[MCQs] The Quizzes about Acute Complaints - Part 4 (20 test)

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Acute Complaints- 4

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Question 1

A 25-year-old woman returned from her honeymoon in Mexico She spent the last day of her trip with frequent loose bowel movements that have persisted over this 3-day period. She has not had fevers or blood in her stool. Her examination is unremarkable. What is most likely cause of her diarrhea?

A	Rotavirus
B	Norwalk virus
C	Giardiasis
D	Salmonella
E	Enterotoxigenic E. coli

Question 1 Explanation:

Approximately one-third of travelers to underdeveloped countries will develop travelers’ diarrhea. Of those, 40% will alter their plans because of the symptoms, 20% will be bed-bound for at least 1 day, and 1% will require hospitalization. Most cases of travelers’ diarrhea are due to enterotoxigenic E. coli. The other causes of diarrhea are less likely in this setting.

Question 2

You have diagnosed travelers’ diarrhea in a 30-year-old otherwise healthy man who has recently returned from an African Which of the following is the best empiric treatment option?

A	Erythromycin
B	Ciprofloxacin
C	Metronidazole
D	Doxycycline
E	Vancomycin

Question 2 Explanation:

The antibiotic of choice for travelers’ diarrhea is a flurorquinolone (ciprofloxacin, ofloxacin, or norfloxacin) with trimethoprim/sulfamethoxazole or azithromycin being acceptable alternatives. The other antibiotics listed may be useful for other causes of diarrhea, but are not indicated for travelers’ diarrhea.

Question 3

A 28-year-old mother of two young children is seeing you to discuss her chronic She reports that symptoms began in her early 20s. She doesn’t have symptoms daily, but does report at least 1 day a week with more frequent bowel movements with a less firm consistency. She reports crampy abdominal pain that is relieved with bowel movements, passage of some mucus with bowel movements, a sensation of incomplete evacuation and abdominal distention. She denies nighttime symptoms, does not note symptoms with certain foods or liquids, has not lost weight, and has never passed blood with her stools. What is the most likely cause of her diarrhea?

A	Giardiasis
B	Entamoeba histolytica
C	Irritable bowel syndrome (IBS)
D	Inflammatory bowel disease
E	Lactose intolerance

Question 3 Explanation:

IBS is a complex of abnormal GI motility, altered visceral sensation and psychological factors that occurs in about 20% of the U.S. population. Most of those affected develop symptoms before age 35, and women are twice as likely as men to suffer from symptoms. The Manning criteria help to differentiate IBS from organic pathology. Four or more criteria make the diagnosis likely, and presence of less than two make the diagnosis less likely. The criteria include pain relief with bowel movement, more frequent bowel movements with the onset of pain, looser stools with the onset of pain, passage of mucus, sensation of incomplete evacuation, and abdominal distension. Giardiasis would generally cause more watery diarrhea, E. histolytica would generally cause daily symptoms with bloody diarrhea and malaise, inflammatory bowel disease would generally present with bloody diarrhea and weight loss, and lactose intolerance would generally be associated with ingestion of lactose.

Question 4

You have diagnosed an otherwise healthy adult with acute viral diar- Which of the following dietary measures should you recommend?

A	The patient should fast until the diarrhea resolves
B	The patient should not eat solids, but should drink an oral rehydrating solution
C	The patient should drink milk
D	The patient should avoid wheat, barley, and rye.
E	The patient should avoid caffeine

Question 4 Explanation:

For acute viral diarrhea, adults should be encouraged to eat potatoes, rice, wheat, noodles, crackers, bananas, yogurt, boiled vegetables, and soup. Dairy products, alcohol, and caffeine should be avoided. Oral rehydrating solutions can be used if vomiting is a problem, and fasting is not indicated. Avoidance of wheat, barley, and rye is indicated for celiac disease, but not for acute viral diarrhea.

