John is a 16-year-old boy who presents to the emergency room after hurting his 

knee in a football game. He described twisting his knee and then being unable to 

extend it completely. John tells the clinician that he heard a pop when the injury 

occurred and has been experiencing localized pain. The clinician suspects a 

meniscal tear. Which test would be most appropriate to assess for the presence of a 

meniscal tear?

a. valgus stress test

b. McMurray circumduction test

c. Lachman's test

d. Varus stress test

b. McMurray circumduction test

Your patient has decided to give Chantix a try to quit smoking. You are discussing 

his quit date, and he will begin taking the medication starting tomorrow. When 

should he plan to quit smoking?

a. he should stop smoking today

b. he should stop smoking tomorrow

c. his quit date should be in one week

d. he will be ready to quit after the first 30 days

c. his quit date should be in one week

Janet is a 30-year-old woman who has been recently diagnosed with a herniated 

disc at the level of L5-S1. She is currently in the emergency room with suspicion

of cauda equna compression. Which of the following is a sign or symptom of 

cauda equina compression?

a. gastrocnemius weakness

b. reduced or absent ankle refles

c. numbness of the lateral foot

d. paresthesia of the perineum and buttocks

d. paresthesia of the perineum and buttocks

The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's 

Criteria. In order to plan care, the clinician understands that this criteria score has 

which of the following meanings?

a. a high mortality rate

b. an increased chance of recurrence

c. 7% chance of the disease becoming chronic

d. all of the above

a. a high mortality rate

Reuben, age 24, has HIV and just had a routine viral load test done. The results 

show a falling viral load What does this indicate

a. a favorable diagnostic trend

b. disease progression

c. the need to be more aggressive with Reuben's medications

d. the eradication of the HIV

a. a favorable diagnostic trend

Which is the differentiating symptom between labyrinthitis and vestibular neuritis?

a. symptoms with vestibular neuritis are usually acute in onset, whereas with 

labyrinthitis the onet is more gradual

b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis

c. symptoms with labyrinthitis are usually acute in onset, ,whereas with vesticular 

neuritis the onset is more gradual

d. hearing loss may be associated with labyrinthitis ,but not with vestibular 

neuritis.

d. hearing loss may be associated with labyrinthitis ,but not with vestibular 

neuritis.

A 27 year old female presents with a chief complaint of burning and pain on 

urination. She has no previous history of urinary tract infection. what are some 

additional symptoms consistant with a diagnosis of lower UTI?

a. back and abdominal pain

b. fever, chills, costovertebral angle (CVA) tenderness

c. blood in urine and frequency

d. foul-smelling discharge, perineal itch

c. blood in urine and frequency

The differential diagnosis for vertigo can be classified into which of the following 

categories:

a. peripheral vestibular disease

b. CNS disorders

c. Systemic disorders

d. all of the above

d. all of the above

Sam is a 25-year-old man who has been diagnosed with low back strain based on 

his history of localized low back pain and muscle spasm along with a normal 

neurological examination. As the clinician, you explain to Sam that low back pain 

is a diagnosis of exclusion. Which of the following symptoms would alert the 

clinician to the more serious finding of a herniated nucleus pulposus or ruptured 

disc?

a. morning stiffness and limited mobility of the lumbar spine

b. unilateral radicular pain symptoms that extend below the knee and are equal to 

or greater than the back pain

c. Fever, chills, and elevated erythrocyte sedimentation rate

d. pathologic fractures, severe night pain, weight loss and fatigue

b. unilateral radicular pain symptoms that extend below the knee and are equal to 

or greater than the back pain

Preceptors must always see the patients that the students see in the clinical setting

a. true

b. false

a. true

An 82 year old man is seen in the primary care office with complaints of dribbling 

urine and difficulty starting his stream. Which of the following should be included 

in the list of differentials?

a. BPH

b. Prostate cancer

c. UTI

d. all of the above

d. all of the above


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