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Exam l 2 : l NU665B/ l NU l 665 B l (NEW l 2025/ l
2026 l Update) l Primary l Care l of l Family l II l
Guide| l Questions l & l Answers| l Grade l A| l
100% l Correct l (Verified l Solutions)- l Regis
QUESTION
categoriesl ofl prostatitis Answer: catl 1:l acutel bacteriall prostatitis catl 2:l chronicl bacteriall prostatitis catl 3:l prostatel painl syndromel (CPPS) catl 4:l asymptomaticl inflammatoryl prostatitis
QUESTION
s/sl ofl acutel prostatitis Answer: urinaryl straining,l dysuria,l hesitancy,l urgency,l obstructionl andl irritation systemicl fever,l malaise,l suprapubicl pain,l chills,l nausea,l emesisl andl s/sl ofl sepsisl withl tachycardial andl hypotension
QUESTION
examl withl acutel bacteriall prostatisis Answer: tender,l boggyl enlargedl onl rectall exam distendedl bladder:l prostaticl massagel notl indicated midstreaml urinel culture:l cbc,l electrolyes,l bloodl culturel ifl neededl basedl onl severity
QUESTION
acutel bacteriall prostatitsl tx Answer: LEADSl TOl SEPSISl IFl Untreated organsism:l el coli,l klebsiella,l proteus,l pseudomonasl G,l graml +l enteroccus orall bactrim,l fluoroquinoloine menl youngerl thanl 25 l yearsl whol arel sexuallyl activel andl menl olderl thanl 35 l yearsl whol engagel inl highl riskl sexuall behaviorl shouldl bel txl withl regimensl thatl coverl nl gonorrheal andl cl trachomatis
QUESTION
txl withl chronicl bacteriall prostatitis Answer: persistentl bacteriall infectionl forl morel thanl 3 l months urinel culturesl obtainedl overl thel coursel ofl illnessl repeatedlyl growl thel samel bacteriall strain organisms:l el coli,l klebsiella,l proteusl andl pseudomonal andl enterococcus
QUESTION
etiologyl ofl chronicl bacteriall prostatatitis Answer: poorlyl understood maybel causedl byl presencel ofl antibioticl resistantl non-culturablel micro-organisms,l chemicall irritation,l intra-ductall refluxl andl obstrution,l dysfunctionall highl pressurel voiding,l neuropathicl pain
QUESTION
chronicl bacteriall prostatisl s/s Answer: doesn'tl appearl ill relapsingl UTI,l urethritis,l orl epididymitisl withl thel samel bacteriall strain irritativel voidingl symptomsl andl vesticular,l perineal,l lowl backl andl occasionall distaall penlinel pain
QUESTION
1stl linel txl chronicl prostatitis/l pelvicl pain Answer: fluoroquinolonesl *l (bestl tissuel concentration) ciprofloxacin,l bactrim atl leastl 6 l weeks,l preferrablyl 6 - 12 l weeks
QUESTION
chronicl prostatitis/l chronicl pelvisl painl 2ndl andl 3rdl linel tx Answer: 2ndl line
- bactrim 3rdl line
- pentosan,l finasteride,l quercetinl (bioflavonoidl supplement)
QUESTION
asympomaticl prostatitis Answer: dxl whenl inflammatoryl cellsl arel identifiedl onl prostatel bxl orl leukocytesl arel ntoedl onl semenl analysisl dyingl urologicl evaluationl forl otherl reasons clinicall signficancel isl unknown txl basedl onl primaryl reasonl forl urologicall evall
- l 0 l - l nol erection,l 1 - l Penisl isl largerl butl notl hard,l 2 - l Penisl isl hardl butl notl hardl enoughl forl penetration,l 3 - l Penisl isl hardl enoughl forl penetrationl butl notl completelyl hard,l 4 - l Penisl isl completelyl hardl andl fullyl rigid
QUESTION
endometriosis Answer: endometriuml growsl outsidel ofl thel uterus,l ovaries,l fallopianl tubes,l peritoneum,l bladder,l intestines implantsl duringl hormall cycle