Question 5

A 33-year-old woman is seeing you with a chief complaint of “dizzi- ” Upon further characterization, she describes “unsteadiness” and a feeling that “her balance is off.” Based on this description, which of the fol- lowing terms should be used to characterize her complaint?

A	Vertigo
B	Orthostasis
C	Presyncope
D	Dysequilibrium
E	Lightheadedness

Question 5 Explanation:

“Dizziness” is a subjective symptom, often meaning different things to different people. It is imperative that this complaint be better characterized to develop an appropriate differential diagnosis and treatment plan. Vertigo is a rotational sensation, in which the room spins around the patient. Orthostasis refers to a lightheadness upon arising, common with orthostatic hypotension. Presyncope is a feeling of impending faint. Disequilibrium is a sensation of unsteadiness, or a loss of balance. If asked whether the problem is in the head or the feet, patients often respond by saying the problem is in the feet. Lightheadedness is often vaguely described as a “floating” sensation.

Question 6

A 42-year-old woman is seeing you to follow up with a new com- plaint of “dizziness.” She reports that symptoms first began several months At that time, she reported a subjective hearing loss and a ringing in her left ear only. Symptoms were mild, and her physical examination was nor- mal, so you elected to follow her. Since that time, her symptoms have pro- gressed to include dizziness and some facial numbness. What is her most likely diagnosis?

A	Vestibular neuronitis
B	Benign positional vertigo
C	Acoustic neuroma
D	Meniere’s disease
E	Cerebellar tumor

Question 6 Explanation:

Acoustic neuroma typically presents with unilateral tinnitus and hearing loss. The symptoms are constant and slowly progressive. With continued tumor growth, symptoms of vertigo, facial weakness, and ataxia occur. Vestibular neuronitis presents with an acute onset of severe vertigo lasting several days, with symptoms improving over several weeks. Benign positional vertigo typically involves symptoms with position changes only. Meniere’s disease presents with discreet attacks of vertigo lasting for several hours, associated with nausea and vomiting, hearing loss, and tinnitus. A cerebellar tumor would typically present with dysequilibrium as opposed to tinnitus.

Question 7

In the evaluation of a 55-year-old man complaining of dizziness, you perform the Dix-Hallpike (Nylen-Barany) maneuver several You had the patient sit on the edge of the examining table and lie down suddenly with the head hanging 45° backward and turned to either side. With this maneu- ver, the vertigo was reproduced immediately, and symptoms did not lessen regardless of repetition. The direction of the nystagmus changed with chang- ing the direction that the head is turned, and the symptoms were of mild intensity. Which of the following is the most likely cause of the vertigo?

A	Stroke
B	Vestibular neuronitis
C	Benign positional vertigo
D	Meinere’s disease
E	Acoustic neuroma

Question 7 Explanation:

The Dix-Hallpike maneuver, described in the question, is often useful to distinguish central from peripheral causes of vertigo. With a peripheral cause of vertigo, the latency time for the onset of symptoms of vertigo or nystagmus is 3–10 seconds, the symptoms are severe, and the direction of the nystagmus is fixed. In addition, repeating the maneuver lessens the symptoms. With a central cause of vertigo, there is no latency to onset of symptoms, no lessening of symptoms with repeat maneuvers, the direction of the nystagmus changes, and the symptoms are of mild intensity. Of the above answers, all are peripheral causes of vertigo, except the correct answer, stroke.

Question 8

You are caring for a 26-year-old man with You have diagnosed him with a peripheral vestibular disorder, and are considering treatment options. Which of the following would be the first-line therapy?

