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LMCC II Exam questions from1992-2004; divided by subject

Ob/Gyn
(94 & 97) Counsel young woman re: oral contraceptive pill
(97) Counsel young woman re: unwanted pregnancy
(93) 7 wks pregnant, lower abdominal pain and vaginal bleeding. Ddx,
and findings on vaginal examination that would confirm most likely dx
(92) 37 y.o healthy G1P0, 9 wks pregnant. Manage
(04) 35 y.o. woman (8 wks pregnant) concerned re: possible genetic
disorder counsel re: genetic testing and risks.
(01, 02) 30 y.o. woman, 10 wks pregnant. Last pregnancy required an
emergency C-section. Has questions about vaginal delivery this time
(wants you to guarantee it) and about home birth. What would you do
if pt asks for a copy of the chart?
(92, 95, 00) 20 yo woman at 36 wks gestation, with HTN and
proteinuria. Counsel pt on etiology and risks to fetus & mother
(95, 98 & 03) 34 y.o. woman who is 30 weeks pregnant comes to the L
& D floor with vaginal bleeding. Take a focused hx. Q: What 2 features
on hx help you make a definitive dx. What is the most likely dx? Would
you do a speculum exam? Outline your mgmt plan.
(?) 30 y.o. female a few days post-delivery of a healthy child,
presenting with abdominal pain and vaginal d/c hx (elicit hx of
PROM), dx (endometritis), write admission orders
(92) Post-menopausal woman with bloody vaginal discharge. Hx.
(93, 00) Young woman with secondary amenorrhea x 6 months.
Investigations, Ddx,
(04) 27 y.o. woman with 24-hr hx of LLQ pain. Physical exam. (findings:
IUD in place). Q: 3 top Ddx (PID, ectopic, ruptured ovarian cyst). What
2 investigations would you do?
(02) 29 y.o. woman with 2-3 day hx of LLQ pain. Focused physical
exam. Ask specifically about speculum exam, appearance of cervix &
os, and any d/c. Ask about bimanual palpation: cervical tenderness,
adnexal tenderness, masses. Q: What 5 things on hx woul d help

detrmine dx? What are the 3 most likely dx? Told that Chlamydia has
grown on culture. What is your obligation to public health?
(?) 65 y.o. woman with bloody nipple discharge. Hx, interpret
mammogram, dx, prognosis
(92) Demonstrate & counsel a pt on breast self-examination &
mammography screening
(96, 01) 19 y.o. with vaginal D/C. Hx. 3 possible dx. Investigations to
sort them out. Hx, investigations. Tx of PID.
(99) 42 y.o. woman with menorrhagia
(99) Couple in their thirties, no success getting pregnant x 18 months.
Hx, investigs, Ddx.
Neuro (not including back pain or head trauma in MSK & trauma
sections)
(97) 16 y.o. boy with epilepsy (documented by a neurologist) comes to
you b/c he does not want to see his parents GP. Wants to drive trucks
for a living. Take a history and counsel.
(94) 15 y.o. male with 3 episodes of sudden loss of awareness lasting
<1 minute, wants information on epilepsy. Counsel.
(96)16 y.o. known epileptic on Dilantin is having 3 sz per month and
requests better meds. Manage. Findings: not taking meds,
experiencing ++ stress.
(00)Sz management over phone take hx (?)
(97) 60 y.o. woman with acute confusion. Perform a focused physical
exam excluding mental status.
(?) 50 y.o. previously well man presents with headache, fever, and first
seizure. Physical exam, management.
(92)60 y.o. male, unsteady gait & bilateral leg weakness. Perform a
neuro exam. (turns out to be B12 deficiency)
(93)64 y.o. woman with rest tremor; concerned about Parkinsons.
Perform focused physical.

