MCCQE Exam Question 51
A 56-year-old woman presents to your office with a 9-month history of intolerable sweating, palpitations, and periodic anxiety. Her last period was 12 months ago. She continues to have regular Papanicolaou testing with no worrisome pathology. She is otherwise healthy. Which one of the following is the most effective treatment for these symptoms?
MCCQE Exam Question 52
A 72-year-old man presents to your clinic with worsening lower leg edema. He has hypertension, type 2 diabetes, and a history of heavy drinking. On examination, he is pale and has a BMI of 35. Vital signs are as follows:
Blood pressure: 110/60 mm Hg
Heart rate: 102/min
Temperature: Afebrile
His jugular venous pressure is 4 cm above the sternal angle. Cardiac auscultation is normal, and his lungs are clear. His liver is not palpable; he has abdominal distension, bulging flanks, and pitting edema below the knees. While awaiting test results, which one of the following is the best next step?
Blood pressure: 110/60 mm Hg
Heart rate: 102/min
Temperature: Afebrile
His jugular venous pressure is 4 cm above the sternal angle. Cardiac auscultation is normal, and his lungs are clear. His liver is not palpable; he has abdominal distension, bulging flanks, and pitting edema below the knees. While awaiting test results, which one of the following is the best next step?
MCCQE Exam Question 53
A 30-year-old woman presents to your office for a follow-up assessment of a sports-related musculoskeletal injury to her right leg. She requests a letter for her employer regarding her return to work. You feel she should be able to manage some aspects of her factory work. Which one of the following is most appropriate to include in your medical note to this patient's employer?
MCCQE Exam Question 54
A 59-year-old woman comes to the office because her 48-year-old sister was recently diagnosed with cervical cancer. Your patient thinks her mother may have also had cervical cancer. A Papanicolaou (Pap) test performed 16 months ago had normal results, as did all previous Pap tests. Which one of the following is the best next step?
MCCQE Exam Question 55
A 67-year-old man presents to the clinic because of elevated liver enzymes. He is asymptomatic.His medical history is significant for type 2 diabetes, which is being treated with metformin. On physical examination, he looks well. His blood pressure is 125/75 mm Hg, his heart rate is 80/min, and his BMI is 35. Findings of the remainder of the examination are normal. His blood work results are as follows:
* Platelet count: 170 × 10#/L (130-380)
* Creatinine: normal
* GGT: 75 µmol/L (49-93)
* ALT: 146 IU/L (15-85)
* AST: 101 IU/L (17-63)
* Bilirubin (total): 17 µmol/L (3-17)
* INR: 1.2 (0.9-1.2)
Which one of the following is the most likely diagnosis?
* Platelet count: 170 × 10#/L (130-380)
* Creatinine: normal
* GGT: 75 µmol/L (49-93)
* ALT: 146 IU/L (15-85)
* AST: 101 IU/L (17-63)
* Bilirubin (total): 17 µmol/L (3-17)
* INR: 1.2 (0.9-1.2)
Which one of the following is the most likely diagnosis?