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A 52-year-old male presents the emergency room concerned about 1 to 2 weeks of persistent abdominal pain in his left lower quadrant. He has noted a low grade fever, has generalized malaise and is noted a change in bowel habits over the last week. On physical examination, the patient has left lower quadrant tenderness. Rectal exam reveals generalized tenderness and no frank bleeding. Guaiac tests are positive. Which of the following is the most likely diagnosis?
An 84-year-old nursing home patient is brought to the emergency room after one week of progressively worsening diffuse abdominal pain, constipation and abdominal distention. The patient has been vomiting for the last 24 to 48 hours and is unable to eat or drink. Exam shows a patient with a markedly distended abdomen, diffuse tenderness and tympanic percussion. Auscultation finds the patient to have high pitched bowel sounds. Which of the following is the best initial diagnostic study?
A 64-year-old male with a history of long-term alcoholism and hepatitis C presents for follow-up. An increasing serum level of which of the following is most suggestive of hepatocellular carcinoma?
A 38-year-old female complains of acute right upper quadrant pain and fever. Examination reveals icteric sclera, right upper quadrant pain with light and deep palpation. Murphy sign is negative. What is the most likely diagnosis?
A 32-year-old male presents complaining of a 3 month history of alternating constipation and diarrhea with transient abdominal pain. He does note that abdominal pain, when it occurs, is relieved with defecation. The patient states he does have mucus but no blood in his stool. He has had no fevers or weight loss. Which of the following is the most likely diagnosis for this patient?
What vitamin deficiency can cause night blindness, Bitot’s spots and keratomalacia?
What vitamin deficiency can cause rickets and osteomalacia?
What vitamin deficiency can leading to spontaneous bleeding?
What vitamin deficiency can cause high output cardiac failure?
What vitamin deficiency can cause fatigue, bleeding gums and impaired wound healing?
Which of the following is a complication of ulcerative colitis?
Which of the following is characteristic of moderate ulcerative colitis (UC)?
A 32-year-old male presents to the emergency department with severe upper abdominal pain, nausea, and vomiting. It started suddenly while he was watching football at a bar with friends. He admits to drinking a “few” beers and eating spicy chicken wings. Included in your differential diagnoses for this patient is acute pancreatitis. If this is the diagnosis, what findings would you expect on lab results?
Which of the following is not an extraintestinal manifestation of inflammatory bowel disease?
Which of the following statements is true regarding diverticular disease?
Which of the following is the most common cause of acute lower gastrointestinal bleeding?
A 52-year-old postmenopausal woman arrives at the office complaining of intermittent, painless rectal bleeding and vague complaints of rectal discomfort associated with defecation for 6 weeks. The rectal bleeding varies from spots of bright red blood on the toilet paper to drips of red blood after a bowel movement. Physical examination discloses a small nonbleeding external hemorrhoid. Significant laboratory findings include a hemoglobin level of 11.8. Which of the following would be the appropriate next step?
Which of the following symptoms or signs is/are most consistent with the clinical presentation of viral hepatitis A?
A patient has the following hepatitis B profile results: HBsAg is negative; anti-HBs is negative; anti-HBc IgM is positive; HBeAg is negative; and anti-HBe is negative. This serologic pattern is consistent with which of the following?
A 39-year-old college algebra teacher is seen in the office after learning that one of her students is out sick with hepatitis A. She admits to only casual contact with the student. She is concerned that she may be at risk of for developing the disease. Which of the following is appropriate advice for the patient?
A 44-year-old slightly overweight man comes to the office complaining of numbness of the skin on his arms, back, and buttocks; tremors in his hands; double vision; and cognitive problems, such as short-term memory loss. The patient reports no other medical problems and states he is “usually healthy as a horse.” During the interview, you learn the patient has been dieting for three months, and eats a lot of fish and salads. When questioned further, the patient states that he eats some type of fish daily, including salmon, tuna, and swordfish, and some freshwater fish such as mackerel. Based on this information, what is the most likely diagnosis?
A 51-year-old male comes to the office for a physical exam. He asks you whether he needs a colonoscopy, and how often he should have one. He states that he has no first-degree relatives with colon cancer or other risk factors. His overall health is good. What do you tell him?
Oral rehydration salts (ORS), used to prevent dehydration in patients experiencing diarrhea, include sugar and salt in specific proportions because:
A hydrogen breath test is the easiest and most reliable method to diagnose which of the following disorders?
Individuals who suffer from phenylketonuria should avoid a diet rich in which of the following substances?
Fecal impaction may result from overuse of which of the following over-the-counter medications?
An 80-year-old male with a history of coronary-bypass graft surgery presents with abdominal pain that occurs within 30 minutes after eating. The pain only subsides after the patient lies down. Abdominal X-ray reveals colonic dilatation. Abdominal angiography was positive for chronic mesenteric ischemia. Which of the following procedures would you perform in order to correct this disorder?
Which of the following medical signs is an indication of acute appendicitis wherein pressure on the left lower quadrant of the abdomen causes pain in the right lower quadrant of the abdomen?
A 44-year-old male presents with a long history of heartburn, chest pain, and regurgitation. His symptoms are relieved with the administration of antacids. Electrocardiogram shows normal sinus rhythm with no S-T segment abnormalities. Based on the patient’s presentation and physical examination, which of the following is the most appropriate diagnosis?
A 42-year-old male presents with diarrhea, abdominal cramps, tenesmus, fever, chills, and headache. Stools are mixed with blood and mucous. Physical examination reveals a tender abdomen. Stool examination is positive for white blood cells and red blood cells. Sigmoidoscopy reveals inflamed, engorged mucosa. Based on the patient’s presentation, physical examination, and test results, which of the following is the most appropriate diagnosis?