Midterm 7.12.23

A 62-year-old woman with type 2 diabetes mellitus comes physican because of a 3-month history of fatigue and weakneww. Her HA1C conectraction was 13.5% 12 weeks ago. Her B\P is 152\92 mmHg . Which of the following is the most appropriate parameter for early detection of this patient's renal condition ?

A 58-year-old man presents to his phisican for follow-up of his hypertension and hyperlipidemia. He also reports ches pain and feeling short breath after ... Flights of starirs or walking three to four blocks. The symptom resolve after several minutes of rest. Which of the following drugs is not indicated as a first- line of tratment of this patient's new condition ?

Nifedipine

Nytroglycerin

Enalapril

Aspirin

A 28-year- old woman at 15 week's gestation is noted to be Rh negative . Which of the following is the most appropriate next step for this patient ?

Check the patient's antibody screen

Schedule the patient for amniocentesis to assess for isoimmunization

Counsel the patient to terminate the pregnancy

Which of the following dimensions is not included in the WHO definition of health

Physical well being

Occupational well being

Mental well being

Social well being

What is the example of tertiary prevention ?

Educate to prevent the disease

Blood pressure and cholesterol control

Prevent future cpmplications and increase life expectancy

Early detection and treatment of the disease

A 53-year-old woman comes to physican beacuse of 2-month hystory of severe pain in her left leg while walking. She can conitinue to walk after a break of around 5 min. She has hypertension and diabetes mellitus. She is smoker. On examination the left lower extermity is cooler the right one, the skin over the left leg appears shing and dry. Pedal pulses are diminished on the left leg. Which of the following is the most appropriate next step in managment ?

All of the following are risk factors of hypertension , except :

A nure is asking the mother of a 4-year-old how much milk he drinks a day. The mother says usualy 1 cup every few days and explains that he really doesnt like milk. The nurse provides education n the importance of calcium for his diet and gives other food items that she could feed him so that he gets enough dairy in the diet. Which of the following levels of prenetions is the nurse providing ?

Secondary

Primary

Screening

Chronic care managment

A 24-yea-old woman who is 8 weeks pregnant isfound to have a thyroid nodule. Biopsy is performed and malignancy of the thyroid is diagnosed. Which management options is most appropriate?

Follow clinically until after delivery of child

Confirm the diagnosis of cancer using rasioisotope scanning.

Perform an immadiate thyroidectomy

Treat with radioactive idoine ablation in the secound or third trimester

A 38-year-old pregnant woman presents for intial visit at 12 weeks gestation . She requests a "genetic screen " because she is concerned about her advanced .. She does not want any invasive testing that may cause a potential miscarrage . Which of the following is mist appropriate to offer this patient ?

If no prior personal of familt history of genetic defects, no sccreen is needed

Draw and send blood for the triple or quad screen, as patient has advanced maternal age.

Nuchal transluncency screening (ultrasoung)

Offer the patient chrionic villus sampling.

Which of the following is the goal of initial evaluation of a person with hypertension

Assess for taarget organ damage

Evaluatefor common secondary causes of hypertension.

Assess for other cardiovascular comorbidites

All of the above

A 48-year-old woman presents for a well-woman examination. She notes that she had a supracervical hysterectomy in the past. Your records reveal that she had her uterus removed, but the cervix and ovaries were left in place. She read on the internet that women who have had a hysterectomy no longer need Pap smears. Which of the following would be your advice?

You should continue to have Pap smears since your hysterectomy does not exclude you from routine screening recommendation for your age group

You no longer need to get Pap smears since you have had a hysterectomy"

You should continue with annual Pap smears until the age of 50. If they are all normal, you can stop having them at that time:"

Which one of the following patints presenting with chest pain is at the highst risk for an acute myocardial infraction

A 40-year-old woman on proton pump inhibitor for reflux disease

A 23-year-old man recently diagnosed with hypertrophic cardiomyopathy

A 67-year-old man with a history of a prior angioplasty, with chest pain radiating to the neck and complaint of diaphoresis

A 75-year-old man with parasternal chest pain, lipid abnormalities, and no past history or cardiac disease

A 62-year-old man with recently diagnosed emphysema presents to your office in November for a rotine examination. Which of the following immunization most appropriate for individual ?

Pneumococcal , and influenza

Rubella

Mumps

Tetanus-diphtheria (Td)

A 52-year-old man comes into the outpatiient clinic for annual "chek-up". He is in good health, and has a relatively unremarkable family history. He has ne sigarettes. For which of the following disorders should a screening test performed?

Lung cancer

Colon cancer

Abdominal aortic aneurysm

Specify the most sutible interention for the inhibition of the vertical transmission of a group B streptococcus infection

Intravenous ampicillin therapy during the delivery for GBS positive pregnant women

Parenteral penicillin therapy of the newborns

Oral antibiotic therapy of GBS positive pregnant women

Parenteral penicillin therapy of all mothers and their newborns

Aspirin chemoprophylaxis is not recommended

In postmenpausal women

In patints with risk of coloreatl cancer

In man 45 year and more

In young people with risk factor of coronary disease

A 63-year-old woman presents for a routine physical examination. She is asymptomatic and is not taking any medications. Her blood pressure is found to be 145/85 m Hg on two readings and her body mass index (BMI) is 29. Review of her chart reveals that her blood pressure was 143/84 mm Hg on a visit 4 months ago for a urinary infection. Which of the following is the most accurate statement regarding her blood pressure?

Her blood pressure is normal and she is at average risk for developing hypertension

She has hypertension and should be started on multidrug therapy

She is at risk for needing pharmacologic treatment for hypertension

She has hypertension and should be started on a thiazide diuretic

Essential components defining the term "risk factor" include all of the following, except:

The correlation between the presence of multiple risk factors and the likelihood of the development of the disease is not linear

The presence of factors and influences that increases the likeli hood of the development of the disease

A causal relationship exists between the presence of risk factors and the development of the disease

A 16-year-old adolescent girl has had an increased craving for sweets. She often consumes two to three ice cream sundaes and four large sodas a day, but has still managed to maintain her weight. Friends often notice her using the bathroom more frequently to urinate but she denies any episodes of purging and states that she just has to urinate after drinking so much cola. On physical examination, she is 5 ft 8 in and 110 lb and her thyroid is not palpable. Which of the following test results is diagnostic of diabetes mellitus?

A HbAic of 6.3%

A single glucose reading of 124 mg/dL

A random glucose greater than 200 mg/dL with symptoms such as polydipsia or polyuria

A 2-hour oral glucose tolerance test greater than 200 mg/dL with a 100-g glucose load

The most requently used indicator for the qyality of life is

The raw ,ortality rate

The life expectancy rate at 60 years of age

The lofe expectancy rate withous chronic disease and disability

The life expectancy rate at birth

Coordinting job of family Doctor meand that

Duodenum

Find's out patints needs and plans next activities according them

Family doctor refers the patients the secound and third levels of the health care system

Refers them to provide labroatory and instrumental examination

Midterm 7.12.23

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