cyclicl sloughingl ofl endometriall implantsl canl forml cystsl (endometriomas)l canl occurl anyhwerel butl mostl commonl inl ovaries,l canl rupturel andl causel acutel pain degreel ofl visiblel endometriosisl hasl nol coorleationl withl degreel ofl painl orl symptoms;l locationl andl depthl ofl implantsl affectl symptoms minlinel dieaasel (intrapelvis/intraabdomianl)l morel painfull thanl laterall disease
QUESTION
causesl ofl endometriosis Answer: retrogradel mentrusation-endometriall cellsl backl throughl thel fallopianl tubes/pelvicl cavity transformationl ofl peritoneall cellsl tol endometriall cellsl (hormone/immunel factors) embryonicl celll transformation-l horemonesl mayl transforml embyronicl cellsl duringl puberty surgical-implantl ofl endometriall cells endometriall cellsl transplantedl byl lymphaticl system immunel system-l bodyl unablel tol recognizel endometriall tissuel outsidel ofl thel uterus
QUESTION
howl doesl endometrisosil present Answer: precedingl menses symptomsl improvel duringl pregnancy/postmenopausall butl canl recurl postpartuml orl withl HRTl mostl commonlyl foundl inl womenl 30s/40s affectsl aboutl 10%l ofl population familyl historyl important-l womenl withl 1stl degreel relativel withl endometriosisl hasl 10xl riskl thanl ifl negl FH stagesl 1 - 4 l determinedl byl type,l location,l appearancel andl depthl ofl invasionl ofl lesionl extentl ofl diseasel andl adhesions
QUESTION
endometriosis Answer: dysmenorrhea heavyl orl irregularl bleeding
QUESTION
ovarianl cysts Answer: mostl commonl inl reproductivel years mostl arel selfl resolvingl inl premenopausall women-l canl bel 1cm-10cm
QUESTION
functionall cyst Answer: alll womenl whol ovulatel producel thesel cystsl whenl al dominantl folliclel maturesl tol releasel anl eggl somel mayl notl rupture,l butl thesel arel stilll likelyl tol resolve
QUESTION
dermoidl cysts Answer: madel ofl germl cellsl thatl mayl contail hair,l teethl orl fat,l nol cancerous
QUESTION
endometriomas Answer: akal 'chocolatel cysts'l arel causedl byl endometriosisl andl containl oldl blood
QUESTION
subjectivel findingsl ovarianl cysts Answer: mayl bel asympomatic
pain,l mayl bel inl lowerl abdominall quadrants/l pelvis,l mayl onlyl noticel painl onl palpationl (incidentall finding) mayl describel itl asl discomfortl orl pressurel ratherl thanl painl althoughl couldl bel sharpl (rupture),l intermittentl orl constant torsion-l painl withl nausea/l vomiting mayl presentl withl genitall tractl bleeding note:l newl and/orl persistentl abdominall bloatingl and/orl earlyl satietyl arel s/sl consistentl withl ovarianl cancer
QUESTION
dxl withl ovarianl cysts Answer: pregl test pevlicl us:l confirml thel presencel ofl al cyst,l helpsl tol identifyl itsl locationl andl determinel whetherl itsl solid,l filledl withl fluidl orl mixed laparoscopy CAl 125 l bloodl test:l onlyl forl postl menopausal,l (canl bel positivel inl endometriosis,l uterinel fibroids,l PID,l kidneyl disease,l heartl diseasel andl liverl abnormalities)
QUESTION
txl ofl ovarianl cystts Answer: seriall US:l 6 - 8 l weeks,l timedl withl menses ifl normal,l checkl inl 3 - 6 l monthsl forl 2 l yearsl tol seel ifl theyl arel resolvedl ifl ca- 125 l elevatedl thenl referl fol gynl coc-l canl helpl preventl morel cystsl byl preventingl ovulation concernl withl solidl components
QUESTION
whenl surgeryl forl cysts Answer: whenl cystl isl causingl persistentl pain/pressure,l orl isl likelyl tol rupture/twistl (torsion) U/Sl showsl thatl thel cystl isl likelyl anl endometrioma,l remoall helpsl preservel fertility
coc,l pop,l gnrh,l lysteda,l NSAID,l iron
QUESTION
fibromyalgial definition Answer: chronicl painl disorderl affectingl connectivel tissue muscles,l tendons,l ligamentsl arel excessivelyl irritatedl causingl centrall sensitizationl andl al heightenedl perceptionl ofl pain