(95, 98) 31 y.o. female with right hand numbness and weakness. Take a
hx and perform a focused physical exam. Q: Most likely dx (carpal
tunnel), 3 risk factors/conditions assd with dx, outline mgmt plan.
(00) Pt with fever, headache and rash in a rural hospital talk to nurse
over the phone and assess/manage (meningococcal meningitis)
(02) Woman in her 40s presenting with shooting leg pains when she
flexes her neck. Also has fleeting visual sx and urinary retention. Hx
only. (hint family hx of MS)
(?) 60 y.o. man with intermittent R hand weakness;. Hx (TIAs), Ddx,
investigs, rx until results available
(97, 01) 50 y.o. woman with left frontal h/a and normal vitals. Take a
hx (jaw s/s and R visual changes). Q: Describe appropriate appropriate
investigations and tx for temporal arteritis. Major complication of this
dx?
(?) Elderly patient presents with dementia do MMSE and a full neuro
exam
MSK/Rheum
(92) Young woman with bilateral migratory arthritis of recent onset.
Take a hx. Q: Give a Ddx. What investigs would you order?
(96)Young man presents to ED having twisted his ankle. Normal xray
(you interpret!) Manage. (RICE, show how to wrap & use crutches).
(95, 96 & 99) 30 y.o. man with AM back pain and stiffness. Take hx and
perform a focused physical exam. Findings: positive Wright-Schober
test), check eyes for iritis. lateral flexion impaired. Q: Give the dx
(ankylosing spond.) and two associated conditions.
(02, 03) Low back pain
(95 & 00) 35 y.o. male with 1 yr hx of back and leg pain. Do a physical
exam. Findings: right foot dorsiflexion weakness with dorsal foot
numbness. Make a dx and identify the level of the lesion.
(99) Construction worker with shoulder pain. Physical exam shoulder,
interpret Xray, Ddx, Rx

(97 & 04)40 y.o. male presents with inability to weight-bear on right
hip. Fever. Hx and physical. What is dx? How do you manage it?
Psych (including somatoform, prescription drug abuse, spousal
abuse)
(92, 97, 00) 43 y.o. woman comlains of bad nerves in her stomach;
has had normal investigs by internist and GI. Take a hx and perform a
mental status examination. Without looking at the patient again,
describe her appearance. What is your diagnosis?
(96, 99) 60 y.o. woman with multiple pains. Investigated by several
other docs, all lab tests normal. Manage.
(?) 65 y.o. female presents with concern about gastric Ca. Hx. (turns
out to be a somatization d/o and reactive depression secondary to
husbands death due to gastric Ca 6 yrs ago.). Examiner asks for
comments on pts appearance, behaviour, etc.
(95) Young woman with tunnel vision. Negative investigations by a
neurologist and opthalmologist. Take a hx. Finding: concerned that her
husband is having an extramarital affair. Counsel.
(95, 96 & 2000) 30 y.o. male from another city. Wants Fiorinal
prescription for chronic headaches renewed. Manage.
(98) 7 y.o. son, whose teacher thinks is hyperactive. In 10 minutes,
take a relevant hx (during which you learn that boys mom died a year
prior)
(95, 98) Adolescent whos taken an ASA od. Referred by ED doc.
Physically stable. Assess. Asked about dicharge. Mgmt/plan.
(94, 96, 04) Middle-aged woman, appears sad, requests sleeping pills.
About to be laid off. ++ social stressors. Manage
(01, 02, 03) Young woman feeling overwhelmed & suicidal. Hx only.
(92, 99)16 y.o. girl brought to office by a classmate for weight loss &
vomiting over the past 6 mos. The classmate is worried about A.N. Take
a hx and counsel.
(93 and (01) 65 y.o. woman states that the Russians are leaking
radiation into her house. Take a hx with mental status exam

-extra from 01 asked to assess if she is competent for tx. Says


shell consent to it if it will make the tingling in her arms from the
radiation stop
(94) 35 y.o. male with 1 week of hyperactivity, histrionic, spending
spree, bizarre behaviour. Take a hx.
(94)22 y.o. male, hears voices. Manage.
(94) 30 y.o. male, married with 2 children. Brought in by police for
violent and dangerous behaviour. Take a hx. Q: Would you admit this
patient? What are the criteria for a form 1?
(03) Lithium counselling
(02, 04) 30 y.o. schizophrenic male with neck pain (acute dystonic rxn!)
Recent med change from Risperdal to haldol. Hx only. What is dx? How
would you treat it? (benztropine 1-2 mg IM). Mother calls you back
after he leaves and says that he is trying to jump off the balcony. What
do you do? (tell her to call 911, issue a Form 1, which you can do as
you assessed him previously)
(93)Young mother with black eye, hit by boyfriend. Manage.
(99) Man who assaulted his wife. Lots of denial. She needed ER
attention. Take hx. Etoh involved.
(?) 50 y.o. man asking for help to stop drinking. Counsel.
Trauma/Emerg (cardiopulmonary emergencies in respective
sections)
(94, 97) A young man is brought to the ED with an epigastric stab
wound sustained in a bar fight. Hypotensive. There is an RN in the
room. Manage.
(92, 01)Telephone in the room. Mother calls b/c her child has just
ingested a caustic cleaner (or grandmothers medication (depending on
the year!). Mom is frantic. Should she induce vomiting? Manage over
the phone Q: What do you do after hanging up the telephone? Give a
plan for management.
-tip: Get name & address right away so that you can send EMS.
For the grandmothers med (of which she doesnt know the
name), ask if she knows the name of drugstore where
prescriptions are filled)

Written questions: list 5 things youd do when kid arrives in ED?


What are three things youd monitor specifically as they pertain
to poisoning (?) You find out that a similar incident happened
with the kids sibling. Who do you call? What is your
responsibility? What do you tell the mother?
(92) Telephone in the room. Physician in a peripheral centre wishing to
transfer an unstable pt who has been in an MVA. Manage (primary and
secondary survey) over the phone. Telephone orders to transfer to your
centre. Read c-spine films. Q: CXR shows opacification of the right lung.
What is your dx? Give the immediate mgt for this problem.
(93)A young man sustains a head injury in a bike-motor vehicle
collison. Pt has been hemodynamically stabilized. Perform a focused
neuro exam. Q: Lateral C-spine X-rays are provided. Are they
adequate? Are they normal? The pt has continuing sanguinous
discharge from his nose. What is the likely cause of this? Tx?
(93)Pt kicked by horse in the abdomen, now hypotensive in the ED.
Severe LUQ pain. Manage.
(?) 25 y.o. male with complaints of neck pain. Do a physical for C6-7
disc herniation. Read C-spine xray.
(93) 29 y.o. male with skin wound on lateral forearm. Examine &
explain findings, know peripheral nerve patterns, radial artery location
& distribution, suturing technique (may be asked to suture 6 cm lac on
synthetic arm!), types of needles, types of sutures.
(93)A young man fell while inebriated and sustained a laceration to the
right wrist. Perform a focused physical exam. Findings: numbness on
ulnar side of hand, Allens test shows no ulnar artery refill, FDS
impaired in little and ring finger. Q: What four structures were
lacerated? Mgmt?
(94, 03) 42 y.o. man found unconscious in the street. Appears to have a
closed head injury. Perform physical exam. Findings: GCS 11, unilateral
body weakness. Q: What is your differential? What 2 investigations and
2 medical interventions woul d you do?
(99) Young man post-MVA; BP 90/60, pulse 122. RN in room. Manage.
(laceration LUQ, abdo pain)
(94, 99, 00, 04) Young. male fell from scaffold, presenting with
decreased A/E and L abdo pain. Bruise over left abdomen. Vitals stable.

Transported in C-spine precautions. Assess & manage for primary and


secondary survey. Read C-spine xrays.
(95) 25 y.o. male with TCA overdose. Manage.
Haem
(02, 03) 24 y.o. male develops fever of 38.8 during a blood transfusion.
Advise and manage.
(97) 30 y.o. woman with 6 wks of epistaxis & purpura. Perform a
focused physical. Q: the pt has a normal CBC except for platelets of 20.
What is the most likely dx? (ITP) What focused areas on hx would help
to confirm this dx? What 4 investigs would you order?
(92)Young man with a swollen cervical lymph node. Perform a focused
physical exam. Q: CXR shows mediastinal widening with perihilar
nodes. Describe. Give five features on hx which would be helpful for
dx.
(94, 01) 81 y.o. man returns to your office for f/u for results of
bloodwork after previous complaint of sx of dizziness, lightheadedness,
ataxia. Bloodwork shows macrocytic anemia. Take appropriate hx. PEP:
what is most likely dx, what other dx could account for neuro sx, what
2 investigs would help confirm dx. Pt tells you hes a bus driver & has
forgotten to make 2 pickups this wk. How do you counsel him?
Resp
(99, 03) Female smoker wants to stop smoking. Recently had
bronchitis. Previously failed one attempt. Counsel.
(97, 99, 00 )HIV positive man. 1 week of SOB, cough, fatigue. Physical.
Q: Give a Ddx for a CXR showing a fine reticular pattern in the LLL.
Manage. (nb treat PCP with Septra)
(93) 60 y.o. male with hemoptysis and SOB. Take a hx. Q: Give Ddx.
What investigations would you order?
(04 and 01)56 y.o. lawyer, on Coumadin for his paroxysmal A.fib,
presenting with hemoptysis. Hx and physical. At nine minutes,
examiner asks what you would do when the next day, the pt calls
saying he is unhappy with the care you have given him and wants a
copy of the chart)

(92)60 y.o. man slipped and fell 6 days ago. Comes to you b/c of
hemoptysis. Perform a focused physical exam. Findings: +ve Honans
sign. Q: What is the most likely dx? Give a plan for mgmt
(02, 03, 94, 98) Pt. presents with fever, productive cough and pleuritic
CP. Do a physical exam. PEP: Interpret CXR (RML infiltrate), what is the
dx (CAP but r/o PE if cough isnt present) what is the most likely
pathogen (S. pneumoniae). What is your recommended tx?
(92 & 95) 53 y.o. female with incidental solitary lung nodule on CXR. Q:
CXR shows homogenous round 2-cm opacification in RUL. Give a Ddx
and identify most likely dx. Order further investigations.
(99) Man with asthma. Several ER visits. Not responding to tx. Hint: on
hx, find that hes just been started on a B-blocker, and isnt using his
inhaler correctly.
(?) 68 y.o. man with progressive SOB hx, investigs, treatment.
Smoker, pets, COPD, recently prescribed B-blockers for his HTN.
(?) 60 y.o. man with known COPD, presenting with cough & SOB. Hx;
describe what contributed to deterioration of condition, investigations
in ER, treatment.
Renal/Urology
(92) Elderly man with a Cr of 1000. What investigs would you order?
(97 & 02) 62 y.o. man presents to the ED with 12-hrs of suprapubic
discomfort and inability to urinate. Catheterization yields 1200 cc of
urine. Take a hx. Q: what is the most likely cause of this mans
problem? Give three other possible diagnoses. What four investigs
would you order?
(93)67 y.o. male complains of progressive bladder distension, inability
to urinate, and dribbling of urine from the urethra. Take a hx. Q: What
investigations would you order? Physical exam shows enlarged
prostate. Next step in mgmt?
(93 & 96) 50 y.o. man with microscopic hematuria on routine U/A. Take
a hx. Q: Give a Ddx; what investigs would be helpful?
(95) 47 y.o. male who cannot maintain erection. Wants a pill for this.
Take a hx and counsel.

