08-30-2014, 01:40 PM
26.
A 45-year-old Hispanic woman, gravida 2, para 2, comes to the office for an annual health maintenance examination. She has been a patient of yours for the past 15 years. Medical history is unremarkable and she takes no medications. When you first saw her at age 30 years, she was 160 cm (5 ft 3 in) tall and weighed 54 kg (120 lb); BMI was 21 kg/m2. Since that time, she has been gradually gaining weight, and at last year's physical examination she weighed 68 kg (150 lb). Today she weighs 73 kg (160 lb); BMI is 28 kg/m2. Physical examination discloses no abnormalities. The patient says she wishes to lose weight. Which of the following is the most appropriate initial step?
A) Obtain history regarding which foods and exercise the patient enjoys
B) Order thyroid function tests
C) Prescribe a low-carbohydrate diet
D) Prescribe orlistat to assist with weight loss
E) Refer the patient to a self-help weight loss group
27.
A 67-year-old woman comes to the office because of increasing constipation for the past 3 months. She has a history of hypertension treated with hydrochlorothiazide. For the past 2 weeks, she notes that "my belly has gotten big and my bowel movements have become very thin." Blood pressure is 140/85 mm Hg. Abdomen is moderately distended and tympanitic to percussion. There is no hepatomegaly or evidence of ascites. Rectal examination shows a small amount of brown stool that tests negative for occult blood. Hemoglobin concentration is now 11.2 g/dL, decreased from 12.8 g/dL last year. Which of the following is the most likely diagnosis?
A) Colon cancer
B) Diverticulosis
C) Inflammatory bowel disease
D) Irritable bowel syndrome
E) Leiomyomata uteri
The following vignette applies to the next 2 items.
A 67-year-old African American man comes to the office for a follow-up visit for hypertension. It has been 1 year since his last visit. He has had hypertension for the past 12 years and prostatism for the past 6 years. Serum prostate-specific antigen (PSA) concentrations during this time have ranged from 4.6 ng/mL to 5.2 ng/mL (N
A 45-year-old Hispanic woman, gravida 2, para 2, comes to the office for an annual health maintenance examination. She has been a patient of yours for the past 15 years. Medical history is unremarkable and she takes no medications. When you first saw her at age 30 years, she was 160 cm (5 ft 3 in) tall and weighed 54 kg (120 lb); BMI was 21 kg/m2. Since that time, she has been gradually gaining weight, and at last year's physical examination she weighed 68 kg (150 lb). Today she weighs 73 kg (160 lb); BMI is 28 kg/m2. Physical examination discloses no abnormalities. The patient says she wishes to lose weight. Which of the following is the most appropriate initial step?
A) Obtain history regarding which foods and exercise the patient enjoys
B) Order thyroid function tests
C) Prescribe a low-carbohydrate diet
D) Prescribe orlistat to assist with weight loss
E) Refer the patient to a self-help weight loss group
27.
A 67-year-old woman comes to the office because of increasing constipation for the past 3 months. She has a history of hypertension treated with hydrochlorothiazide. For the past 2 weeks, she notes that "my belly has gotten big and my bowel movements have become very thin." Blood pressure is 140/85 mm Hg. Abdomen is moderately distended and tympanitic to percussion. There is no hepatomegaly or evidence of ascites. Rectal examination shows a small amount of brown stool that tests negative for occult blood. Hemoglobin concentration is now 11.2 g/dL, decreased from 12.8 g/dL last year. Which of the following is the most likely diagnosis?
A) Colon cancer
B) Diverticulosis
C) Inflammatory bowel disease
D) Irritable bowel syndrome
E) Leiomyomata uteri
The following vignette applies to the next 2 items.
A 67-year-old African American man comes to the office for a follow-up visit for hypertension. It has been 1 year since his last visit. He has had hypertension for the past 12 years and prostatism for the past 6 years. Serum prostate-specific antigen (PSA) concentrations during this time have ranged from 4.6 ng/mL to 5.2 ng/mL (N