QUESTION
whol isl atl riskl forl fibromyalgia Answer: affectsl 8%l ofl peoplel byl agel 70 mostl commonl causel ofl generalizedl painl inl womenl agedl 22 - 55 geneticsl mayl playl al rolel withl thosel affectedl havingl al heightenedl sensel ofl pain causel isl unknownl butl theoriesl existl suggestingl variousl illnesses,l physicall andl emotionall factorsl canl precipitatel symptoms
- infectionl (lyme,l virall illnesses)
- medicall conditionsl (RA,l SLE)
- injury(physicall trauma,l surgery)
- stressl (emotionall trauma)
QUESTION
subjectivel complaints Answer: widespread,l persistentl pain
- deepl soreness,l stiffness,l burning,l throbbing,l numbness,l 'feelingl likel Il alwaysl havel al flu' additionall symptoms
- chronicl headaches,l IBS,l TMJ,l fatiguel andl sleepl distubances,l sleepl apnea,l chronicl fatiguel syndrome,l depression/anxiety
QUESTION
differentiall diagnosisl withl fibromyalgia Answer: RA:l veryl similarl butl oftenl hasl inflammationl ofl synoviall membranesl andl wouldl havel +rheumatoidl factorl and/orl anti-citrullinatedl peptidel antibodis SLE:l isl anl autoimmunel processl andl canl havel morel lifel threateningl outcomesl asl comparesl tol fibromyalgia,l alsol hasl differentiatingl diagnositcl testing osteoarthritis:l differentiationl isl basedl onl medicall hxl andl exam.l xl raysl wouldl showl degenerativel jointl changesl thatl arel notl seenl inl fibromyalgia ankylosingl spondylitis-l xl raysl showl characteristicl findingsl associatedl withl asl whichl arel absentl inl fibromyalgia,l oftenl affectsl onlyl spine polymyalgial rheymatic-l canl differentiatl basedl onl medicall hxl andl bloodl tests thyroidl disorders:l TSHl bloodl testl canl helpl differentiate myositis:l causesl musclel weaknessl andl fatiguel wherel asl fibromyalgial causesl widespreadl pain.l CKMMl testsl forl musclel enzymesl wouldl bel elevatedl inl myositisl andl normall inl fibromyalgia
QUESTION
objectivel findingsl withl fibromyalgia Answer: nol specificl labsl orl imagingl testl tol confirml dx
QUESTION
tenderl pointsl inl fibromyalgia Answer:
- notel thel bilaterall symmetryl withl tendernessl onl palpationl ofl atl leastl 11 l ofl thel 18 l sites,l withl atl leastl al threel monthl hxl ofl musculoskeletall painl isl al dxl standardl forl fibromyalgial
- underl thel lowerl steromastoidl muscle
- nearl thel costochondrall junction
- 2cml distall tol thel laterll epicondyle
- atl thel prominencel ofl thel greaterl trochanter
- atl thel medicall fatl padl ofl thel knee
- insertionl ofl thel suboccipitall muscle
- midl upperl trap
- originl ofl thel supraspinatusl muscle
- upperl outerl quadl ofl thel butt
Answer: eralyl localizedl disease
- appearancel ofl thel characteristicl skinl lesion,l erythemal migrans,l 3 - 30 l daysl afterl tickl bite,l wl orl w/ol constitutionall symptoms earlyl disseminatedl disease
- characterizedl myl multiplel EMl lesionsl involvedl withl skin,l heart,l musculoskeletall syseml andl nervousl system,l persistentl fatigue,l weeksl tol monthsl afterl infection latel lyme
- intermittentl orl persistentl arthritisl involvingl largel joints,l especiallyl monoarticularel artharlgiasl mostl oftenl affectingl thel knee
- alsol associatedl withl rarel neurologicall probelemsl (encetophalopathyl orl polyneuropathy)
- developsl monthsl tol al fewl yearsl afterl thel initiall infection
QUESTION
