FAMILY MED

Elevation of CRP can be caused by:

1. Inflammation
2. Severe Trauma
3. Surgery
4. Pregnancy
5. Age
6. Food intake
7. Neoplastic proliferation

 Adenocacinoma of prostate mostly rises from:

28-year-old woman, from about 5 years suffers from bloating and diarrhea after ingesting milk. What is the next

procedure?

37-year-old woman comes to the physician because of a 3-year history of intermittent, mild, diffuse abdominal cramps and bloating. Her symptoms occur after meals and are relieved with bowel movements. She also has constipation four to six times monthly. She says the constipation resolves spontaneously, but she sometimes has diarrhea for 1 to 2 days afterwards.

She has not had any other symptoms. She has no history of serious illness and takes no medications. Examination shows no abnormalities. Which of the following is the most likely diagnosis?

50-year old patient complains of nocturia, ankle region edema particularly in the evenings, pain in the right

subcostal area, worsening of physical activity tolerance. The most probable reason of his condition is:

86 -year-old male complains of difficulty driving at night because of glare from oncoming vehicles and difficulty reading fine print . Which of the following is the most likely condition ?

A 14-year-old presents for a routine sports examination. You are examining his spine because a nurse at his school

told him that he had an “abnormal curvature of his spine.” On forward-bending test, there is slight elevation of the

right paravertebral muscle mass, which you estimate to be about 10 degrees. On radiographic films, there is 15

degrees of angulation. What is the most appropriate initial plan for management?

A 22-year-old man has an acute, painful, red right eye with blurring of vision for one day. He had a similar episode

one year ago and has had episodic back pain and stiffness relieved by exercise and diclofenac for four years. What

is the single most likely cause of his red eye?

A 23-year-old woman returns after an abnormal Pap smear result. Her results show LSIL with a positive HPV test.

She has had 3 male sexual partners in her life over the last 4 years and has been in an exclusive relationship with

the same man for the last 3 years. She denies consistent use of barrier protection during intercourse. Her periods

are regular, lasting 5 days every 20 days. She denies menorrhagia, vaginal discharge, abnormal bleeding, dysuria,

or past history of STIs. She had her first Pap smear 2 years ago with her regular doctor; she is uncertain of the

result. What is the appropriate step in the management of this patient?

A 25-year-old woman has a blood pressure of 160/90 mmHg at week 10 of her first pregnancy. She had recurrent

urinary infections in childhood. Her urinalysis shows protein but no blood. Her blood tests show: Hb 109, BUN 7.5,

Cr 125. What is the single most likely diagnosis of her hypertension?

A 31-year-old man with longstanding alcohol dependence has vertigo and a tremor every morning. What is the

single most likely diagnosis?

A 32-year-old woman has had a febrile illness and swelling of the small joints of her hands, feet, wrists, and knees

for 2 days. She has a maculopapular rash and a few palpable cervical lymph nodes. She was previously well. There

is no history of relevant travel outside of Poland. She has 2 young children. What is the single most likely

diagnosis?

A 38-year-old man with longstanding alcohol dependence has vertigo and a tremor every morning. What is the single most likely diagnosis?

A 4-year-old girl has a temperature of 38.5 for 2 days and has not wanted to eat her food. Yesterday she developed

a sore throat and small, painful ulcers inside her mouth. Today she has small blisters on the palms of her hands

and soles of her feet which are painful but not itchy. What is the single most likely underlying cause?

A 55-year-old female with T-score 1,5 in DEXA scan should be advised:

A 55-year-old white male with a history of T2DM presents to his PCP for a routine follow-up. He is generally doing

well without any new complaints and is taking aspirin and metformin. On exam, the patient’s blood pressure is

155/92. At his previous 2 visits, he had elevated blood pressures in this range as well. Routine labs are checked

and indicate new microalbuminuria. What is the next step in management?

A 57-year-old woman comes to the physician 1 week after noticing a mass in her left breast during breast self-examination . Menopause occurred 6 months ago . She was receiving oestrogen therapy but discontinued it 6 weeks ago ; she has had no menopausal symptoms . There is no family history of breast cancer . Examination shows a 2-cm , palpable , nontender , mobile mass in the upper outer quadrant of the left breast , no nipple discharge can be expressed.  Examination of the right breast shows no abnormalities . Which of the following is the most appropriate next step in management ?

A 64-year-old man, treated for coronary heart disease, after a heart attack, and for rheumatoid arthritis, reports due to increasing myalgia. A significant increase in CK concentration was found. Which of the drugs used is the most likely cause of the described symptoms?

A 68-year-old patient is seen for a general examination. Current recommendations for immunisations include:

A 79-year old man reports to the doctor because of fainting. The patient has had diarrhea for two days. What is the most likely cause of fainting?

A feature of the LAH is not:

A healthy newborn baby begins with a healthy pregnant mother. Key points during pregnancy are: 

A heart attack is diagnosed when increase of cardiac biomarkers (especially cardiac troponin) is observed and at

least 1 of listed is present:

i. ECG – new or presumably new diagnostic changes in ST segment or the newly formed LBBB

ii. Pathological Q waves in ECG

iii. Confirmed in imaging studies new changes to the vitality of the myocardium or new contractility

dysfunction

iv. Coronary artery thrombus in angiography

v. New atrial fibrillation

To the correct definition of a heart attack do not match:

A mother of 2-months old baby is distressed – she breast-feeds her child and she thinks, that this is not enough for her child, because the child awakes about 2-3 times every night. What would you tell her?

A mother of a newborn has come with her child to your GPs clinic for routine check-up. What are necessary

procedures you should conduct during the visit? Choose from the list below:

i. Obtaining general condition of the child, weight, chest and head measurements

ii. Normal physical examination (throat, lungs, heart, abdomen and so on) and hip joints

examination

iii. Neurological assessment

iv. Examination of external sex organs

v. Education according to breastfeeding and schedule of vaccinations of the child

a. All of the above

A patient with chemical injury of the eye caused by wet cement

A patient with diagnosed variant angina (Prinzmetal) came to the GP. What medications should not be used in conservative treatment in this patient?

A previously well 15-year-old girl had an acute onset of fever, sweating, bruising and petechiae. A blood count

showed: Hb 63, WBC 1.1, Neutrophils 0.1, Platelets 14. No abnormal white cells were seen on the blood film. She

was transfused and given IV antibiotics and her condition improved. Three weeks later her blood count has

returned to a similar picture. What is the single most likely underlying diagnosis?

A refractive error is:

A seven years old boy suffers from recurrent infections of upper respiratory tract. His mother suspects, that his hearing sense is impaired. What would you do?

According to ERC 2010 during children CPR you should start defibrillation with energy:

According to ERC 2010 standards the proper dosage of atropin in asystole therapy is:

According to ERC 2010 standards the proper volume of recue breath when resuscitating an adult is:

According to microbiological etiology – how often is acute pharyngitis caused by bacteria?

According to the WHO, osteoporosis occurs at the T-score:

According to vision screening guidelines of American Academy of Ophthalmology newbornscwith no family history of eye disease, no child and maternal risk factors should undergo an eye examine which includes:

Acute gout attack should be treated with:

ADHD is a disorder that manifests in childhood with symptoms of hyperactivity, impulsivity, and/or inattention.

Intellectual disability is present in about 60-70% of cases

ADHD treatment involves:

Adverse effects of vaccination could be: