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44) A 28 year old male patient comes to you for help. He has just gotten his first full-time computer programming job. He's enjoying working in Silicon Valley. The only problem is that he's started to develop headaches and it makes it hard for him to concentrate. You ask him how many hours a day he's staring at his computer screen and he explains anywhere from 16 to 20 hours a day. You ask if he can cut back on this at all, but he says that he can't because of a big project push. The deadline is coming up in the next two weeks. For now, he has to do something about his headache and he can't use any of the painkillers that the doctor gave him because they make him too woosy. You ask him about his symptoms and he says that it is a steady, aching, and dull headache that comes on gradually. It will last anywhere from all day to only a few hours. It gets better with sleep and is better after taking breaks and getting up and away from his computer. The last comment he makes is that he has an odd sandy like sensation in his eyes. Where is his headache most likely located?
A) Around and over the eyes, may radiate to the occipital area
B) Usually bilateral; may be generalized or localized to the back of the head and upper neck or to the front temporal area
C) One-sided; high in the nose, and behind and over the eye
D) In and around one eye
A) Around and over the eyes, may radiate to the occipital area
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100) A 37 year old female patient comes to you for help. She's been having a very hard time sleeping. About 3 to 4 times a week she's been experiencing headaches a few hours after falling asleep that will wake her up and they will last about an hour. Then it is impossible for her to fall back asleep. She's also been experiencing a stuffy nose on her right side and a reddening and tearing of the eye. Where is her headache most likely located?
A) Usually bilateral; may be generalized or localized to the back of the head and upper neck or to the front temporal area
B) Around and over the eyes, may radiate to the occipital area
C) One-sided; high in the nose, and behind and over the eye
D) Typically frontal or temporal, one or both sides, but may be occipital or generalized
C) One-sided; high in the nose, and behind and over the eye
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177) A patient comes to you wondering if there is anything you can do to help them with their allergic skin reaction. They have had an eruption of pale red elevated patches. What is their condition called?
A) Urticaria
B) Vitiligo
C) Keratosis
D) Tinea
A) Urticaria
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2) A patient has been diagnosed with an aneurysm, what does this mean?
A) A mass of undissolved matter that circulates until it becomes lodged in a vessel.
B) A lack of a steady rhythm that can be considered too fast, too slow, regular or irregular.
C) The sound that blood makes as it rushes past an obstruction in an artery.
D) They have a blood-filled, localized dilation of a blood vessel caused by a weakening of a vessel wall, usually an artery.
D) They have a blood-filled, localized dilation of a blood vessel caused by a weakening of a vessel wall, usually an artery.
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158) A patient presents with a barrel-chest appearance. They have been a smoker for over 30 years. It is easier for them to breathe when standing or sitting up. Which one of the following do they most likely have?
A) Lung Cancer
B) Emphysema
C) Chronic Bronchitis
D) Chronic Pheumonitis
B) Emphysema
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18) A patient presents with a resonant barking cough along with difficulty breathing, what does this most likely indicate?
A) Extravascular fluid accumulation in lung tissues and alveoli.
B) Inflammation of the pleural membrane.
C) Deficiency of oxygen in the blood.
D) Inflammation of the larynx, trachea, and bronchial passage.
D) Inflammation of the larynx, trachea, and bronchial passage.
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5) A patient presents with a swollen face, a buffalo hump, and depression of the immune system and inflammatory responses. Which one of the following do you suspect?
A) Hypothyroidism
B) Addison's Disease
C) Cushing's Disease
D) Hyperthyroidism
C) Cushing's Disease
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121) A patient presents with bleeding due to deficiency of prothrombin and other factors. What is the function and where can you find the vitamin this patient is deficient in?
A) Maturation of RBCs, neural functions, DNA synthesis, myelin synthesis and repair and found in bacteria in the GI tract after the neonatal period.
B) Formation of prothrombin, other coagulation factors, and bone proteins and bacteria in the GI tract after the neonatal period.
C) Carnitine, hormone, amino acid formation, and mineralization and repair of bone and found in green leafy vegetables (especially collards, spinach, and salad greens), soy beans, and vegetable oils.
D) Maturation of RBCs, synthesis of purines, pyrimidines, and methionine and found in green leafy vegetables (especially collards, spinach, and salad greens), soy beans, and vegetable oils.
