Nokea
Papilledema is a cause for concern because it is suggestive of:
- A. Optic atrophy
- B. Microaneurysms
- C. Increased intracranial pressure
- D. Retinal hemorrhage
Correct Answer: C
Rationale: Papilledema is caused by increased intracranial pressure, leading to swelling of the optic disc.
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Which of the following statements is true?
- A. Decision-making capacity can be determined only by a psychiatrist.
- B. A diagnosis of dementia precludes competent decision making.
- C. Lack of decision-making capacity should not be presumed if the patient goes against medical advice.
- D. Expression of a choice is sufficient to indicate decision-making capacity.
Correct Answer: C
Rationale: A patient's decision-making capacity cannot be assumed to be absent solely based on their refusal of medical advice.
Mr. B is an 82-year-old enrolled in your primary care clinic panel. His wife is his primary caregiver and feels stressed and overwhelmed. What option would be appropriate for Mr. B except:
- A. Adult day program
- B. Assisted living
- C. Skilled nursing facility
- D. In-home paid care provider
Correct Answer: C
Rationale: Skilled nursing facilities are typically for patients who require higher levels of medical care, which may not be needed for Mr. B.
A 72-year-old woman reports vaginal dryness that interferes with coitus. Her medical history includes type 2 diabetes, hypertension, and osteoarthritis. Medications are glyburide, chlorthalidone, and acetaminophen. What would be your first step in therapy?
- A. Stop glyburide
- B. Stop chlorthalidone
- C. Stop acetaminophen
- D. Start topical vaginal lubricant
Correct Answer: D
Rationale: Topical vaginal lubricants can help alleviate vaginal dryness and improve sexual function.
Headache warning signs that need prompt investigation include all of the following except:
- A. New onset after 50
- B. Aggravated or relieved by change of position
- C. Precipitated by Valsalva maneuver
- D. Headaches relieved with mild recurrent use of analgesics
Correct Answer: D
Rationale: Headaches relieved with mild, infrequent analgesic use typically don’t require urgent investigation.
A common cause of decreased libido in men is due to:
- A. Decreased blood flow in the hypogastric arterial system
- B. Endocrine dysfunction
- C. Neurologic deficit
- D. Impaired neural innervation
Correct Answer: B
Rationale: Endocrine dysfunction, particularly low testosterone, is a common cause of decreased libido in men.