Professional Practice II

17 Questions | Attempts: 148
Share
Quiz Flashcard
SettingsSettings
Please wait...
  • 1/17 Questions

    What is the most common aetiology of albumin proteinuria?

    • Increased glomerular permeability
    • Overflow of tubular reabsorptive capacity
    • Reduced tubular reabsorption
    • Chyluria
Please wait...
About This Quiz

Professional Practice for medical students

Professional Practice Quizzes & Trivia

Quiz Preview

  • 2. 

    These are all management for stress incontinence except...

    • Tension free vaginal taping

    • Pelvic floor exercises

    • Periurethral bulking injections or artificial sphincter

    • Drinking less water

    Correct Answer
    A. Drinking less water
  • 3. 

    A 12 year old boy with Crohn's disease presents to the ER with an acute abdomen. The pediatric ER physician completes a complete workup and diagnoses the boy with a small bowel obstruction. Medical management was unsuccessful and he underwent surgical resection of the ileum. Which of the following nutritional deficiencies is he now at risk for?

    • Vitamin B12 deficiency

    • Folic acid deficiency

    • Calcium deficiency

    • Iron deficiency

    Correct Answer
    A. Vitamin B12 deficiency
  • 4. 

    An otherwise healthy 20 year old patient of yours visited yesterday complaining of fever, sore throat, cough, and general cruminess. He mentioned that his pee had been darker over the last little while, but he didn't think much of it because it comes and goes about once a year. What is the most appropriate diagnostic testing to do?

    • Full blood count

    • Urinalysis

    • Sputum test

    • ESR and CRP

    Correct Answer
    A. Urinalysis
    Explanation
    Urine is showing the presenting illness, other tests than is done to support.

    Rate this question:

  • 5. 

    After further history taking, he has type 1 diabetes but claims it is well controlled. His only medication is insulin, and he has no allergies.What should be done next?

    • Abdominal examination

    • Full blood count

    • Abdominal X-ray

    • Vital signs

    Correct Answer
    A. Vital signs
    Explanation
    Vital signs should always be done first before any invasive procedures.

    Rate this question:

  • 6. 

    In patient centered management of chronic disease, the important aspects are these except...

    • Empowering self-responsibility or Self management and therefore compliance

    • Patient education – evidence shows that a knowledgeable patient achieves better outcomes

    • Continuity of care – creates a healing relationship (patient and doctor) and efficient organization

    • Integration of care provided by the doctor

    Correct Answer
    A. Integration of care provided by the doctor
    Explanation
    D. Integration of care provided by all professionals (FALSE)

    Rate this question:

  • 7. 

    A 34 year old man presents to the emergency department in excruciating abdominal pain. It woke him from sleep about one hour ago and he now has severe right lower quadrant pain radiating into his testicle. He is nauseated and has vomited twice in the past hour. The pain is not relieved in any position, and he has never experienced anything like this before. What should be asked or performed next?

    • Past medical history

    • Social history

    • System review

    • Abdominal examination

    Correct Answer
    A. Past medical history
    Explanation
    Medical history consists of hospital or GP treatment
    surgery or any anaesthetic problems

    MI / IHD / CVA / TIA / ep / asth / TB / liver / pu / DM / rhF / bp

    medications and allergies, any side effects, previous medical therapies

    Rate this question:

  • 8. 

    A three month old infant, Jason, presents with irritability. Mom describes him to be "incredibly fussy and always crying". He is difficult to settle down to sleep and if placed on his back he will not stop crying until held or rolled onto his stomach. It is impossible to go anywhere in the car because he "hates his car seat and won't stop screaming". He has been irritable since birth but it wasn't until about 3 weeks ago that she began to worry. Mom is exasperated and does not know what to do. Upon further questioning you discover that Jason only likes to be held on his side or in a vertical position, not cradled horizontally. He is feeding from one or both breasts every 2-3 hours however after he is done mom finds that he is continually swallowing and arching his back. In addition he often vomits a small amount after feeds. He has no signs of respiratory distress. Jason's growing along the 50th percentile for height and weight. Mom had a normal pregnancy with no significant prenatal history or complications during or after delivery. Jason is an otherwise healthy baby. What is the most likely diagnosis?

    • Viral gastroenteritis

    • Gastroesophageal reflux disease

    • GI obstruction

    • Intussusception

    Correct Answer
    A. Gastroesophageal reflux disease
    Explanation
    Gastroesophageal reflux disease is extremely common in infancy and may present with [non-bilious] vomiting after feeding, irritability, arching of the back and feeding problems. Further investigation may be required if the infant presents with failure to thrive, blood in the vomitus, recurrent cough, pneumonia or persistent symptoms. Management may include a trial of prevacid, frequent smaller feeds and positional changes.

    Rate this question:

  • 9. 

    He's back today to discuss his urinalysis (red cells, otherwise bland) and blood work (unremarkable). Thankfully, you called a nephrologist buddy of yours who told you to...

    • start him on prednisone

    • get a biopsy to solidify the diagnosis

    • diagnose IgA nephropathy and monitor with urinalysis/renal function testing (GFR)

    • aggressively treat his blood pressure with an AT-II blocker and an ACE inhibitor

    Correct Answer
    A. diagnose IgA nephropathy and monitor with urinalysis/renal function testing (GFR)
    Explanation
    BIG NOTE: IgA nephropathy is actually much more common in males, but I noticed that after writing the question. It has a widely variable clinical course, but in an otherwise healthy patient (normotensive) with isolated hematuria, it's usually quite benign. I think the most sensible thing to do would be monitoring his risk factors (BP, proteinuria) for progression to renal failure.

    Rate this question:

  • 10. 