B) Formation of prothrombin, other coagulation factors, and bone proteins and bacteria in the GI tract after the neonatal period.
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39) A patient presents with fever, chills, headache, generalized muscle pain, loss of appetite, and they recovered in about 7 to 10 days. What did they most likely have?
A) Pneumonia
B) Common Cold
C) Bronchitis
D) Influenza
D) Influenza
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159) A patient presents with fever, cramping, diarrhea, and weight loss. Cancer has been ruled out. What do you suspect they have?
A) Irritable Bowel Syndrome
B) Diverticulosis
C) Ulcerative Colitis
D) Crohn's Disease
D) Crohn's Disease
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33) A patient presents with finger clubbing. With what is this usually associated?
A) Pulmonary disease
B) Pneumoconiosis
C) Pertussis
D) Obstruction due to secretions, mucosal secretions, and tumor tissue.
A) Pulmonary disease
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139) A patient presents with pain in the lower left quadrant, extreme constipation or diarrhea, fever, abdominal swelling, and occasional blood in the bowel movements. Cancer has been ruled out. Based on these symptoms, what do you suspect they have?
A) Appendicitis
B) Irritable Bowel Syndrome
C) Diverticulosis
D) Chron's disease
C) Diverticulosis
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172) A patient presents with profuse, watery diarrhea containing varying amounts of blood, mucus, and pus. Because they have this condition, what is their risk of colon cancer?
A) There is no way to tell what their colon cancer risk is.
B) Their risk of colon cancer is no different based on this condition.
C) They have a higher risk of colon cancer.
D) They have a lower risk of colon cancer.
C) They have a higher risk of colon cancer.
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124) A patient tells you that they have steatorrhea, what does this mean?
A) That they have passage of fat in large amounts in the feces due to failure to digest and absorb.
B) That they have passage of dark-colored, tarry stools., due to the presence of blood altered by intestinal juices.
C) That they are experiencing bloody diarrhea from ingesting water or food that contains chemical irritants, bacteria, protozoa, or parasites.
D) That they are experiencing abdominal pain, altered bowel function with constipation and diarrhea or both alternating.
A) That they have passage of fat in large amounts in the feces due to failure to digest and absorb.
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75) A patient tells you that they their cancer is Stage III. Which one of the following best describes what this means?
A) That their cancer has some degree of lymph node involvement.
B) That their cancer has evidence of metastasis.
C) That their tumor is large with extensive local invasion into surrounding tissues.
D) That there is no invasion of other tissues involved
A) That their cancer has some degree of lymph node involvement.
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79) Acute inflammation may be present with knobby swellings around the joints that sometimes ulcerate and discharge white chalklike urates is found in which one of the following kinds of arthritis?
A) Acute Rheumatoid Arthritis
B) Osteoarthritis
C) Chronic Tophaceous Gout
D) Chronic Rheumatoid Arthritis
C) Chronic Tophaceous Gout
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24) After needling one of your patients they start to experience headache, nausea, vomiting, and disorientation. This may be the first indications for which one of the following?
A) Puncturing the Medulla Oblongata
B) Puncturing the Spinal Cord
C) Puncturing the Stomach
D) Puncturing the Perineum
A) Puncturing the Medulla Oblongata
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30) All of the following are conditions where sensitivity of local nerves may be diminished, and therefore moxa should be used very cautiously, except:
A) Pathology resulting in paralysis
B) Neural injury
C) Parkinson's Disease
D) Diabetes
C) Parkinson's Disease
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79) All of the following are considered to be the three major disorders included in COPD except:
A) Chronic Bronchitis
B) Emphysema
C) Asthma
D) Pneumonia
D) Pneumonia
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70) All of the following hormones are secreted by the Anterior Pituitary except:
A) Adrenocorticotropic Hormone
B) Melanocyte Stimulating Hormone
C) Antidiuretic Hormone
D) Luteinizing Hormone
C) Antidiuretic Hormone
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48) All of the following statements about cartilaginous joints are true EXCEPT:
A) Center of each disc is the nucleus pulposus, fibrocartilaginous material that serves as a cushion or shock absorber between any bony surface
B) Fibrocartilaginous discs separate the bony surfaces
C) Bones are almost in direct contact, and this allows for no appreciable movement
D) They are slightly moveable,
C) Bones are almost in direct contact, and this allows for no appreciable movement
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18) Cupping at LI-15 is good for which one of the following conditions?