(02 & 03) Man in 50s presents with acute flank pain. Physical only.
Exam shows CVAT. PEP: Interpret IVP (shows unilateral hydroureter and
stone at PU jxn)
(?) 20 y.o. male with urethral burning. Hx, dx, likely organism given
Gram stain results, tx
Peds
(99) 45 y.o. woman who just delivered a amall-for-gestational-age baby.
Hx (dates, progress of pregnancy, smoking , Etoh, drugs), ddx,
investigations
(93 & 99) 6 hours after the delivery of a full-term low birthweight baby.
Take a hx. Q: What investigs would you order? Q: On physical exam of
babe, you find emaciation with wrinkled yellow-green skin and yellow
tears. What is the problem? Give three underlying causes for this. Give
two potential problems which may arise in the next 48 hours.
(92, 97 & 98) 6 month old child has just had a seizure. Take a hx from
Mom in the ED. Findings: short seizure with temp of 39.5. Never had sz
before. Developmentally normal. Q: what is the most likely dx? What 3
things on hx convince you? What would you tell Mom about likely
outcome & recurrence rate? What advice to give if child has another ?
(96 & 99))Young mother with 6-week old baby; new immigrant, poor
English skills. Concerned about whether she should have her baby
immunized. Counsel.
(96 & 2000)A 2-day old infant has serum bili 220 (ref. Max 200). Take a
hx from Mom. Q: What are the possible causes for this abnormality?
Manage.
(00 & 02) 6 y.o. male with new peanut allergy, stable after treated for
anaphylaxis in ER. Counsel mother.
(93)12 y.o. female with fever, photophobia, neck stiffness. Manage.
(92)A mother is worried that her 1-yr old looks pale. Take a hx.
Findings: breastfed for the first 2 months, then 2% milk. Q: What is the
most likely dx? What investigs would you order?
(93, 94 & 04) 2 1/2 y.o. has persistent cough after having URTI 3 wks
ago treated with abx. Ongoing cough. Hx only. 1. what is your dx. 2.
what supports it on hx (wheeze, atopy, worse at night). 3. 3 mgmt
options (parents stop smoking, bronchodilators, inhaled steroids)

(99) Mom brings in her 10 y.o. child with frequent upper respiratory
infections. Mom is concerned about meningitis. Hx and physical,
counsel.
(94) 22 month old female child brought to ED by her mother with
fractured left humerus. Two previous fractures in past 3 months,
bruises seen on forehead. Manage.
(?) 6 month old baby with skull #: hx from mom reveals that husband
abuses her & baby). Manage.
(94) 5 y.o. girl with pain on urination. Mother concerned about UTI and
sexual abuse. Order investigations and counsel.
(00) Primary nocturnal eneuresis in a 9 year old. Take history from Mom
and manage.
(95 & 04) Mom is worried that her 3 1/2 yr old daughter is not using
complex sentences; just single words. Recurrent otitis media. Mother
concerned that she is developmentally delayed. Hx only. Q: What is
your Ddx of hearing loss.
(01) Young first time mom worried about baby crying a lot. Hx. Turns
out baby is crying about 3 x day >3 hrs/time (colic). Hasnt tried usual
stuff to comfort colicky baby. Written: what is your dx? What test, if
any, do you want to order? Outline mgmt of pt. What are three factors
that would put this child at risk of abuse? Also get the babes growth
charts shes 50th percentile
(92, 95, 99) Mother with a 6 month old child who has diarrhea. Take a
hx. Finding: recently switched from breast milk to milk powder formula.
Q: Give a Ddx. Recommend tx.
(?) 6 month old baby with diarrhea and FTT hx, ddx, clinical
parameters for dehydration, general feeding advice for mom.
(00) Foster mother of 10 month old child. 8 wk hx of diarrhea. Adult
diet. At nine minutes two potential dx; what you would do if the
babys real mom called later that day and asked for info on the babys
condition. ?toddlers diarrhea, lactose intolerance
(02) Mom brings in 3 month old child with regurg after every meal.
Shows you copies of growth curves showing that child is <5th percentile
and has fallen 3 curves. Mother depressed and overwhelmed. Denies
projectile vomiting and varies on abuse history. Hx and counsel. Q: 1.