serologyl studiesl withl lyme Answer: ptsl withl earlyl lymel mayl initiallyl bel seroneg,l willl convertl afterl 1 l monthl evenl withl abx falsel negsl arel moel commonl thanl falsel pos oncel presentl antibodiesl alwaysl therel serologyl shouldl notl bel usedl tol accessl efficcyl ofl abx,l ratherl therel arel bestl tol confirml exposurel atl somel timel andl arel notl indicativel ofl activel infection
QUESTION
ELISA
Answer: enzymel linkedl immunosorbentl assayl withl bl burgdorferil antigensl asl al screeningl tooll forl IgMl andl IgGl reactivity Igm-l appearsl withinl firstl fewl weeksl ofl infection IgG-l responsesl appearl withinl al month immunoblotl (westernl blot-l shouldl bel usedl tol confirml specificityl ofl antibodiesl forl alll positivel orl equivicall ELISAl samples
- IgMl neesdl 2 l ofl 3 l bandsl forl positive
- IgGl needsl 5 l ofl 10 l forl positiive
QUESTION
txl forl lyme Answer: earlyl diseasel doxyl (100mgl bidl 10 - 21 l days),l amoxl 500mgl TIDl 14 - 21 l days,l cefuroximel 500mgl 14 - 21 l days
QUESTION
jarischl herxheimerl reaction Answer: 15%l ofl patientsl experiencel al transientl worseningl ofl lymel symptomsl duringl thel firstl 24 l hrs,l duel tol hostl immunel responel tol antigensl relesaesl byl dyingl organisms response:l majorityl ofl ptsl withl earlyl lymel whol recievel txl havel completel reolutionl ofl s/sl ofl infectionl withinl 20 l days somel ptsl havel mildl subjectivel symptomsl suchl asl headache,l musckolskeletall pain,l arthalgiasl orl fatiguel thatl persistl weeksl tol monthsl afterl tx.l typicallyl resolvel withinl 6 l monthsl w/ol furhterl abx morel prolongedl subjectivel s/sl afterl appropraitel abxl havel beenl calledl post-lymel diseasel syndromel andl arel difficultl tol tx
QUESTION
osteoarthritis Answer: degenerationl ofl jointl cartilagel andl underlyingl bone mostl commonl chronicl conditionl affectingl jointsl inl thel us mostl commonl froml middlel agel onward causesl pain,l stiffness,l hip,l kneel andl handl joints cartilagel coveringl thel endl ofl bonesl roughensl andl becomesl thin,l whilel thel bonel underl thel cartilagel growsl thicker.l thisl causesl osteophytesl tol growl andl spacel betweenl thel jointl tol narrow
QUESTION
riskl factorsl forl osteoarthritis Answer: jointl injuryl orl overuse-kneel bendingl andl repetetivel stressl onl al joint
MRIl notl necessaryl butl canl bel usedl tol diagnosel OAl earlyl asl itl canl identifyl earlyl stagesl withl cartiliagel defectsl andl bonel marrowl lesions US-l canl detectl synoviall inflammation,l effusion,l andl osteophytosis
QUESTION
howl tol treatl osteol arthritis Answer: mild
- exercise,l splintsl andl assistaivel devices
- weightl lossl (initiall targetl isl 5 - 10 l %l reductionl withinl 6 l months)
- NSAIDsl (topicall diclofenacl orl ketoprofen)
- topicall capsaicin moderate
- intraarticularl steriodsl (duloxetine)l nol morel tahnl 3 - 4 l injectionsl perl jointl perl year
- orthopedicl consult
QUESTION
topicall agentsl tol treatl OA Answer: diclofenacl topicall gel
- kneesl rubl inl 4gl tol affectedl kneel 3 - 4 l timesl daily
- handsl rubl inl 2gl tol affectedl joijntl 3 - 4 l timesl daily
- maxl 16gl perl joint,l 32gl perl dayl diclofenacl topicall solutionl drosl 1.5%
- knees:l rubl inl 40 l dropsl perl kneel upl tol 4 l timesl daily topicall capsacin: rubl inl al smalll amountl 1 - 4 l tiemsl daily
QUESTION
rheumatoidl arthritis Answer: inflammatoryl arthritisl ofl unknownl etiologu oftenl occursl inl symmetricl fashionl andl leadsl tol deformityl becausel ofl stretchingl ofl tendonsl andl ligaments