A) Vomiting
B) Neurodermatitis
C) Rheumatoid Arthritis
D) Supraspinatus tendonitis
D) Supraspinatus tendonitis
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188) For which one of the following would you suspect abuse?
A) If your patient presents with cellulitis over large areas of their body.
B) If your patient presents with ecchymosis over large areas of their body.
C) If your patient presents with petechia over large areas of their body.
D) If your patient presents with erythema over large areas of their body.
B) If your patient presents with ecchymosis over large areas of their body.
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3) Good range of motion in all joints. Hand with degenerative changes of Heberden's nodes at the distal interphalangeal joints, Bouchard's nodes at proximal interphalangeal joints. Mild pain with flexion, extension, and rotation of both hips. Good range of motion in the knees, with moderate crepitus; no effusion but boggy synovium and osteophytes along the tibiofemoral joint line bilaterally. Suggests?
A) Osteoarthritis
B) Gonococcal arthritis
C) Rheumatoid Arthritis
D) Gout
A) Osteoarthritis
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91) Hemifacial spasm refers to unilateral painless, synchronous contractions of facial muscles due to dysfunction of which one of the following cranial nerves?
A) CN VI
B) CN IV
C) CN VII
D) CN V
C) CN VII
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83) In a patient with joint pain, fever, chills, warmth, and redness, you should consider all of the following except:
A) Septic arthritis
B) Rheumatic fever
C) Gout
D) Osteoarthritis
D) Osteoarthritis
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29) In clinic, cupping is specifically mentioned to treat what kinds of Lung diseases?
A) Bronchitis
B) Pneumonia
C) Asthma
D) Emphysema
C) Asthma
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24) Joint disorder with a butterfly rash on the cheeks suggests:
A) Degenerative joint disease
B) Lyme disease
C) Reiter's syndrome
D) Systemic Lupus Erythematosus
D) Systemic Lupus Erythematosus
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61) Joint disorder with mental status change, facial or other weakness, and a stiff neck suggests which one of the following:
A) Lyme disease with central nervous system involvement
B) Systemic Lupus Erythematosus
C) Scleroderma
D) Bell's Palsy
A) Lyme disease with central nervous system involvement
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17) Joint disorder with proceeding sore throat suggests:
A) Reiter's syndrome
B) Behcet's syndrome
C) Gonococcal arthritis
D) Acute rheumatic fever
- C) Gonococcal arthritis
- &
- D) Acute rheumatic fever
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92) Ligamentous laxity of the ACL indicates:
A) Rheumatoid Arthritis
B) Knee trauma
C) Osteoarthritis
D) Postmenopausal osteoporosis
B) Knee trauma
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14) What does rale mean?
A) A high-pitched sound due to turbulent air flow in the upper airway.
B) It is a crackle; an abnormal respiratory sound heard on auscultation.
C) Breathing sounds like snoring/rattling that indicates there is an obstruction due to secretions, mucosal secretions, or tumor tissue.
D) Whistling or sighing sound that is characteristic of asthma, croup, and hay fever.
B) It is a crackle; an abnormal respiratory sound heard on auscultation.
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23) Stiffness and limited motion after inactivity, sometimes called gelling, but only lasts a few minutes
suggests:
A) Degenerative joint disease
B) Systemic Lupus Erythematosus
C) Osteoarthritis
D) Reiter's syndrome
A) Degenerative joint disease
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85) Subcutaneous nodules are found in all of the following except:
A) Osteoarthritis
B) Rheumatoid arthritis
C) Effusions in trauma
D) Rheumatic fever
A) Osteoarthritis
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19) The closure of what valve produces the second heart sound?
A) Tricuspid
B) Aortic
C) Pulmonic
D) Mitral
B) Aortic
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48) The dub sound of the heart is produced by the closing of which one of the following?
A) Tricuspid valves
B) Bicuspid valves
C) Semilunar valves at the end of ventricular systole
D) Semilunar valves at the start of ventricular systole
D) Semilunar valves at the start of ventricular systole
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61) What are the early signs and symptoms of Hepatitis B?
