PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps
Study diagnoses, tests, next steps and management with a source-linked PANCE deck organized by the January 2025 NCCPA blueprint.
Bu deste hakkında
Reviewed for 2026, this 600-card English deck follows the January 2025 NCCPA PANCE blueprint. Its two public tag axes let you switch between medical-content systems and exam-task retrievals: discriminating history and examination cues, diagnosis, diagnostic-study choice, prevention, next-step intervention, pharmacotherapy, and selected foundations. Every answer links to a current first-party clinical guideline or authoritative public-health or professional body and records the 2026-08-26 review date. Official PANCE eligibility and certification requirements remain with NCCPA. No recalled or leaked exam questions, exam items, mark schemes, curriculum prose, commercial deck wording, logos, figures, or trade dress were copied. Educational review only. This deck isn't medical advice and isn't a substitute for current clinical guidance, supervision, local protocols, or patient-specific judgment. This independently written resource is unofficial and is not affiliated with or endorsed by NCCPA.
Bu destedeki kartlar
Kart 1
Soru
What core mechanism explains acute coronary syndrome?
Cevap
Plaque disruption with superimposed coronary thrombosis causes most acute coronary syndromes.
2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
Kart 2
Soru
When an adult patient with decision-making capacity refuses a recommended treatment, what is the clinician’s next step?
Cevap
Confirm that the choice is informed and voluntary, explain material risks and alternatives, document the discussion, and respect the refusal.
Informed Consent · reviewed 2026-08-26
Kart 3
Soru
In a child or adolescent, what core mechanism explains asthma?
Cevap
Airway inflammation and hyperresponsiveness create variable, usually reversible airflow obstruction.
2026 GINA Strategy Report · reviewed 2026-08-26
Kart 4
Soru
What core mechanism explains upper gastrointestinal bleeding?
Cevap
Bleeding proximal to the ligament of Treitz is altered by gastric acid and intestinal transit, producing hematemesis or melena.
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
Kart 5
Soru
In a child or adolescent, what core mechanism explains septic arthritis?
Cevap
Bacterial invasion of synovium triggers destructive inflammation that can rapidly damage cartilage.
Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
Kart 6
Soru
What core mechanism explains acute ischemic stroke?
Cevap
Arterial occlusion deprives brain tissue of oxygen, leaving a salvageable penumbra around the infarct core.
2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
Kart 7
Soru
What core mechanism explains community-acquired pneumonia?
Cevap
Alveolar infection fills air spaces with inflammatory exudate and impairs gas exchange.
Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
Kart 8
Soru
What core mechanism explains ectopic pregnancy?
Cevap
Implantation outside the endometrial cavity, usually in the tube, can erode vessels and rupture.
Ectopic Pregnancy · reviewed 2026-08-26
Kart 9
Soru
In a child or adolescent, what core mechanism explains major depressive disorder?
Cevap
Mood-network and stress-system dysregulation interacts with genetic and environmental vulnerability; no single neurotransmitter explains the disorder.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
Kart 10
Soru
What core mechanism explains type 2 diabetes mellitus?
Cevap
Insulin resistance plus progressive beta-cell dysfunction produces chronic hyperglycemia.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 11
Soru
What core mechanism explains acute angle-closure glaucoma?
Cevap
Closure of the anterior-chamber angle blocks aqueous outflow and abruptly raises intraocular pressure.
Management of Angle-Closure Glaucoma · reviewed 2026-08-26
Kart 12
Soru
What clinical clue should raise suspicion for aortic dissection?
Cevap
Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
Kart 13
Soru
What core mechanism explains chronic kidney disease?
Cevap
Progressive nephron loss causes hyperfiltration in remaining nephrons, fibrosis, and multisystem toxin accumulation.
2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
Kart 14
Soru
What core mechanism explains iron-deficiency anemia?
Cevap
Iron depletion limits heme synthesis, producing hypochromic microcytes and eventually tissue iron symptoms.
British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
Kart 15
Soru
In an infant aged 1–23 months with a viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty, what is the most likely diagnosis?
Cevap
Bronchiolitis. An infant with viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty likely has bronchiolitis.
Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
Kart 16
Soru
In a child or adolescent, what core mechanism explains atopic dermatitis?
Cevap
Skin-barrier dysfunction and type 2 inflammation increase transepidermal water loss and itch.
Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
Kart 17
Soru
What clinical clue should raise suspicion for acute pancreatitis?
Cevap
Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical.
ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
Kart 18
Soru
What core mechanism explains uncomplicated cystitis?
Cevap
Ascending periurethral bacteria inflame the bladder mucosa without renal-parenchymal involvement.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 19
Soru
Which diagnosis causes symmetric synovitis of the MCP, PIP, or wrist joints with prolonged morning stiffness?
Cevap
Rheumatoid arthritis. Symmetric inflammatory pain and prolonged morning stiffness in MCP, PIP, or wrist joints with synovitis suggest rheumatoid arthritis.
Rheumatoid Arthritis · reviewed 2026-08-26
Kart 20
Soru
What abilities are assessed when determining decision-making capacity for a specific choice?
Cevap
The patient must communicate a choice, understand relevant information, appreciate how it applies personally, and reason about the options.
Informed Consent · reviewed 2026-08-26
Kart 21
Soru
Which diagnosis causes fluctuating, fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use?
Cevap
Myasthenia gravis. Fluctuating fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use suggests myasthenia.
International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
Kart 22
Soru
Which diagnosis best fits new clinically significant diarrhea after antibiotics or healthcare exposure, especially with abdominal pain or leukocytosis?
Cevap
Clostridioides difficile infection. New clinically significant diarrhea after antibiotics or healthcare exposure, with abdominal pain or leukocytosis, suggests C. difficile.
2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26
Kart 23
Soru
For surgical decision-making, after delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicate which obstetric emergency?
Cevap
Shoulder dystocia. After delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicates dystocia.
Shoulder Dystocia · reviewed 2026-08-26
Kart 24
Soru
In a child or adolescent, which diagnosis causes persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment?
Cevap
Attention-deficit/hyperactivity disorder. Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment suggests ADHD.
ADHD in Children and Youth: Part 1—Etiology, Diagnosis, and Comorbidity · reviewed 2026-08-26
Kart 25
Soru
Which diagnosis best fits sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation?
Cevap
Acute pericarditis. Sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation support pericarditis.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 26
Soru
Which next action matters most in acute respiratory distress syndrome?
Cevap
Treat the cause, ventilate with low tidal volumes and limited pressures, and use prone positioning for severe hypoxemia.
An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
Kart 27
Soru
For surgical decision-making, identify the condition from this pattern: Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.
Cevap
Cushing syndrome. Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.
Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
Kart 28
Soru
For surgical decision-making, identify the condition from this pattern: Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.
Cevap
Peritonsillar abscess. Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.
Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
Kart 29
Soru
What clinical clue should raise suspicion for anterior cruciate ligament tear?
Cevap
A noncontact pivot, audible pop, immediate swelling, and instability with a positive Lachman test suggest an ACL tear.
Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 30
Soru
Which diagnosis may be silent until edema, pruritus, anemia, hypertension, or abnormal urine testing appears?
Cevap
Chronic kidney disease. CKD may be silent; edema, pruritus, anemia, hypertension, or abnormal urine testing often appears later.
2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
Kart 31
Soru
For surgical decision-making, which next action matters most in aortic dissection?
Cevap
Start rapid heart-rate and blood-pressure control and obtain emergency surgical evaluation for ascending dissection.
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
Kart 32
Soru
Identify the condition from this pattern: Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia.
Cevap
Iron-deficiency anemia. Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia.
British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
Kart 33
Soru
What clinical clue should raise suspicion for bacterial brain abscess?
Cevap
Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.
ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
Kart 34
Soru
Which diagnosis best fits chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions?
Cevap
Crohn disease. Chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions support Crohn disease.
Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
Kart 35
Soru
What clinical clue should raise suspicion for pulmonary tuberculosis?
Cevap
Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.
Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26
Kart 36
Soru
Which diagnosis causes well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting?
Cevap
Plaque psoriasis. Well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting support psoriasis.
Psoriasis Clinical Guidelines · reviewed 2026-08-26
Kart 37
Soru
What clinical clue should raise suspicion for endometriosis?
Cevap
Cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility suggests endometriosis.
Endometriosis · reviewed 2026-08-26
Kart 38
Soru
Identify the condition from this pattern: Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.
Cevap
Acute pyelonephritis. Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 39
Soru
What clinical clue should raise suspicion for panic disorder?
Cevap
Recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least a month suggests panic disorder.
Panic Disorder: What You Need to Know · reviewed 2026-08-26
Kart 40
Soru
What drug class or regimen fits acute pericarditis?
Cevap
Use an NSAID plus colchicine for uncomplicated acute pericarditis when not contraindicated.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 41
Soru
What clinical clue should raise suspicion for tension pneumothorax?
Cevap
Severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock suggest tension physiology.
Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
Kart 42
Soru
In a child or adolescent, which next action matters most in diabetic ketoacidosis?
Cevap
Begin isotonic fluids, replace potassium according to the measured level, and start IV insulin once potassium is safe.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 43
Soru
Who makes decisions when an adult patient lacks capacity and has no applicable advance directive?
Cevap
Use the legally authorized surrogate and guide decisions by the patient’s known wishes or, if unknown, best interests.
Decisions for Adult Patients Who Lack Capacity · reviewed 2026-08-26
Kart 44
Soru
For surgical decision-making, which next action matters most in retinal detachment?
Cevap
Send the patient to an eye doctor or emergency department immediately for retinal evaluation and treatment. Early treatment helps prevent permanent vision loss.
Retinal Detachment · reviewed 2026-08-26
Kart 45
Soru
What clinical clue should raise suspicion for acute deep-vein thrombosis?
Cevap
Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.
ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
Kart 46
Soru
Which next action matters most in Crohn disease?
Cevap
Drain abscesses and involve surgery for obstruction, fistula complications, perforation, or refractory disease.
Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
Kart 47
Soru
Which next action matters most in rheumatoid arthritis?
Cevap
Refer early and start disease-modifying therapy rather than relying on symptomatic treatment.
2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis · reviewed 2026-08-26
Kart 48
Soru
What antimicrobial approach is appropriate for suspected or confirmed pleural infection?
Cevap
Start empiric antibiotics before culture results, covering likely organisms including anaerobes, then narrow therapy to microbiology and clinical context.
British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
Kart 49
Soru
In a child or adolescent, which next action matters most in nephritic syndrome?
Cevap
Control pressure and volume, treat the cause, and obtain urgent nephrology input for rapidly progressive loss.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 50
Soru
Which prevention or risk-reduction step is important for acute coronary syndrome?
Cevap
Treat tobacco use, hypertension, diabetes, and dyslipidemia to reduce atherosclerotic risk.
2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
Kart 51
Soru
Which next action matters most in multiple sclerosis relapse?
Cevap
Exclude infection or pseudo-relapse, then treat functionally significant relapse and reassess disease-modifying therapy.
Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
Kart 52
Soru
Which next action matters most in HIV infection?
Cevap
Link a newly diagnosed patient rapidly to HIV care and begin antiretroviral therapy as soon as feasible.
Initiation of Antiretroviral Therapy · reviewed 2026-08-26
Kart 53
Soru
For surgical decision-making, which next action matters most in postpartum hemorrhage?
Cevap
Call the hemorrhage team, massage an atonic uterus, give uterotonics, replace blood products, and control the cause procedurally if needed.
Postpartum Hemorrhage · reviewed 2026-08-26
Kart 54
Soru
Which next action matters most in delirium?
Cevap
Treat the cause, protect the patient, and use nonpharmacologic measures first.
Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
Kart 55
Soru
After successful endoscopic hemostasis of a high-risk bleeding peptic ulcer, what medication strategy is recommended?
Cevap
Give high-dose proton-pump inhibitor therapy continuously or intermittently for 3 days.
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
Kart 56
Soru
What clinical clue should raise suspicion for thyroid storm?
Cevap
Fever, marked tachycardia, agitation or delirium, gastrointestinal symptoms, and heart failure in thyrotoxicosis suggest storm.
2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
Kart 57
Soru
In a child or adolescent, what drug class or regimen fits septic arthritis?
Cevap
Cover likely gram-positive organisms initially, adding gram-negative coverage for relevant risk.
Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
Kart 58
Soru
What clinical clue should raise suspicion for acute bacterial rhinosinusitis?
Cevap
Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.
Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
Kart 59
Soru
How should a clinician respond when a patient asks not to hear serious diagnostic information?
Cevap
Explore the request and preferences, confirm it is voluntary, and identify whether the patient wants information shared with a chosen surrogate.
Withholding Information from Patients · reviewed 2026-08-26
Kart 60
Soru
What is the key first diagnostic step for cardiac tamponade?
Cevap
Bedside echocardiography can show effusion with chamber collapse and respiratory flow variation.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 61
Soru
In a child or adolescent, which next action matters most in atopic dermatitis?
Cevap
Treat active inflammation and address infection, sleep disruption, and trigger exposure.
Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
Kart 62
Soru
What is the key first diagnostic step for idiopathic pulmonary fibrosis?
Cevap
High-resolution CT showing a usual interstitial pneumonia pattern can establish diagnosis in the right context; multidisciplinary review is key.
Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
Kart 63
Soru
What drug class or regimen fits benign prostatic hyperplasia?
Cevap
Alpha-1 blockers improve symptoms quickly; 5-alpha-reductase inhibitors reduce progression in appropriately enlarged prostates.
EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
Kart 64
Soru
In a child or adolescent, what clinical clue should raise suspicion for nephritic syndrome?
Cevap
Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 65
Soru
In a child or adolescent, which initial medication regimen is indicated for a convulsive seizure lasting at least five minutes or recurring without recovery?
Cevap
A benzodiazepine is first-line for convulsive status epilepticus, followed by an appropriate longer-acting antiseizure medicine.
Treatment of Prolonged Seizures in Children and Adults · reviewed 2026-08-26
Kart 66
Soru
Which next action matters most in acute deep-vein thrombosis?
Cevap
Start anticoagulation promptly after acute deep-vein thrombosis is confirmed, unless a contraindication changes the plan.
ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
Kart 67
Soru
What drug class or regimen fits sepsis?
Cevap
Use broad therapy matched to source, host, and local resistance, then de-escalate from cultures and response.
2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
Kart 68
Soru
Which bedside pattern best points to infective endocarditis?
Cevap
Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 69
Soru
What drug class or regimen fits pelvic inflammatory disease?
Cevap
Outpatient therapy commonly uses ceftriaxone plus doxycycline and metronidazole.
Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
Kart 70
Soru
Which prevention or risk-reduction step is important for acute pancreatitis?
Cevap
Treat gallstones, avoid alcohol excess, and control severe hypertriglyceridemia to reduce recurrence.
ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
Kart 71
Soru
What drug class or regimen fits schizophrenia?
Cevap
Use an antipsychotic through shared decision-making; clozapine is indicated for treatment resistance or persistent suicide risk under monitoring.
Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
Kart 72
Soru
Which prevention or risk-reduction step is important for anterior cruciate ligament tear?
Cevap
Neuromuscular warm-up and landing programs reduce noncontact ACL injuries in high-risk athletes.
Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 73
Soru
What is the key first diagnostic step for primary hypothyroidism?
Cevap
Measure TSH first in most patients and free T4 to characterize overt disease.
Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
Kart 74
Soru
In an acutely ill hospitalized medical patient, what VTE prevention strategy is appropriate?
Cevap
Assess VTE and bleeding risk, then use pharmacologic prophylaxis when indicated or mechanical prophylaxis when anticoagulation is unsuitable.
ASH VTE Guidelines: Prophylaxis for Medical Patients · reviewed 2026-08-26
Kart 75
Soru
In a child aged 6 months or older, what drug class or regimen fits acute otitis media?
Cevap
Amoxicillin is first-line for most children who need an antibiotic, with alternatives guided by allergy and prior treatment.
Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
Kart 76
Soru
What makes informed consent more than a signed form?
Cevap
It is a communication process covering the nature, expected benefits, material risks, alternatives, and the option to decline, followed by a voluntary decision.
Informed Consent · reviewed 2026-08-26
Kart 77
Soru
What condition should be suspected from this finding: Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.
Cevap
Hypertensive emergency. Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 78
Soru
Which prevention or risk-reduction step is important for migraine with aura?