A	NSAIDs
B	Antihistamines
C	Antiemetics
D	Antibiotics
E	Benzodiazepines

Question 8 Explanation:

Once diagnosed with a peripheral vestibular disorder, antihistamines are the first-line therapy for symptomatic relief. They suppress the vestibular end organ receptors and inhibit activation of the vagal response. Meclizine (Antivert), 25 mg orally every 4–6 hours and diphenhydramine (Benadryl), 50 mg orally every 4–6 hours are commonly recommended choices. Antiemetics may be used if nausea and vomiting are prominent symptoms. Benzodiazepines may be helpful in symptom reduction, but are usually second-line agents. NSAIDs and antibiotics are not helpful.

Question 9

You are evaluating a patient complaining of “dizziness,” but your his- tory and examination cannot distinguish whether his symptoms are sug- gestive of a central or peripheral Which of the following tests is the best option for clarification?

A	MRI of the brain
B	CT scan of the brain
C	Audiometry
D	Brainstem evoked audiometry
E	Electronystagmography

Question 9 Explanation:

Brain imaging is indicated in the workup of dizziness if history and examination cannot reliably distinguish between central or peripheral causes. MRI and magnetic resonance angiography (MRA) are the tests of choice, although a CT scan cutting through the cerebellum may be an alternative if MRI isn’t available. Audiometry is used to distinguish between cochlear versus retrocochlear causes of peripheral vertigo. Brainstem evoked audiometry is used to detect acoustic neuromas, and electronystagmography does not distinguish between central and peripheral problems. Barton J, Branch WT. Approach to the patient with vertigo. http://www.utdol. com/utd/content/topic.do?topicKey=genneuro/2118&type=A&selectedTitle= 2~29. Accessed 8/21/2006.

Question 10

You are evaluating a 56-year-old farmer who is complaining of dysp- nea. His history includes being hospitalized for bronchiolitis as a young child leading to childhood asthma, and a history of pneumonia 2 years ago, for which he was also He has a 20-pack year history of smok- ing. Which of the following increase his risk for having restrictive lung dis- ease as the cause of his dyspnea?

A	A history of childhood bronchiolitis
B	A history of asthma
C	A smoking history
D	A recent history of pneumonia
E	His occupation as a farmer

Question 10 Explanation:

Those at risk for obstructive lung disease include pediatric patients (asthma, bronchitis, bronchiolitis), adults with asthma and adults with chronic cigarette smoking. Dyspnea due to restrictive lung disease is more likely with occupational exposures (for farmers, cotton dust, grain dust, and hay mold), those with severe scoliosis, the morbidly obese and pregnant patients.

Question 11

You are seeing a 26-year-old female patient complaining of She reports having an upper respiratory infection 2–3 weeks ago, but that seemed to resolve. Since then, she has noted progressive weakness of the muscles in her legs, and yesterday began feeling short of breath. She is worse today. On examination, she has symmetric proximal leg muscle weakness with markedly depressed deep tendon reflexes. Her lung exami- nation is significant for decreased inspiratory volume without crackles or wheezes. What is her most likely diagnosis?

A	Parkinson’s disease
B	Gullain-Barre syndrome
C	Amyotrophic lateral sclerosis
D	Lyme disease
E	Psychogenic weakness and dyspnea

Question 11 Explanation:

Gullain-Barre syndrome causes dyspnea due to respiratory muscle paralysis or dysfunction. A main clinical feature is bilateral symmetric progressive weakness. Parkinson’s disease and ALS generally present in an older population. Lyme disease can cause a polyneuropathy, but is unlikely without other symptoms. Psychogenic weakness and dyspnea is less likely with these clinical findings

Question 12

You are evaluating a 36-year-old woman with She reports a cough and some pleuritic chest pain. On examination, her temperature is 101°F, and you note egophony in the left lower lobe. What is the likely cause of the dyspnea?

