quiz

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
bacteria
2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.

3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?''
not second thoughts, maybe skin cancer? caucasian man-high risk for skin cancer. but does it itch for cancer?


5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.

Tell him to take ibuprofen first and wear loose underwear. if the pain doesn't go away, then take to ER. If pain is severe, take to ER straight away. I won't take the risk of not being a grandma.

6. You're 55 yrs old and quit smoking 20yrs ago. What next?
- get screened for Lung Ca
- get screend for Prostate Ca
- depends on the gender
- get screened for an abdominal aneurysm
- oh shove it already.

7. All but one of the following are not part of the normal aging process:
- loss of muscle mass - dementia - chin recession - hair line recession

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride

10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)

12. The number of chambers in a frog's heart:
1, 2, 3, 4

Vidya Bagchi wrote:what are we doing up so late, DM?

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
-fungus -bacterium -protozoa -parasite

2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.

3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?

5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.

6. You're 55 yrs old and quit smoking 20yrs ago. What next?
- get screened for Lung Ca
- get screend for Prostate Ca
- depends on the gender
- get screened for an abdominal aneurysm
- oh shove it already.

7. All but one of the following are not part of the normal aging process:
- loss of muscle mass - dementia - chin recession - hair line recession

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride

10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)

12. The number of chambers in a frog's heart:
1, 2, 3, 4

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
-fungus -bacterium -protozoa -parasite

2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.

I thought there were a lot of false positives in this test, so it could be a false positive? They had me get a chest X-ray because I did develop the swelling.

3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?

5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.

6. You're 55 yrs old and quit smoking 20yrs ago. What next?
- get screened for Lung Ca
- get screend for Prostate Ca
- depends on the gender
- get screened for an abdominal aneurysm
- oh shove it already.

7. All but one of the following are not part of the normal aging process:
- loss of muscle mass - dementia - chin recession - hair line recession

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride

10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)

12. The number of chambers in a frog's heart:
1, 2, 3, 4

kinnera wrote:

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
bacteria
correct
2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.
correct
3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice
correct - malt is just barley

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?''
not second thoughts, maybe skin cancer? caucasian man-high risk for skin cancer. but does it itch for cancer?


5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.

Tell him to take ibuprofen first and wear loose underwear. if the pain doesn't go away, then take to ER. If pain is severe, take to ER straight away. I won't take the risk of not being a grandma.

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice
correct

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride
correct

10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)

12. The number of chambers in a frog's heart:
1, 2, 3, 4

Vidya Bagchi wrote:

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
-fungus -bacterium -protozoa -parasite
correct, it's mycobacterium tuberculosis

2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.
correct

3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?

5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.

6. You're 55 yrs old and quit smoking 20yrs ago. What next?
- get screened for Lung Ca
- get screend for Prostate Ca
- depends on the gender
- get screened for an abdominal aneurysm
- oh shove it already.
you get a mark for this one!

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice
correct

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride
correct

10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)

12. The number of chambers in a frog's heart:
1, 2, 3, 4
correct: 2 atria and 1 ventricle!

most of the above are guesses.

Idéfix wrote:

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
-fungus -bacterium -protozoa -parasite
correct

2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.
correct

I thought there were a lot of false positives in this test, so it could be a false positive? They had me get a chest X-ray because I did develop the swelling.
It's a poor screening tool, and there was concern as to how it should be interpreted in patients who've received the bcg vaccine and those with scars from the vaccine. finally they decided on the following: to treat a positive test in a bcg-vaccinated individual as they would any other; it's the safe thing to do. so given that your pretest probability is high because you are an indian immigrant, if the size of the induration was more than 10mm  you would be informed that you are PPD positive.
Possibly, you were exposed to TB had good cellular immunity and were able to curb the infection at the time of initial insult. A positive PPD means that you have TB, if that alone is positive you have latent TB infection. Next a chest X-Ray is done to see if you have any signs of active TB, if the CXR is negative, that's great, you don't have active TB, and you will be treated for latent TB for 9 mos with INH. They treat latent TB so that it doesn't reactivate when you're older and your immunity is not so strong. Did you go on INH for 9 mos?
Anyhow, they don't use the PPD now in most states. I prefer the Quantiferon test - it's a blood test, sensitivity and specificity above 90, no second-look, no examiner subjectivity.

3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice
correct

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?

5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice
correct

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride
correct
10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)

12. The number of chambers in a frog's heart:
1, 2, 3, 4
correct

I don't even understand many of the questions fully, but it's easy to take a guess in a multiple-choice test... even if my guesses are all wrong.
thanks for saying that, I reread my questions and actually, two of my questions were incorrect, i'm rephrasing them with the answers below.

dominic mistry wrote:Did you go on INH for 9 mos?

dominic mistry wrote:6. You're 65 yrs old and quit smoking 20yrs ago. What next?
- get screened for Lung Ca
- get screend for Prostate Ca
- depends on the gender
- get screened for an abdominal aneurysm
- oh shove it already.

7. All of the following are part of the normal aging process except:
- loss of muscle mass - dementia - chin recession - hair line recession
if you observe old people, you will note that muscle mass declines, hair lines recede, but dementia or cognitive decline is pathologic, it's not a part of normal aging, many people don't realize it. chins will recede as a person grows older - I don't know off-hand exactly why but I think it's related to lower muscle and bone mineral mass and loss of teeth - the bone atrophies. this is why elder patients need to have their dentures re-sized every few years.

alright.

