[MCQs] The Quizzes about Acute Complaints - Part 6 (20 test)

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Acute Complaints-6

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Question 1

You are evaluating a 55-year-old man with hypertension and hyper- lipidemia who complains of unilateral lower extremity It has been present on and off for almost a year. He denies dyspnea or recent trauma, and has no evidence of inflammation. Which of the following would the best treatment option for his condition?

A	Diuresis
B	Anticoagulation
C	Elastic stockings
D	Sodium restriction
E	An angiotensin converting enzyme (ACE) inhibitor

Question 1 Explanation:

In patients with chronic venous insufficiency, knee-length elastic stockings can aid venous return. Additional treatment options include leg elevation throughout the day. Prolonged standing should be limited. Unilateral edema usually does not respond to diuresis, sodium restriction, or an ACE inhibitor. The case described above would be unlikely to be related to a DVT because of its chronic nature.

Question 2

You are evaluating a 5-year-old girl brought in by her parents to dis- cuss She was toilet trained in the daytime at the age of 3 years, and was dry at night at about 3¹/2 years of age. Four months ago, her par- ents had another child, and the 5-year-old began to wet the bed at night. She has no medical condition that would account for the change. What term correctly describes this condition?

A	Primary nocturnal enuresis
B	Primary diurnal enuresis
C	Secondary nocturnal enuresis
D	Secondary diurnal enuresis
E	Primary intentional enuresis

Question 2 Explanation:

It is important to classify enuresis correctly, as treatment may vary depending on type. Enuresis is classified as primary if it has never followed a period of dryness. Enuresis that occurs after 6 months of dryness is classified as secondary enuresis. Enuresis is nocturnal if it only happens at night, and diurnal if it happens during the day and at night. There is no classification of “primary intentional enuresis.”

Question 3

You are seeing a 6-year-old girl whose parents brought her in to have her bedwetting She has been toilet trained during the day since the age of 4, but still wets the bed at night. Her father wet the bed until the age of 8 years. Her physical examination reveals no abnormalities, and her urinalysis is normal. Which of the following statements is true regarding this situation?

A	Up to 20% of 6-year-olds are enuretic
B	Her father’s history is inconsequential in this situation
C	It is unusual for young girls to have a problem with enuresis
D	The problem is likely due to her being a deeper sleeper than other children
E	There is likely an organic cause to her problem

Question 3 Explanation:

While the cause of nocturnal enuresis is unknown, it is felt to be due to decreased production of nocturnal164 Family Medicine antidiuretic hormone. It is not likely due to deep sleep, though most enuretic patients do not spontaneously awaken after bedwetting. It is associated with a maturational delay, and statistically 25% of 5-year-olds are enuritic. The numbers decrease about 15% per year. Forty to fifty percent of bedwetters are female. Family history is very important. If one parent was enuretic, there is a 40% likelihood that the child will be. If both parents were bedwetters, there is a 70% risk that the child will be. Interestingly, the child will usually stop around the same time that the parent did. Very few patients have an organic cause.

Question 4

You are counseling a parent whose 7-year-old son wets the bed at Which intervention has proven to be the most effective for this condition?

A	Frequent night-time wakening to encourage voiding
B	Use of an alarm that wakes the child when he wets at night
C	Use of desmopressin (synthetic DDAVP)
D	Use of tricyclic antidepressant medications (e.g., imipramine)
E	Use of an anticholinergic antispasmodic (e.g., oxybutynin)

Question 4 Explanation:

Enuresis alarms have been shown to be the most effective treatment for nocturnal enuresis. Initial cure rates are high, and relapse rates are low. The alarms need to be used appropriately, with parental involvement in order to be effective. Frequent nighttime wakening may be effective, but compliance is a barrier to effectiveness. DDAVP can also be effective, but relapse rate is high once the medication is discontinued. Tricyclics have a lower initial cure rate and a high relapse rate. They can also be lethal, if overdosed. Oxybutynin has a high relapse rate and has not been proven to be efficacious when compared with placebo.

Question 5

You are evaluating a 6-year-old His mother has brought him in because he wets the bed. He has never been dry at night, and his parents are starting to get concerned. You obtain a thorough voiding history, and find the child to be completely normal on physical examination. He is otherwise developmentally normal. His urinalysis is also normal. What is the next step in the workup of this patient?