A	Asthma
B	Bronchitis
C	Pneumonia
D	PE
E	Congestive heart failure (CHF)

Question 12 Explanation:

Symptoms of pneumonia include dyspnea, cough, sputum production, and occasionally pleuritic158 Family Medicine chest pain. Signs include fever, tachypnea, rales, dullness to percussion, and egophony. Asthma, PE, and CHF would be less likely to be associated with a fever, and bronchitis would be unlikely to be associated with egophony

Question 13

You are evaluating a 71-year-old male patient with the complaint of shortness of It mainly occurs with exertion. He also complains of fatigue, and needing to sleep propped up on two pillows. On physical examination, you note a large apical impulse and jugular venous distension (JVD). He has fine crackles in the bases of both lungs with decreased breath sounds. What would be the most appropriate treatment?

A	Bronchodilators
B	Antibiotics
C	Steroids
D	Anticoagulation
E	Diuretics

Question 13 Explanation:

The patient is presenting with signs and symptoms of CHF. These include abnormal heart sounds (a murmur or an additional heart sound), cardiomegaly, JVD, basilar rales, and dependent edema. Bronchodilators would be appropriate for asthma or bronchitis. Antibiotics may be appropriate for pneumonia. Steroids would be helpful with an asthma or COPD exacerbation. Anticoagulation may be appropriate for a deep venous thrombus.

Question 14

You are seeing a young child whose mother says she is having trou- ble She is 3 years old, and this is her third episode of difficulty breathing. On examination, you note nasal flaring and sternal retractions with accessory muscle use. You auscultate expiratory wheezes bilaterally. Which of the following is the most likely diagnosis?

A	Bronchiolitis
B	Asthma
C	Pneumonia
D	Ventricular septal defect
E	Valvular disease

Question 14 Explanation:

Asthma in children is characterized by recurrent episodes of wheezing. Bronchiolitis and pneumonia may also cause wheezing, but would be less likely to be recurrent. Congenital heart disease can also cause dyspnea and even cyanosis with exertion, but are less likely to cause wheezing.

Question 15

You are seeing a 23-year-old woman with the complaint of shortness of She is otherwise healthy, taking only oral contraceptives regularly. The dyspnea began suddenly, and is associated with pleuritic chest pain. On physical examination, you note tachypnea, tachycardia, and some mild uni- lateral lower extremity edema. What would the best treatment option be for this patient?

A	Bronchodilators
B	Antibiotics
C	Steroids
D	Anticoagulation
E	Diuretics

Question 15 Explanation:

The signs and symptoms in this case indicate a deep venous thrombus causing a PE, likely due to oral contraceptives. The treatment of choice would be anticoagulation.

Question 16

You are evaluating a 69-year-old woman with a history of asthma and ischemic cardiomyopathy who is complaining of You are not sure if her symptoms are related to asthma or CHF, and you order a b-type natri- uretic peptide to help in her evaluation. The level is found to be 76 pg/mL (normal is 0–100 pg/mL). Which of the following is most correct regarding the interpretation of this laboratory value?

A	The probability that her symptoms are related to CHF is near zero
B	The probability that her symptoms are related to CHF is low
C	The probability that her symptoms are related to CHF is moderate
D	The probability that her symptoms are related to CHF is high
E	The probability that her symptoms are related to CHF is indeterminate

Question 16 Explanation:

B-type natriuretic peptide evaluates for the presence of CHF. Studies indicate that a value less than 80 pg/mL has a high (99%) negative predicative value and helps rule out CHF.

Question 17

You are seeing a sedentary, obese 41-year-old woman who presents to you with acute shortness of She has tachycardia, but no other abnormal examination findings. You order a d-dimer and it comes back low. Which of the following is the most appropriate option?

A	Order a spiral CT of the chest
B	Order a ventilation/perfusion (V/Q) scan
C	Order Doppler flow studies of her lower extremities
D	Order a pulmonary angiogram
E	Reassure the patient

Question 17 Explanation:

A d-dimer test is useful in determining the risk for a DVT or PE. A low result has a high negative predictive value for the presence of thrombus. If the result were high, a confirmatory test would be appropriate. A spiral CT scan has become a standard validated test. A V/Q scan, often used in the past, can be used when a spiral CT is unavailable, but is often indeterminate. A pulmonary angiogram is the gold standard. Doppler flow studies are used to verify a DVT. If positive, a PE can be assumed in the correct clinical setting

Question 18

One of your patients is dying of end stage breast She is com- plaining of dyspnea. Which of the following treatment options would be most beneficial?

