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Curing a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient's nose. What will the provider do? - ANS ✓Refer the patient for possible electrodessication and curettage What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion? - ANS ✓Excisional biopsy A patient has acne and the provider notes lesions on half of the face, some nodules, and two scarred areas. Which treatment will be prescribed? - ANS ✓Topical benzoyl peroxide and clindamycin A provider is considering an oral contraceptive medication to treat acne in an adolescent female. Which is an important consideration when prescribing this drug? - ANS ✓Yaz, Ortho Tri-Cyclen, and Estrostep are approved for acne treatment.
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Curing a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient's nose. What will the provider do? - ANS ✓Refer the patient for possible electrodessication and curettage What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion? - ANS ✓Excisional biopsy A patient has acne and the provider notes lesions on half of the face, some nodules, and two scarred areas. Which treatment will be prescribed? - ANS ✓Topical benzoyl peroxide and clindamycin A provider is considering an oral contraceptive medication to treat acne in an adolescent female. Which is an important consideration when prescribing this drug? - ANS ✓Yaz, Ortho Tri-Cyclen, and Estrostep are approved for acne treatment. When counselling a patient with rosacea about management of this condition, the provider may recommend: - ANS ✓eliminating spicy foods. A patient is in the clinic with patches of hair loss. The provider notes several well-demarcated patches on the scalp and eyebrows without areas of inflammation and several hairs within the patch with thinner shafts near the scalp. Based on these findings, which type of alopecia is most likely? - ANS ✓Alopecia areata
A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury? - ANS ✓Potential septic arthritis or osteomyelitis Which type of bite is generally closed by delayed primary closure? - ANS ✓Bites to the hand An elderly adult patient with bullous pemphigoid is prescribed oral prednisone and hydroxyzine to manage symptoms. Which medication side effect is of immediate concern for this patient? - ANS ✓Sedation A patient is newly diagnosed with bullous pemphigoid and has moderate to severe itching. The provider orders a topical corticosteroid will discuss which potential complication with this patient? - ANS ✓Secondary infection A patient suffers chemical burns on both arms after a spill at work. What is the initial action by the providers? - ANS ✓Remove the offending chemical and garments A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection? - ANS ✓Amoxicillin-clavulanate A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient? - ANS ✓Prescribe oral clindamycin A patient who has been exposed to poison ivy presents with inflammation and a vesicular rash on one arm. The provider recommends a topical steroid, but the next day the patient calls to report similar lesions
pending. What is the initial treatment while waiting for these results? - ANS ✓Elbow pads, NSAIDs, rest, and ice What is NOT included in the initial management of bursitis of the heel? - ANS ✓Closed heel shoes to prevent further injury A patient experiences a recurrent gouty flare and the provider decides to begin urate-lowering therapy (ULT). How should this be prescribed? - ANS ✓Start ULT in 5 weeks along with an anti-inflammatory drug A patient reports severe back pain located in the lumbar spine. To evaluate whether the patient has axial pain or radicular pain, which assessment is necessary? - ANS ✓Asking the patient to perform the Valsalva manoeuvre A patient has an acute onset of lower back pain associated with lifting heavy objects at work. A physical examination reveals no loss of lower extremity function or neurological symptoms. What is the initial intervention for this patient? - ANS ✓Treatment with a nonsteroidal anti- inflammatory drug A provider suspects degenerative disk disease in a patient with chronic neck pain. Which diagnostic test will be performed? - ANS ✓Magnetic resonance imaging A patient has chronic radicular neck pain that no longer responds to over- the-counter NSAIDs and physical therapy measures and reports having difficulty sleeping. Which medication will the provider order? - ANS ✓Gabapentin A 50-year-old woman reports pain in one knee upon awakening each morning that goes away later in the morning. A knee radiograph is negative for pathology and serum inflammatory markers are normal. What will the provider tell this patient? - ANS ✓To take acetaminophen 1 gram 2-3 times daily for pain
