Exam (elaborations)
PACKRAT EXAM QUESTIONS AND ANSWERS 2024
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PACKRAT EXAM QUESTIONS AND ANSWERS 2024
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PACKRAT EXAM66 yo female with a history of DM and HTN presents for routine evaluation. Since
beginning her ACEI and diuretic therapy her BP has averaged 135/85. What is the
next best step in management - ANSWERS-increase ACEI to achieve a BP of less
than 130/80
8 yo female presents with a 5 day history of honey crusted rash beneath her nose.
Best treatment option - ANSWERS-oral cephalexin (Keflex)
62 to male presents with a right hilar mass. Needle-biopsy of the mass reveals the
presence of small cell carcinoma and a bone scan reveals the presence of
scattered hot spots throughout the skeleton. Most appropriate treatment -
ANSWERS-combination chemotherapy
A radiograph reveals a fracture of the proximal third of the ulnar diaphysis with an
anterior dislocation of the radial head. What type of fx does this describe -
ANSWERS-Monteggia Fracture
Your pt is an 18 yo male with a family hx of MEN1. What screening electrolyte
level would you recommend - ANSWERS-calcium
The corneal light reflex is used to test for the presence of which condition -
ANSWERS-strabismus
,Which class of medications is considered first line for the treatment of panic
disorder - ANSWERS-SSRI
10 yo AA immigrant presents 2 wks after arriving in the US describing dry eyes
and difficulty with night vision. Exam reveals numerous, small white conjunctival
patches bilaterally. This pts sxs are most likely due to which deficiency -
ANSWERS-Vitamin A
13 yo pt is hopsitalized with a fever of 102.5 and a rash. After 36 hrs the rash has
rapidly progressed to enlarging macules that appear ring or crescent shaped with
central clearing. He also c/o multiple arthralgias involving his ankles, knees, and
now his elbows. The ECG shwos evidence of a first degree AV block. Labs were
significant for an elevated ESR and leukocytosis. Which PE finding is most likely -
ANSWERS-mitral regurgitation murmur
What is indicated in the treatment for a pt who presents with headache, fever,
and faint macular eruptions on the ankles and wrists with several days after
returning from a vacation in NC - ANSWERS-doxycycline (Doryx)
7 yo white male presents with a life long history of frequent and commonly
complicated, bouts of bronchiectasis and other respiratory tract infections. His
past history includes poor weight gain, low exercise endurance, and pancreatitis.
Exam reveals a barrel chest and hyperresonance to percussion while a mixed
obstructive restrictive pattern is seen on pulmonary function testing.
Peribronchial cuffing and increased interstitial markings are noted on chest
radiograph. What test would confirm - ANSWERS-sweat chloride test
,18 yo female presents with dysmenorrhea associated with nausea and diarrhea
for the last 3 years. She is not taking any medications at this time. Exam reveals a
midline, mobile, and non tender uterus of normal size. She has no cervical motion
tenderness. Most likely pathophysiology - ANSWERS-excessive prostaglandin-
induced myometrial contraction
37 yo obese, otherwise healthy female presents with c/o an enlarging painful red
mass on her left medial thigh. She had tried over the counter hydrocortisone
cream and triple antibiotic ointment without improvement. Exam reveals a 4cm,
warm, tender, fluctuant mass with surrounding erythema and no inguinal
lymphadenopathy. Most appropriate clinical intervention - ANSWERS-Incision and
drainage, wound culture and oral antibiotic therapy
35 yo male s/p PDA repair at 5 years of age, presents with low-grade fever,
fatigue, and dyspnea worsening over the past 10 days. Prior to the onset of these
sxs, he was healthy and free of any complaints. Exam is significant for petechiae
on the palate, a high pitched holo systolic murmur heard best at the apex, and
splinter hemorrhages on both hands under his fingernails. What is the most
appropriate next step in the eval of this pt - ANSWERS-echocardiogram
A pt who recently immigrated from Southeast Asia presents with a 6 month
history of weight loss, frequent cough with hemoptysis and fever. A sputum
smear is positive for acid fast bacilli. What lab tests are most important in routine
treatment of this condition - ANSWERS-AST/ALT
An asx 30 year old male with no signficant past medical history presents to the
office. He is concerned about his father being diagnosed with colon cancer at the
age of 60. Most appropriate health counseling for this pt - ANSWERS-colonoscopy
at age 40
, 44 yo male preesents as a new pt. He has a hx of HTN, RA, polycystic kidney
disease, and seasonal allergies. On review of his current meds, which agent would
you consider removeing - ANSWERS-indomethacin (indocin) - potential for renal
toxicity
23 yo male with recent URI sxs presents c/o chest pain. His pain is worse when
lying down and better sitting up and leaning forward. ECG shows widespread ST
segment elevation. Dx - ANSWERS-Pericardial friction rub
75 yo woman presents to the office with complain of vision loss. Exam reveals a
palpable cord in the temporal region. Most helpful initial test to order -
ANSWERS-ESR
Recommended LDL tor educe risk of CAD in a diabetic pt - ANSWERS-100mg/dL
What is the reason for giving IV mag sulfate to a pt with pre-eclampsia -
ANSWERS-prevention of seizure by increasing the seizure threshold
53 yo man with h/o HTN presents c/o recent 4/10 left sided chest pain with
exertion that is relieved with rest. Heart exam reveals regular rate and rhythm
with no S3, S4 or murmur. Lungs are CTA bilat. ECG reveals no acute changes.
Most appropriate initial test - ANSWERS-Nuclear Stress Test
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