Idéfix wrote:

dominic mistry wrote:Did you go on INH for 9 mos?

No. I got BCG as a kid, had no documentation to prove it but do have a scar. The chest x-ray was negative, so the doctor certified me. No meds. The doctor said this is how it goes for many Indian immigrants.

dominic mistry wrote:

Idéfix wrote:

dominic mistry wrote:Did you go on INH for 9 mos?

No. I got BCG as a kid, had no documentation to prove it but do have a scar. The chest x-ray was negative, so the doctor certified me. No meds. The doctor said this is how it goes for many Indian immigrants.

as a policy I don't discuss personal medical matters online, but if I was in your shoes, i'd request a quantiferon assay in the future. all we know for certain now based on the above info is that you don't have active TB. we don't know if you have latent TB - anyhow it's not going to kill you and you can't infect anybody and it's not  reportable.

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
-fungus -bacterium -protozoa -parasite

2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.

3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?

5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.
-advise him eschew underwear altogether

6. You're 55 yrs old and quit smoking 20yrs ago. What next?
- get screened for Lung Ca
- get screend for Prostate Ca
- depends on the gender
- get screened for an abdominal aneurysm
- oh shove it already.

7. All but one of the following are not part of the normal aging process:
- loss of muscle mass - dementia - chin recession - hair line recession

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride

10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)

12. The number of chambers in a frog's heart:
1, 2, 3, 4

indophile wrote:

dominic mistry wrote:1. Tuberculosis is thought to affect 1 out of every 3 people in the world. It is caused by a:
-fungus -bacterium -protozoa -parasite
correct

2. A nurse places an intradermal shot called the PPD on your forearm. If a significant induration develops at the site, it means that you have:
-active TB -latent TB -TB lung -TB skin - I want to know why the doc didn't give me the shot himself, that's his job.
correct

3. If one's on a gluten-free diet he must eschew:
-spelt, oats, rye
-wheat, rice, barley
-wheat, malt, rye
-egg whites, wheat, rice
the correct answer is wheat(including spelt), barley (malt) and rye. sometimes patients are unaware that they should avoid spelt and malt, hence the question.

4. A 50-yr-old Caucasian man visits his internist for the first time for a severe sunburn and an itch in his groin, he smoked briefly in college, he should undergo screening for:
-Skin Cancer - Colon Ca - Prostate Ca - Lung Ca - May I know the color of your langot?
the current recommendations are that men and women with average risk of colon ca undergo colon ca screening at age 50. yes, black.

5. Your 16-yr-old son c/o pain in his balls. You
-pretend you did not hear that.
-tell him to take ibuprofen.
-tell him to wear loose underwear.
-tell him to wear tight underwear for better support.
-take him to the ER.
-make an appointment with his pediatrician.
-advise him eschew underwear altogether
haha, i once met a guy who was in a real rush decided to go a-la-gringo and zipped his foreskin, not a pretty sight. the answer: take him to the ER - it could be a surgical emergency like a testicular torsion - the spermatic cord twists and the artery clamps and the blood supply to the testes is cut off. and it's common sense, would any child randomly complain about his private parts?

6. You're 65 yrs old and quit smoking 20yrs ago. What next?
- get screened for Lung Ca
- get screend for Prostate Ca
- depends on the gender
- get screened for an abdominal aneurysm
- oh shove it already.
you get a mark for this because i made a mistake - the age cut-off should've been 65 (i just changed it), but you got the answer right anyway. if you're 65 and male and have ever smoked, then you should get screened for an abdominal aneurysm. there are no recc for women smokers.

8. The food with the maximum number of drug interactions:
- cranberry juice - apple juice - pineapple juice -gooseberry juice - grapefruit juice
grapefruit juice

9. Salt substitute commonly consists of:
-Potassium Chloride -Magnesium Oxide - Zinc Oxide - Calcium Carbonate - Sodium Chloride
correct. i actually didn't know this until a few weeks ago, amazing that all of you got it right.

10. The mechanoreceptor in the skin responsible for two-point discrimination:
- Pacinian corpuscles - Meissner's  -Dermatophytes  -Merkel's disks
meissner's. all the above are mechanoreceptors found on the ends of nerve endings in the skin with the exception of dermatophytes which are a kind of fungi found on the skin and nails. pacinian corpuscles sense pressure. merkel's i don't know off-hand.

11. A woman with a h/o migraines calls your office to say she has a bad headache and has run out of her meds. She was in Africa six weeks ago and has since been otherwise well.
- call the pharmacy for a prescription (costs 70)
- tell her to take ibuprofen (costs 5)
- tell her to see you in the office (costs 150)
-send her to the ER (cost 2000)
this woman has been to Africa and six weeks later is not too late for a malaria to manifest itself. i'd have her quickly run to the ed so she can get a blood smear done to look for the parasites. malaria can kill in hours, i wouldn't take a chance. if it's just a migraine we can send her back home.

12. The number of chambers in a frog's heart:
1, 2, 3, 4
3 chambers. 2 atria and 1 ventricle. the human heart has  chambers: 2 atria and 2 ventricles.

thanks for playing!

two of questions were poorly written/incorrect.  i'm reposting one of them below with the answers. the other one was no 6 above.