A	Bronchodilators
B	Steroids
C	Anxiolytics
D	Opioids
E	A pulmonary rehabilitation program

Question 18 Explanation:

Many studies have shown that opioids relieve dyspnea in patients with cancer, but the mechanism is unknown. Bronchodilators are better in the setting of COPD and asthma, as are steroids. Anxiolytics help, but seem to relieve the anxiety associatedAcute Complaints Answers 159 with dyspnea more than the dyspnea itself. Pulmonary rehabilitation would be an inappropriate step in a dying patient.

Question 19

A 23-year-old sexually active woman visits a free clinic, reporting a sudden onset of dysuria that began 2 days On further questioning, she also reports urinary frequency, some back pain, and a pink discoloration to her urine. She denies vaginal discharge or irritation, and has been afebrile. The clinic has no microscope or urine dip sticks available. Based on this history, what is her most likely diagnosis?

A	Acute bacterial cystitis
B	Urethritis
C	Pyelonephritis
D	Interstitial cystitis
E	Vulvovaginitis

Question 19 Explanation:

A recent meta-analysis found that four factors correlate significantly with a diagnosis of acute bacterial cystitis. They are frequency, hematuria, dysuria, and back pain. In addition, four factors decrease the likelihood of UTI (absent dysuria, absent back pain, history of vaginal discharge, and history of vaginal irritation). Women with any combination of the positive and negative symptoms have a more than 90% probability of a UTI. Urethritis is more likely with a gradual onset. Patients with pyelonephritis often have fever. Interstitial cystitis tends to be more chronic in nature, and is generally not associated with back pain. Vulvovaginitis is a common cause of dysuria, but is associated with vaginal irritation or discharge.

Question 20

An 18-year-old woman is seeing you for back pain, frequency, and She has never had a urinary tract infection (UTI) in the past, and though she recently became sexually active, she denies vaginal discharge or risk for sexually transmitted infection. In this setting, when would a urine culture be necessary?

A	If a urine dipstick were negative
B	If a urine dipstick was positive for leukocyte esterase only
C	If a urine dipstick was positive for leukocyte esterase and blood
D	If a microscopic evaluation of her centrifuged urine revealed more than 5 white blood cells per high powered field
E	If a microscopic evaluation of her centrifuged urine revealed significant bacteriuria

Question 20 Explanation:

Urine culture is indicated when acute bacterial cystitis is suspected, but the urninalysis leaves the diagnosis in question. Therefore, in the setting of classic symptoms but a negative dipstick or microscopic evaluation, a culture will confirm the diagnosis. In the other cases, either the urine dipstick or microscopic evaluation confirms the clinical suspicion, and culture is not indicated.

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II. Preview all questions below

1.A 25-year-old woman returned from her honeymoon in Mexico She spent the last day of her trip with frequent loose bowel movements that have persisted over this 3-day period. She has not had fevers or blood in her stool. Her examination is unremarkable. What is most likely cause of her diarrhea?

Rotavirus
Norwalk virus
Giardiasis
Salmonella
Enterotoxigenic E. coli

2. You have diagnosed travelers’ diarrhea in a 30-year-old otherwise healthy man who has recently returned from an African Which of the following is the best empiric treatment option?

Erythromycin
Ciprofloxacin
Metronidazole
Doxycycline
Vancomycin

3. A 28-year-old mother of two young children is seeing you to discuss her chronic She reports that symptoms began in her early 20s. She doesn’t have symptoms daily, but does report at least 1 day a week with more frequent bowel movements with a less firm consistency. She reports crampy abdominal pain that is relieved with bowel movements, passage of some mucus with bowel movements, a sensation of incomplete evacuation and abdominal distention. She denies nighttime symptoms, does not note symptoms with certain foods or liquids, has not lost weight, and has never passed blood with her stools. What is the most likely cause of her diarrhea?