A	Observation
B	X-rays of the lumbar and sacral spine
C	Renal ultrasound
D	Voiding cystourethrogram (VCUG)
E	Both renal ultrasound and voiding cystourethrogram

Question 5 Explanation:

In the child with monosymptomatic nocturnal enuresis, no further evaluation is needed, other than a thorough voiding history, physical examination, and urinalysis. X-rays of the lumbar and sacral spine are indicated if there is suspicion of spina bifida occulta, and renal ultrasound/VCUG are indicated if there are suspected anatomic abnormalities that would lead to enuresis.

Question 6

One of the children in your practice is troubled by nocturnal enure- He is 7 years old, and has avoided overnight activities with friends. Which of the following is the best initial treatment measure?

A	Treatment of constipation
B	Motivational therapy with consequences for not maintaining a dry bed
C	Desmopressin acetate (DDAVP)
D	Imipramine (Tofranil)
E	Tolterodine (Detrol)

Question 6 Explanation:

Treatment for nocturnal enuresis should be first directed at treating constipation. It often coexists, and when constipation is treated, the situation improves dramatically. Motivational therapy should be considered for families not interested in pharmacologic therapy, but should never include consequences for wetting. The child has no control over wet nights, and should never be punished for a wet bed. DDAVP, a synthetic analog of vasopressin, works well in the form of a nasal spray or oral pill, but should not be the first measure tried. Imipramine is a tricyclic antidepressant with anticholenergic side effects, including urinary retention. It is useful, but not as an initial measure. Tolterodine is a treatment for overactive bladder, and has not been shown to be helpful for simple nocturnal enuresis.

Question 7

You are discussing enuresis therapy with the mother of an 8-year-old girl that you care She is not interested in pharmacologic therapies, but would like to discuss using a moisture-sensitive alarm. Which of the fol- lowing is true regarding the use of these alarms for nocturnal enuresis?

A	The goal of this alarm is to wake the child just after the initiation of urination
B	The success rate is greater for boys than for girls
C	The success rate is less than 50%
D	If the process will be successful, it only takes 3–4 weeks on average
E	The alarms are easier for families because the child takes responsibility for the treatment

Question 7 Explanation:

Moisture-sensitive alarms can be a very successful behavioral treatment for nocturnal enuresis. The first drops of urine complete a circuit, activating an alarm that will wake the child (and the parents). The parents then help the child complete voiding in the toilet. Over time, a conditioned response develops, and the child awakens voluntarily with the sensation of a full bladder. There is no gender difference in success rates, and with appropriate use and parent involvement, success rates are between 70% and 90%. It may take weeks or months to be successful, and requires a sizeable commitment from the parents and child involved. The child should not take responsibility for this treatment, because without parental involvement, success rates drop.

Question 8

You are seeing a 13-month-old Caucasian His growth chart is shown. His past medical history and physical examination are otherwise unremarkable, and he is meeting his developmental milestones. Which of the following is most likely to reveal the cause of his growth pattern?

A	A thorough dietary history
B	Serum albumin levels
C	Serum prealbumin levels
D	Assessment of the thyroid stimulating hormone
E	Serum IgA levels

Question 8 Explanation:

The growth chart raises concern for failure to thrive. In the United States, the vast majority of failure to thrive is secondary to inadequate nutrition and a thorough dietary history is most likely to reveal the cause. Albumin has a long half-life, and is a poor indicator of recent undernutrition. Prealbumin is decreased in acute inflammation and undernutrition, and is therefore insensitive. Organic disease, including hypothyroidism, is found in less than 10% of cases of failure to thrive. IgA levels are sensitive to undernutrition and would be decreased in failure to thrive.

Question 9

You are evaluating a 9-month-old Caucasian girl for poor weight She has gone from the 75th percentile to the 10th percentile in height and weight. She has had recurrent respiratory infections and diarrhea, but cultures obtained have been negative. Which of the following will be the most useful test in this setting?

A	A Mantoux test for tuberculosis
B	Assessment for human immunodeficiency virus
C	Stool for ova and parasites
D	A sweat chloride test
E	Renal function tests

Question 9 Explanation:

In a child with failure to thrive diarrhea and recurrent respiratory infections, cystic fibrosis must be considered, and a sweat chloride test should be ordered. The other tests may be indicated in the workup of failure to thrive, but only with a reasonable degree of clinical suspicion. With the history given, the most useful test would be the sweat chloride test.

Question 10

You are seeing a 15-month-old for a well-child His parents have no concerns and his developmental history is normal. His growth chart is shown.

