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Multiple Choice Questions (MCQ)

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Category: Medicine--->General Medicine and Prevention
Page: 2

Question 6#Print Question

A 58-year-old man who smokes cigarettes has a history of hypertension and asks about reducing his risk for myocardial infarction. A lipid profile shows low HDL cholesterol at 32 mg/dL.

Which of the following is an important recommendation in attempting to raise the HDL? 

a. Aspirin, 325 mg each day
b. Low-cholesterol diet
c. Vitamin E, 400 units each day
d. DHEA (dehydroepiandrosterone) supplementation
e. Exercise and smoking cessation


Question 7#Print Question

You are the primary care physician for a 78-year-old man with severe dementia, coronary artery disease, COPD, hyperlipidemia, and HTN. He takes hydrochlorothiazide, lisinopril, metoprolol, aspirin, simvastatin, and tiotropium as well as oxygen at 2 L/minute. The patient no longer recognizes his wife or other family members and requires total care at a nursing home facility. The wife approaches you stating that her husband never wanted to live like this and asks you to stop all of his medications including the oxygen and enroll him in hospice for comfort care. The patient’s living will states that his wife is to make decisions if he becomes incapacitated. The patient’s two grown children object to this plan and ask you to continue all current medications.

What is the appropriate next step? 

a. Hold a family conference and explain that you will need to stop all medications and enroll the patient in hospice as per the wife’s expressed wishes as she legally has the power of attorney
b. Continue all medications and follow the wishes of the children while explaining to the wife that a majority of the family desires this course of action
c. Request an ethics consult to evaluate the situation
d. Attempt to negotiate with all of the family members some middle ground course of action such as stopping all medications except the oxygen
e. Advise the family that if they cannot come to an agreement that they will need to find a new primary care physician


Question 8#Print Question

A 42-year-old banker sees you as a new patient. He states that he is healthy and takes no regular medications. His examination is normal except for a blood pressure of 150/94. When questioning him about alcohol use, he admits that he goes out drinking with friends about two Saturdays each month to relieve stress. At these times he will often have 8 to 10 mixed alcohol drinks. He and his wife have recently had several arguments about this habit, and she has threatened to divorce him if he doesn’t change his ways. Despite this, he has been unable to change. On one occasion he was arrested for driving while intoxicated. Nonetheless, he has continued to be successfully employed, has never been hospitalized for an alcohol-related problem, and has never had symptoms of alcohol withdrawal.

Which of the following statements is true regarding treatment of this patient? 

a. Advice from a physician to reduce his alcohol consumption is likely to be successful
b. The patient should be advised that complete abstinence from alcohol and referral to a mutual aid group is the best strategy in treating his alcohol use disorder
c. Abstinence from alcohol may necessitate treatment of his blood pressure because he is currently using alcohol to treat stress
d. Medications for alcohol dependence are not usually helpful
e. The fact that this patient has had no symptoms of alcohol dependence proves that he does not abuse alcohol


Question 9#Print Question

A 32-year-old stockbroker sees you because she has felt anxious almost every day for the past 9 months. She feels “keyed up” at work. At times she has difficulty concentrating and has made several minor errors in clients’ accounts. For the past year she has frequently had trouble falling asleep at night despite the fact that she always feels tired. She does not fall asleep during the day at inopportune times. She denies substance or alcohol abuse. Her vital signs and physical examination are normal. CBC, TSH, and chemistry panel are normal.

What is the most appropriate initial treatment alternative? 

a. Long-acting benzodiazepine such as clonazepam on a regularly scheduled basis
b. Selective serotonin reuptake inhibitor (SSRI) such as fluoxetine or citalopram
c. Tricyclic antidepressant such as amitriptyline
d. Atypical antipsychotic such as olanzapine
e. Centrally acting antihypertensive such as clonidine


Question 10#Print Question

A 25-year-old PhD candidate recently traveled to Central America for 1 month to gain information regarding the socioeconomics of that region. While there, he took ciprofloxacin twice a day for 5 days for diarrhea. However, over the 2 to 3 weeks since coming home, he has continued to have occasional loose stools plus vague abdominal discomfort and bloating. There has been no rectal bleeding.

Which of the following therapies is most likely to relieve this traveler’s diarrhea? 

a. Another course of ciprofloxacin
b. Doxycycline
c. Metronidazole
d. Trimethoprim-sulfamethoxazole
e. Oral glucose-electrolyte solution




Category: Medicine--->General Medicine and Prevention
Page: 2 of 6