Giardiasis
Entamoeba histolytica
Irritable bowel syndrome (IBS)
Inflammatory bowel disease
Lactose intolerance

4. You have diagnosed an otherwise healthy adult with acute viral diar- Which of the following dietary measures should you recommend?

The patient should fast until the diarrhea resolves
The patient should not eat solids, but should drink an oral rehydrating solution
The patient should drink milk
The patient should avoid wheat, barley, and rye.
The patient should avoid caffeine

5. A 33-year-old woman is seeing you with a chief complaint of “dizzi- ” Upon further characterization, she describes “unsteadiness” and a feeling that “her balance is off.” Based on this description, which of the fol- lowing terms should be used to characterize her complaint?

Vertigo
Orthostasis
Presyncope
Dysequilibrium
Lightheadedness

6. A 42-year-old woman is seeing you to follow up with a new com- plaint of “dizziness.” She reports that symptoms first began several months At that time, she reported a subjective hearing loss and a ringing in her left ear only. Symptoms were mild, and her physical examination was nor- mal, so you elected to follow her. Since that time, her symptoms have pro- gressed to include dizziness and some facial numbness. What is her most likely diagnosis?

Vestibular neuronitis
Benign positional vertigo
Acoustic neuroma
Meniere’s disease
Cerebellar tumor

7. In the evaluation of a 55-year-old man complaining of dizziness, you perform the Dix-Hallpike (Nylen-Barany) maneuver several You had the patient sit on the edge of the examining table and lie down suddenly with the head hanging 45° backward and turned to either side. With this maneu- ver, the vertigo was reproduced immediately, and symptoms did not lessen regardless of repetition. The direction of the nystagmus changed with chang- ing the direction that the head is turned, and the symptoms were of mild intensity. Which of the following is the most likely cause of the vertigo?

Stroke
Vestibular neuronitis
Benign positional vertigo
Meinere’s disease
Acoustic neuroma

8. You are caring for a 26-year-old man with You have diagnosed him with a peripheral vestibular disorder, and are considering treatment options. Which of the following would be the first-line therapy?

NSAIDs
Antihistamines
Antiemetics
Antibiotics
Benzodiazepines

9. You are evaluating a patient complaining of “dizziness,” but your his- tory and examination cannot distinguish whether his symptoms are sug- gestive of a central or peripheral Which of the following tests is the best option for clarification?

MRI of the brain
CT scan of the brain
Audiometry
Brainstem evoked audiometry
Electronystagmography

10. You are evaluating a 56-year-old farmer who is complaining of dysp- nea. His history includes being hospitalized for bronchiolitis as a young child leading to childhood asthma, and a history of pneumonia 2 years ago, for which he was also He has a 20-pack year history of smok- ing. Which of the following increase his risk for having restrictive lung dis- ease as the cause of his dyspnea?

A history of childhood bronchiolitis
A history of asthma
A smoking history
A recent history of pneumonia
His occupation as a farmer

11. You are seeing a 26-year-old female patient complaining of She reports having an upper respiratory infection 2–3 weeks ago, but that seemed to resolve. Since then, she has noted progressive weakness of the muscles in her legs, and yesterday began feeling short of breath. She is worse today. On examination, she has symmetric proximal leg muscle weakness with markedly depressed deep tendon reflexes. Her lung exami- nation is significant for decreased inspiratory volume without crackles or wheezes. What is her most likely diagnosis?

