Block 4- Ethics

Which one of the following conditions can affect hemoglobin A1c levels?

At a routine health maintenance visit a 60-year-old male complains of urinary frequency. A review of systems reveals nocturia but no dysuria. He is otherwise healthy. He has smoked 1 pack of cigarettes per day since age 18 and has a history of benign prostatic hyperplasia (BPH). On examination his prostate is smooth and enlarged without nodules. A dipstick urinalysis shows 1+ blood but is otherwise negative. Urine microscopy reveals 7 RBCs/hpf and 2 WBCs/hpf. Which one of the following would be most appropriate at this point?

23 year old female presents with complaint of vaginal discharge. She is sexually active and is on birth control. You perform wet mount and see this under microscopy. What is the most likely diagnosis?

Which one of the following is true regarding the use of agreements or contracts for patients using opioids for chronic pain?

34-year-old female with newly diagnosed diarrhea-predominant irritable bowel syndrome (IBS) presents with worsening abdominal discomfort. Her abdominal discomfort is not severe but it is constant. She has tried dicyclomine (Bentyl) without relief and is interested in trying a different approach. The patient has had negative testing for inflammatory bowel disease and celiac disease, along with normal blood tests. She asks about specific dietary modifications or medications that may be helpful for her abdominal discomfort. Which one of the following interventions would you recommend?

A 34-year-old female presents with intermittent facial pain. The pain occurs in brief episodes and is always on the left side of her face. She describes the pain as being like an electric shock. She thinks the episodes may sometimes be evoked by smoking, talking, or washing her face, but at other times there does not appear to be a trigger. Between episodes she is pain free and there are no sensation deficits on her face. Which one of these is the best first line therapy for this condition?

A 46 year old presents with a 3 day history of sore throat, hoarseness, temperature to 100°F (38°C) and cough. Your examination reveals tonsillar swelling without exudate, shoddy lymphadenopathy, and normal breath sounds. Abdominal exam is normal. There is no splenomegaly or axillary lymphadenopathy. Which one of the following would be most appropriate?

A 61-year-old female tells you that her brother was recently diagnosed with hereditary hemochromatosis and his physician suggested that she get tested. She feels well and has no significant health problems. Which one of the following would be most appropriate for initial screening?

A 54-year-old male presents with hearing loss associated with tinnitus. Which one of the following additional characteristics would be an indication for MRI of the brain to assess for an intracranial tumor?

A 4-month-old infant is brought to clinic with concerns of rash. Over the past week, his mother noted a red rash over both of his cheeks. The rash has neither spread nor remitted. He has otherwise been healthy. On examination, he exhibits erythematous, scaling, excoriated plaques over both cheeks. What is the most likely diagnosis?