Cevap
Regular sleep, meals, hydration, activity, trigger management, and limiting acute-medicine overuse reduce attacks.
AHS Consensus Statement: Integrating New Migraine Treatments into Clinical Practice · reviewed 2026-08-26
Kart 79
Soru
What is the key first diagnostic step for upper gastrointestinal bleeding?
Cevap
Check hemodynamics, CBC, metabolic and coagulation studies, type and screen, then perform timely upper endoscopy after stabilization.
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
Kart 80
Soru
Which prevention or risk-reduction step is important for early syphilis?
Cevap
Condom use, partner services, repeat testing for ongoing risk, and prenatal screening reduce transmission and congenital disease.
Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
Kart 81
Soru
In a child or adolescent, what is the key first diagnostic step for septic arthritis?
Cevap
Perform urgent arthrocentesis for cell count, crystals, Gram stain, and culture; obtain blood cultures.
Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
Kart 82
Soru
Which prevention or risk-reduction step is important for abnormal uterine bleeding from anovulation?
Cevap
Address reversible causes of ovulatory dysfunction, review medicines that worsen bleeding, and monitor for anemia.
Abnormal Uterine Bleeding · reviewed 2026-08-26
Kart 83
Soru
In a young child, which diagnosis best fits a barking cough, hoarseness, and inspiratory stridor after a viral prodrome?
Cevap
Croup. Barking cough, hoarseness, and inspiratory stridor after a viral prodrome in a young child suggests croup.
Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
Kart 84
Soru
Which intervention is recommended to reduce later PTSD in an adult diagnosed with acute stress disorder?
Cevap
Offer individual trauma-focused cognitive behavioral psychotherapy with exposure and/or cognitive restructuring.
Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
Kart 85
Soru
What clinical clue should raise suspicion for cellulitis?
Cevap
Unilateral expanding warmth, tenderness, erythema, and edema without a sharply raised border favor cellulitis.
Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
Kart 86
Soru
How should a clinician initially manage infective endocarditis?
Cevap
Start targeted IV antibiotics after cultures; seek early valve-team input for heart failure, uncontrolled infection, or major embolic risk.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 87
Soru
What clinical clue should raise suspicion for benign prostatic hyperplasia?
Cevap
Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms.
EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
Kart 88
Soru
What drug class or regimen fits chronic kidney disease?
Cevap
Use an ACE inhibitor or ARB for appropriate albuminuric CKD and an SGLT2 inhibitor for eligible patients.
2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
Kart 89
Soru
Which microbiologic test is essential when gonococcal conjunctivitis is suspected?
Cevap
Obtain a conjunctival specimen for culture; add a locally validated nucleic-acid amplification test when available, and perform susceptibility testing on cultured isolates when indicated.
Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
Kart 90
Soru
What drug class or regimen fits iron-deficiency anemia?
Cevap
Oral iron is first-line for many patients; IV iron is useful when absorption, tolerance, severity, or speed makes oral therapy unsuitable.
British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
Kart 91
Soru
When may treatment proceed without prior consent in an emergency?
Cevap
When urgent treatment is needed, the patient cannot participate, no surrogate is available, and delay threatens life or serious health; document the circumstances.
Informed Consent · reviewed 2026-08-26
Kart 92
Soru
What drug class or regimen fits primary adrenal insufficiency?
Cevap
Replace glucocorticoid and usually mineralocorticoid in chronic primary disease.
Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
Kart 93
Soru
What is the key first diagnostic step for subarachnoid hemorrhage?
Cevap
Use immediate noncontrast CT; if negative but suspicion remains, follow the time-appropriate pathway with lumbar puncture or vascular imaging.
2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
Kart 94
Soru
Which bedside pattern best points to celiac disease?
Cevap
Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
Kart 95
Soru
In a child or adolescent, what is the key first diagnostic step for bacterial meningitis?
Cevap
Obtain blood cultures and lumbar puncture when safe; perform head imaging first only for defined risk features.
WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
Kart 96
Soru
In a postmenopausal woman or man aged 50 or older, which diagnosis is established by a hip or vertebral fragility fracture?
Cevap
Osteoporosis. A hip or vertebral fracture from low trauma establishes osteoporosis regardless of T-score.
The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26
Kart 97
Soru
What is the key first diagnostic step for preeclampsia with severe features?
Cevap
Confirm pressure correctly and assess urine protein, CBC, creatinine, liver tests, fetal status, and symptoms.
Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
Kart 98
Soru
In an infant aged 1–23 months, how should a clinician initially manage bronchiolitis?
Cevap
Support oxygenation and hydration; use suction selectively and assess apnea or exhaustion.
Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
Kart 99
Soru
What is the key first diagnostic step for bipolar I mania?
Cevap
Diagnosis is clinical; assess substances, thyroid disease, medicines, psychosis, and safety.
Management of Bipolar Disorder in Adults · reviewed 2026-08-26
Kart 100
Soru
How should medication be used in hypertensive emergency?
Cevap
Choose a titratable IV agent suited to the clinical syndrome; do not rapidly normalize pressure in most presentations.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 101
Soru
Which bedside pattern best points to obstructive sleep apnea?
Cevap
Loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension suggests OSA.
Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea · reviewed 2026-08-26
Kart 102
Soru
What counseling point helps reduce harm from heart failure with reduced ejection fraction?
Cevap
Control blood pressure and coronary risk, and avoid medicines that worsen fluid retention.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 103
Soru
What condition should be suspected from this finding: Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.
Cevap
Cirrhosis with ascites. Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.
Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
Kart 104
Soru
Which bedside pattern best points to carpal tunnel syndrome?
Cevap
Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.
Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 105
Soru
In a patient with prior demyelinating events, which diagnosis fits a new focal neurologic deficit evolving over hours to days and lasting more than 24 hours?
Cevap
Multiple sclerosis relapse. A focal neurologic deficit evolving over hours to days and lasting over 24 hours, separated in time and space from prior events, suggests relapse.
Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
Kart 106
Soru
Which prevention or risk-reduction step is important for primary hyperparathyroidism?
Cevap
Maintain hydration and avoid unnecessary calcium-raising medicines while monitoring patients who do not have surgery.
Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
Kart 107
Soru
What condition should be suspected from this finding: Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.
Cevap
HIV infection. Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.
About HIV · reviewed 2026-08-26
Kart 108
Soru
Which prevention or risk-reduction step is important for sudden sensorineural hearing loss?
Cevap
Counsel patients to seek same-day care for sudden hearing change rather than waiting for spontaneous recovery.
Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
Kart 109
Soru
For surgical decision-making, what condition should be suspected from this finding: Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.
Cevap
Postpartum hemorrhage. Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.
Postpartum Hemorrhage · reviewed 2026-08-26
Kart 110
Soru
What is the clinician’s duty after recognizing a significant medical error that harmed a patient?
Cevap
Disclose the known facts honestly, explain the clinical impact and next care steps, express appropriate concern, and follow reporting processes.
Promoting Patient Safety · reviewed 2026-08-26
Kart 111
Soru
Which diagnosis causes an acute, fluctuating disturbance of attention and awareness with disorganized thinking?
Cevap
Delirium. An acute fluctuating disturbance of attention and awareness with disorganized thinking suggests delirium.
Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
Kart 112
Soru
In a child or adolescent, what is the key first diagnostic step for nephritic syndrome?
Cevap
Use urine microscopy, protein quantification, complement and serologic testing, and biopsy for severe or unclear disease.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 113
Soru
Which next action matters most in uncomplicated cystitis?
Cevap
Assess for pyelonephritis, pregnancy, obstruction, or sepsis before treating as uncomplicated disease.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 114
Soru
What is the key first diagnostic step for acute deep-vein thrombosis?
Cevap
Use pretest probability with D-dimer or compression ultrasonography rather than symptoms alone.
ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
Kart 115
Soru
How should medication be used in idiopathic pulmonary fibrosis?
Cevap
Nintedanib or pirfenidone can slow functional decline; neither reverses established fibrosis.
Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
Kart 116
Soru
What diagnostic approach is most appropriate when stable chronic hypertension is suspected?
Cevap
Confirm persistent elevation with standardized office technique and out-of-office monitoring when appropriate.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 117
Soru
How should a clinician initially manage cirrhosis with ascites?
Cevap
Restrict sodium, assess for infection, and perform large-volume paracentesis with albumin when tense ascites causes symptoms.
Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
Kart 118
Soru
What is the key first diagnostic step for herpes zoster?
Cevap
Clinical diagnosis is typical; PCR from a lesion is most useful when confirmation matters.
Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
Kart 119
Soru
How should a clinician initially manage osteoporosis in a postmenopausal woman at high fracture risk?
Cevap
Offer pharmacologic therapy after shared decision-making, then reassess adherence and fracture risk.
Pharmacological Management of Osteoporosis in Postmenopausal Women · reviewed 2026-08-26
Kart 120
Soru
Which bedside pattern best points to migraine with aura?
Cevap
Recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms, suggests migraine with aura.
ICHD-3: Migraine with Aura · reviewed 2026-08-26
Kart 121
Soru
What condition should be suspected from this finding: Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.
Cevap
Type 2 diabetes mellitus. Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 122
Soru
Which bedside pattern best points to early syphilis?
Cevap
A painless chancre or a diffuse rash involving palms and soles with generalized lymphadenopathy suggests syphilis by stage.
Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
Kart 123
Soru
For surgical decision-making, what condition should be suspected from this finding: Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.
Cevap
Acute angle-closure glaucoma. Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.
Management of Angle-Closure Glaucoma · reviewed 2026-08-26
Kart 124
Soru
Which bedside pattern best points to abnormal uterine bleeding from anovulation?
Cevap
Irregular unpredictable bleeding without cyclic ovulation is common at reproductive extremes or with endocrine disruption.
Abnormal Uterine Bleeding · reviewed 2026-08-26
Kart 125
Soru
How should a clinician manage a boundary-crossing gift from a patient?
Cevap
Assess its meaning, value, timing, and effect on care; decline gifts that exploit, obligate, or distort the professional relationship.
Gifts from Patients · reviewed 2026-08-26
Kart 126
Soru
A clinician is considering symptomatic aortic stenosis. Which finding adds the most support?
Cevap
Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 127
Soru
Which bedside pattern best points to post-traumatic stress disorder?
Cevap
Intrusion, avoidance, negative mood or cognition, and hyperarousal lasting over a month after trauma suggest PTSD.
Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
Kart 128
Soru
In a child aged 6–11 years or an adolescent, what diagnostic approach is most appropriate when asthma is suspected?
Cevap
Demonstrate variable expiratory airflow limitation with spirometry and bronchodilator response or an accepted alternative.
2026 GINA Strategy Report · reviewed 2026-08-26
Kart 129
Soru
Which prevention or risk-reduction step is important for chronic kidney disease?
Cevap
Control blood pressure, diabetes, tobacco use, and nephrotoxin exposure; vaccinate and reduce cardiovascular risk.
2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
Kart 130
Soru
In a child or adolescent, how should medication be used in acute appendicitis?
Cevap
Preoperative antibiotics should cover enteric gram-negative organisms and anaerobes.
Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
Kart 131
Soru
Which prevention or risk-reduction step is important for iron-deficiency anemia?
Cevap
Adequate dietary iron and evaluation of menstrual or gastrointestinal blood loss prevent recurrence.
British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
Kart 132
Soru
Which drug class is preferred before oral therapy for knee osteoarthritis pain when topical treatment is feasible?
Cevap
Use a topical NSAID first; it provides local pain relief with less systemic exposure than an oral NSAID.
2019 ACR/Arthritis Foundation Guideline for Osteoarthritis · reviewed 2026-08-26
Kart 133
Soru
A patient has this pattern: Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease. What is the most likely diagnosis?
Cevap
Peripheral artery disease. Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease.
2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
Kart 134
Soru
For surgical decision-making, how should a clinician initially manage acute ischemic stroke?
Cevap
Activate a stroke pathway and evaluate immediately for IV thrombolysis and mechanical thrombectomy eligibility.
2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
Kart 135
Soru
Which prevention or risk-reduction step is important for melanoma?
Cevap
Use sun protection and teach patients to report changing lesions rather than relying on routine self-treatment.
Melanoma Clinical Guidelines · reviewed 2026-08-26
Kart 136
Soru
How should a clinician initially manage community-acquired pneumonia?
Cevap
Stabilize oxygenation and sepsis, then choose outpatient or inpatient care using clinical judgment and a validated severity tool.
Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
Kart 137
Soru
Which prevention or risk-reduction step is important for ureteral stone?
Cevap
High fluid intake and stone-specific dietary changes based on metabolic evaluation reduce recurrence.
EAU Guidelines on Urolithiasis · reviewed 2026-08-26
Kart 138
Soru
For surgical decision-making, how should a clinician initially manage ectopic pregnancy?
Cevap
Hemodynamic instability or suspected rupture requires emergency surgery; stable management depends on imaging, hCG, size, and follow-up reliability.
Ectopic Pregnancy · reviewed 2026-08-26
Kart 139
Soru
What counseling point helps reduce harm from tension pneumothorax?
Cevap
After chest trauma or an invasive thoracic procedure, urgently reassess new dyspnea, hypotension, or unilateral breath-sound loss so tension physiology is decompressed without delay.
Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
Kart 140
Soru
In a child or adolescent, how should a clinician initially manage major depressive disorder?
Cevap
Assess safety first, create an urgent plan for imminent risk, and use psychotherapy, medication, or both by severity and preference.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
Kart 141
Soru
What should happen when a clinician’s personal belief conflicts with a requested legal service?
Cevap
Disclose the limitation without judgment, protect urgent care, provide timely information or referral, and avoid abandoning the patient.
Physician Exercise of Conscience · reviewed 2026-08-26
Kart 142
Soru
For surgical decision-making, what immediate plan is appropriate for symptomatic aortic stenosis?
Cevap
Severe symptomatic aortic stenosis requires valve-replacement evaluation rather than medical therapy alone.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 143
Soru
What counseling point helps reduce harm from celiac disease?
Cevap
Screen appropriate first-degree relatives and correct micronutrient deficits.
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
Kart 144
Soru
How should a clinician initially manage primary hypothyroidism?
Cevap
Start replacement when indicated and recheck TSH after dose changes rather than adjusting from symptoms alone.
Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
Kart 145
Soru
Which activity counseling can reduce carpal tunnel symptoms or slow progression?
Cevap
Modify job or recreational activities that aggravate symptoms, especially prolonged wrist flexion or extension.
Carpal Tunnel Syndrome · reviewed 2026-08-26
Kart 146
Soru
How should a clinician initially manage bacterial conjunctivitis?
Cevap
Remove contact lenses and urgently assess pain, photophobia, vision loss, corneal opacity, or hyperacute discharge.
Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26
Kart 147
Soru
Which diagnosis is marked by a rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis?
Cevap
Acute kidney injury. A rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis indicates AKI.
KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
Kart 148
Soru
How should medication be used in bacterial brain abscess?
Cevap
Empiric therapy should cover likely streptococci, anaerobes, and staphylococci according to source, then narrow to cultures.
ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
Kart 149
Soru
In a child or adolescent, what condition should be suspected from this finding: Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.
Cevap
Immune thrombocytopenia. Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.
American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
Kart 150
Soru
What medication strategy is appropriate for peripheral artery disease?
Cevap
Antiplatelet and high-intensity statin therapy reduce cardiovascular risk in symptomatic disease.
2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
Kart 151
Soru
A patient has this pattern: Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid. What is the most likely diagnosis?
Cevap
Pleural effusion. Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid.
British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
Kart 152
Soru
How should medication be used in pulmonary tuberculosis?
Cevap
Treat drug-susceptible disease with a multidrug regimen and adherence support; tailor to susceptibility and patient factors.
Treatment for Drug-Susceptible Tuberculosis Disease · reviewed 2026-08-26
Kart 153
Soru
How should medication be used in endometriosis?
Cevap
Combined hormonal contraceptives or progestins are common first-line suppressive therapies when pregnancy is not desired.
Endometriosis · reviewed 2026-08-26
Kart 154
Soru
How should medication be used in panic disorder?
Cevap
SSRIs or SNRIs are preferred long-term medicines; benzodiazepines carry dependence and safety risks.
Panic Disorder: What You Need to Know · reviewed 2026-08-26
Kart 155
Soru
A clinician is considering ulcerative colitis. Which finding adds the most support?
Cevap
Bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation suggest ulcerative colitis.
Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
Kart 156
Soru
In a patient younger than 16, which diagnosis fits persistent joint swelling, limited motion, or morning stiffness after other causes are excluded?
Cevap
Juvenile idiopathic arthritis. Persistent joint swelling, limited motion, or morning stiffness beginning before age 16, after excluding other causes, suggests JIA.
2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
Kart 157
Soru
Which bedside pattern best points to primary adrenal insufficiency?
Cevap
Weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia suggest primary adrenal failure.
Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
Kart 158
Soru
When can confidential information be shared with another treating clinician without a separate HIPAA authorization?
Cevap
HIPAA generally permits disclosure for treatment, using reasonable safeguards and only information relevant to care.
Uses and Disclosures for Treatment, Payment, and Health Care Operations · reviewed 2026-08-26
Kart 159
Soru
In a child aged 6 months or older, which bedside pattern best points to acute otitis media?
Cevap
A bulging tympanic membrane with acute ear pain or new otorrhea is more specific than redness alone.
Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
Kart 160
Soru
Which pathophysiologic process drives heart failure with reduced ejection fraction?
Cevap
Reduced contractility activates sympathetic and renin-angiotensin-aldosterone pathways that drive maladaptive remodeling.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 161
Soru
In a child, typically 6 months to 3 years, what immediate plan is appropriate for croup?
Cevap
Keep the child calm, give dexamethasone, and add nebulized epinephrine for moderate or severe stridor.
Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
Kart 162
Soru
What drug class or regimen fits cellulitis?
Cevap
Use an agent active against streptococci for nonpurulent disease; add MRSA coverage when risk or purulence warrants it.
Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
Kart 163
Soru
What is the key first diagnostic step for testicular torsion?
Cevap
Make a clinical diagnosis and obtain urgent urologic assessment; use Doppler ultrasound only if the diagnosis is uncertain and imaging will not delay exploration.
Testicular Torsion · reviewed 2026-08-26
Kart 164
Soru
What counseling point helps reduce harm from Parkinson disease?
Cevap
Exercise, fall-risk reduction, medication review, and driving and swallowing assessment reduce complications.
Parkinson’s Disease in Adults · reviewed 2026-08-26
Kart 165
Soru
How should a clinician initially manage hyperkalemia?
Cevap
With ECG changes or severe elevation, stabilize the myocardium, shift potassium intracellularly, and remove it from the body.
Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
Kart 166
Soru
What counseling point helps reduce harm from gonococcal urethritis or cervicitis?
Cevap
Condom use, routine screening by risk, and partner treatment reduce reinfection and complications.
Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
Kart 167
Soru
Which history or examination finding most strongly supports acute pericarditis?
Cevap
Sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation support pericarditis.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 168
Soru
What counseling point helps reduce harm from menopause vasomotor symptoms?
Cevap
Cooling strategies and avoiding individual triggers can reduce symptom burden; assess bone and cardiovascular risk separately.
The Menopause Years · reviewed 2026-08-26
Kart 169
Soru
A patient has this pattern: Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease. What is the most likely diagnosis?
Cevap
Chronic hepatitis C. Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease.
Viral Hepatitis Clinical Care · reviewed 2026-08-26
Kart 170
Soru
What counseling point helps reduce harm from alcohol withdrawal?
Cevap
Treat alcohol-use disorder, plan medically supported withdrawal for high-risk patients, and provide thiamine when nutrition is poor.
The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
Kart 171
Soru
What diagnostic approach is most appropriate when acute compartment syndrome is suspected?
Cevap
Diagnosis is clinical; compartment-pressure measurement helps when the examination is unreliable or equivocal.
Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 172
Soru
In a child or adolescent with sickle cell disease, which pain pattern supports an acute vaso-occlusive episode?
Cevap
Acute severe extremity, back, or bone pain that matches the patient’s typical vaso-occlusive pattern and has no alternative cause supports an acute vaso-occlusive pain episode.
ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
Kart 173
Soru
What diagnostic approach is most appropriate when thyroid storm is suspected?
Cevap
Diagnosis is clinical; obtain thyroid tests and evaluate the trigger without delaying treatment.
2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
Kart 174
Soru
A clinician is considering acute respiratory distress syndrome. Which finding adds the most support?
Cevap
Acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult suggests ARDS.
An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
Kart 175
Soru
How should medication be used in sudden sensorineural hearing loss?
Cevap
Offer corticosteroids within the treatment window when appropriate; intratympanic therapy is an option in selected cases.
Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
Kart 176
Soru
What is the HIPAA minimum-necessary rule?
Cevap
For many uses and disclosures, limit protected information to what is reasonably needed for the purpose; the rule does not apply in the same way to disclosures for treatment.
Minimum Necessary Requirement · reviewed 2026-08-26
Kart 177
Soru
For surgical decision-making, hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus indicate which diagnosis?
Cevap
Cardiac tamponade. Hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus suggest tamponade physiology.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 178
Soru
In a child or adolescent, what diagnostic approach is most appropriate when acute appendicitis is suspected?
Cevap
Use ultrasound as the initial imaging study in many children; use CT or MRI when ultrasound is nondiagnostic and suspicion persists, according to local expertise.
Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
Kart 179
Soru
For surgical decision-making, sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia indicate which time-critical diagnosis?
Cevap
Acute ischemic stroke. Sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia is stroke until proved otherwise.
2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
Kart 180
Soru
A clinician is considering gout flare. Which finding adds the most support?
Cevap
Abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint, suggests gout.
Gout · reviewed 2026-08-26
Kart 181
Soru
Which diagnosis best fits new cough, fever, dyspnea, pleuritic pain, and focal crackles when an infiltrate is confirmed?
Cevap
Community-acquired pneumonia. New cough, fever, dyspnea, pleuritic pain, and focal crackles suggest pneumonia, but clinical findings alone are imperfect.
Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
Kart 182
Soru
In a child aged 6–11 years or an adolescent, what medication strategy is appropriate for asthma?
Cevap
For children 6–11 years and adolescents, use an age-appropriate inhaled corticosteroid-containing strategy rather than short-acting beta agonist-only treatment.
2026 GINA Strategy Report · reviewed 2026-08-26
Kart 183
Soru
For surgical decision-making, a patient has this pattern: Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation. What is the most likely diagnosis?
Cevap
Ectopic pregnancy. Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation.
Ectopic Pregnancy · reviewed 2026-08-26
Kart 184
Soru
In a child or adolescent, which diagnosis requires at least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms?
Cevap
Major depressive disorder. At least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms suggests major depression.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
Kart 185
Soru
Which preventive measure belongs in care for atrial fibrillation?
Cevap
Address hypertension, obesity, sleep apnea, alcohol excess, and other modifiable drivers.
2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
Kart 186
Soru
For surgical decision-making, what condition should be suspected from this finding: An evolving asymmetric pigmented lesion with border irregularity, color variation, or a concerning outlier pattern requires evaluation.
Cevap
Melanoma. An evolving asymmetric pigmented lesion with border irregularity, color variation, or a concerning outlier pattern requires evaluation.
Melanoma Clinical Guidelines · reviewed 2026-08-26
Kart 187
Soru
Which bedside pattern best points to hyperkalemia?
Cevap
Weakness, paresthesias, bradycardia, or ECG changes can occur, but dangerous hyperkalemia may be asymptomatic.
Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
Kart 188
Soru
For surgical decision-making, what condition should be suspected from this finding: Sudden colicky flank pain radiating to the groin with hematuria and restlessness is typical.
Cevap
Ureteral stone. Sudden colicky flank pain radiating to the groin with hematuria and restlessness is typical.
EAU Guidelines on Urolithiasis · reviewed 2026-08-26
Kart 189
Soru
In a child or adolescent, how should a clinician initially manage sickle cell vaso-occlusive crisis?
Cevap
Provide rapid individualized analgesia, assess oxygenation and hydration, and evaluate acute chest syndrome or infection.
ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
Kart 190
Soru
How should medication be used in primary hyperparathyroidism?
Cevap
Cinacalcet can lower calcium when surgery is not possible; antiresorptive therapy targets low bone density.
Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
Kart 191
Soru
What diagnostic approach is most appropriate when acute bacterial rhinosinusitis is suspected?
Cevap
Diagnosis is clinical; routine imaging is not needed unless a complication or alternative diagnosis is suspected.
Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
Kart 192
Soru
What should a clinician do before discussing a patient in a public or semipublic area?
Cevap
Move to a private setting when practical and use reasonable safeguards so others do not overhear identifiable information.
Incidental Uses and Disclosures · reviewed 2026-08-26
Kart 193
Soru
A clinician is considering Parkinson disease. Which finding adds the most support?
Cevap
Bradykinesia plus rest tremor or rigidity, with reduced arm swing and shuffling gait, supports parkinsonism.
Parkinson’s Disease in Adults · reviewed 2026-08-26
Kart 194
Soru
What immediate plan is appropriate for chronic hepatitis C?
Cevap
Stage liver disease, review interactions, test for coinfections, and link every patient with active infection to curative treatment.
Viral Hepatitis Clinical Care · reviewed 2026-08-26
Kart 195
Soru
A clinician is considering gonococcal urethritis or cervicitis. Which finding adds the most support?
Cevap
Purulent urethral discharge, dysuria, cervicitis, pelvic pain, or exposure may indicate gonorrhea, but infection can be asymptomatic.
Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
Kart 196
Soru
In a child or adolescent, what immediate plan is appropriate for juvenile idiopathic arthritis?
Cevap
Refer to pediatric rheumatology early and treat to control inflammation and preserve function.
2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
Kart 197
Soru
A clinician is considering menopause vasomotor symptoms. Which finding adds the most support?
Cevap
Hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age usually identify menopausal vasomotor symptoms.
The Menopause Years · reviewed 2026-08-26
Kart 198
Soru
Which diagnosis best fits this presentation: Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.
Cevap
Idiopathic pulmonary fibrosis. Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.
Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
Kart 199
Soru
A clinician is considering alcohol withdrawal. Which finding adds the most support?
Cevap
Tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use suggests withdrawal.
The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
Kart 200
Soru
What is the priority management step for acute pericarditis?
Cevap
Assess immediately for tamponade or high-risk features that require admission.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 201
Soru
In complicated acute calculous cholecystitis, how should empiric antibiotics be selected?
Cevap
Base the regimen on likely biliary pathogens and local resistance patterns, with enteric gram-negative aerobes and anaerobes among the common targets.
2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
Kart 202
Soru
For surgical decision-making, what is the priority management step for pleural effusion?
Cevap
Drain a large symptomatic effusion or complicated parapneumonic collection and treat the underlying disease.
British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
Kart 203
Soru
In acute decompensated heart failure with fluid overload, which drug class is used first to relieve congestion?
Cevap
Give an intravenous loop diuretic and adjust it to urine output, symptoms, renal function, and electrolytes.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 204
Soru
For surgical decision-making, what immediate plan is appropriate for subarachnoid hemorrhage?
Cevap
Stabilize, control pressure carefully, give nimodipine, and obtain urgent neurovascular treatment of the aneurysm.
2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
Kart 205
Soru
What medication strategy is appropriate for hip fracture?
Cevap
Use multimodal analgesia and guideline-based VTE prophylaxis around surgery.
Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 206
Soru
In a child or adolescent, what immediate plan is appropriate for bacterial meningitis?
Cevap
Give empiric antibiotics immediately; do not delay for imaging or lumbar puncture when delay is likely.
WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
Kart 207
Soru
In a child or adolescent, which diagnosis fits hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status?
Cevap
Diabetic ketoacidosis. Hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status suggests ketoacidosis.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 208
Soru
For surgical decision-making, what immediate plan is appropriate for preeclampsia with severe features?
Cevap
Stabilize the mother, prevent seizure, control persistent severe pressure, and plan delivery by gestational age and status.
Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
Kart 209
Soru
For surgical decision-making, new flashes, floaters, and a curtain or shadow across the visual field indicate which diagnosis?
Cevap
Retinal detachment. New flashes, floaters, and a curtain or shadow across the visual field suggest detachment.
Retinal Detachment · reviewed 2026-08-26
Kart 210
Soru
What immediate plan is appropriate for bipolar I mania?
Cevap
Hospitalize when danger, grave disability, or severe psychosis requires containment; stop antidepressant monotherapy.
Management of Bipolar Disorder in Adults · reviewed 2026-08-26
Kart 211
Soru
May a clinician leave appointment information in a voicemail?
Cevap
Yes, with reasonable safeguards: keep the message limited and follow any confidential communication request the patient has made.
Incidental Uses and Disclosures · reviewed 2026-08-26
Kart 212
Soru
When is a loop diuretic appropriate in acute kidney injury?
Cevap
Use a loop diuretic only to manage volume overload; it does not reverse intrinsic kidney injury or improve renal recovery.
KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
Kart 213
Soru
How should a clinician initially manage plaque psoriasis?
Cevap
Assess body-surface area, special-site involvement, symptoms, and joint disease before selecting therapy.
Psoriasis Clinical Guidelines · reviewed 2026-08-26
Kart 214
Soru
In a child or adolescent, how should medication be used in immune thrombocytopenia?
Cevap
Corticosteroids or IVIG are common initial treatments when therapy is needed; longer-term choices depend on response and duration.
American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
Kart 215
Soru
Which test or testing sequence best evaluates suspected ventricular fibrillation cardiac arrest?
Cevap
Use rhythm analysis during high-quality CPR without delaying compressions.
2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
Kart 216
Soru
Which drug class is first-line for erectile dysfunction when no contraindication such as nitrate use exists?
Cevap
Use a phosphodiesterase-5 inhibitor after reviewing cardiovascular fitness, interactions, and correct use; never combine it with nitrates.
Erectile Dysfunction Guideline · reviewed 2026-08-26
Kart 217
Soru
Which pathophysiologic process drives COPD?
Cevap
Small-airway disease and emphysematous parenchymal destruction cause persistent expiratory flow limitation.
2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
Kart 218
Soru
Which history or examination finding most strongly supports Crohn disease?
Cevap
Chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions support Crohn disease.
Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
Kart 219
Soru
Which pathophysiologic process drives acute compartment syndrome?
Cevap
Rising pressure within a closed fascial space compromises capillary perfusion and causes muscle and nerve ischemia.
Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 220
Soru
What medication strategy is appropriate for migraine with aura?
Cevap
Use an NSAID or triptan for many acute attacks; select preventive therapy around comorbidities and patient preference.
AHS Consensus Statement: Integrating New Migraine Treatments into Clinical Practice · reviewed 2026-08-26
Kart 221
Soru
What clinical clue should raise suspicion for hypertensive emergency?
Cevap
Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 222
Soru
What medication strategy is appropriate for early syphilis?
Cevap
Benzathine penicillin G is preferred for early syphilis; penicillin is required in pregnancy.
Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
Kart 223
Soru
What counseling point helps reduce harm from Cushing syndrome?
Cevap
Limit avoidable exogenous glucocorticoid exposure and taper chronic therapy safely when appropriate.
Treatment of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
Kart 224
Soru
What medication strategy is appropriate for abnormal uterine bleeding from anovulation?
Cevap
Progestin or combined hormonal therapy can regulate bleeding; tranexamic acid reduces heavy bleeding in eligible patients.
Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women · reviewed 2026-08-26
Kart 225
Soru
What counseling point helps reduce harm from peritonsillar abscess?
Cevap
Seek prompt care for worsening unilateral throat pain, drooling, muffled voice, trismus, or breathing difficulty so an abscess and airway risk are not missed.
Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
Kart 226
Soru
What medication strategy is appropriate for post-traumatic stress disorder?
Cevap
Sertraline, paroxetine, or venlafaxine can help; benzodiazepines are not recommended for PTSD treatment.
Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
Kart 227
Soru
When may protected health information be disclosed to prevent a serious threat?
Cevap
HIPAA permits a good-faith disclosure consistent with law and ethical standards to someone reasonably able to prevent or lessen a serious and imminent threat.
HIPAA Disclosure to Prevent or Lessen a Serious and Imminent Threat · reviewed 2026-08-26
Kart 228
Soru
In an infant aged 1–23 months, which history or examination finding most strongly supports bronchiolitis?
Cevap
An infant with viral prodrome followed by cough, wheeze or crackles, tachypnea, and feeding difficulty likely has bronchiolitis.
Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
Kart 229
Soru
Which diagnosis causes marked edema, heavy proteinuria, hypoalbuminemia, and hyperlipidemia?