    A 23-year old woman has been seeing her family doctor for crampy abdominal pain and constant diarrhea, which is occasionally bloody. She says the pain is mostly in her right lower quadrant. She's lost about 15 pounds over the past year. Upon reviewing her labs in a follow up visit, the doctor notices her erythrocyte sedimentation rate and C-reactive protein are elevated. What would top your differential diagnosis?

    • Ulcerative colitis

    • Coeliac disease

    • Irritable bowel syndrome

    • Crohn's colitis

    Correct Answer
    A. Crohn's colitis
    Explanation
    CRP and ESR are markers of systemic inflammation, pointing to some sort of inflammatory process. Crohn's usually (50% of the time) affects the terminal ileum and cecum, found in the RLQ, and classically presents with symptoms like bloody diarrhea, pain and weight loss.

    Rate this question:

  • 11. 

    What fat-soluble vitamin is administered to all newborn infants?

    • Vitamin A

    • Vitamin D

    • Vitamin E

    • Vitamin K

    Correct Answer
    A. Vitamin K
    Explanation
    Vitamin K is administered to all newborns to prevent the development of hemorrhagic disease of the newborn (HDN). Newborns are deficient vitamin K due to low stores at birth, low levels in breast milk and poor placental transfer. Most standard commercial infant formulas contain supplemental vitamin K therefore HDN is primarily a problem of exclusively breast fed infants.

    Please see article on HDN: http://www.emedicine.com/ped/TOPIC966.HTM

    Rate this question:

  • 12. 

    Abdomen: soft, bowel sounds present, right-sided tenderness worse in upper quadrant Genitalia: uncircumcised phallus, non bloody meatus, non tender descended testis Rectal: normalThink about your differential diagnosis, then reveal the options and choose the one most likely diagnosis.

    • Acute appendicitis

    • Acute renal colic

    • Bowel obstruction

    • Cholecystitis

    • Testicular torsion

    Correct Answer
    A. Acute renal colic
    Explanation
    Pain that radiates "from loin to groin" is a classic presentation for renal colic. Nausea and vomiting are almost always present because the kidney shares autonomic innervation with the gastrointestinal tract. The abdomen is typically soft with mild tenderness on the affected side, and ileus may occur in protracted cases. Signs of peritonitis are rare.

    Rate this question:

  • 13. 

    Which of the following is FALSE regarding renal colic?

    • Gross or microscopy hematuria is seen in over 75% of patients

    • CT scan or IVP is required to confirm the diagnosis

    • Pain is characteristically intense, radiates from the flank to the groin, and is of sudden onset

    • Urinary extravasation is an operative indication

    Correct Answer
    A. Urinary extravasation is an operative indication
    Explanation
    Urinary extravasation is inconsequential.

    Remember these key points about renal colic:
    1. presents as intense pain radiating from loin to groin with nausea and vomiting
    2. diagnosed by CT scan
    3. management is usually outpatient oral hydration and pain control until the stone passes spontaneously
    4. admission indications include: compromised renal function, inability to tolerate outpatient management, evidence of infection

    Rate this question:

  • 14. 

    What are not the secondary causes of osteoarthritis of the hip?

    • Developmental dysplasia (DDH)

    • Slipped femoral capital epiphysis

    • Fracture

    • Idiopathic

    Correct Answer
    A. Idiopathic
    Explanation
    Idiopathic is the primary cause of osteoarthritis of the hip.

    Rate this question:

  • 15. 

    CT reveals a stone 4 mm in diameter in the right distal ureter. The lab results are as follows: Blood: - WBC 9,600/uL (4,000-10,000) - BUN 11 mg/dL (8-20) - creatinine 1.0 mg/dL (0.7-1.3) Urinalysis: - specific gravity 1.040 - RBC: 60-100/hpf - no bacteria - pH 5 Your initial management includes all this except:

    • Morphine 10 mg IM/SC q4h prn

    • Instruct patient to strain urine

    • Admission to hospital

    • IV fluids

    Correct Answer
    A. Admission to hospital
    Explanation
    Stones less than 5 mm in diameter will pass spontaneously 75% of the time. Therefore, this patient can be managed on an outpatient basis with oral hydration, oral pain control, and urine straining. Retrieval of the stone or stone fragments allows for analysis that can guide future preventative measures.

    Admission criteria include: inability to tolerate oral hydration or pain control, evidence of infection, renal failure, or solitary kidney.

    Rate this question:

  • 16. 

    Aims and objectives of an AMS are these except...

    • To promote secondary health care

    • To advocate for Aboriginal self determination and community control

    • To serve as a peak body and forum

    • To alleviate sickness and assist aboriginal groups

    Correct Answer
    A. To promote secondary health care
    Explanation
    To promote primary health care

    Rate this question:

  • 17. 

    Choose the initial investigation which is not helpful to confirm your suspected diagnosis from the last question

    • Unenhanced CT scan

    • Serum creatinine

    • IV pyelogram

    • Full Blood Count with differential

    • KUB X-rays

    Correct Answer
    A. IV pyelogram
    Explanation
    Unenhanced CT is the preferred imaging modality, since essentially all stones show up on CT. IV pyelogram allows visualization of the degree of obstruction, but it is time consuming and requires contrast that cannot be administered until it is established that the patient does not have pre-existing renal failure (thus the creatinine).

    An elevated leukocyte count may suggest urinary tract infection, which necessitates more aggressive intervention or admission. Urine pH may help determine the type of stone (acidic pH suggests uric acid stone, alkaline pH suggests infective or struvite stone). Gross or microhematuria is often seen.

    Rate this question:

Quiz Review Timeline (Updated): Dec 14, 2012 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Dec 14, 2012
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 09, 2008
    Quiz Created by
    Kevinqool
Back to Top Back to top
Advertisement
×

Wait!
Here's an interesting quiz for you.

We have other quizzes matching your interest.