1. A 22-year-old female comes to your office with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours. On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of Digital rectal examination Endoscopy Pelvic examination UrinalysisDefinition 2. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients? Clinical practice guideline Clinical decision rule Clinical algorithm Clinical recommendation 3. A common auscultatory finding in advanced CHF is S3 gallop rhythm 4. Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history of an appendectomy, presenting with an acute onset of significant right upper-quadrant abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain seems to radiate to his back. Despite a family history of cardiac disease, he reports no classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight loss. Finally, there are no dermatologic signs, nor genitourinary symptoms. The chosen imaging study reveals: “GB normal in size without wall-thickening, but with 5-6 stones with shadowing. Common bile duct not dilated. Liver is homogenous and normal in size. Pancreas and kidneys are normal.” What is the most effective therapeutic/management option at this point? chole 5. A patient complains of fever, fatigue, and pharyngitis. On physical examination there is pronounced cervical lymphadenopathy. Which of the following diagnostic tests should be considered? Mono spot Strep test Throat culture All of the above 6. Which of the following is not a contributing factor to the development of esophagitis in older adults? 7. Essential parts of a health history include all of the following except: 8. What test is used to confirm the diagnosis of appendicitis? 9. The first assessment to complete related to the eyes is Eye lids Visual acuity Extraocular movements Peripheral vision 10. The best way to diagnose structural heart disease/dysfunction non-invasively is Chest X-ray EKG CORRECT Echocardiogram Heart catheterization 11. Which of the following is considered a “red flag” when diagnosing a patient with pneumonia Fever of 102 Infiltrates on chest X-ray Pleural effusion on chest X-ray Elevated white blood cell count 12. In a patient presenting with suspected recurrence of diverticulitis, abdominal pain usually presents where in the abdomen? Left upper quadrant Right upper quadrant Left lower quadrant Right lower quadrant 13. Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to his back. He was mowing his lawn. He reports the pain lasting for about 8 minutes and went away after sitting down. What is his most likely diagnosis based on his presenting symptoms Acute MI GERD Pneumonia Angina 14. In autosomal recessive (AR) disorders, individuals need Only one mutated gene on the sex chromosomes to acquire the disease Only one mutated gene to acquire the disease Two mutated genes to acquire the disease Two mutated genes to become carriers 15. Susan P., a 60-year-old woman with a 30 pack year history, presents to your primary care practice for evaluation of a persistent, daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “I have the same thing, year after year.” Which of the following choices would you consider strongly in your critical thinking process? chronic bronichitis 16. The best evidence rating drugs to consider in a post myocardial infarction patient include: ASA, ACE/ARB, beta-blocker, aldosterone blockade ACE, ARB, Calcium channel blocker, ASA Long-acting nitrates, warfarin, ACE, and ARB ASA, clopidogrel, nitrates 17. A 76-year-old patient with a 200-pack year smoking history presents with complaints of chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2 months. The physical exam reveals decreased breath sounds and dullness to percussion over the left lower lung field. The chest X-ray demonstrates shift of the mediastinum and trachea to the left. These are classic signs of: Lung cancer Tuberculosis Pneumonia COPD