Which of the following is the most likely?

A	Familial short stature
B	Failure to thrive
C	Hypothyroidism
D	A normal breast-fed infant
E	Constitutional growth delay

Question 10 Explanation:

Familial short stature has a growth curve that shows simultaneous changes in height and weight. In failure to thrive and constitutional growth delay, weight decreases first, then height. In hypothyroidism, height velocity slows first and may plateau before weight changes. In breast-fed infants, weight decreases relative to peers after 4–6 months, but catches up after 12 months.

Question 11

You have been following a 12-month-old At 9 months, his height was at the 25th percentile while his weight was at the 5th percentile. At 12 months, his weight and height are unchanged. His physical exami- nation shows:

Blood pressure: 62/32 (low) Heart rate: 72 beats per minute Respiratory rate: 16 per minute Temperature: 98.8°F

Which is the best therapeutic option for this child?

A	Nutritional instruction to take two times the normal caloric intake
B	Iron supplementation with increased calorie intake
C	Zinc with increased caloric intake
D	Referral to social services for neglect
E	Hospital admission

Question 11 Explanation:

Hospital admission is indicated for failure to thrive, in the face of hypotension and bradycardia. Other interventions may be appropriate, but with vital sign abnormalities,166 Family Medicine it is important to admit the patient. Patients like this are generally not neglected, especially since he has been seen all along for well child checks.

Question 12

A 19-year-old presented to your office with a 3-day history of fatigue, sore throat, and low-grade fevers. On examination, his temperature was 3°F, and you noted an exudative pharyngitis with cervical adenopathy. You sent a throat culture and started him on amoxicillin prophylactically. Two days later, he presents for follow up with continued symptoms and a diffuse, symmetrical erythematous maculopapular rash. What is the most likely cause of his symptoms?

A	Scarlet fever
B	Allergic reaction to amoxicillin
C	Viral exanthem
D	Mononucleosis
E	Measles

Question 12 Explanation:

Mononucleosis is often mistaken for streptococcal pharyngitis. Both have symptoms of sore throat, fatigue, fever, and adenopathy. If patients with mononucleosis are given ampicillin (and other penicillin derivatives), they often develop the rash described above, sometimes confused as an allergic reaction to penicillin. The rash of scarlet fever is more confluent, and has a sandpaper-like texture.

Question 13

A 48-year-old man presents with a history of “feeling tired” for about 6 His previous doctor told him he probably had chronic fatigue syndrome, and he is presenting to you for a second opinion. He reports that his sleep is not refreshing. He has postexertional fatigue, weight loss, and also reports impaired concentration and headaches. Which of those symptoms is less likely to be associated with chronic fatigue syndrome?

A	Unrefreshing sleep
B	Postexertional fatigue
C	Weight loss
D	Impaired concentration
E	Headaches

Question 13 Explanation:

The most common causes of fatigue in primary care include depression, life stress, chronic medical conditions, and medication reactions. Red flags for other causes include all of the symptoms listed in this question. Chronic fatigue syndrome can be associated with unrefreshing sleep, postexertional fatigue, difficulty with concentration, and headaches. It is usually not associated with weight loss, and if that sign is present, one should look for other causes for fatigue.

Question 14

A 23-year-old woman presents to your office to discuss She describes a “lack of energy” and “tiredness,” denying weakness or hyper- somnolence. What is the next step in the workup?

A	Screen for depression
B	Screen for sleep apnea
C	Screen for anemia
D	Screen for hypothyroidism
E	Screen for pregnancy

Question 14 Explanation:

Depression is one of the most common diagnoses in patients presenting with fatigue, especially when denying weakness or hypersomnolence. Once the complaint is defined, the practitioner should screen for depression. Screening for sleep apnea, anemia, hypothyroidism, and pregnancy should happen if the screen is negative.

Question 15

You are discussing fatigue with one of your 53-year-old She reports that her symptoms have occurred for the past 6 months, and have been getting progressively worse. She reports increased stress and working longer hours at work, and she is drinking a glass of red wine each evening after work to relax. Which component of her history points to a physical cause of her fatigue?