Parkinson’s disease
Gullain-Barre syndrome
Amyotrophic lateral sclerosis
Lyme disease
Psychogenic weakness and dyspnea

12. You are evaluating a 36-year-old woman with She reports a cough and some pleuritic chest pain. On examination, her temperature is 101°F, and you note egophony in the left lower lobe. What is the likely cause of the dyspnea?

Asthma
Bronchitis
Pneumonia
PE
Congestive heart failure (CHF)

13. You are evaluating a 71-year-old male patient with the complaint of shortness of It mainly occurs with exertion. He also complains of fatigue, and needing to sleep propped up on two pillows. On physical examination, you note a large apical impulse and jugular venous distension (JVD). He has fine crackles in the bases of both lungs with decreased breath sounds. What would be the most appropriate treatment?

Bronchodilators
Antibiotics
Steroids
Anticoagulation
Diuretics

14. You are seeing a young child whose mother says she is having trou- ble She is 3 years old, and this is her third episode of difficulty breathing. On examination, you note nasal flaring and sternal retractions with accessory muscle use. You auscultate expiratory wheezes bilaterally. Which of the following is the most likely diagnosis?

Bronchiolitis
Asthma
Pneumonia
Ventricular septal defect
Valvular disease

15. You are seeing a 23-year-old woman with the complaint of shortness of She is otherwise healthy, taking only oral contraceptives regularly. The dyspnea began suddenly, and is associated with pleuritic chest pain. On physical examination, you note tachypnea, tachycardia, and some mild uni- lateral lower extremity edema. What would the best treatment option be for this patient?

Bronchodilators
Antibiotics
Steroids
Anticoagulation
Diuretics

16. You are evaluating a 69-year-old woman with a history of asthma and ischemic cardiomyopathy who is complaining of You are not sure if her symptoms are related to asthma or CHF, and you order a b-type natri- uretic peptide to help in her evaluation. The level is found to be 76 pg/mL (normal is 0–100 pg/mL). Which of the following is most correct regarding the interpretation of this laboratory value?

The probability that her symptoms are related to CHF is near zero
The probability that her symptoms are related to CHF is low
The probability that her symptoms are related to CHF is moderate
The probability that her symptoms are related to CHF is high
The probability that her symptoms are related to CHF is indeterminate

17. You are seeing a sedentary, obese 41-year-old woman who presents to you with acute shortness of She has tachycardia, but no other abnormal examination findings. You order a d-dimer and it comes back low. Which of the following is the most appropriate option?

Order a spiral CT of the chest
Order a ventilation/perfusion (V/Q) scan
Order Doppler flow studies of her lower extremities
Order a pulmonary angiogram
Reassure the patient

18. One of your patients is dying of end stage breast She is com- plaining of dyspnea. Which of the following treatment options would be most beneficial?

Bronchodilators
Steroids
Anxiolytics
Opioids
A pulmonary rehabilitation program

19. A 23-year-old sexually active woman visits a free clinic, reporting a sudden onset of dysuria that began 2 days On further questioning, she also reports urinary frequency, some back pain, and a pink discoloration to her urine. She denies vaginal discharge or irritation, and has been afebrile. The clinic has no microscope or urine dip sticks available. Based on this history, what is her most likely diagnosis?

Acute bacterial cystitis
Urethritis
Pyelonephritis
Interstitial cystitis
Vulvovaginitis

20. An 18-year-old woman is seeing you for back pain, frequency, and She has never had a urinary tract infection (UTI) in the past, and though she recently became sexually active, she denies vaginal discharge or risk for sexually transmitted infection. In this setting, when would a urine culture be necessary?

If a urine dipstick were negative
If a urine dipstick was positive for leukocyte esterase only
If a urine dipstick was positive for leukocyte esterase and blood
If a microscopic evaluation of her centrifuged urine revealed more than 5 white blood cells per high powered field
If a microscopic evaluation of her centrifuged urine revealed significant bacteriuria

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[MCQs] The Quizzes about Acute Complaints – Part 4 (20 test)

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Acute Complaints- 4

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