Cevap
Nephrotic syndrome. Marked edema, heavy proteinuria, hypoalbuminemia, and hyperlipidemia define a nephrotic pattern.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 230
Soru
Which bedside pattern best points to herpes zoster?
Cevap
A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.
Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
Kart 231
Soru
A patient has this pattern: Thrombocytopenia plus microangiopathic hemolytic anemia, often with neurologic, renal, or fever findings, is an emergency. What is the most likely diagnosis?
Cevap
Thrombotic thrombocytopenic purpura. Thrombocytopenia plus microangiopathic hemolytic anemia, often with neurologic, renal, or fever findings, is an emergency.
ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
Kart 232
Soru
Which bedside pattern best points to testicular torsion?
Cevap
Sudden severe unilateral testicular pain with nausea or vomiting, a high-riding transverse testis, and loss of the cremasteric reflex strongly suggests torsion.
Testicular Torsion · reviewed 2026-08-26
Kart 233
Soru
For surgical decision-making, which diagnosis best fits hematemesis, coffee-ground emesis, or melena with orthostasis?
Cevap
Upper gastrointestinal bleeding. Hematemesis, coffee-ground emesis, or melena with orthostasis indicates an upper gastrointestinal source until shown otherwise.
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
Kart 234
Soru
In a child or adolescent, what diagnostic approach is most appropriate when generalized tonic-clonic seizure is suspected?
Cevap
Check glucose and reversible causes; use EEG and brain imaging based on whether this is a first unprovoked event or known epilepsy.
Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
Kart 235
Soru
Identify the condition from this pattern: Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.
Cevap
Stable chronic hypertension. Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 236
Soru
What diagnostic approach is most appropriate when sepsis is suspected?
Cevap
Measure lactate, obtain cultures before antibiotics when this causes no meaningful delay, and evaluate the source.
2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
Kart 237
Soru
For surgical decision-making, in a child with acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk, which diagnosis must be excluded urgently?
Cevap
Septic arthritis. Acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk is septic arthritis until excluded.
Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
Kart 238
Soru
What diagnostic approach is most appropriate when pelvic inflammatory disease is suspected?
Cevap
Test for gonorrhea, chlamydia, HIV, and syphilis; use ultrasound when abscess or another diagnosis is possible.
Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
Kart 239
Soru
Which pharmacologic approach is preferred for COPD?
Cevap
Long-acting bronchodilators are maintenance therapy; add inhaled corticosteroid for selected exacerbation-prone patients based on phenotype and eosinophils.
2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
Kart 240
Soru
What diagnostic approach is most appropriate when schizophrenia is suspected?
Cevap
Diagnosis is clinical with medical, neurologic, and substance evaluation for first-episode psychosis.
Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
Kart 241
Soru
Which next action matters most in hypertensive emergency?
Cevap
Lower pressure with monitored IV therapy at a controlled rate tailored to the injured organ.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 242
Soru
How should an interpreter be used for a patient with limited English proficiency?
Cevap
Use a qualified medical interpreter, speak to the patient directly, pause in short segments, and avoid relying on children or untrained family for consequential decisions.
Limited English Proficiency Guidance · reviewed 2026-08-26
Kart 243
Soru
What immediate plan is appropriate for thyroid storm?
Cevap
Give a beta-blocker, block hormone synthesis, then block hormone release, add glucocorticoid, cool supportively, and treat the trigger.
2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
Kart 244
Soru
Which preventive measure belongs in care for ulcerative colitis?
Cevap
Use effective maintenance therapy and monitor symptoms together with objective inflammatory activity to reduce relapse and complications.
Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
Kart 245
Soru
What immediate plan is appropriate for acute bacterial rhinosinusitis?
Cevap
Assess orbital or intracranial red flags and arrange urgent evaluation when present.
Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
Kart 246
Soru
Which preventive measure belongs in care for gout flare?
Cevap
Weight management, limiting excess alcohol, reviewing urate-raising medicines, and long-term urate control reduce flares.
Gout · reviewed 2026-08-26
Kart 247
Soru
What immediate plan is appropriate for hyponatremia due to SIADH?
Cevap
Treat severe neurologic symptoms with carefully dosed hypertonic saline and avoid overly rapid correction.
Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
Kart 248
Soru
In a child or adolescent, which pathophysiologic process drives immune thrombocytopenia?
Cevap
Autoantibodies accelerate platelet clearance and can impair platelet production.
American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
Kart 249
Soru
Which test or testing sequence best evaluates suspected COPD?
Cevap
Post-bronchodilator spirometry confirms persistent airflow obstruction.
2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
Kart 250
Soru
Why does atrial fibrillation produce its defining clinical pattern?
Cevap
Chaotic atrial activation eliminates coordinated atrial contraction and creates irregular AV nodal conduction.
2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
Kart 251
Soru
Which pathophysiologic process drives subarachnoid hemorrhage?
Cevap
Arterial blood entering the subarachnoid space raises intracranial pressure and can trigger vasospasm.
2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
Kart 252
Soru
In a child or adolescent, which pathophysiologic process drives bacterial meningitis?
Cevap
Bacterial invasion of the subarachnoid space triggers intense inflammation, edema, and raised intracranial pressure.
WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
Kart 253
Soru
Which pathophysiologic process drives preeclampsia with severe features?
Cevap
Abnormal placentation and systemic endothelial dysfunction produce vasoconstriction and multisystem injury.
Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
Kart 254
Soru
Which clinical feature defines bipolar I disorder?
Cevap
At least one manic episode defines bipolar I disorder; a major depressive episode is common but is not required for the diagnosis.
Management of Bipolar Disorder in Adults · reviewed 2026-08-26
Kart 255
Soru
For surgical decision-making, what is the priority management step for upper gastrointestinal bleeding?
Cevap
Establish IV access, resuscitate, use a restrictive transfusion strategy for most patients, and arrange endoscopic hemostasis.
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
Kart 256
Soru
Which history or examination finding most strongly supports rheumatoid arthritis?
Cevap
Symmetric inflammatory pain and prolonged morning stiffness in MCP, PIP, or wrist joints with synovitis suggest rheumatoid arthritis.
Rheumatoid Arthritis · reviewed 2026-08-26
Kart 257
Soru
What is teach-back?
Cevap
Ask the patient to explain the plan in their own words so the clinician can find and correct communication gaps without testing or blaming the patient.
Use the Teach-Back Method · reviewed 2026-08-26
Kart 258
Soru
A clinician is considering primary hyperparathyroidism. Which finding adds the most support?
Cevap
Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue.
Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
Kart 259
Soru
How can a clinician reduce avoidable harm related to aortic dissection?
Cevap
Long-term blood-pressure control and surveillance imaging reduce later aortic complications.
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
Kart 260
Soru
A clinician is considering sudden sensorineural hearing loss. Which finding adds the most support?
Cevap
A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency.
Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
Kart 261
Soru
Which preventive measure belongs in care for obstructive sleep apnea?
Cevap
Weight management, alcohol and sedative avoidance near bedtime, and treatment of nasal obstruction reduce severity.
Sleep Apnea Treatment · reviewed 2026-08-26
Kart 262
Soru
In a child or adolescent, what diagnostic approach is most appropriate when atopic dermatitis is suspected?
Cevap
Diagnosis is clinical; testing is reserved for an alternative diagnosis or a specific suspected trigger.
Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
Kart 263
Soru
How should a clinician initially manage acute pyelonephritis?
Cevap
Give fluids and antibiotics, and admit patients with sepsis, inability to take oral therapy, pregnancy concerns, or obstruction.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 264
Soru
For surgical decision-making, which diagnosis best fits this presentation: A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.
Cevap
Subarachnoid hemorrhage. A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.
2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
Kart 265
Soru
What diagnostic approach is most appropriate when hyperkalemia is suspected?
Cevap
Repeat a possibly hemolyzed sample while obtaining an ECG; assess kidney function, acid-base status, and contributing medicines.
Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
Kart 266
Soru
In a child or adolescent, which diagnosis best fits this presentation: Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.
Cevap
Bacterial meningitis. Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.
WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
Kart 267
Soru
What drug class or regimen fits stable chronic hypertension?
Cevap
First-line classes include thiazide-type diuretics, ACE inhibitors or ARBs, and long-acting dihydropyridine calcium-channel blockers.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 268
Soru
For surgical decision-making, which diagnosis best fits this presentation: New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.
Cevap
Preeclampsia with severe features. New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.
Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
Kart 269
Soru
Which pharmacologic approach is preferred for acute pancreatitis?
Cevap
Routine prophylactic antibiotics do not treat sterile pancreatitis; reserve antimicrobials for proven or strongly suspected infection.
ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
Kart 270
Soru
Which diagnosis best fits this presentation: At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.
Cevap
Bipolar I mania. At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.
Management of Bipolar Disorder in Adults · reviewed 2026-08-26
Kart 271
Soru
For surgical decision-making, in a child or adolescent, what is the priority management step for septic arthritis?
Cevap
Drain the joint promptly and start empiric antibiotics after cultures unless the patient is unstable.
Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
Kart 272
Soru
In a child or adolescent, what diagnostic approach is most appropriate when sickle cell vaso-occlusive crisis is suspected?
Cevap
Use focused labs and imaging for the suspected complication; do not require a changed hemoglobin to validate pain.
ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
Kart 273
Soru
In a child or adolescent, which diagnosis causes variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers?
Cevap
Asthma. Variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers suggests asthma.
2026 GINA Strategy Report · reviewed 2026-08-26
Kart 274
Soru
In a child or adolescent, which pathophysiologic process drives diabetic ketoacidosis?
Cevap
Absolute or marked insulin deficiency drives lipolysis, ketogenesis, osmotic diuresis, and total-body potassium loss.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 275
Soru
How should a clinician respond to a patient requesting an unnecessary antibiotic?
Cevap
Acknowledge the concern, explain why the antibiotic will not help and may harm, offer a clear alternative plan, and define return precautions.
Core Elements of Outpatient Antibiotic Stewardship · reviewed 2026-08-26
Kart 276
Soru
Which pathophysiologic process drives retinal detachment?
Cevap
Fluid passing through a retinal break separates neurosensory retina from the pigment epithelium.
Retinal Detachment · reviewed 2026-08-26
Kart 277
Soru
Which bedside pattern best points to peripheral artery disease?
Cevap
Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease.
2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
Kart 278
Soru
Which preventive measure belongs in care for myasthenia gravis?
Cevap
Avoid medicines that worsen neuromuscular transmission and plan carefully for infection, surgery, and pregnancy.
International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
Kart 279
Soru
In a child or adolescent, which pathophysiologic process drives acute appendicitis?
Cevap
Luminal obstruction causes distention, ischemia, bacterial overgrowth, and eventual perforation.
Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
Kart 280
Soru
Which preventive measure belongs in care for Clostridioides difficile infection?
Cevap
Isolate suspected or confirmed CDI with contact precautions, use C. difficile sporicidal agents for daily and terminal cleaning, and engage antibiotic stewardship.
Clinical Guidance for C. diff Infection Prevention in Acute Care Facilities · reviewed 2026-08-26
Kart 281
Soru
After an acute ACL tear, which nonprescription medicines may be used for symptom relief when safe?
Cevap
Ibuprofen or naproxen can reduce pain and swelling; acetaminophen can reduce pain. Check comorbidities and contraindications before NSAID use.
Anterior cruciate ligament (ACL) injury - aftercare · reviewed 2026-08-26
Kart 282
Soru
Which preventive measure belongs in care for shoulder dystocia?
Cevap
Team drills, clear communication, and avoiding fundal pressure reduce preventable harm.
Shoulder Dystocia · reviewed 2026-08-26
Kart 283
Soru
Which next action matters most in idiopathic pulmonary fibrosis?
Cevap
Assess oxygen need, comorbidity, transplant eligibility, and goals while monitoring progression.
Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
Kart 284
Soru
In a child or adolescent, which preventive measure belongs in care for attention-deficit/hyperactivity disorder?
Cevap
Use an individualized multimodal plan with psychoeducation, parent and school interventions, and clear functional goals.
ADHD in Children and Youth: Part 2—Treatment · reviewed 2026-08-26
Kart 285
Soru
Which diagnosis best fits unilateral expanding warmth, tenderness, erythema, and edema without a sharply raised border?
Cevap
Cellulitis. Unilateral expanding warmth, tenderness, erythema, and edema without a sharply raised border favor cellulitis.
Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
Kart 286
Soru
A clinician is considering hyponatremia due to SIADH. Which finding adds the most support?
Cevap
Nausea, confusion, gait change, seizure, or subtle cognitive symptoms with hypotonic euvolemic hyponatremia may reflect SIADH.
Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
Kart 287
Soru
During a pulseless arrest, the monitor shows chaotic ventricular activity without organized QRS complexes. Which arrest rhythm is present?
Cevap
Ventricular fibrillation cardiac arrest. Sudden unresponsiveness with absent normal breathing and no pulse is cardiac arrest; the monitor may show chaotic ventricular activity.
2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
Kart 288
Soru
A clinician is considering neutropenic fever. Which finding adds the most support?
Cevap
A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.
Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
Kart 289
Soru
A patient has this pattern: Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms. What is the most likely diagnosis?
Cevap
Benign prostatic hyperplasia. Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms.
EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
Kart 290
Soru
Which test or testing sequence best evaluates suspected primary adrenal insufficiency?
Cevap
Measure morning cortisol and ACTH, then confirm with cosyntropin testing when the patient is stable.
Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
Kart 291
Soru
What medication strategy is appropriate for peritonsillar abscess?
Cevap
Use antibiotics covering group A streptococci and oral anaerobes after drainage.
Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
Kart 292
Soru
What belongs in a safe handoff?
Cevap
State illness severity, active problems, recent changes, pending results, contingency plans, and who owns each next action, then allow questions.
TeamSTEPPS Communication Module · reviewed 2026-08-26
Kart 293
Soru
Which history or examination finding most strongly supports myasthenia gravis?
Cevap
Fluctuating fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use suggests myasthenia.
International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
Kart 294
Soru
For surgical decision-making, identify the condition from this pattern: Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.
Cevap
Acute compartment syndrome. Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.
Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 295
Soru
Which history or examination finding most strongly supports Clostridioides difficile infection?
Cevap
New clinically significant diarrhea after antibiotics or healthcare exposure, with abdominal pain or leukocytosis, suggests C. difficile.
2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26
Kart 296
Soru
How should a clinician confirm or characterize acute coronary syndrome?
Cevap
Obtain a 12-lead ECG within 10 minutes and measure serial high-sensitivity troponin.
2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
Kart 297
Soru
Which history or examination finding most strongly supports shoulder dystocia?
Cevap
After delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicates dystocia.
Shoulder Dystocia · reviewed 2026-08-26
Kart 298
Soru
In a child or adolescent, which history or examination finding most strongly supports attention-deficit/hyperactivity disorder?
Cevap
Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment suggests ADHD.
ADHD in Children and Youth: Part 1—Etiology, Diagnosis, and Comorbidity · reviewed 2026-08-26
Kart 299
Soru
What clinical clue should raise suspicion for cirrhosis with ascites?
Cevap
Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.
Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
Kart 300
Soru
In a child, typically 6 months to 3 years, what clinical clue should raise suspicion for croup?
Cevap
Barking cough, hoarseness, and inspiratory stridor after a viral prodrome in a young child suggests croup.
Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
600 kart
PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps
Bu desteyle ücretsiz çalışNibomo açılır ve hemen çalışmaya başlayabilirsiniz.
Kart 301
Soru
How should a clinician initially manage peripheral artery disease?
Cevap
Use supervised or structured exercise; evaluate revascularization for lifestyle-limiting symptoms despite therapy or limb threat.
2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26
Kart 302
Soru
What drug class or regimen fits pulmonary embolism?
Cevap
Direct oral anticoagulants are preferred for many stable eligible patients; choose differently for pregnancy, severe renal disease, or specific cancer contexts.
ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
Kart 303
Soru
For surgical decision-making, in a child or adolescent, identify the condition from this pattern: Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.
Cevap
Acute appendicitis. Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.
Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
Kart 304
Soru
Which test or testing sequence best evaluates suspected hip fracture?
Cevap
Obtain hip and pelvis radiographs; MRI detects an occult fracture when suspicion remains high.
Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 305
Soru
In a child or adolescent, what is the priority management step for generalized tonic-clonic seizure?
Cevap
Protect from injury, position for airway safety, time the event, and treat as status epilepticus when it persists.
Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
Kart 306
Soru
Which diagnosis causes fatigue, cold intolerance, constipation, dry skin, bradycardia, and delayed reflex relaxation?
Cevap
Primary hypothyroidism. Fatigue, cold intolerance, constipation, dry skin, bradycardia, and delayed reflex relaxation support hypothyroidism.
Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
Kart 307
Soru
What is the priority management step for sepsis?
Cevap
Start rapid resuscitation, broad empiric antimicrobials, and urgent source control.
2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
Kart 308
Soru
Which diagnosis best fits diffuse conjunctival injection with mucopurulent discharge and eyelids stuck on waking?
Cevap
Bacterial conjunctivitis. Diffuse conjunctival injection with mucopurulent discharge and eyelids stuck on waking supports bacterial conjunctivitis.
Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26
Kart 309
Soru
What is the priority management step for pelvic inflammatory disease?
Cevap
Start empiric treatment promptly; admit for pregnancy, severe illness, abscess, surgical emergency uncertainty, or failed outpatient care.
Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
Kart 310
Soru
What is closed-loop communication during an emergency?
Cevap
The receiver repeats the instruction, the sender confirms or corrects it, and completion is announced so the team shares the same state.
TeamSTEPPS Check-Back Tool · reviewed 2026-08-26
Kart 311
Soru
What is the priority management step for schizophrenia?
Cevap
Assess danger, catatonia, and ability to care for self, then combine antipsychotic treatment with psychosocial support.
Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
Kart 312
Soru
What medication strategy is appropriate for nephrotic syndrome?
Cevap
Use renin-angiotensin system blockade to reduce proteinuria when appropriate; disease-specific immunotherapy depends on pathology.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 313
Soru
What immediate plan is appropriate for neutropenic fever?
Cevap
Give empiric antipseudomonal antibiotics rapidly and stratify for inpatient versus carefully selected outpatient care.
Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
Kart 314
Soru
What counseling point helps reduce harm from cellulitis?
Cevap
Treat tinea pedis, edema, skin breaks, and other portals of entry to reduce recurrence.
Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
Kart 315
Soru
A clinician is considering cardiac tamponade. Which finding adds the most support?
Cevap
Hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus suggest tamponade physiology.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 316
Soru
What counseling point helps reduce harm from benign prostatic hyperplasia?
Cevap
Review fluid timing and medicines that worsen retention, and monitor complications.
EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
Kart 317
Soru
Which diagnosis best fits progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants?
Cevap
COPD. Progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants suggest COPD.
2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
Kart 318
Soru
Which test or testing sequence best evaluates suspected acute cholecystitis?
Cevap
Right-upper-quadrant ultrasound is first-line; a gallbladder nuclear-medicine scan (HIDA) is an appropriate next study when ultrasound is negative or equivocal and suspicion remains high.
ACR Appropriateness Criteria® Right Upper Quadrant Pain · reviewed 2026-08-26
Kart 319
Soru
In a postmenopausal woman or man aged 50 or older, what clinical clue should raise suspicion for osteoporosis?
Cevap
A fragility fracture, height loss, or kyphosis should prompt assessment for osteoporosis and vertebral fracture.
The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26
Kart 320
Soru
Which pharmacologic approach is preferred for Parkinson disease?
Cevap
Levodopa provides the strongest motor benefit for many patients; dopamine agonists carry impulse-control and sleep risks.
Parkinson’s Disease in Adults · reviewed 2026-08-26
Kart 321
Soru
A patient has this pattern: Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern. What is the most likely diagnosis?
Cevap
Acute coronary syndrome. Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern.
2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
Kart 322
Soru
Which pharmacologic approach is preferred for gonococcal urethritis or cervicitis?
Cevap
Ceftriaxone is first-line for uncomplicated infection; add chlamydia treatment if it has not been excluded.
Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
Kart 323
Soru
In a child aged 6 months or older, which examination best evaluates suspected acute otitis media?
Cevap
Use pneumatic otoscopy to confirm middle-ear effusion and assess for a bulging tympanic membrane; tympanometry is less reliable in young infants.
Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
Kart 324
Soru
Which pharmacologic approach is preferred for menopause vasomotor symptoms?
Cevap
Systemic menopausal hormone therapy is most effective for eligible patients; nonhormonal options include selected SSRIs, SNRIs, gabapentin, or fezolinetant.
Hormone Therapy for Menopause · reviewed 2026-08-26
Kart 325
Soru
How should a clinician handle an ambiguous verbal medication order?
Cevap
Stop and clarify the drug, dose, route, timing, and patient; read it back and do not guess.
TeamSTEPPS Communication Module · reviewed 2026-08-26
Kart 326
Soru
Which pharmacologic approach is preferred for alcohol withdrawal?
Cevap
Benzodiazepines are first-line for clinically significant withdrawal; phenobarbital requires experienced protocols and monitoring.
The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
Kart 327
Soru
In a child or adolescent, how should a clinician initially manage asthma?
Cevap
Assess severity during exacerbation, give repeated bronchodilator, systemic corticosteroid when indicated, oxygen, and escalate for fatigue or silent chest.
2026 GINA Strategy Report · reviewed 2026-08-26
Kart 328
Soru
What medication strategy is appropriate for Cushing syndrome?
Cevap
Medical cortisol-lowering therapy can bridge or treat selected patients when definitive source control is delayed or unavailable.
Treatment of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
Kart 329
Soru
What counseling point helps reduce harm from acute kidney injury?
Cevap
Avoid unnecessary nephrotoxins, adjust medicine doses, maintain perfusion, and monitor high-risk patients.
KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
Kart 330
Soru
What medication strategy is appropriate for thrombotic thrombocytopenic purpura?
Cevap
Caplacizumab is added in many acute immune TTP protocols under specialist care.
ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
Kart 331
Soru
For surgical decision-making, in a child or adolescent, which next action matters most in acute appendicitis?
Cevap
Give fluids, analgesia, antibiotics, and obtain prompt surgical consultation.
Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
Kart 332
Soru
How should medication be used in ventricular fibrillation cardiac arrest?
Cevap
Give epinephrine during the arrest algorithm and consider amiodarone or lidocaine for refractory shockable rhythms.
2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
Kart 333
Soru
For surgical decision-making, which next action matters most in acute compartment syndrome?
Cevap
Remove constrictive material and obtain immediate surgical fasciotomy evaluation.
Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 334
Soru
In a child or adolescent, which diagnosis fits sudden loss of consciousness with bilateral tonic then clonic movements followed by confusion?
Cevap
Generalized tonic-clonic seizure. Sudden loss of consciousness with bilateral tonic then clonic movements followed by confusion supports a generalized convulsion.
Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
Kart 335
Soru
How should medication be used in herpes zoster?
Cevap
Start an oral antiviral early for eligible patients, especially with severe pain, older age, or high-risk sites.
Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
Kart 336
Soru
Which diagnosis is defined by suspected infection with acute organ dysfunction and may include altered mentation, hypotension, tachypnea, or poor perfusion?
Cevap
Sepsis. Suspected infection with acute organ dysfunction, altered mentation, hypotension, tachypnea, or poor perfusion suggests sepsis.
2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
Kart 337
Soru
What medication strategy is appropriate for uncomplicated cystitis?
Cevap
Nitrofurantoin, trimethoprim-sulfamethoxazole where appropriate, or fosfomycin are common first-line options guided by patient factors and resistance.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 338
Soru
Which diagnosis warrants empiric treatment when lower abdominal pain occurs with cervical-motion, uterine, or adnexal tenderness in a patient at STI risk?
Cevap
Pelvic inflammatory disease. Lower abdominal pain with cervical motion, uterine, or adnexal tenderness in a patient at STI risk supports empiric PID treatment.
Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
Kart 339
Soru
How should a clinician confirm or characterize pulmonary embolism?
Cevap
Use pretest probability with PERC or D-dimer when appropriate and CT pulmonary angiography for indicated stable patients.
ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
Kart 340
Soru
Which diagnosis requires at least six months of illness with psychosis and functional decline, including at least one month of active symptoms, after exclusions?
Cevap
Schizophrenia. At least six months of illness with psychosis and functional decline, including at least one month of active symptoms, supports schizophrenia after exclusions.
Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
Kart 341
Soru
Which prevention or risk-reduction step is important for infective endocarditis?
Cevap
Reserve antibiotic prophylaxis for defined high-risk cardiac conditions undergoing relevant dental procedures.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 342
Soru
What is the priority management step for primary adrenal insufficiency?
Cevap
Suspected adrenal crisis requires immediate glucocorticoid and isotonic fluid treatment before confirmatory results.
Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
Kart 343
Soru
What is the safest response to a critical test result that arrives after a patient leaves?
Cevap
Acknowledge it promptly, contact the patient or responsible team, document attempts and advice, and escalate until ownership is clear.
Quick Safety 52: Advancing Safety with Closed-loop Communication of Test Results · reviewed 2026-08-26
Kart 344
Soru
In a child aged 6 months or older, what is the priority management step for acute otitis media?
Cevap
Provide analgesia; treat severe illness promptly with antibiotics and use 24–48 hours of watchful waiting only for selected mildly ill children with reliable follow-up.
Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
Kart 345
Soru
When antibiotic susceptibility is unknown, which empiric regimen is preferred for most treatment-naive Helicobacter pylori infection?
Cevap
Use 14-day optimized bismuth quadruple therapy: a proton-pump inhibitor, bismuth, tetracycline, and metronidazole.
ACG Clinical Guideline: Treatment of Helicobacter pylori Infection · reviewed 2026-08-26
Kart 346
Soru
In a child or adolescent, which diagnosis best fits this presentation: Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.
Cevap
Nephritic syndrome. Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 347
Soru
What drug class or regimen fits carpal tunnel syndrome?
Cevap
A local corticosteroid injection can provide relief; oral medicines do not correct the compression.
Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 348
Soru
In a child or adolescent, what counseling point helps reduce harm from immune thrombocytopenia?
Cevap
Avoid platelet-impairing medicines and counsel on bleeding precautions when counts are low.
American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
Kart 349
Soru
Which test or testing sequence best evaluates suspected bacterial brain abscess?
Cevap
Contrast-enhanced MRI is preferred; obtain blood cultures and avoid lumbar puncture when mass effect is possible.
ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
Kart 350
Soru
What physiologic disturbance underlies aortic dissection?
Cevap
An intimal tear lets blood split the aortic media, creating a false lumen.
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
Kart 351
Soru
How can a clinician reduce avoidable harm related to acute respiratory distress syndrome?
Cevap
Use lung-protective ventilation in mechanically ventilated patients at risk for ARDS to reduce ventilator-induced injury.
An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
Kart 352
Soru
Which test or testing sequence best evaluates suspected pulmonary tuberculosis?
Cevap
Obtain chest imaging and multiple respiratory specimens for nucleic-acid testing, smear, and culture with susceptibility testing.
Clinical and Laboratory Diagnosis for Tuberculosis · reviewed 2026-08-26
Kart 353
Soru
Which test or testing sequence best evaluates suspected endometriosis?
Cevap
Diagnosis can be clinical with imaging for endometrioma or deep disease; laparoscopy is not mandatory before initial treatment.
Endometriosis · reviewed 2026-08-26
Kart 354
Soru
Which test or testing sequence best evaluates suspected panic disorder?
Cevap
Diagnosis is clinical after considering cardiac, pulmonary, endocrine, neurologic, medication, and substance causes.
Panic Disorder: What You Need to Know · reviewed 2026-08-26
Kart 355
Soru
How can a clinician reduce avoidable harm related to Crohn disease?
Cevap
Support smoking cessation and use effective maintenance therapy with objective monitoring to reduce relapse and complications.
Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
Kart 356
Soru
Which history or examination finding most strongly supports Cushing syndrome?
Cevap
Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.
Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
Kart 357
Soru
How can a clinician reduce avoidable harm related to rheumatoid arthritis?
Cevap
Keep indicated vaccines current and coordinate timing with immunosuppressive therapy to reduce preventable infection risk.
2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases · reviewed 2026-08-26
Kart 358
Soru
Which history or examination finding most strongly supports peritonsillar abscess?
Cevap
Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.
Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
Kart 359
Soru
When should a safety event or near miss be reported?
Cevap
Report it through the local safety system promptly, including near misses, so hazards can be corrected without waiting for patient harm.
Reporting Patient Safety Events · reviewed 2026-08-26
Kart 360
Soru
For surgical decision-making, what immediate plan is appropriate for cardiac tamponade?
Cevap
Urgent pericardial drainage is the definitive step when tamponade causes hemodynamic compromise.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 361
Soru
Which bedside pattern best points to pleural effusion?
Cevap
Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid.
British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26
Kart 362
Soru
For surgical decision-making, what immediate plan is appropriate for melanoma?
Cevap
Prompt complete diagnostic excision and staging guide definitive surgical management.
Melanoma Clinical Guidelines · reviewed 2026-08-26
Kart 363
Soru
A clinician is considering uncomplicated cystitis. Which finding adds the most support?
Cevap
Dysuria and frequency without vaginal symptoms strongly support lower urinary infection in an appropriate patient.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 364
Soru
In a child or adolescent, which clinical sequence defines a generalized tonic-clonic seizure?
Cevap
Loss of consciousness with bilateral tonic stiffening followed by clonic jerking and a postictal period defines the typical sequence.
Epilepsies in Children, Young People and Adults · reviewed 2026-08-26
Kart 365
Soru
What is the priority management step for chronic kidney disease?
Cevap
Identify cause, quantify progression risk, treat complications, and refer for high-risk features or advanced disease.
2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
Kart 366
Soru
Why does sepsis produce its defining clinical pattern?
Cevap
A dysregulated host response causes endothelial injury, vasodilation, capillary leak, and organ dysfunction.
2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26
Kart 367
Soru
Which history or examination finding most strongly supports stable chronic hypertension?
Cevap
Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 368
Soru
Why does pelvic inflammatory disease produce its defining clinical pattern?
Cevap
Ascending polymicrobial infection inflames endometrium and tubes, causing scarring and future ectopic or infertility risk.
Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26
Kart 369
Soru
Which bedside pattern best points to chronic hepatitis C?
Cevap
Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease.
Viral Hepatitis Clinical Care · reviewed 2026-08-26
Kart 370
Soru
Which symptom domains should a clinician assess in schizophrenia?
Cevap
Assess positive, negative, cognitive, and mood symptoms together with substance use, functioning, and safety.
Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26
Kart 371
Soru
For surgical decision-making, an older adult after a fall has groin pain, cannot bear weight, and holds a shortened, externally rotated leg. Which diagnosis is most likely?
Cevap
Hip fracture. An older adult after a fall with groin pain, inability to bear weight, and a shortened externally rotated leg likely has a hip fracture.
Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 372
Soru
In pulmonary embolism with hemodynamic compromise and no prohibitive bleeding risk, which drug class should be considered for reperfusion?
Cevap
Use systemic thrombolytic therapy followed by anticoagulation; weigh the immediate bleeding risk and activate an advanced-reperfusion pathway.
ASH 2020 Guidelines for Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
Kart 373
Soru
Which diagnosis best fits this presentation: Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.
Cevap
Acute deep-vein thrombosis. Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.
ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
Kart 374
Soru
Which preventive measure belongs in care for type 2 diabetes mellitus?
Cevap
Weight-supportive nutrition, physical activity, tobacco avoidance, and cardiometabolic risk control prevent complications.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 375
Soru
What is the first response when a colleague appears impaired while providing care?
Cevap
Protect patients immediately, remove the colleague from unsafe duties through the proper chain, and activate confidential professional-assistance procedures.
Physician Responsibilities to Colleagues with Illness, Disability or Impairment · reviewed 2026-08-26
Kart 376
Soru
Which preventive measure belongs in care for acute angle-closure glaucoma?
Cevap
Definitive treatment of the fellow narrow-angle eye helps prevent a second attack.
Management of Angle-Closure Glaucoma · reviewed 2026-08-26
Kart 377
Soru
Exertional dyspnea, orthopnea, edema, elevated jugular venous pressure, an S3, and an echocardiographic LVEF of 35% indicate which heart-failure phenotype?
Cevap
Heart failure with reduced ejection fraction (HFrEF). The congestion findings establish heart failure, and an LVEF of 40% or less identifies the reduced-EF phenotype.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 378
Soru
What clinical clue should raise suspicion for multiple sclerosis relapse?