canl alsol leadl tol destrucionl ofl jointsl throughl erosionl ofl cartilagel andl bone.l if.l untreatedl orl unresponsivel tol txl patientsl canl havel lossl ofl physicall function,l difficultyl carryingl outl dailyl tasksl ofl livingl andl maintainingl employment affectsl thel smalll jointsl ofl thel handsl andl feetl butl canl progressl tol largerl jointsl ofl knees,l hipsl andl back
QUESTION
riskl factorsl forl RA Answer: femalesl x3l morel likelyl tol developl RA heredity-l notl inheritedl butl peoplel withl HLAl genel morel likelyl tol developl thel disease infection-l nol linkgl tol specificl infectionsl butl alterationl inl bacterial inl thel mouthl andl getl canl increasel developmentl ofl thel disease smoking-l womenl whol smokel havel 2.5%l greaterl riskl ofl developing stress-l ptsl oftenl reportl anl episodel ofl stressl orl traumal proceedingl developmentl ofl thel disease
QUESTION
keyl symptomsl andl hxl withl RA Answer: fatigue,l musclel painl (symetric,l usuallyl startsl peripherally),l numbnessl andl tinglingl inl hands,l weightl loss,l recentl illness,l stress stiffnessl commonl inl aml orl afterl sittingl forl al longl time handsl usuallyl impactedl firstl RAl canl causel increasaedl riskl ofl coronaryl arthersclerosisl reducel riskl factorsl suchl asl cigs,l htn,l yperlipid
QUESTION
howl tol testl forl RA Answer: clinicall symptoms
- morningl stiffnessl lastingl >1l hourl forl >6l weeks
- swellingl inl threel orl morel jointsl >6l weeks
- swellingl inl wrists,l handl orl fingerl jointsl >6l weeks
Answer: weightl lossl ofl >5%l inl lastl 6 - 12 l months
QUESTION
criterial tol definel frailty Answer: weightl loss
- l >10l lbl unintentionall weightl lossl overl pastl year exhaustion slowness
- timel tol walkl 15 l feet lowl activity
- expendsl <270l kcal/weekl froml activityl scale weakness
- gripl strengthl measuredl usingl handl dynamometer
QUESTION
BMI
Answer: ØIfl yourl BMIl isl lessl thanl 18.5,l itl fallsl withinl thel underweightl range ØMild:l > ØModerate:l 16 l - l 16. ØSevere:l 15 - 15. ØExtreme:l < •Ifl yourl BMIl isl lessl thanl 18.5,l itl fallsl withinl thel underweightl range •Ifl yourl BMIl isl 18.5l tol <25,l itl fallsl withinl thel normal •Ifl yourl BMIl isl 25.0l tol <30,l itl fallsl withinl thel overweightl range •Ifl yourl BMIl isl 30.0l orl higher,l itl fallsl withinl thel obesel range
QUESTION
albuminl vsl prealbumin Answer: Totall Protein
- Measuresl thel totall amountl ofl albuminl andl globulinl proteinsl inl thel blood
- Normall apr.l 6 - 8g/dl Albumin
- al plasmal bindingl proteinl composesl 60%l totall protein
- Maintainl osmoticl pressurel inl vascularl space
- Reflectsl overalll nutritionall statusl Normall apr.l 3.5-5.5g/dl Prealbumin
- Precursorl tol albumin,l Plasmal proteinl madel byl liver
- Normall apr.l 15 - 35g/dl
QUESTION
proteinl caloriel malnutrition Answer:
- Albuminl <3.
5%l weightl lossl inl pastl 6 - 12 l months.
- BMIl <18.5,l especiallyl withl co-morbidity
- poorl nutritionl orl lossl ofl appetite
- Wastingl appearancel orl musclel wasting
QUESTION
appetitel stimulants Answer:
- •Dronabinol/Marinoll (canniboid)l canl bel effectivel doesl havel cnsl effects •Megace
- Complication:l worseningl chf,l weaknessl constipation,l edema,l thrombosis,l thisl isl onl beersl listl usel withl caution •Mirtazapine:/Remeron:l antidepressantl sidel effectl wtl gain,l increasedl appetite •Grehlinl mimetics:l endogenousl growthl hormonel secretagoguesl initiall trialsl showsl goodl resultsl withl youngerl adults.l Adversel effectsl includel hypergycemia,l dizziness,l nausea
QUESTION
anorexial andl bullemial features Answer:
