An 18-year-old male college student has urinary frequency, dysuria, and urethral discharge

An 18-year-old male college student is seen in the student health clinic for urinary frequency, dysuria, and urethral discharge. Which of the following is likely to explain his condition?

1. Herpes simplex
2. Escherichia coli urinary tract infection
3. Chlamydial urethritis
4. Syphilis
5. HIV infection

the answer is below…

A 16-year-old girl presents with lower abdominal pain and fever

A 16-year-old girl presents with lower abdominal pain and fever. On physical examination, a tender adnexal mass is felt. Further questioning in private reveals the following: she has a new sexual partner; her periods are irregular; she has a vaginal discharge. Which of the following is the most likely diagnosis?

1. Appendiceal abscess
2. Tuboovarian abscess
3. Ovarian cyst
4. Renal cyst
5. Ectopic pregnancy

the answer is below…

A 19-year-old male college student with complaints of acute pain and swelling of the scrotum

A 19-year-old male college student returns from spring break in Fort Lauderdale, Florida, with complaints of acute pain and swelling of the scrotum. Physical examination reveals an exquisitely tender, swollen right testis that is rather hard to examine. The cremasteric reflex is absent, but there is no swelling in the inguinal area. The rest of his genitourinary examination appears to be normal. A urine dip is negative for red and white blood cells. Which of the following is the appropriate next step in management?

1. Administration of antibiotics after culture of urethra for chlamydia and gonorrhea
2. Reassurance
3. Intravenous fluid administration, pain medications, and straining of all voids
4. Ultrasound of the scrotum
5. Laproscopic exploration of both inguinal regions

the answer is below…

An 18-year-old male college student is seen for urinary frequency, dysuria, and urethral discharge

An 18-year-old male college student is seen in the student health clinic for urinary frequency, dysuria, and urethral discharge. Which of the following is likely to explain his condition?

1. Herpes simplex
2. Escherichia coli urinary tract infection
3. Chlamydial urethritis
4. Syphilis
5. HIV infection

the answer is below…

How long after a stroke is patient for developing a depressive disorder?

How long after a stroke is a patient at a higher risk for developing a depressive disorder?

1.  Two weeks
2.  Two months
3.  Six months
4.  One year
5.  Two years

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A 15-month-old boy is brought to the emergency room because of fever and a rash

A 15-month-old boy is brought to the emergency room because of fever and a rash. Six hours earlier he was fine, except for tugging on his ears; another physician diagnosed otitis media and prescribed amoxicillin. During the interim period, the child has developed an erythematous rash on his face, trunk, and extremities. Some of the lesions, which are of variable size, do not blanch on pressure. The child is now very irritable, and he does not interact well with the examiner. Temperature is 39.5°C (103.1°F). He continues to have injected, immobile tympanic membranes, but you are concerned about his change in mental status. Which of the following is the most appropriate next step in the management of this infant?

1.  Begin administration of intravenous ampicillin
2.  Begin diphenhydramine
3.  Discontinue administration of ampicillin and begin trimethoprim with sulfamethoxazole
4.  Perform bilateral myringotomies
5.  Perform a lumbar puncture

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8-year-old boy has a 3-week history of low-grade fever, fatigue, weight loss

A previously healthy 8-year-old boy has a 3-week history of low-grade fever of unknown source, fatigue, weight loss, myalgia, and headaches. On repeated examinations during this time, he is found to have developed a heart murmur, petechiae, and mild splenomegaly. Which of the following is the most likely diagnosis?

1.  Rheumatic fever
2.  Kawasaki disease
3.  Scarlet fever
4.  Endocarditis
5.  Tuberculosis

the answer is below…

A 17-year-old male complains of acute, painful, scrotal swelling

A 17-year-old male complains of acute, painful, scrotal swelling. Ultrasound of the testes is normal, but the urinalysis reveals pyuria. Which of the following is the most likely diagnosis?

1. Incarcerated inguinal hernia
2. Torsion of the testes
3. Varicocele
4. Epididymitis
5. Urinary tract infection

the answer is below…

A patient was diagnosed with infective endocarditis and is currently being treated appropriately

A patient comes to your office for a hospital follow-up. You had sent him to the hospital three weeks earlier for persistent fevers but no other symptoms; he was diagnosed with infective endocarditis and is currently being treated appropriately. Advice to this family should now include which of the following?

1.  Restrict the child from all strenuous activities
2.  Give the child a no-salt-added diet
3.  Provide the child with antibiotic prophylaxis for dental procedures
4.  Test all family members in the home with repeated blood cultures
5.  Avoid allowing the child to get upset or agitated

the answer is below…

an adolescent patient about the long-term management of her asthma

You are counseling an adolescent patient about the long-term management of her asthma while she is away at college. She brought an article she found on the Internet that promotes an herbal supplement purported to be a “safe, natural” treatment for asthma. You recall a recent study in the medical literature showing inhaled steroids to be statistically superior to the advertised herbal supplement at preventing asthma exacerbations at the p < 0.05 level. You explain to her that this means which of the following?

1.  The inhaled steroids are 5% better than herbal treatment
2. A critical threshold for medical significance has been reached
3. Patients will not benefit from the herbal treatment 5% of the time
4. The odds are less than 1 in 20 that the differences observed were only a chance variation
5. It would be unethical to use herbal treatment’

the answer is below…