Cevap
A focal neurologic deficit evolving over hours to days and lasting over 24 hours, separated in time and space from prior events, suggests relapse.
Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
Kart 379
Soru
For surgical decision-making, which diagnosis best fits persistent right-upper-quadrant pain or tenderness, fever, leukocytosis, and a positive Murphy sign?
Cevap
Acute calculous cholecystitis. The combined clinical and inflammatory findings support the diagnosis; confirm it with imaging.
2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
Kart 380
Soru
What clinical clue should raise suspicion for HIV infection?
Cevap
Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.
About HIV · reviewed 2026-08-26
Kart 381
Soru
Why does hip fracture produce its defining clinical pattern?
Cevap
Osteoporotic bone can fail under low-energy load, and immobility rapidly adds medical risk.
Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 382
Soru
What clinical clue should raise suspicion for postpartum hemorrhage?
Cevap
Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.
Postpartum Hemorrhage · reviewed 2026-08-26
Kart 383
Soru
Why does pulmonary embolism produce its defining clinical pattern?
Cevap
Pulmonary embolism is venous thromboembolism obstructing the pulmonary arteries, which increases right-ventricular afterload.
ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
Kart 384
Soru
What clinical clue should raise suspicion for delirium?
Cevap
An acute fluctuating disturbance of attention and awareness with disorganized thinking suggests delirium.
Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
Kart 385
Soru
For surgical decision-making, what immediate plan is appropriate for ureteral stone?
Cevap
Provide analgesia, check for infection and kidney injury, and decompress urgently when obstruction is infected.
EAU Guidelines on Urolithiasis · reviewed 2026-08-26
Kart 386
Soru
What is the key first diagnostic step for heart failure with reduced ejection fraction?
Cevap
Transthoracic echocardiography defines ejection fraction and structural disease.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 387
Soru
In a child or adolescent, a clinician is considering atopic dermatitis. Which finding adds the most support?
Cevap
Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.
Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
Kart 388
Soru
Which diagnosis causes fever, marked tachycardia, agitation or delirium, gastrointestinal symptoms, and heart failure in a patient with thyrotoxicosis?
Cevap
Thyroid storm. Fever, marked tachycardia, agitation or delirium, gastrointestinal symptoms, and heart failure in thyrotoxicosis suggest storm.
2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis · reviewed 2026-08-26
Kart 389
Soru
Which history or examination finding most strongly supports chronic kidney disease?
Cevap
CKD may be silent; edema, pruritus, anemia, hypertension, or abnormal urine testing often appears later.
2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26
Kart 390
Soru
Identify the condition from this pattern: Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.
Cevap
Acute bacterial rhinosinusitis. Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.
Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26
Kart 391
Soru
Which history or examination finding most strongly supports iron-deficiency anemia?
Cevap
Fatigue, pica, restless legs, koilonychia, or chronic blood loss can accompany microcytic anemia.
British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
Kart 392
Soru
How should a clinician respond to a patient’s prejudiced request or discriminatory behavior?
Cevap
Address the behavior directly, explore its reasons, set limits that protect staff and other patients, and do not accommodate invidious discrimination; urgent care still takes priority.
Discrimination and Disruptive Behavior by Patients · reviewed 2026-08-26
Kart 393
Soru
For surgical decision-making, which next action matters most in bacterial brain abscess?
Cevap
Start IV antibiotics and obtain urgent neurosurgical consultation for aspiration or drainage when indicated.
ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
Kart 394
Soru
How should a clinician confirm or characterize acute pancreatitis?
Cevap
Diagnosis requires two of three: characteristic pain, lipase or amylase at least three times normal, or compatible imaging.
ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
Kart 395
Soru
Which next action matters most in pulmonary tuberculosis?
Cevap
Isolate suspected contagious disease and coordinate promptly with public health.
Tuberculosis Infection Control · reviewed 2026-08-26
Kart 396
Soru
How should a clinician confirm or characterize anterior cruciate ligament tear?
Cevap
MRI confirms associated soft-tissue injury when it will guide management; radiographs assess fracture.
Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 397
Soru
For surgical decision-making, which next action matters most in endometriosis?
Cevap
Offer empiric symptom treatment or surgery based on severity, fertility goals, masses, and response.
Endometriosis · reviewed 2026-08-26
Kart 398
Soru
A patient has this pattern: Sudden dyspnea, pleuritic pain, tachycardia, hypoxemia, hemoptysis, or syncope with VTE risk raises suspicion. What is the most likely diagnosis?
Cevap
Pulmonary embolism. Sudden dyspnea, pleuritic pain, tachycardia, hypoxemia, hemoptysis, or syncope with VTE risk raises suspicion.
ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26
Kart 399
Soru
Which next action matters most in panic disorder?
Cevap
During an attack, ensure safety and exclude an emergency; for ongoing disorder, offer cognitive behavioral therapy and/or medication.
Panic Disorder: What You Need to Know · reviewed 2026-08-26
Kart 400
Soru
What medication strategy is appropriate for acute coronary syndrome?
Cevap
Use dual antiplatelet therapy after ACS when indicated, balancing ischemic benefit against bleeding risk.
2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
Kart 401
Soru
What immediate plan is appropriate for COPD?
Cevap
For an exacerbation, increase short-acting bronchodilation, use systemic steroids, add antibiotics when indicated, and support ventilation.
2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
Kart 402
Soru
In a child or adolescent, which bedside pattern best points to juvenile idiopathic arthritis?
Cevap
Persistent joint swelling, limited motion, or morning stiffness beginning before age 16, after excluding other causes, suggests JIA.
2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
Kart 403
Soru
What is the priority management step for stable chronic hypertension?
Cevap
Estimate cardiovascular risk, assess target-organ damage, and set an individualized treatment plan.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 404
Soru
What drug class or regimen fits myasthenia gravis?
Cevap
Pyridostigmine treats symptoms; corticosteroid or other immunotherapy controls autoimmune activity.
International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26
Kart 405
Soru
For surgical decision-making, how should a fit patient with acute calculous cholecystitis be managed initially?
Cevap
Give fluids and analgesia, prescribe antibiotics when indicated, and arrange early laparoscopic cholecystectomy as soon as possible.
2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
Kart 406
Soru
What drug class or regimen fits Clostridioides difficile infection?
Cevap
Oral fidaxomicin is preferred for many initial episodes; oral vancomycin remains an accepted alternative.
2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26
Kart 407
Soru
How should a clinician confirm or characterize primary hyperparathyroidism?
Cevap
Confirm elevated albumin-corrected or ionized calcium with an inappropriately high PTH; assess kidneys and bone.
Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
Kart 408
Soru
Which medication prevents seizures in preeclampsia with severe features?
Cevap
Use magnesium sulfate for seizure prophylaxis while controlling severe hypertension and planning delivery according to maternal and fetal status.
Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
Kart 409
Soru
What is shared decision-making?
Cevap
The clinician presents reasonable options and evidence, elicits the patient’s goals and tradeoffs, and reaches a choice together when more than one path is reasonable.
The SHARE Approach · reviewed 2026-08-26
Kart 410
Soru
In a child aged 6 years or older or an adolescent, what drug class or regimen fits attention-deficit/hyperactivity disorder?
Cevap
Extended-release stimulants are first-line medication for most children and adolescents when combined with nonpharmacologic care and monitored for benefit and adverse effects.
ADHD in Children and Youth: Part 2—Treatment · reviewed 2026-08-26
Kart 411
Soru
What is the priority management step for iron-deficiency anemia?
Cevap
Identify and control bleeding, then replace iron; investigate occult gastrointestinal loss when appropriate.
British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults · reviewed 2026-08-26
Kart 412
Soru
Which pharmacologic approach is preferred for acute angle-closure glaucoma?
Cevap
Use pressure-lowering topical agents plus systemic acetazolamide when appropriate; pilocarpine is added after pressure begins to fall.
Management of Angle-Closure Glaucoma · reviewed 2026-08-26
Kart 413
Soru
Which diagnosis best fits this presentation: A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.
Cevap
Herpes zoster. A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.
Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
Kart 414
Soru
In a child or adolescent, which pharmacologic approach is preferred for nephritic syndrome?
Cevap
Immunosuppression is disease-specific and should follow a supported diagnosis rather than empiric routine use.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 415
Soru
What counseling point helps reduce harm from symptomatic aortic stenosis?
Cevap
Teach patients to report exertional dyspnea, angina, presyncope, or syncope promptly; new symptoms require timely reassessment, and severe symptomatic AS warrants valve-team evaluation rather than surveillance alone.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 416
Soru
For surgical decision-making, which diagnosis best fits this presentation: Abrupt severe unilateral scrotal pain, a high-riding transverse testis, nausea, and an absent cremasteric reflex are concerning.
Cevap
Testicular torsion. Sudden severe unilateral pain with nausea or vomiting, a high-riding transverse testis, and loss of the cremasteric reflex is the classic pattern.
Testicular Torsion · reviewed 2026-08-26
Kart 417
Soru
A clinician is considering idiopathic pulmonary fibrosis. Which finding adds the most support?
Cevap
Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.
Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26
Kart 418
Soru
How should medication be used in ulcerative colitis?
Cevap
Use 5-aminosalicylates for many mild-to-moderate cases; advanced therapy is selected by severity and prior response.
Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
Kart 419
Soru
For surgical decision-making, how should a clinician initially manage hip fracture?
Cevap
Provide analgesia, optimize medical issues, and arrange timely operative management for most displaced fractures.
Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 420
Soru
For surgical decision-making, what condition should be suspected from this finding: Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.
Cevap
Bacterial brain abscess. Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.
ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
Kart 421
Soru
What clinical clue should raise suspicion for ventricular fibrillation cardiac arrest?
Cevap
Sudden unresponsiveness with absent normal breathing and no pulse is cardiac arrest; the monitor may show chaotic ventricular activity.
2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
Kart 422
Soru
What condition should be suspected from this finding: Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.
Cevap
Pulmonary tuberculosis. Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.
Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26
Kart 423
Soru
Which pharmacologic approach is preferred for type 2 diabetes mellitus?
Cevap
Choose glucose-lowering therapy around comorbid ASCVD, heart failure, CKD, weight goals, hypoglycemia risk, and patient priorities; metformin remains appropriate for many.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 424
Soru
For surgical decision-making, which diagnosis best fits cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility?
Cevap
Endometriosis. Cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility suggests endometriosis.
Endometriosis · reviewed 2026-08-26
Kart 425
Soru
How should a clinician confirm or characterize sudden sensorineural hearing loss?
Cevap
Differentiate sensorineural from conductive loss with bedside testing and urgent audiometry.
Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
Kart 426
Soru
Which diagnosis requires recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least one month?
Cevap
Panic disorder. Recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least a month suggests panic disorder.
Panic Disorder: What You Need to Know · reviewed 2026-08-26
Kart 427
Soru
How should uncertainty be communicated?
Cevap
Name what is known and unknown, explain the leading possibilities and why, state the plan to reduce uncertainty, and give specific follow-up or return precautions.
Why Does Clinical Uncertainty Matter? · reviewed 2026-08-26
Kart 428
Soru
Which medication is FDA-approved for moderate-to-severe obstructive sleep apnea in adults with obesity?
Cevap
Tirzepatide is approved for adults with obesity and moderate-to-severe obstructive sleep apnea, used with a reduced-calorie diet and increased physical activity.
FDA Approves First Medication for Obstructive Sleep Apnea · reviewed 2026-08-26
Kart 429
Soru
Which pathophysiologic process drives acute kidney injury?
Cevap
Abrupt loss of filtration disturbs volume, electrolytes, acid-base balance, and toxin clearance.
KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
Kart 430
Soru
Which pharmacologic approach is preferred for acute deep-vein thrombosis?
Cevap
A direct oral anticoagulant is preferred for many eligible patients; selection changes with pregnancy, cancer, renal function, and antiphospholipid syndrome.
ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
Kart 431
Soru
A clinician is considering upper gastrointestinal bleeding. Which finding adds the most support?
Cevap
Hematemesis, coffee-ground emesis, or melena with orthostasis indicates an upper gastrointestinal source until shown otherwise.
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26
Kart 432
Soru
How should medication be used in gout flare?
Cevap
Use an NSAID, colchicine, or glucocorticoid based on comorbidity and timing; allopurinol is preferred long-term urate lowering for most.
2020 American College of Rheumatology Guideline for the Management of Gout · reviewed 2026-08-26
Kart 433
Soru
Which diagnosis best fits an irregularly irregular pulse with palpitations, fatigue, or dyspnea?
Cevap
Atrial fibrillation. An irregularly irregular pulse with palpitations, fatigue, or dyspnea suggests atrial fibrillation.
2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
Kart 434
Soru
Which treatment should not be offered solely to treat multiple sclerosis?
Cevap
Do not offer vitamin D solely to treat multiple sclerosis.
Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
Kart 435
Soru
Which pathophysiologic process drives plaque psoriasis?
Cevap
IL-23 and Th17 pathway activation drives accelerated keratinocyte turnover.
Psoriasis Clinical Guidelines · reviewed 2026-08-26
Kart 436
Soru
How can a clinician reduce avoidable harm related to HIV infection?
Cevap
PrEP, condoms, sterile injection equipment, perinatal treatment, and sustained viral suppression prevent transmission.
Preventing HIV · reviewed 2026-08-26
Kart 437
Soru
Which pathophysiologic process drives acute pyelonephritis?
Cevap
Ascending infection reaches the renal pelvis and parenchyma, producing systemic illness.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 438
Soru
How can a clinician reduce avoidable harm related to postpartum hemorrhage?
Cevap
Antenatal anemia treatment, active management of the third stage, and hemorrhage protocols reduce morbidity.
Postpartum Hemorrhage · reviewed 2026-08-26
Kart 439
Soru
What is the key first diagnostic step for tension pneumothorax?
Cevap
Diagnosis is clinical in an unstable patient; bedside ultrasound can support it but imaging must not delay decompression.
Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
Kart 440
Soru
How can a clinician reduce avoidable harm related to delirium?
Cevap
Orientation, mobility, sleep protection, hearing and vision aids, hydration, and medication review reduce hospital delirium.
Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
Kart 441
Soru
What core mechanism explains infective endocarditis?
Cevap
Microbial adherence to damaged endocardium or prosthetic material produces infected vegetations.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 442
Soru
For surgical decision-making, which next action matters most in primary hyperparathyroidism?
Cevap
Refer for parathyroidectomy when symptomatic or when guideline thresholds for calcium, kidney, bone, or age are met.
Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
Kart 443
Soru
What makes a useful return precaution?
Cevap
It names concrete symptoms or changes, states how urgently to act, and tells the patient where to seek help.
IDEAL Discharge Planning Overview, Process, and Checklist · reviewed 2026-08-26
Kart 444
Soru
Which next action matters most in sudden sensorineural hearing loss?
Cevap
Arrange urgent otolaryngology evaluation and assess for retrocochlear pathology.
Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
Kart 445
Soru
A patient has this pattern: Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical. What is the most likely diagnosis?
Cevap
Acute pancreatitis. Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical.
ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
Kart 446
Soru
For surgical decision-making, a noncontact pivot causes an audible pop, immediate swelling, instability, and a positive Lachman test. What is the most likely diagnosis?
Cevap
Anterior cruciate ligament tear. A noncontact pivot, audible pop, immediate swelling, and instability with a positive Lachman test suggest an ACL tear.
Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 447
Soru
Which bedside pattern best points to acute ischemic stroke?
Cevap
Sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia is stroke until proved otherwise.
2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
Kart 448
Soru
Which electrolyte disorder may cause weakness, paresthesias, bradycardia, or ECG changes but can be dangerous even without symptoms?
Cevap
Hyperkalemia. Weakness, paresthesias, bradycardia, or ECG changes can occur, but dangerous hyperkalemia may be asymptomatic.
Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
Kart 449
Soru
Which bedside pattern best points to community-acquired pneumonia?
Cevap
New cough, fever, dyspnea, pleuritic pain, and focal crackles suggest pneumonia, but clinical findings alone are imperfect.
Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
Kart 450
Soru
Which pharmacologic approach is preferred for heart failure with reduced ejection fraction?
Cevap
Foundational chronic therapy includes an ARNI or ACE inhibitor/ARB, an evidence-based beta-blocker, an MRA, and an SGLT2 inhibitor when tolerated.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 451
Soru
For surgical decision-making, severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock indicate which diagnosis?
Cevap
Tension pneumothorax. Severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock suggest tension physiology.
Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
Kart 452
Soru
Which bedside pattern best points to ectopic pregnancy?
Cevap
Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation.
Ectopic Pregnancy · reviewed 2026-08-26
Kart 453
Soru
In a child with sickle cell disease, sudden severe limb or back pain matches prior vaso-occlusive episodes and no alternative cause is found. Which diagnosis best fits?
Cevap
Acute sickle cell vaso-occlusive pain episode.
ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
Kart 454
Soru
In a child or adolescent, which bedside pattern best points to major depressive disorder?
Cevap
At least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms suggests major depression.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
Kart 455
Soru
Which prevention or risk-reduction step is important for cirrhosis with ascites?
Cevap
Use sodium restriction, review medicines that can worsen kidney perfusion, and monitor weight, kidney function, and electrolytes.
Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
Kart 456
Soru
What clinical clue should raise suspicion for type 2 diabetes mellitus?
Cevap
Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 457
Soru
In a postmenopausal woman or man aged 50 or older, which steps support bone health and reduce fracture risk?
Cevap
Adequate calcium and vitamin D, weight-bearing and muscle-strengthening exercise, fall-risk reduction, tobacco cessation, and avoiding excess alcohol support bone health.
The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26
Kart 458
Soru
What clinical clue should raise suspicion for acute angle-closure glaucoma?
Cevap
Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.
Management of Angle-Closure Glaucoma · reviewed 2026-08-26
Kart 459
Soru
How should a clinician respond to an incidental finding outside the visit’s main problem?
Cevap
Explain the finding and its uncertainty, recommend proportionate follow-up, assign ownership, and document the plan.
Catching Those Who Fall Through the Cracks: Follow-up for Incidental Radiologic Findings · reviewed 2026-08-26
Kart 460
Soru
Which next action matters most in ventricular fibrillation cardiac arrest?
Cevap
Start high-quality CPR and defibrillate ventricular fibrillation or pulseless ventricular tachycardia as soon as possible.
2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26
Kart 461
Soru
Which test or testing sequence best evaluates suspected plaque psoriasis?
Cevap
Diagnosis is usually clinical; biopsy is reserved for uncertain morphology.
Psoriasis Clinical Guidelines · reviewed 2026-08-26
Kart 462
Soru
What is the priority management step for pulmonary embolism?
Cevap
Start anticoagulation for confirmed pulmonary embolism; consider thrombolysis for selected patients with hemodynamic compromise and acceptable bleeding risk.
ASH VTE Guidelines: Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26
Kart 463
Soru
What diagnostic approach is most appropriate when uncomplicated cystitis is suspected?
Cevap
Urinalysis supports the diagnosis; culture is important for complicated, recurrent, resistant, pregnant, or atypical cases.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 464
Soru
How should a clinician initially manage migraine with aura?
Cevap
Treat early with an effective acute medicine and choose prevention when frequency or disability justifies it.
AHS Consensus Statement: Integrating New Migraine Treatments into Clinical Practice · reviewed 2026-08-26
Kart 465
Soru
Why does thrombotic thrombocytopenic purpura produce its defining clinical pattern?
Cevap
Severe ADAMTS13 deficiency permits ultra-large von Willebrand factor multimers to form platelet-rich microthrombi.
ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
Kart 466
Soru
How should a clinician initially manage early syphilis?
Cevap
Treat the patient and ensure partner evaluation; urgent specialist evaluation is needed for ocular, otic, or neurologic disease.
Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
Kart 467
Soru
What diagnostic approach is most appropriate when atrial fibrillation is suspected?
Cevap
Confirm the rhythm with a 12-lead ECG and assess for structural disease and reversible triggers.
2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
Kart 468
Soru
How should a clinician initially manage abnormal uterine bleeding from anovulation?
Cevap
Stabilize acute heavy bleeding first, then protect the endometrium and control ongoing blood loss.
Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women · reviewed 2026-08-26
Kart 469
Soru
Why does acute cholecystitis produce its defining clinical pattern?
Cevap
A gallstone can block bile flow, causing gallbladder pain and swelling (inflammation).
Cholecystectomy · reviewed 2026-08-26
Kart 470
Soru
How should a clinician initially manage post-traumatic stress disorder?
Cevap
Offer individual trauma-focused psychotherapy as first-line treatment when available and acceptable.
Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
Kart 471
Soru
In a child or adolescent, a clinician is considering septic arthritis. Which finding adds the most support?
Cevap
Acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk is septic arthritis until excluded.
Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26
Kart 472
Soru
Which next action matters most in acute kidney injury?
Cevap
Treat the cause, restore perfusion without overload, stop nephrotoxins, and relieve obstruction.
KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
Kart 473
Soru
For an eligible infant or selected high-risk child aged 8–19 months, which immunization strategy reduces severe RSV disease?
Cevap
Use either maternal RSV vaccination or a recommended long-acting RSV antibody to protect infants; give nirsevimab to eligible high-risk children aged 8–19 months entering a second RSV season.
RSV Immunization Guidance for Infants and Young Children · reviewed 2026-08-26
Kart 474
Soru
Which diagnosis causes weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia?
Cevap
Primary adrenal insufficiency. Weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia suggest primary adrenal failure.
Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26
Kart 475
Soru
What is the ethical approach to a learner performing a procedure?
Cevap
Tell the patient who will participate, describe supervision, obtain voluntary agreement, and ensure refusal does not compromise care.
Residents and Fellows: Patient Involvement in Self-Education · reviewed 2026-08-26
Kart 476
Soru
In a child aged 6 months or older, what condition should be suspected from a bulging tympanic membrane with acute ear pain or new otorrhea?
Cevap
Acute otitis media. A bulging tympanic membrane with acute ear pain or new otorrhea is more specific than redness alone.
Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26
Kart 477
Soru
Which bedside pattern best points to acute coronary syndrome?
Cevap
Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern.
2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
Kart 478
Soru
How should medication be used in multiple sclerosis relapse?
Cevap
High-dose corticosteroids shorten a disabling relapse; they do not alter long-term progression by themselves.
Multiple Sclerosis in Adults: Management · reviewed 2026-08-26
Kart 479
Soru
What immediate plan is appropriate for acute pancreatitis?
Cevap
Use early isotonic fluids guided by response, analgesia, and early oral feeding as tolerated; address the cause.
ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26
Kart 480
Soru
How should medication be used in HIV infection?
Cevap
Use a recommended combination antiretroviral regimen selected for resistance, interactions, comorbidity, pregnancy potential, and patient preference.
What to Start: Initial Combination Antiretroviral Regimens · reviewed 2026-08-26
Kart 481
Soru
For surgical decision-making, what immediate plan is appropriate for anterior cruciate ligament tear?
Cevap
Control swelling, restore motion, begin rehabilitation, and individualize reconstruction by instability and activity goals.
Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 482
Soru
How should medication be used in postpartum hemorrhage?
Cevap
Oxytocin is first-line for uterine atony; add other uterotonics according to contraindications and give tranexamic acid early when indicated.
Postpartum Hemorrhage · reviewed 2026-08-26
Kart 483
Soru
In a child or adolescent, which history or examination finding most strongly supports asthma?
Cevap
Variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers suggests asthma.
2026 GINA Strategy Report · reviewed 2026-08-26
Kart 484
Soru
How should medication be used in delirium?
Cevap
Reserve short-term antipsychotic use for severe dangerous agitation after reversible causes and contraindications are addressed.
Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26
Kart 485
Soru
Which preventive measure belongs in care for herpes zoster?
Cevap
Age-appropriate recombinant zoster vaccination lowers zoster and postherpetic-neuralgia risk.
Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26
Kart 486
Soru
For surgical decision-making, what condition should be suspected from this finding: Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.
Cevap
Aortic dissection. Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
Kart 487
Soru
Which preventive step is required during surgery for viable testicular torsion?
Cevap
Perform bilateral orchiopexy, fixing the affected and contralateral testes to reduce future torsion risk.
Testicular Torsion · reviewed 2026-08-26
Kart 488
Soru
Which test or testing sequence best evaluates suspected hyponatremia due to SIADH?
Cevap
Confirm low serum osmolality with inappropriately concentrated urine and urine sodium after excluding thyroid, adrenal, renal, and diuretic causes.
Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
Kart 489
Soru
Why does primary hypothyroidism produce its defining clinical pattern?
Cevap
Low thyroid hormone removes feedback inhibition, so TSH rises in primary gland failure.
Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26
Kart 490
Soru
Which test or testing sequence best evaluates suspected neutropenic fever?
Cevap
Obtain blood cultures and targeted cultures or imaging, but do not delay empiric antibiotics.
Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
Kart 491
Soru
Why does bacterial conjunctivitis produce its defining clinical pattern?
Cevap
Bacterial infection of the conjunctiva commonly produces red eye with purulent discharge that mats the eyelids.
Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26
Kart 492
Soru
When is a chaperone appropriate for an intimate examination?
Cevap
Offer a trained chaperone, respect patient preferences when safety permits, explain the examination, obtain consent, and document who was present.
Use of Chaperones · reviewed 2026-08-26
Kart 493
Soru
Which diagnosis causes recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms?
Cevap
Migraine with aura. Recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms, suggests migraine with aura.
ICHD-3: Migraine with Aura · reviewed 2026-08-26
Kart 494
Soru
What medication strategy is appropriate for Crohn disease?
Cevap
Corticosteroids can induce remission but are not maintenance therapy; immunomodulator or biologic selection depends on risk and phenotype.
Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26
Kart 495
Soru
Which diagnosis best fits a painless chancre or a diffuse rash involving the palms and soles with generalized lymphadenopathy?
Cevap
Early syphilis. A painless chancre or a diffuse rash involving palms and soles with generalized lymphadenopathy suggests syphilis by stage.
Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
Kart 496
Soru
What medication strategy is appropriate for rheumatoid arthritis?
Cevap
Methotrexate is a preferred anchor drug for many patients with moderate-to-high activity, with folate and safety monitoring.
2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis · reviewed 2026-08-26
Kart 497
Soru
Which diagnosis best fits irregular, unpredictable uterine bleeding at reproductive extremes or with endocrine disruption?
Cevap
Abnormal uterine bleeding from anovulation. Irregular unpredictable bleeding without cyclic ovulation is common at reproductive extremes or with endocrine disruption.
Abnormal Uterine Bleeding · reviewed 2026-08-26
Kart 498
Soru
Which medication class does the 2024 SCCM focused update suggest for an adult with acute respiratory distress syndrome?
Cevap
Use systemic corticosteroids in selected adults with ARDS; the guideline does not specify one best molecule, dose, or duration.
2024 Focused Update: Corticosteroids in Sepsis, ARDS, and Community-Acquired Pneumonia · reviewed 2026-08-26
Kart 499
Soru
Which diagnosis requires intrusion, avoidance, negative mood or cognition, and hyperarousal lasting more than one month after trauma?
Cevap
Post-traumatic stress disorder. Intrusion, avoidance, negative mood or cognition, and hyperarousal lasting over a month after trauma suggest PTSD.
Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
Kart 500
Soru
Which preventive measure belongs in care for acute pericarditis?
Cevap
Restrict strenuous activity until symptoms and inflammatory findings resolve.
2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26
Kart 501
Soru
Which diagnosis best fits loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension?
Cevap
Obstructive sleep apnea. Loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension suggests OSA.
Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea · reviewed 2026-08-26
Kart 502
Soru
What drug class or regimen fits atrial fibrillation?
Cevap
Choose anticoagulation from validated thromboembolic-risk assessment; direct oral anticoagulants are preferred for most eligible patients without mechanical valves or moderate-to-severe rheumatic mitral stenosis.
2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
Kart 503
Soru
In a child or adolescent, which history or examination finding most strongly supports acute appendicitis?
Cevap
Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.
Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26
Kart 504
Soru
Which diagnosis best fits this presentation: Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.
Cevap
Carpal tunnel syndrome. Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.
Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 505
Soru
In an adult with headaches consistent with migraine with aura and a normal neurologic examination, when is neuroimaging needed?
Cevap
Routine neuroimaging is unnecessary; consider it when the aura is unusual, prolonged, or persistent or when other atypical or red-flag features are present.
Neuroimaging for Migraine: The American Headache Society Systematic Review and Evidence-Based Guideline · reviewed 2026-08-26
Kart 506
Soru
In a child or adolescent, how can a clinician reduce avoidable harm related to diabetic ketoacidosis?
Cevap
Sick-day planning, continued basal insulin, ketone checks, and early contact for illness reduce recurrence.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 507
Soru
How should a clinician confirm or characterize early syphilis?
Cevap
Use a nontreponemal test with a treponemal confirmatory test, or the reverse sequence; evaluate neurologic or ocular symptoms separately.
Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26
Kart 508
Soru
How can a clinician reduce avoidable harm related to retinal detachment?
Cevap
Assess sudden new floaters, flashes, or a curtain immediately; early treatment can prevent permanent vision loss. Dilated examination can find a small tear or detachment before vision is affected.
Retinal Detachment · reviewed 2026-08-26
Kart 509
Soru
How should a clinician confirm or characterize abnormal uterine bleeding from anovulation?
Cevap
Exclude pregnancy, assess anemia, review medicines and systemic causes, and sample endometrium when age or risk warrants.
Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women · reviewed 2026-08-26
Kart 510
Soru
How should social media be handled when a clinical story seems de-identified?
Cevap
Do not post patient material without proper authorization; combinations of details can identify a person even when names are removed.
Professionalism in the Use of Social Media · reviewed 2026-08-26
Kart 511
Soru
How should a clinician confirm or characterize post-traumatic stress disorder?
Cevap
Use a trauma-informed clinical assessment and a validated symptom measure while checking safety and comorbidity.
Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26
Kart 512
Soru
Which preventive measure belongs in care for nephrotic syndrome?
Cevap
Vaccination, thrombosis-risk assessment, infection prevention, and cardiovascular-risk control reduce complications.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 513
Soru
In a child or adolescent, what medication strategy is appropriate for atopic dermatitis?
Cevap
Topical corticosteroids are first-line for most flares; steroid-sparing topical agents help at sensitive sites or with maintenance.
Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
Kart 514
Soru
Which preventive measure belongs in care for thrombotic thrombocytopenic purpura?
Cevap
Recognize relapse symptoms early and maintain specialist follow-up after recovery.
ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26
Kart 515
Soru
How should a clinician initially manage acute coronary syndrome?
Cevap
Give aspirin promptly when acute coronary syndrome is suspected and no contraindication exists; activate reperfusion pathways for STEMI.
2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26
Kart 516
Soru
Which history or examination finding most strongly supports acute pyelonephritis?
Cevap
Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 517
Soru
For surgical decision-making, which next action matters most in tension pneumothorax?
Cevap
Perform immediate decompression followed by tube thoracostomy.
Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
Kart 518
Soru
Which diagnosis best fits this presentation: Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.
Cevap
Celiac disease. Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
Kart 519
Soru
What physiologic disturbance underlies anterior cruciate ligament tear?
Cevap
An ACL tear removes a primary restraint to anterior tibial translation and rotation, producing anterior and rotational instability.
The Management of Anterior Cruciate Ligament Injuries · reviewed 2026-08-26
Kart 520
Soru
A clinician is considering heart failure with reduced ejection fraction. Which finding adds the most support?
Cevap
Exertional dyspnea, orthopnea, edema, elevated jugular venous pressure, and an S3 support volume-overloaded heart failure.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 521
Soru
What physiologic disturbance underlies bacterial brain abscess?
Cevap
Localized infection produces cerebritis and a capsule with surrounding edema and mass effect.
ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26
Kart 522
Soru
What is the key first diagnostic step for Cushing syndrome?
Cevap
Use an accepted first-line screen such as late-night salivary cortisol, 24-hour urinary free cortisol, or overnight dexamethasone suppression.
Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
Kart 523
Soru
What physiologic disturbance underlies pulmonary tuberculosis?
Cevap
Mycobacteria survive in macrophages and drive granulomatous inflammation with latent or active disease.
Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26
Kart 524
Soru
Which antibiotic is required for gonococcal conjunctivitis in an adult?
Cevap
Give systemic ceftriaxone; consider one-time saline lavage and evaluate for chlamydial coinfection when it has not been excluded.
Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
Kart 525
Soru
What physiologic disturbance underlies endometriosis?
Cevap
Estrogen-responsive ectopic endometrial-like tissue drives inflammation, fibrosis, and pain.