A) Mild fl-like signs and symptoms, fever (in 60% of cases), general malaise, insidious onset of anorexia and abdominal pain. Chills, nausea, joint pains, rash and diarrhea.
B) Febrile illness resembling mononucleosis or influenza which resolves spontaneously and which many people do not note as significant at the time.
C) Fever, malaise, body aches, maculopapular rash, lymphadenopathy, and headache
D) Persistent fever, night sweats, rapid, unexplained loss of weight and chronic diarrhea
A) Mild fl-like signs and symptoms, fever (in 60% of cases), general malaise, insidious onset of anorexia and abdominal pain. Chills, nausea, joint pains, rash and diarrhea.
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40) What does the adrenal medulla secrete?
A) Norepinephrine only
B) Epinephrine and Norepinephrine
C) Melatonin
D) Epinephrine only
B) Epinephrine and Norepinephrine
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144) What is the yellow product formed when erythrocytes are destroyed?
A) Hemoglobin
B) Bilirubin
C) Hematocrit
D) Jaundice
B) Bilirubin
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103) What type of Influenza is very strong and causes worldwide epidemics that occur every 2 to 3 years?
A) Influenza Type B
B) Influenza Type A
C) Influenza Type C
D) Influenza Type D
B) Influenza Type A
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92) When coronary arteries are unable to deliver sufficient oxygen, localized areas of the heart experience which one of the following?
A) Coronary atherosclerosis
B) Arteriosclerosis
C) Ischemia
D) Myocardial Infarction
C) Ischemia
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141) Which one of the following conditions commonly begins in the rectum or sigmoid colon and extends upwards into the entire colon?
A) Chron's Disease
B) Irritable Bowel Syndrome
C) Ulcerative Colitis
D) Diverticulosis
C) Ulcerative Colitis
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90) Which one of the following conditions describes Polymyalgia Rheumatica?
A) Gradual onset of pain with recurrent attacks with swelling present as tophi, in joints, bursae, and subcutaneous tissues
B) Sudden, onset of pain often at night, often after injury, surgery, fasting, or excessive food or alcohol intake
C) Pain is usually insidious, slowly progressive, with temporary exacerbations after periods of overuse, swelling with small effusions in the joints may be present, especially in the knees; also bony enlargements
D) Insidious or abrupt onset of pain, even appearing overnight, chronic but self-limiting, and muscles are often tender, but not warm or red.
D) Insidious or abrupt onset of pain, even appearing overnight, chronic but self-limiting, and muscles are often tender, but not warm or red.
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93) Which one of the following conditions impairs the superior oblique muscle, causing paresis of vertical gaze, main in adduction?
A) Seventh cranial nerve palsy
B) Fourth cranial nerve palsy
C) Sixth cranial nerve palsy
D) Third cranial nerve palsy
B) Fourth cranial nerve palsy
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132) Which one of the following describes the characteristics of a Second degree burn?
A) Epidermis and dermis are destroyed, ulcerating wounds develop, and scar tissue forms.
B) Only the epidermis is damaged, and it is characterized by erythema and hyperesthesia.
C) Both epidermis and dermis are destroyed, some underlying connective tissue is damaged, skin is waxy and charred, and there is insensitivity to touch.
D) Epidermis and part of the dermis is damages, formation of fluid filled blisters, recovery is usually slow, but complete with no scar formation.
D) Epidermis and part of the dermis is damages, formation of fluid filled blisters, recovery is usually slow, but complete with no scar formation.
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83) Which one of the following disorders has decreased elasticity of the alveoli where they cannot contract to their original size causing air to become trapped and causing a barrel chested appearance?
A) Chronic Obstructive Pulmonary Disease
B) Pneumonia
C) Emphysema
D) Chronic Bronchitis
C) Emphysema
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126) Which one of the following glands secretes melatonin?
A) Pineal Gland
B) Anterior Pituitary
C) Zona Glomerulosa
D) Posterior Pituitary
A) Pineal Gland
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47) Which one of the following hormones induces contraction of the smooth muscles or reproductive organs in both males and females and signals the uterus to contract and thus expelling the infant during childbirth?