A	Symptoms for 6 months
B	Progressively worsening
C	Associated with increased stress
D	Occurring when working longer hours
E	Alcohol overuse

Question 15 Explanation:

There are three general categories of fatigue: Physiologic, physical, and psychological. Physiologic fatigue is generally due to overwork, lack of sleep, or a defined physical stress, such as pregnancy. Physical fatigue is due to infections, endocrine imbalances, anemia, cardiovascular diseases, and more concerning causes like cancer. Psychological fatigue is generally associated with stress, depression, anxiety, or adjustment reaction. While all types of fatigue can last for 6 months, the progressive nature of this patient’s symptoms should lead one to look for a physical cause. Increased stress, overwork, and alcohol use generally do not point to a physical cause of stress.

Question 16

You are evaluating a 55-year-old African American man for His history and physical are unremarkable, and your diagnosis is uncer- tain. What should be included in your initial workup?

A	Chest x-ray
B	ECG
C	HIV test
D	Prostate cancer screen
E	Drug screen

Question 16 Explanation:

The initial laboratory workup for an uncertain diagnosis of fatigue included a complete blood count, sedimentation rate, urinalysis, chemistry panel, thyroid testing, pregnancy test (for women of childbearing age), and age/gender appropriateAcute Complaints Answers 167 cancer screening. In a 55-year-old African American male, a prostate screen would be appropriate. Chest x-ray, ECG, HIV test, and a drug screen would be appropriate if the initial screen is negative.

Question 17

A mother brings her son in to see He is almost 2 years old, and had a significant amount of painless bleeding from his rectum last evening. He is currently hemodynamically stable, and in no distress when you see him. What is the most likely diagnosis?

A	Juvenile polyposis
B	Colitis
C	Anal fissure
D	Intussusception
E	Meckel’s diverticulum

Question 17 Explanation:

Meckel’s diverticulum is the most common cause of significant GI bleeding in children. It is a congenital abnormality that occurs in about 2% of the population, with a male to female ration of 2:1. It occurs about 2 feet from the ileocecal valve, and is usually about 2 in long. About 2% of cases have complications. These facts are often remembered as “the rule of 2s.” Intussusception also occurs in this age group, but is usually painful. Anal fissures, colitis, and juvenile polyposis generally do not cause significant bleeding.

Question 18

A 36-year-old man reports a 1-day history of He is complaining of some mild abdominal pain, but otherwise feels well. He denies alcohol use. On examination, he is tender in the epigastric region without peritoneal signs. His fecal occult blood test is positive, but his stool is not grossly bloody. What is the next step in his workup?

A	Gastric lavage
B	Barium study
C	Endoscopy
D	Red cell scan
E	Angiography

Question 18 Explanation:

Upper endoscopy is the best diagnostic testing option in the setting of an acute upper GI bleed. It can localize the source of bleeding, potentially allow therapeutic intervention, and allow for tissue diagnosis when necessary. Gastric lavage is less useful, and a barium study might interfere with subsequent intervention. Red cell scans are better to locate bleeding sources in the lower GI tract, and angiography may miss slower bleeds.

Question 19

You are evaluating a 44-year-old man with painless, large volume intestinal You suspect a Meckel’s diverticulum as the possible cause. What is the best test to confirm this diagnosis?

A	An esophagogastroduodenoscopy
B	A sigmoidoscopy
C	A colonoscopy
D	A technetium-99m pertechnetate scintigraphic study
E	A laparotomy

Question 19 Explanation:

Meckel’s diverticulum is the most common congenital abnormality of the GI tract, present in about 2% of the population. Most are asymptomatic, but a common presentation is painless large-volume intestinal hemorrhage. A Meckel’s diverticulum is often incidentally diagnosed at laparotomy. A noninvasive diagnostic modality is the technetium scan, often called the “Meckel’s scan.” The labeled tracer is picked up by the heterotopic gastric mucosa in the diverticulum. A Meckel’s diverticulum is located in the distal ileum, and would not be identified by the other endoscopic procedures above.

Question 20

A 56-year-old man is found to have asymptomatic diverticulosis on screening He is concerned about his risk for GI bleeding from the diverticula. Which of the following statements is most accurate regard- ing his concern?

A	Severe diverticular bleeding is relatively common, occurring in up to 50% of patients with diverticulosis
B	Diverticular bleeding is usually triggered by the ingestion of nuts, berries, seeds, popcorn, or other relatively indigestible material
C	Diverticular bleeding resolves spontaneously in the vast majority of cases
D	In patients with diverticular bleeding undergoing colonoscopy, blood emanat- ing from a diverticulum is usually seen
E	If colonoscopy fails to localize the source of active bleeding, a subtotal colec- tomy is needed to ensure no future bleeding

Question 20 Explanation:

Approximately 5–15% of patients with colonic diverticulosis develop severe diverticular bleeding. While many believe it may be triggered by the ingestion of indigestible foods, that has never been proven by studies. It is unusual to find the source of bleeding using colonoscopy. If colonoscopy does not localize the bleeding, a tagged red blood cell scan should be the next step, and will help guide segmental resection if necessary. A subtotal colectomy is only necessary for recurrent severe bleeding with no source identified.