A patient has osteomyelitis related to vascular insufficiency. Which initial consultation is necessary? - ANS ✓Surgical consultation A 45-year-old patient reports a recent onset of unilateral shoulder pain which is described as diffuse and is associated with weakness of the shoulder but no loss of passive range of motion. What does the provider suspect as the cause of these symptoms? - ANS ✓Rotator cuff injury An examiner is evaluating a patient who reports unilateral shoulder pain and notes limited active and passive range of motion in the affected shoulder along with erythema and bulging on the anterior shoulder. What diagnosis is likely with this presentation? - ANS ✓Inflammatory bursitis A patient reports a deep ache in one shoulder and the provider suspects tendonitis secondary to repetitive activity. To determine whether the pain is caused by impingement on the acromion, the provider will ask the patient to: - ANS ✓abduct the arm. A provider is giving instructions for rest, ice, compression, and elevation (RICE) treatment in a patient with a sprain. What is included in teaching about this home care? - ANS ✓Moist heat therapy may be applied if muscle spasm occurs A patient is diagnosed with polymyalgia rheumatica with giant cell arteritis. Which dose of prednisolone will be given initially? - ANS ✓60 mg daily A 60-year-old patient reports new onset of bilateral shoulder pain with morning stiffness lasting approximately one hour. The pain causes difficulty rolling to sides in bed and getting out of bed. Which is imperative in initial diagnostic testing for this patient? - ANS ✓ESR and non-cardiac CRP
A patient has recurrent cluster headaches and asks about abortive therapy. Which therapy is effective for a majority of patients with cluster headaches? - ANS ✓Oxygen Which musculoskeletal disease primarily involves the distal joints, hips, knees, and spine, and is characterized by the development of Heberden and Bouchard nodes? - ANS ✓Osteoarthritis The initial test of preference for the diagnosis of Rheumatoid Arthritis is: - ANS ✓Rheumatoid Factor A 76-year old patient complains of stiffness and pain of the fingers. What is the best conservative therapy to recommend - ANS ✓Warm packs and exercise When evaluating a patient for suspected TIA, a fundoscopic examination that reveals emboli suggest - ANS ✓carotid artery disease In adults with low back pain, which symptom indicates the need for an urgent MRI of the lumbosacral spine? - ANS ✓Urinary retention On physical examination, nodular enlargement of an 83-year-old patient's distal interphalangeal joints is noted. Enlargement of these joints is known as - ANS ✓Heberden's nodes Which of the following best describes the presentation of a patient with osteoarthritis? - ANS ✓Worst symptoms in weight-bearing joints later in the day Which of the following best describes the presentation of a patient with rheumatoid arthritis? - ANS ✓Symmetrical early morning stiffness
A 64 year-old male presents with a 2-month duration of stiffness in his left knee and hip. He states that the stiffness generally lasts about 20- 30 minutes when he first gets out of bed in the morning and is relieved with a hot shower and moderate activity such as walking. The most likely diagnosis is: - ANS ✓osteoarthritis The most common type of joint disease in the United States is: - ANS ✓osteoarthritis COX 2 inhibitors are widely used for treatment of osteoarthritic pain. In what patients should they NOT be prescribed - ANS ✓Those with renal insufficiency Antibiotic treatment of choice for cat bites in adults is: - ANS ✓Augmentin 500 - 875 mg TID for 7-10 days A 40-year-old male has come into the clinic with complaints of "severe pain in his great toe, which seem to be a little swollen and red." His complaints would suggest: - ANS ✓gouty arthritis This type of headache is almost exclusively seen in males, esp. those who smoke. They usually begin in 20's & 30's, but symptoms usually do not become severe until middle age. They tend to be seasonal - worse in spring & fall. They are characterized by intense, unilateral pain, usually in or behind the eye - may radiate to same side of forehead or temple. - ANS ✓cluster headache The majority (around 75%) of sufferers of this type of headache are women. 40% have a positive family history of similar headaches. The etiology includes anxiety, depression, fatigue, environmental stress, increased platelet function, drug rebound. - ANS ✓migraine