Nokea
A 70-year-old man walks 20 minutes most days of the week. He has begun to complain of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20-minute walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease?
- A. A sharp, stabbing pain
- B. A dull pain and cramp
- C. An electric shock
- D. A pulsating pain
Correct Answer: B
Rationale: Claudication pain due to peripheral artery disease is typically dull and cramp-like during exercise.
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A 75-year-old man presents with the chief concern, “I may have a bladder infection.” Further questioning reveals for several months he has been needing to void every couple of hours (can’t sit through a whole ball game), feels he must go as soon as he feels the urge (he tried putting it off and had urinary leakage), and is getting up two to three times at night to void. He denies delay in voiding or straining to initiate voiding, slow stream, feeling of incomplete emptying, or dribbling after completion of urination. He also denies dysuria and abdominal pain. Which of the following best describes the category or type of his lower urinary tract symptoms?
- A. Prostatism
- B. Overactive bladder
- C. Postmicturition
- D. Storage (irritative)
Correct Answer: D
Rationale: Storage symptoms (irritative) include urgency, frequency, and nocturia, which are characteristic of overactive bladder.
Which antihypertensive would be appropriate to prescribe for a hypertensive patient (B/P 150/95) in her third trimester?
- A. Candesartan
- B. Lisinopril
- C. Methyldopa
- D. Furosemide
Correct Answer: C
Rationale: Methyldopa is safe for use in pregnancy and is the preferred antihypertensive for hypertension during pregnancy.
A 27-year-old male patient presents with a painless chancre on the shaft of his penis and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial treatment is:
- A. Ceftriaxone (Rocephin)
- B. Clindamycin (Cleocin)
- C. Metronidazole (Flagyl)
- D. Benzathine penicillin G (Bicillin L.A)
Correct Answer: D
Rationale: Benzathine penicillin G is the first-line treatment for primary syphilis.
Which is the most reasonable first step in the treatment of older men with erectile dysfunction?
- A. Sex therapy
- B. Testosterone
- C. Yohimbine
- D. Sildenafil
Correct Answer: B
Rationale: Testosterone therapy should be considered first if a deficiency is identified, as low testosterone can contribute to erectile dysfunction.
George Hall is a 91-year-old man. If the physician agrees with his daughter and does not inform George of bad news, which ethical principle might this violate?
- A. Paternalism
- B. Autonomy
- C. Authenticity
- D. None of the above
Correct Answer: B
Rationale: Autonomy is violated when the patient is not informed about his medical condition.