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3P Clinical Analysis Practice Exam With Answers (162 Solved Questions)

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    3P Exam Study 1 / 14 1. What would cause decrease in Digoxin levels: Antacids 2. Taking Pyridium for UTI, what can Pyridium cause?: Hemolytic Anemia 3. What can PCOS result in?: increased insulin levels, Androgens, hirsutism 4. What is a hypertensive used in pregnancy: Methyldopa 5. What is a characteristic of Placenta Previa?: painless red bleeding 6. What is a characteristic of Rheumatoid arthritis ?: Red hot joints 7. Medications that cause ototoxicity: Aminoglycosides, nasal decongestants, antihistamines 8. Treatment period for enterobiasis: 2 weeks 9. CBC Interpretation: MCV - mean corpuscular volume help diagnose different types of anemia (High=macrocytic like B12, Low=microcytic like Fe anemia) 10. Rhogham given at how many weeks gestation?: 27 weeks 11. Janesway lesions: Happen with endocarditis, non painful lesions seen on hands and feet, Osler same but painful 12. Warfarin management - forgot a dose?: If under 12 hours take missed dose, if over skip and need INR redraw 13. Taking an ACE or ARB what to know?: ACE (dry hacking) cough starts 1-2 weeks after med started, ACE (Lol) ARB (sartan) first line in HTN avoid initially in african americans, angioedema can occur 14. Contraindication for hydrochlorithiazide: sulfa allergy, asthma, PCN hyper- sensitvity 15. Murmurs Systolic: MR=Mitral regurge (SOB/Fatigue HF) Peyton Manning=phys murmur (asymptomatic) AS=Aortic Stenosis (Angina, syncope HF) MVP=Mitral valve prolapse (palps, CP, "click") 16. Diastolic Murmurs (ABnormal): AR= Aortic Regurge (angina, HF, dizzinness, CP) MS=Mitral stenosis (Dyspnea, Afib) 17. Motivated: Systole-S1 closure of AV Mitral/tricuspid valve (lub) Mitral, Tricuspid, atrioventricular valves 18. Apples: Diastole s2 closure of the aortic pulmonic valves (dub) aortic pulmonic semilunar

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    2 / 14 19. Abnormal (extra) heart sounds: S3- CHF; possible normal for adolescent athletes, S4 LVH poorly controlled HTN, unstable angina 20. Assessment of PAD: antiplatelets (Plavix, ASA), Pentoxifylline (decreases blood viscosity) to treat, ankle brachial index to check, angiography gold standard to diagnose 21. Coronary artery Disease tx: Atorvastatin/rovustatin- use high dose meds for LDL>150, watch for LFTs and arthralgia. Change type and dose if problems. Stabilization of plaque with statins 22. HF treatment: ACEI, ARB, or ARNI with BB and aldosterone receptor antag- onist 23. Scabies Treatment (Sarcopter Scabiei): Topical Permethrin massaged from head to soles of feet and wach off with shower or bath after 8-14 hours. Treat again in 1 week 24. Names of skin findings: Macule; freckle <1 cm, Papule Macule >1 cm chloas- ma, Papule <0.5cm elevated nevi (molluscum wart), Plaque (psoriasis, lichen planus), Nodule 0.5-2 cm lipoma, vesicle (herpes simplex contact derm, 25. Keloid: hypertrophic scar that is invasive beyond point of original injury 26. Skin continued: Bulla-second degree burn, friction burn Wheal- raised, mosquito bite, hive Scales;dandruff Crusts-scab from abrasian, impetigo 27. Tinea: Fungal infections; Tinea capitis-round patchy scales on scalp (cradle cap) treatment Grisefulvin take with high fat meal 4-6 weeks 500 mg tinea corporis -red and scaly plaque on trunk (ring worm) Treatment is an azole for 2 weeks 28. Melanoma How do you assess: ABCDE Asymmetry, border, color, diameter >6 mm, elevation 29. Psoriasis: silvery white scales, nails are pitted; positive Auspitz sign- pinpoint bleeding occurs when lesions are scraped 30. Shingles (Herpes Zoster): Unilateral dermatomal rash- painful as it progress- es to vesicles, Acyclovir within 48-72 hours or symptoms. May only transmit chickenpox virus to susceptible patients that have not gotten exposed or vaccinated yet. Post herpetic neuralgia pain is longer than 1 month after rash has resolved.