what is your dx? (r/o pyloric stenois) 2. what is your mgmt plan?
(referral to surgeon for further investigations), 3. what are four rfs for
abuse in this child
(03) Initial presentation of a child with DM
(00) 2-day old infant with jaundice, receiving tx counsel
mother/address her questions & concerns (you dont know the reason
for jaundice)
GI & Surgery
(93, 94 & 97) 68 y.o. man with difficulty swallowing solids. Hx. Q: xray
of barium swallow showing narrowing of contrast at T5-6; describe the
abnormality. What is the likely dx? What investigs would confirm the
dx? What further investigs would you order?
(97) 21 y.o. female with bloody diarrhea. Take a hx. Findings: abdo
cramping. 6 watery stools in past 4 hrs containing maroon-coloured
blood. Feels dizzy and weak. No prior hx diarrhea, previously well. Q:
What two findings on hx indicate the hx of the problem? Give 3
possible dx. Give focused investigs appropriate to the situation
(96, 99 & 04) A 50 y.o. man is denied life insurance b/c of abnormal
LFTs. Several hepatitis RFs. Hx only. Q: Give a Ddx. What
investigations would you order? What are three likely etiologies of
acute hepatitis? (HBV, HCV, Etoh), what is your reporting responsibility
at this time? (none, but if HBV or HCV, must report to public health)
(96 & 00) 25 y.o. man with a history of dyspepsia and binge drinking
has epigastric abdo pain. Perform a focused physical. Q: What
radiological investigs would you order and why? At nine minutes, wife
is on the phone wanting info. Pt says shell nag me about my drinking
tell her I have the flu
(92, 95, 98 & 02) 30 y.o. man with hematemesis and abdo pain in the
ED. BP 80/50. Give orders to RN
(93)17 y.o. woman with chronic diarrhea. Take a hx.
(95) 23 y.o. woman with 24 hrs of abdo pain. Perform a focused
physical exam. Findings: peritoneal signs, point tenderness at
McBurneys. Q: Give a ddx, order investigations. What further hx would
help confirm dx?

(95)62 y.o. female with LLQ pain. Perform physical exam. Findings: lowgrade fever, some abdo distension, LLQ tenderness without rigidity,
poorly defined LLQ mass. Q: Abdo series shown multiple air/fluid levels.
Describe. Give Ddx with most likely dx. Order further investigations.
(00) Crohns patient with RLQ pain. Examine and AXR. (SBO)
(02, 04) Man in 40s presenting with abdo pain & vomiting. Prior appy.
Last BM 24 hrs ago. Interpret AXR (dilated SB, multiple air/fluid levels,
no free air). Give dx & initial mgmt. If his pain worsens, his abdo
becomes peritoneal, and he becomes tachycardic, what 3 things would
you do? (IV fluids, abx, gensurg consult!)
(98) A 25y.o. woman comes to office with abdo pain. In 5 minutes, do a
focused phycial. PEP what 5 additional points do you need on hx?
What are 3 most likely dxs? What investigations would you do?
CV
(93, 97) Young person with BP of 160/100 in both arms. Perform a
focused physical. Q: give 4 possible dx. What 4 investigs would you
order? If these investigs were negative, give the steps in your initial
mangagement plan.
(96, 94, 98, 00 04) mgmt acute MI. Treat medically with help of RN.
Consider TPA
Q: If man wants to leave AMA, what do you do?
(96) Middle-aged woman with eystolic ejection murmur radiating into
the carotids. Perform a physical exam.
(94)Elderly lady on Digoxin and Lasix with syncopal attacks. Take a hx.
Q: Give a Ddx. What investigations would you order?
(94) A 60 y.o. woman with a hx of atrial fibrillation and CHF returns to
the office for the results of a Dig level, wich is subtherapeutic. Take a
hx and counsel. Q: What are the effects of a Dig overdose?
(95,00) 70 y.o. woman brought in after collapsing in mall.
Unresponsive, GCS 8. List of meds in purse when you ask dig,
spironolactone. Give orders to nurse & manage in ED. Complete heart
block on EKG. HR comes from 40 to 70 when you give her atropine. ?
dig toxicity exacerbated by hypokalemia