Endometriosis · reviewed 2026-08-26
Kart 526
Soru
What should a clinician do after sending protected information to the wrong recipient?
Cevap
Act immediately to limit further disclosure, notify the organization’s privacy or security process, document facts, and follow breach assessment requirements.
Breach Notification Rule · reviewed 2026-08-26
Kart 527
Soru
Which clinical pattern defines a panic attack?
Cevap
An abrupt surge of intense fear or discomfort with physical and cognitive symptoms that peaks within minutes defines a panic attack.
Panic Disorder: What You Need to Know · reviewed 2026-08-26
Kart 528
Soru
What clinical clue should raise suspicion for acute kidney injury?
Cevap
A rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis indicates AKI.
KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26
Kart 529
Soru
What physiologic disturbance underlies tension pneumothorax?
Cevap
A one-way pleural air leak raises intrathoracic pressure, collapses the lung, and impairs venous return.
Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26
Kart 530
Soru
In a child or adolescent, what clinical clue should raise suspicion for immune thrombocytopenia?
Cevap
Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.
American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
Kart 531
Soru
What is the key first diagnostic step for celiac disease?
Cevap
Order tissue-transglutaminase IgA with total IgA while the patient is eating gluten; confirm as guideline-directed.
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
Kart 532
Soru
A patient has this pattern: Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion. What is the most likely diagnosis?
Cevap
Infective endocarditis. Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 533
Soru
What is the key first diagnostic step for carpal tunnel syndrome?
Cevap
Diagnosis is often clinical; electrodiagnostic testing helps when severe, atypical, or before selected surgery.
Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 534
Soru
Which prevention step is essential before oral intake in acute ischemic stroke?
Cevap
Screen swallowing before food, fluids, or oral medication to reduce aspiration risk.
2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
Kart 535
Soru
What is the priority management step for cellulitis?
Cevap
Mark the margin, assess for abscess or necrotizing infection, and escalate care for systemic toxicity.
Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections · reviewed 2026-08-26
Kart 536
Soru
Which prevention or risk-reduction step is important for community-acquired pneumonia?
Cevap
Keep age- and risk-appropriate pneumococcal vaccination current to reduce preventable pneumococcal pneumonia.
Pneumococcal Vaccine Recommendations · reviewed 2026-08-26
Kart 537
Soru
For surgical decision-making, what is the priority management step for benign prostatic hyperplasia?
Cevap
Urgently catheterize acute urinary retention and evaluate infection, kidney injury, or severe hematuria.
EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26
Kart 538
Soru
Which prevention or risk-reduction step is important for ectopic pregnancy?
Cevap
Early testing after a missed period and prompt evaluation of pain or bleeding reduce rupture morbidity.
Ectopic Pregnancy · reviewed 2026-08-26
Kart 539
Soru
What diagnostic approach is most appropriate when obstructive sleep apnea is suspected?
Cevap
Confirm with polysomnography or an appropriate home sleep-apnea test in selected uncomplicated adults.
Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea · reviewed 2026-08-26
Kart 540
Soru
In a child or adolescent, which prevention or risk-reduction step is important for major depressive disorder?
Cevap
Monitor symptoms, suicidality, functioning, treatment adherence, and recurrence with a clear follow-up and safety plan.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
Kart 541
Soru
Which pathophysiologic process drives symptomatic aortic stenosis?
Cevap
Calcific leaflet narrowing creates a fixed left-ventricular outflow obstruction and pressure overload.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
Kart 542
Soru
In a child or adolescent, what drug class or regimen fits diabetic ketoacidosis?
Cevap
Use continuous IV regular insulin; add dextrose as glucose falls so ketone clearance can continue.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 543
Soru
What is the key first diagnostic step for peritonsillar abscess?
Cevap
Diagnosis is usually clinical; ultrasound or CT helps when the diagnosis or deep-space extension is uncertain.
Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
Kart 544
Soru
What does continuity require before ending a clinician-patient relationship?
Cevap
Give reasonable notice, provide urgent coverage during the transition, offer transfer resources, and make records available as permitted.
Terminating a Patient-Physician Relationship · reviewed 2026-08-26
Kart 545
Soru
What counseling point helps reduce harm from chronic hepatitis C?
Cevap
Avoid blood exposure, do not share injection equipment, and screen all adults and each pregnancy as recommended.
Viral Hepatitis Clinical Care · reviewed 2026-08-26
Kart 546
Soru
What drug class or regimen fits hyperkalemia?
Cevap
IV calcium protects the heart; insulin with glucose shifts potassium, while diuresis, binders, or dialysis remove it.
Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26
Kart 547
Soru
In a child or adolescent, what counseling point helps reduce harm from juvenile idiopathic arthritis?
Cevap
Vaccination, eye screening, activity, and growth monitoring reduce preventable morbidity.
2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26
Kart 548
Soru
In a child or adolescent, which next action matters most in immune thrombocytopenia?
Cevap
Treat clinically important bleeding urgently; observation is appropriate for selected patients with minor symptoms.
American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26
Kart 549
Soru
A clinician is considering subarachnoid hemorrhage. Which finding adds the most support?
Cevap
A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.
2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26
Kart 550
Soru
Which test or testing sequence best evaluates suspected aortic dissection?
Cevap
CT angiography is the usual rapid definitive study in a stable patient; transesophageal echocardiography is useful when unstable.
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
Kart 551
Soru
In a child, typically 6 months to 3 years, what counseling point helps reduce harm from croup?
Cevap
Caregivers should seek urgent assessment for stridor at rest, marked chest retractions, cyanosis, lethargy, or poor air entry.
Acute Management of Croup in the Emergency Department · reviewed 2026-08-26
Kart 552
Soru
In a child or adolescent, a clinician is considering bacterial meningitis. Which finding adds the most support?
Cevap
Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.
WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26
Kart 553
Soru
A clinician is considering preeclampsia with severe features. Which finding adds the most support?
Cevap
New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.
Gestational Hypertension and Preeclampsia · reviewed 2026-08-26
Kart 554
Soru
A clinician is considering bipolar I mania. Which finding adds the most support?
Cevap
At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.
Management of Bipolar Disorder in Adults · reviewed 2026-08-26
Kart 555
Soru
What is the priority management step for celiac disease?
Cevap
Do not start a gluten-free diet before completing diagnostic testing unless immediate clinical needs demand it.
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26
Kart 556
Soru
Which history or examination finding most strongly supports acute compartment syndrome?
Cevap
Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.
Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 557
Soru
For surgical decision-making, how should a clinician initially manage Cushing syndrome?
Cevap
Confirm hypercortisolism, identify whether it is ACTH dependent, and localize the source before definitive treatment.
Treatment of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26
Kart 558
Soru
Which bedside pattern best points to retinal detachment?
Cevap
New flashes, floaters, and a curtain or shadow across the visual field suggest detachment.
Retinal Detachment · reviewed 2026-08-26
Kart 559
Soru
How should a clinician respond when requested to falsify a work note or record?
Cevap
Decline, document objective facts accurately, explain what can truthfully be certified, and preserve the integrity of the record.
Management of Medical Records · reviewed 2026-08-26
Kart 560
Soru
How can a clinician reduce avoidable harm related to hypertensive emergency?
Cevap
Accurate home monitoring and sustained treatment adherence reduce progression to crisis.
2025 High Blood Pressure Guideline · reviewed 2026-08-26
Kart 561
Soru
What clinical clue should raise suspicion for COPD?
Cevap
Progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants suggest COPD.
2026 GOLD Report and Pocket Guide · reviewed 2026-08-26
Kart 562
Soru
Which pharmacologic approach is preferred for acute pyelonephritis?
Cevap
Select empiric therapy from local resistance and severity, then narrow to the culture.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 563
Soru
Which history or examination finding most strongly supports plaque psoriasis?
Cevap
Well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting support psoriasis.
Psoriasis Clinical Guidelines · reviewed 2026-08-26
Kart 564
Soru
What immediate plan is appropriate for Parkinson disease?
Cevap
Start multidisciplinary care and choose symptomatic treatment by functional impact, age, cognition, and adverse-effect risk.
Parkinson’s Disease in Adults · reviewed 2026-08-26
Kart 565
Soru
Which diagnosis best fits hypotonic euvolemic hyponatremia with inappropriately concentrated urine after thyroid, adrenal, renal, and diuretic causes are excluded?
Cevap
Hyponatremia due to SIADH. Nausea, confusion, gait change, seizure, or subtle cognitive symptoms with hypotonic euvolemic hyponatremia may reflect SIADH.
Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26
Kart 566
Soru
What immediate plan is appropriate for gonococcal urethritis or cervicitis?
Cevap
Treat promptly, test for other STIs, abstain until treatment criteria are met, and arrange partner services.
Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
Kart 567
Soru
How should medication be used in aortic dissection?
Cevap
Use an IV beta-blocker first to reduce shear stress, then add a vasodilator if pressure remains high.
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26
Kart 568
Soru
What immediate plan is appropriate for menopause vasomotor symptoms?
Cevap
Match treatment to symptom burden, uterus status, contraindications, and patient preference.
Hormone Therapy for Menopause · reviewed 2026-08-26
Kart 569
Soru
Which pharmacologic approach is preferred for cirrhosis with ascites?
Cevap
Spironolactone with furosemide is a common diuretic combination when renal function and electrolytes allow.
Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26
Kart 570
Soru
What immediate plan is appropriate for alcohol withdrawal?
Cevap
Stabilize, give thiamine, use symptom- or risk-guided withdrawal treatment, and admit high-risk patients.
The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
Kart 571
Soru
In a child or adolescent, what drug class or regimen fits sickle cell vaso-occlusive crisis?
Cevap
Use rapid individualized analgesia, with nonsteroidal anti-inflammatory drugs for selected mild pain and opioids for severe pain, followed by frequent reassessment.
ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26
Kart 572
Soru
For surgical decision-making, what is the priority management step for carpal tunnel syndrome?
Cevap
Use neutral-position night splinting initially; refer for decompression with severe weakness, denervation, or persistent symptoms.
Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26
Kart 573
Soru
In an infant aged 1–23 months, what drug class or regimen fits bronchiolitis?
Cevap
Routine salbutamol, corticosteroids, and antibiotics are not recommended; use antibiotics only when bacterial infection is evident or strongly suspected.
Bronchiolitis: Recommendations for Diagnosis, Monitoring and Management of Children One to 24 Months · reviewed 2026-08-26
Kart 574
Soru
In a child or adolescent, which bedside pattern best points to diabetic ketoacidosis?
Cevap
Hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status suggests ketoacidosis.
Standards of Care in Diabetes—2026 · reviewed 2026-08-26
Kart 575
Soru
For surgical decision-making, how should a clinician initially manage peritonsillar abscess?
Cevap
Assess the airway, drain the abscess, hydrate, and treat infection.
Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26
Kart 576
Soru
Which factors determine a PA’s scope of practice?
Cevap
A PA’s education and experience, state law, practice-setting policy and credentialing, and the care team’s arrangements together define the services the PA may provide.
PA Scope of Practice · reviewed 2026-08-26
Kart 577
Soru
What immediate plan is appropriate for heart failure with reduced ejection fraction?
Cevap
For acute pulmonary edema, support oxygenation and relieve congestion while identifying the trigger.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26
Kart 578
Soru
What medication strategy is appropriate for acute ischemic stroke?
Cevap
Antiplatelet therapy is used after hemorrhage is excluded when thrombolysis timing and stroke mechanism allow.
2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26
Kart 579
Soru
What combination of findings should raise suspicion for acute calculous cholecystitis?
Cevap
Right-upper-quadrant pain or tenderness, fever, leukocytosis, and a positive Murphy sign support the diagnosis when considered together.
2020 World Society of Emergency Surgery Updated Guidelines for the Diagnosis and Treatment of Acute Calculous Cholecystitis · reviewed 2026-08-26
Kart 580
Soru
What medication strategy is appropriate for community-acquired pneumonia?
Cevap
Use guideline-concordant empiric antibiotics based on setting, comorbidity, and local resistance; narrow when microbiology permits.
Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26
Kart 581
Soru
Which diagnosis is defined by acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult?
Cevap
Acute respiratory distress syndrome. Acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult suggests ARDS.
An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26
Kart 582
Soru
What medication strategy is appropriate for ectopic pregnancy?
Cevap
Methotrexate is an option for selected stable unruptured ectopic pregnancy without contraindications.
Ectopic Pregnancy · reviewed 2026-08-26
Kart 583
Soru
In a child or adolescent, what medication strategy is appropriate for major depressive disorder?
Cevap
When medication is indicated for an adolescent, use an evidence-supported SSRI with close monitoring; combine it with psychotherapy according to severity and preference.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26
Kart 584
Soru
In a child or adolescent, identify the condition from this pattern: Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.
Cevap
Atopic dermatitis. Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.
Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26
Kart 585
Soru
Which pharmacologic approach is preferred for a postmenopausal woman with osteoporosis at high fracture risk?
Cevap
Bisphosphonates are first-line for many postmenopausal women at high fracture risk; consider anabolic therapy for very high risk.
Pharmacological Management of Osteoporosis in Postmenopausal Women · reviewed 2026-08-26
Kart 586
Soru
Which history or examination finding most strongly supports atrial fibrillation?
Cevap
An irregularly irregular pulse with palpitations, fatigue, or dyspnea suggests atrial fibrillation.
2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26
Kart 587
Soru
Which diagnosis best fits dysuria and frequency without vaginal symptoms in an otherwise appropriate patient?
Cevap
Uncomplicated cystitis. Dysuria and frequency without vaginal symptoms strongly support lower urinary infection in an appropriate patient.
EAU Guidelines on Urological Infections · reviewed 2026-08-26
Kart 588
Soru
How should a clinician initially manage nephrotic syndrome?
Cevap
Manage edema and cause, and urgently evaluate thrombosis, infection, or severe volume compromise.
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26
Kart 589
Soru
What condition should be suspected from this finding: A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.
Cevap
Neutropenic fever. A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.
Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26
Kart 590
Soru
What is the purpose of root cause analysis after a serious patient-safety event?
Cevap
Identify active and latent system contributors, then design and track corrective actions that reduce recurrence rather than stopping at individual blame.
Root Cause Analysis · reviewed 2026-08-26
Kart 591
Soru
For surgical decision-making, a patient has this pattern: Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue. What is the most likely diagnosis?
Cevap
Primary hyperparathyroidism. Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue.
Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26
Kart 592
Soru
How should a clinician initially manage obstructive sleep apnea?
Cevap
Offer positive airway pressure for obstructive sleep apnea with excessive sleepiness and consider it for impaired sleep-related quality of life or comorbid hypertension.
Clinical Practice Guideline for Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure · reviewed 2026-08-26
Kart 593
Soru
A patient has this pattern: A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency. What is the most likely diagnosis?
Cevap
Sudden sensorineural hearing loss. A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency.
Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26
Kart 594
Soru
Which diagnosis requires bradykinesia plus rest tremor or rigidity and often includes reduced arm swing or a shuffling gait?
Cevap
Parkinson disease. Bradykinesia plus rest tremor or rigidity, with reduced arm swing and shuffling gait, supports parkinsonism.
Parkinson’s Disease in Adults · reviewed 2026-08-26
Kart 595
Soru
Which diagnosis best fits purulent urethral discharge, dysuria, cervicitis, pelvic pain, or a relevant sexual exposure, although infection may be asymptomatic?
Cevap
Gonococcal urethritis or cervicitis. Purulent urethral discharge, dysuria, cervicitis, pelvic pain, or exposure may indicate gonorrhea, but infection can be asymptomatic.
Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26
Kart 596
Soru
Which diagnosis best fits hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age?
Cevap
Menopause vasomotor symptoms. Hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age usually identify menopausal vasomotor symptoms.
The Menopause Years · reviewed 2026-08-26
Kart 597
Soru
Which diagnosis causes tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use?
Cevap
Alcohol withdrawal. Tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use suggests withdrawal.
The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26
Kart 598
Soru
Which diagnosis causes bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation?
Cevap
Ulcerative colitis. Bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation suggest ulcerative colitis.
Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26
Kart 599
Soru
Which diagnosis best fits abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint?
Cevap
Gout flare. Abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint, suggests gout.
Gout · reviewed 2026-08-26
Kart 600
Soru
For surgical decision-making, which diagnosis best fits this presentation: Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.
Cevap
Symptomatic aortic stenosis. Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26
600 kart
PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps
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