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1.You are evaluating a 55-year-old man with hypertension and hyper- lipidemia who complains of unilateral lower extremity It has been present on and off for almost a year. He denies dyspnea or recent trauma, and has no evidence of inflammation. Which of the following would the best treatment option for his condition?

Diuresis
Anticoagulation
Elastic stockings
Sodium restriction
An angiotensin converting enzyme (ACE) inhibitor

2. You are evaluating a 5-year-old girl brought in by her parents to dis- cuss She was toilet trained in the daytime at the age of 3 years, and was dry at night at about 3¹/2 years of age. Four months ago, her par- ents had another child, and the 5-year-old began to wet the bed at night. She has no medical condition that would account for the change. What term correctly describes this condition?

Primary nocturnal enuresis
Primary diurnal enuresis
Secondary nocturnal enuresis
Secondary diurnal enuresis
Primary intentional enuresis

3. You are seeing a 6-year-old girl whose parents brought her in to have her bedwetting She has been toilet trained during the day since the age of 4, but still wets the bed at night. Her father wet the bed until the age of 8 years. Her physical examination reveals no abnormalities, and her urinalysis is normal. Which of the following statements is true regarding this situation?

Up to 20% of 6-year-olds are enuretic
Her father’s history is inconsequential in this situation
It is unusual for young girls to have a problem with enuresis
The problem is likely due to her being a deeper sleeper than other children
There is likely an organic cause to her problem

4. You are counseling a parent whose 7-year-old son wets the bed at Which intervention has proven to be the most effective for this condition?

Frequent night-time wakening to encourage voiding
Use of an alarm that wakes the child when he wets at night
Use of desmopressin (synthetic DDAVP)
Use of tricyclic antidepressant medications (e.g., imipramine)
Use of an anticholinergic antispasmodic (e.g., oxybutynin)

5. You are evaluating a 6-year-old His mother has brought him in because he wets the bed. He has never been dry at night, and his parents are starting to get concerned. You obtain a thorough voiding history, and find the child to be completely normal on physical examination. He is otherwise developmentally normal. His urinalysis is also normal. What is the next step in the workup of this patient?

Observation
X-rays of the lumbar and sacral spine
Renal ultrasound
Voiding cystourethrogram (VCUG)
Both renal ultrasound and voiding cystourethrogram

6. One of the children in your practice is troubled by nocturnal enure- He is 7 years old, and has avoided overnight activities with friends. Which of the following is the best initial treatment measure?

Treatment of constipation
Motivational therapy with consequences for not maintaining a dry bed
Desmopressin acetate (DDAVP)
Imipramine (Tofranil)
Tolterodine (Detrol)

7. You are discussing enuresis therapy with the mother of an 8-year-old girl that you care She is not interested in pharmacologic therapies, but would like to discuss using a moisture-sensitive alarm. Which of the fol- lowing is true regarding the use of these alarms for nocturnal enuresis?

The goal of this alarm is to wake the child just after the initiation of urination
The success rate is greater for boys than for girls
The success rate is less than 50%
If the process will be successful, it only takes 3–4 weeks on average
The alarms are easier for families because the child takes responsibility for the treatment

8. You are seeing a 13-month-old Caucasian His growth chart is shown. His past medical history and physical examination are otherwise unremarkable, and he is meeting his developmental milestones. Which of the following is most likely to reveal the cause of his growth pattern?

A thorough dietary history
Serum albumin levels
Serum prealbumin levels
Assessment of the thyroid stimulating hormone
Serum IgA levels

9. You are evaluating a 9-month-old Caucasian girl for poor weight She has gone from the 75th percentile to the 10th percentile in height and weight. She has had recurrent respiratory infections and diarrhea, but cultures obtained have been negative. Which of the following will be the most useful test in this setting?

A Mantoux test for tuberculosis
Assessment for human immunodeficiency virus
Stool for ova and parasites
A sweat chloride test
Renal function tests

10. You are seeing a 15-month-old for a well-child His parents have no concerns and his developmental history is normal. His growth chart is shown.