A) Antidiuretic Hormone
B) Prolactin
C) Oxytocin
D) Progesterone
C) Oxytocin
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31) Which one of the following is an ultrasound technique used to detect and measure blood-flow velocity and direction through the cardiac chambers, valves, and peripheral vessels by reflecting sound waves off moving blood cells?
A) Fluoroscopy
B) Single Photon Emission Computed Tomography (SPECT)
C) Doppler
D) Positron Emission Tomography
C) Doppler
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51) Which one of the following is due to a hyposecretion of glucocorticoid hormones?
A) Hyperthyroidism
B) Hypothyroidism
C) Addison's Disease
D) Cushing's Disease
C) Addison's Disease
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111) Which one of the following is due to a T-cell mediated autoimmune response that destroys the insulin secreting Beta cells in the pancreas?
A) Diabetes Insipidus
B) Diabetes Mellitus Type II
C) Diabetes Insipidus Type II
D) Diabetes Mellitus Type I
D) Diabetes Mellitus Type I
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68) Which one of the following is known as the pacemaker of the heart and is responsible for propagating each heartbeat?
A) Bundle of HIS
B) Purkinje Fibers
C) Atrioventricular Node
D) Sinoatrial Node
D) Sinoatrial Node
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2) Which one of the following is particularly useful in scanning the brain
and nervous system to diagnose disorders that involve abnormal tissue
metabolism, such as schizophrenia, brain tumors, epilepsy, stroke, and
Alzheimer disease as well as cardiac and pulmonary disorders?
A) Single Photon Emission Computed Tomography (SPECT)
B) Computed tomography (CT)
C) Positron Emission tomography (PET)
D) Magnetic resonance imaging (MRI)
C) Positron Emission tomography (PET)
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99) Which one of the following is not an indication for cupping with blood letting?
A) Pruritis
B) Neurasthenia
C) Neurodermatitis
D) Allergic skin conditions
D) Allergic skin conditions
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92) Which one of the following types of headaches is most likely in a patient that has just been in a very severe car accident with head trauma?
A) A headache that is aching, throbbing, or burning and often severe. The onset is rapid and it persists over weeks to months. Associated symptoms are tenderness of the adjacent scalp, fever, malaise, fatigue, and anorexia; muscular aches and stiffness; visual loss or blindness.
B) A headache that is variable in quality lasting weeks, moths, or even years that tends to diminish over time. Associated with such symptoms as alterations in consciousness, changes in personality, and weakness on one side of the body.
C) A headache that is usually bilateral, may be generalized or localized to the back of the head and upper neck or to the front temporal area. It is mild and aching or a nonpainful tightness and pressure. The headache lasts week or months and persists over long periods of time. Associated symptoms are anxiety, tension, and depression.
D) A headache that is generalized, the most severe headache of their life, comes on abruptly and is persistent in acute illness. Associated symptoms are nausea, vomiting, possibly loss of consciousness, and neck pain.
B) A headache that is variable in quality lasting weeks, moths, or even years that tends to diminish over time. Associated with such symptoms as alterations in consciousness, changes in personality, and weakness on one side of the body.
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17) Which one of the following would require an ER referral?
A) Numbness of the fingers, elbow and arm on one side only (especially of the first three fingers)
B) Numbness of arms and legs or only hands and feet on both sides
C) Dull ache in the muscles, especially of the limbs, with feeling of heaviness
D) Boring pain with inability to turn the waist
A) Numbness of the fingers, elbow and arm on one side only (especially of the first three fingers)
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89) Which type of anemia is due to Vitamin B 12 deficiency, is a chronic, progressive disorder, and is mostly found in people over the age of 50?
A) Pernicious anemia
B) Iron deficiency anemia
C) Folic Acid deficient anemia
D) Aplastic anemia
A) Pernicious anemia
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155) You are reading one of your patient's medical charts from their western medical doctor. It says that your patient suffers from bouts of eructation. What does this mean?
A) Your patient belches.
B) You patient is experiencing epigastric discomfort after eating.
C) Your patient is experiencing a general lack of nutrition and wasting occurring in the course of a chronic disease or emotional disturbance.
D) Your patient has an inability or difficulty swallowing.
A) Your patient belches.
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