse when lying down and better sitting up and leaning forward. ECG shows widespread ST segment ... elevation. Dx - ANS - Pericardial friction rub 75 yo woman presents to the office with complain of vision loss. Exam reveals a palpable cord in the temporal region. Most helpful initial test to order - ANS - ESR Recommended LDL tor educe risk of CAD in a diabetic pt - ANS - 100mg/dL What is the reason for giving IV mag sulfate to a pt with pre-eclampsia - ANS - prevention of seizure by increasing the seizure threshold 53 yo man with h/o HTN presents c/o recent 4/10 left sided chest pain with exertion that is relieved with rest. Heart exam reveals regular rate and rhythm with no S3, S4 or murmur. Lungs are CTA bilat. ECG reveals no acute changes. Most appropriate initial test - ANS - Nuclear Stress Test 36 yo AA female comes to the clinic for an insurance physical which requires a CXR. She denies any respiratory sxs. Exam of her chest is negative. Xray results show marked LAD in the right paratracheal region. ACE levels are elevated. Most likely dx - ANS - Sarcoidosis 33 year old presents to your office with a c/o right knee injury associated with pain and swelling. He states he was running after his loose dog and suddently stopped, hyperextended his knee, heard a pop, and noticed immediate swelling. On PE, the Lachman test and anterior drawer test demonstates joint laxity. Most likely injury - ANS - ACL 22 yo woman comes to the office because her urine is cola colored and she hasnot urinated since yesturday morning. Her past medical hx is significant for pharyngitis two weeks ago. Her mother and grandmother have type 2 diabetes. Her BP is 146/92 mmHg. On PE she has edema of her face and hands. Dx - ANS - glomerulonephritis 15 yo girl hit in the right eye by a golf ball. There is swelling and echymosis of the orbit. She c/o double vision. The right eye doesn't move with downward gaze or right lateral gaze. Dx test that will provide the most information - ANS - facial x-ray A 48 yo male with DM presents for routine PE. Of note his BP each of his last two f/u visits was 150/90. Today his BP is 148/88. The pt denies c/o chest pain, change in vision, or headache. Most appropriate management - ANS - linsinopril (Zestril) 68 yo male with a h/o a-fib treated with warfarin (Coumadin) presents to the ED after vomiting large amounds of bright red blood. INR is 3. Most appropriate treatment to rapidly lower the patient's INR - ANS - administer FFP 72 yo farmer comes to the office for eval of a pearly ulcerated papule on his right nostril. The papule has been bleeding off and on for hte past couple weeks. Which of the following findings would be most concerning on the PE of this pt - ANS - Telangiectasia 24 yo female presents with c/o abd pain, bloating, and chronic diarrhea. She says she felt worse last month while on vacation in Italy. Despite eating well she lost weight. What would be the most appropriate traetment for this pt - ANS - Gluten-Free diet Hypoglycemia in an elderly pt with diabetes is most likely to manifest as what sx - ANS - Mental confusion An 85 yo nursing home resident presents witha abrupt onset of cough, sore throat, HA, myalgias, and malaise. On exam pt temp is 102F, the rest of the exam is unremarkable. Nasal smear is positive for Influenza B. Tx of choice for this pt - ANS - Oseltamivir (tamiflu) 36 yo female presents for routine PE. She has no current complaints and her only medication is oral contraceptives. The pt is preparing for a trip in Australia and is worried about the long flight as her Mom has a hx of DVT after a long trip several yaers ago. PE reveals BP 110/60. HR 66, regular. Heart is regular rate and rhythm without murmur, lungs are clear to auscultation bilaterally and extremities are without edema. Most appropriate recommendation - ANS - recommend walking frequently during the flight 43 yo woman presents with episodes of facial flushing with increased skin temp. followed by the development of tiny papules and pustules primarily on her cheeks and chin. These sxs worsen when she eats spicy food. On exam, telangiectasias are noted along the nasal folds and tiny pustules on both cheeks. Dx - ANS - rosacea 25 yo male presents to the ED for eval of a wound on his hand. He cut his hand while tearing down a chicken coop. On exam of his right hand you note a dirty 3cm jagged laceration. The pt is unaware of his tetanus immunization status. Besides cleaning and debriding the wound, what is the recommended intervention - ANS - administer tetanus-diptheria toxoid (Th) and tetanus immune globulin (TIG) 25 yo female presents for a routine gynecological exam. You palpate a 2cm breast mass in her right breast. Her menstrual period was last week. She has no family hx of breast cancer. What is the modality of choice to further evaluate her breast mass - ANS - ultrasound 60 yo right hand dominant male presents to your office complaining of right shoulder pain and progressively worsening arm weakness. His sxs are aggravated when working above the shoulder level. On PE, there is no evidence of muscle atrophy. He has strong (5/5) adduction of his right shoulder but considerable weakness (1/5) with abduction when raising his arm above his head. Passive range of motion is intact. Dx - ANS - rotator cuff tear Newborn weighs 8 pounds at birth. what would you expect her to weigh at 1 year of age - ANS - 24 pounds 3 month old female presents with her Mom for PE. The pts Mom denies any complaints. On exam you note a well developed, well nourished infant in no apparent distress. There is no cyanosis noted. Heart exam reveals a normal S1 with a physiologically split S2. There is a grade III/VI high pitched, harsh pansystolic murmur heard best at the 3rd and 4th left intercostal spaces with radiation across the precordium. Initial study of choice - ANS - echocardiogram 62 yo male smoker presents to the clinic with c/o chronic cough, hemoptysis, and weight loss. Chest CT shows a mass obstructing the bronchus with hilar and mediastinal lymph node abnormalities. Bronchoscopy with biopsy is performed. On reviewing pathology results you explain to the pt that his type fo lung cancer is prone to early hematogenous spread, is rarely amenable to surgical resection and has a very aggressive course. Dx - ANS - small cell lung cancer Otitis externa can be differentiated from uncomplicated otitis media by which of the following PE findings - ANS - normal pneumatic otoscopy 20 yo male presents with complaint of brief episod [Show More]

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