Which of the following is the most likely?

Familial short stature
Failure to thrive
Hypothyroidism
A normal breast-fed infant
Constitutional growth delay

11. You have been following a 12-month-old At 9 months, his height was at the 25th percentile while his weight was at the 5th percentile. At 12 months, his weight and height are unchanged. His physical exami- nation shows:

Blood pressure: 62/32 (low) Heart rate: 72 beats per minute Respiratory rate: 16 per minute Temperature: 98.8°F

Which is the best therapeutic option for this child?

Nutritional instruction to take two times the normal caloric intake
Iron supplementation with increased calorie intake
Zinc with increased caloric intake
Referral to social services for neglect
Hospital admission

12. A 19-year-old presented to your office with a 3-day history of fatigue, sore throat, and low-grade fevers. On examination, his temperature was 3°F, and you noted an exudative pharyngitis with cervical adenopathy. You sent a throat culture and started him on amoxicillin prophylactically. Two days later, he presents for follow up with continued symptoms and a diffuse, symmetrical erythematous maculopapular rash. What is the most likely cause of his symptoms?

Scarlet fever
Allergic reaction to amoxicillin
Viral exanthem
Mononucleosis
Measles

13. A 48-year-old man presents with a history of “feeling tired” for about 6 His previous doctor told him he probably had chronic fatigue syndrome, and he is presenting to you for a second opinion. He reports that his sleep is not refreshing. He has postexertional fatigue, weight loss, and also reports impaired concentration and headaches. Which of those symptoms is less likely to be associated with chronic fatigue syndrome?

Unrefreshing sleep
Postexertional fatigue
Weight loss
Impaired concentration
Headaches

14. A 23-year-old woman presents to your office to discuss She describes a “lack of energy” and “tiredness,” denying weakness or hyper- somnolence. What is the next step in the workup?

Screen for depression
Screen for sleep apnea
Screen for anemia
Screen for hypothyroidism
Screen for pregnancy

15. You are discussing fatigue with one of your 53-year-old She reports that her symptoms have occurred for the past 6 months, and have been getting progressively worse. She reports increased stress and working longer hours at work, and she is drinking a glass of red wine each evening after work to relax. Which component of her history points to a physical cause of her fatigue?

Symptoms for 6 months
Progressively worsening
Associated with increased stress
Occurring when working longer hours
Alcohol overuse

16. You are evaluating a 55-year-old African American man for His history and physical are unremarkable, and your diagnosis is uncer- tain. What should be included in your initial workup?

Chest x-ray
ECG
HIV test
Prostate cancer screen
Drug screen

17. A mother brings her son in to see He is almost 2 years old, and had a significant amount of painless bleeding from his rectum last evening. He is currently hemodynamically stable, and in no distress when you see him. What is the most likely diagnosis?

Juvenile polyposis
Colitis
Anal fissure
Intussusception
Meckel’s diverticulum

18. A 36-year-old man reports a 1-day history of He is complaining of some mild abdominal pain, but otherwise feels well. He denies alcohol use. On examination, he is tender in the epigastric region without peritoneal signs. His fecal occult blood test is positive, but his stool is not grossly bloody. What is the next step in his workup?

Gastric lavage
Barium study
Endoscopy
Red cell scan
Angiography

19. You are evaluating a 44-year-old man with painless, large volume intestinal You suspect a Meckel’s diverticulum as the possible cause. What is the best test to confirm this diagnosis?

An esophagogastroduodenoscopy
A sigmoidoscopy
A colonoscopy
A technetium-99m pertechnetate scintigraphic study
A laparotomy

20. A 56-year-old man is found to have asymptomatic diverticulosis on screening He is concerned about his risk for GI bleeding from the diverticula. Which of the following statements is most accurate regard- ing his concern?

Severe diverticular bleeding is relatively common, occurring in up to 50% of patients with diverticulosis
Diverticular bleeding is usually triggered by the ingestion of nuts, berries, seeds, popcorn, or other relatively indigestible material
Diverticular bleeding resolves spontaneously in the vast majority of cases
In patients with diverticular bleeding undergoing colonoscopy, blood emanat- ing from a diverticulum is usually seen
If colonoscopy fails to localize the source of active bleeding, a subtotal colec- tomy is needed to ensure no future bleeding

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[MCQs] The Quizzes about Acute Complaints – Part 6 (20 test)

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