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    3 / 14 31. Contact dermatitis: papules or vesicles 5mm or less, scaling, crusting, oozing. Tx corticosteroids/antihistamines 32. Acne Vulgaris: Inflamm disorder where androgen-dependent sebaceous glands produce excess sebum. Areas most commonly affected are face, anterior and posterior chest, arms and shoulders. Treatment: Erythromycin/Benzyl perox- ide=limit exposure to sunlight peroxide can decrease resistance to erythromycin 33. Atopic dermatitis: Patchy plaque like rash with inflammation. common in people with other atopic illnesses (asthma, allergic rhinitis) 34. Eye Findings in HTN and DM: AV nicking-arteries indent and displace veins, cotton wool spots-gradual vision loss, flame hemorrhages- blot and dot hemor- rhages 35. Tx of acute sinusitis in adults and pediatrics: Viral symptomatic tx only, is bacterial- amoxicillin first line symptoms>10 days purulent nasal discharge, fever, unilateral face or tooth pain 36. Snellen test: Test for visual acuity; CN II 37. What medications can cause ototoxicity: Aminoglycosides (tx otitis externa) , loop diuretics, quinine, ASA 38. Rhinitis: Eosinophils due to WORMS, wheezes, weird diseases. Most effective tx for allergic rhinitis- Fluticasone Flonase 39. Acute bacterial rhinosinusitis: For empiric tx of patients with acute bacterial rhinosinusitis who are allergic to penicillin, the best alternative first line therapy is Doxycycline 40. Which immunoglobulin is responisble for the symptoms in the patient with allergic rhinitis?: IgE 41. Assessment of a 4 year old visual acuity resulted in 20/30 in L eye and 20/40 in R eye.: Means vision is normal for his age, 20/20 vision at 6 years old 42. Distinctive feature of cataracts: Absent red reflex 43. Meclizine: Given for patients who present with Positional vertigo 44. Pterygium: growth on conjunctiva of fleshy tissue, sx redness, swelling, yellow spot or bump dry itchy like sand in eye 45. Eye emergencies: papillaedema (increase ICP, swollen optic disc engorged tortuous retinal veins), Acute closed angle glaucoma is unilateral eye pain rapid onset and loss of vision

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    4 / 14 46. Presentation with foreign body in eye: only remove with wet cotton swab if not able to send to opthamologist 47. Meniere's Disease: A 45 year old patient complains of vertigo, tinitus, and pressure in the right ear 48. Hyperopia: Light that is focused behind the retina causes the visual distur- bance 49. Mononuleosis: Most commonly caused by EBV can be passed sexually 50. Which medication is most commonly associated with hypoglycemia: Gly- buride 51. How does myxedema present and what is its indicative of: found in patients with hypothyroid, hypothermia, thickening of the tongue, and disorientation 52. Assessment findings PCOS: Hirsutism, hyperinsulinemia, elevated lipids, abnormal hair, acne 53. Assessment finding and RX for hyperthyroidism: M/C cause is Graves' disease, finding include tachyC, Afib, weight loss, hyperactivity, warm, moist skin, flushed 54. Hyperprolactinemia: Menstrual dysfunction, ED, pain in breast, loss of libido, lactation, vaginal dryness, infertility 55. Hyperandrogenism: High levels of Androgens in females, sx include acne, seborrhea, hair loss on scalp, increased body or facial hair, infrequent or absent menstruation, Can be caused by PCOS 56. DM: A1c over 6.5 or fasting glucose over 126, initiate Metformin at initial diagnosis 57. Assessment of neuropathy: In distal lower extremities, long effect of hyper- glycemia, paresthesias and burning 58. Treatment and Presentation of Giardiasis: Foul smelling stools, abdominal pain, flatulence spread fecal-oral route. Tx is Metronidazole 250 mg TID 59. Presentation and assessment of Cirrhosis: Coagulopathy, variceal bleed, hepatic encephalopathy, extrahepatic sx- neuro, psychiatric, arthralgia, autoim- mune disorders, glucose intolerance. Pt early stage of cirrhosis likely to have thrombocytopenia 60. Assessment of Hepatitis: Malaise, fever, jaundice, fatigue, weight loss, joint pain, dark urine, RUQ pain, liver enlargement, pancytopenia. Elevated ALT/AST, bili, alk phos

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