Q: Has a living will in her purse that says she doesnt want to be
recusitated. At 9 minutes, the examiner asks you what you would do
re: the will if the EKG degenerates into VF.
(00, 01) 60 y.o. man with episodic leg pain (claudication). Physical
exam for PVD (upper and lower extrems). Interpret EKG (normal). What
two investigs would you order for PVD (dopplers with ABI,
angiography). Five RFs for PVD (HTN, DM, smoking, lipids, CAD, CVD,
ESRD)
(?) 65 y.o. male with exertional angina, recently admittd with CHF,
coming for f/u with SOB physical exam
Post-op
(92, 98 & 03)58 y.o. lady in the hospital 4 days post hysterectomy for
fibroids. Agitated, had tactile hallucinations the previous night. Take a
hx. Finding: hx of alcoholism. Q: what is the most likely dx?
(99)63 y.o. woman 4-days post GI surgery with 15 minute hx of SOB.
Physical exam.
(96)elderly woman in hospital post-op day 5 of THR. Acute chest pain,
tachycardia, tachypnea, SOB. Manage.
ENDO
(93)Obese pt, wants help with weight loss. Counsel.
(95)40 y.o. female with fatigue. Take a hx. Findings: cold intolerance,
weight gain. Dx, investigs, tx
(98) Adolescent presents with 2nd episode of hypoglycemia in one
week. Sent to ER by her boss at work. Unconscious on arrival. Manage
in ER.
(?) 30 y.o. male with IDDM, 2d hx of N/V/D, not taking insulin. Hx, given
labs; management for first hour; what clinical and lab parameters to
follow tx
MISC
(94) Young female with malaise, tender lymph nodes in the neck, and
LUQ abdo pain. Perform a physical exam. Give a Ddx

(94) 60 y.o. woman with hypercalcemia on an insurance physical. Take


a hx and perform a physical exam. Q: Give a ddx for hypercalcemia.
What investigations would you order?
(99) Woman in her 60s, D/Cd from hospital 4 days ago on Coumadin.
INR is 1.0 today. Counsel and manage (worried b/c cousin died of a GI
bleed while on Coumadin)
(98, 00) 65 y.o. female with rectal Ca does not want OR. Counsel (turns
out friend died of same operation)
(98) 25 y.o. woman with intermittent L neck mass, fever, weight loss.
In 5 min, do a focused physical. I. Interpret CXR (bilateral hilar
lymphadenopathy)), ii what are 3 most likely dxs, iii) what 5
additional points on hx would help confirm your diagnostic impression
(98) 55 y.o. man with hoarseness. In 5 minutes, take a focused hx.
PEP: give 2 SPECIFIC pathophysiologic reasons for this mans
hoarseness (damage to recurrent laryngeal nerve, or to larynx itself)
What 3 things on hx cause the most concern? What are the 2 most
likely dxs? What 3 investigs would you order?
(98) Confused elderly woman with COPD, living with daughter. Hx from
daughter. Polypharmacy. Advise on how to manage. Stop meds!
(tagamet, ativan, thiazide, theophylline). Explain metabolism in elderly.
(?) 33 y.o. male with numerous questions about contraction of HIV
counsel and answer questions
(92)OR nurse sustained needlestick injury. Worried about hepatitis and
AIDS. Known Hpe B + (HIV -) pt. Prt planning to get pregnant in near
future, has not had Hep B immunizations counsel.
(?) 60 y.o. man with bilateral ankle edema after a canoe trip hx, dx,
managment

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