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6020 Week 9 Quiz Latest SU
Jacob, a 33-year-old construction worker, complains of a “lump on his back” over his scapula .It
has been there for about a year and is getting larger .He says his wife has
been able to squeeze out a cheesy-textured substance on occasion .He worries
this may be cancer .When gently pinched from the side, a prominent dimple forms
in the middle of the mass .What is most likely?
8-year-old retired farmer comes to your office for evaluation of
a skin lesion .On the right temporal area of the forehead, you see a flattened
papule the same color as his skin, covered by a dry scale that is round and
feels hard .He has several more of these scattered on the forehead, arms, and
legs .Based on this description, what is your most likely diagnosis?
B
Seborrheic keratosis
C
Basal cell carcinoma
D
Squamous cell carcinomaTerm
A new patient is complaining of severe pruritus that is worse at
night .Several family members also have the same symptoms .Upon examination,
areas of excoriated papules are noted on some of the interdigital webs of both
hands and on the axillae .This finding is most consistent with:
A
.Contact dermatitis
B
.Impetigo
C
.Larva migrans
D
.Scabies
A 58-year-old man comes to your office complaining of bilateral
back pain that now awakens him at night .This has been steadily increasing for
the past 2 months .Which one of the following is the most reassuring in this
patient with back pain?
A
.Age over 50
B
.Pain at night
C
.Pain lasting more than 1 month or not responding to therapy
D
.Pain that is bilateralTerm
A 32-year-old warehouse worker presents for evaluation of low
back pain .He notes a sudden onset of pain after lifting a set of boxes that
were heavier than usual .He also states that he has numbness and tingling in
the left leg .He wants to know if he needs to be off of work .What test should
you perform to assess for a herniated disc?
A
Leg-length test
B
.Straight-leg raise
C
.Tinel\’s test
D
.Phalen\’s testTerm
Mrs .Anderson presents with an itchy rash which is raised and
appears and disappears in various locations .Each lesion lasts for many minutes
.What most likely accounts for this rash?
Insect
bites
Urticaria
or hives
Psoriasis
Purpura
Term
A 50-year-old woman presents with “left hip pain” of several weeks
duration .There is marked tenderness when you press over her proximal lateral
thigh .What do you think she has?
A
Osteoarthritis
B
.Rheumatoid arthritis
C
.Sciatica
D
.Trochanteric bursitis
A 28-year-old graduate student comes to your clinic for
evaluation of pain “all over .” With further questioning, she is able to relate that the pain
is worse in the neck, shoulders, hands, low back, and knees .She denies
swelling in her joints .She states that the pain is worse in the morning .There
is no limitation in her range of motion .On physical examination, she has
several points on the muscles of the neck, shoulders, and back that are tender
to palpation .Muscle strength and range of motion are normal .Which one of the
following is likely the cause of her pain?
A
.Rheumatoid arthritis
B
.Osteoarthritis
C
.Fibromyalgia
D
.Polymyalgia rheumatica
A mother brings her 11-month-old to you because her
mother-in-law and others have told her that her baby is jaundiced .She is
eating and growing well and performing the developmental milestones she should
for her age .On examination, you indeed notice a yellow tone to her skin from
head to toe .Her sclerae are white .To which area should your next questions be
related?
Diet
Family
history of liver diseases
Family
history of blood diseases
Ethnicity
of the child
Term
You are beginning the examination of the skin on a 25-year-old
teacher .You have previously elicited that she came to the office for
evaluation of fatigue, weight gain, and hair loss .You strongly suspect that
she has hypothyroidism .What is the expected moisture and texture of the skin
of a patient with hypothyroidism?
A
.Moist and smooth
B
.Moist and rough
C
.Dry and smooth
D
.Dry and rough
You are assessing a patient with joint pain and are trying to
decide whether it is inflammatory or noninflammatory in nature .Which one of
the following symptoms is consistent with an inflammatory process?
You are assessing a patient with diffuse joint pains and want to
make sure that only the joints are the problem, and that the pain is not
related to other diseases .Which of the following is a systemic cause of joint
pain?
A 19-year-old college sophomore comes to the clinic for
evaluation of joint pains .The student has been back from spring break for 2
weeks; during her holiday, she went camping .She notes that she had a red spot,
shaped like a target, but then it started spreading, and then the joint pains
started .She used insect repellant but was in an area known to have ticks .She
has never been sick and takes no medications routinely; she has never been
sexually active .What is the most likely cause of her joint pain?
An 85-year-old retired housewife comes with her daughter to
establish care .Her daughter is concerned because her mother has started to
fall more .As part of her physical examination, you ask her to walk across the
examination room .Which of the following is not part of the stance phase of
gait?
A 32-year-old warehouse worker presents for evaluation of low
back pain .He notes a sudden onset of pain after lifting a set of boxes that
were heavier than usual .He also states that he has numbness and tingling in
the left leg .He wants to know if he needs to be off of work .What test should
you perform to assess for a herniated disc?
A 33-year-old construction worker comes for evaluation and
treatment of acute onset of low back pain .He notes that the pain is an aching
located in the lumbosacral area .It has been present intermittently for several
years; there is no known trauma or injury .He points to the left lower back
.The pain does not radiate and there is no numbness or tingling in the legs or
incontinence .He was moving furniture for a friend over the weekend .On
physical examination, you note muscle spasm, with normal deep tendon reflexes
and muscle strength .What is the most likely cause of this patient\’s low back pain
A 50-year-old realtor comes to your office for evaluation of
neck pain .She was in a motor vehicle collision 2 days ago and was assessed by
the emergency medical technicians on site, but she didn\’t think that she needed
to go to the emergency room at that time .Now, she has severe pain and
stiffness in her neck .On physical examination, you note pain and spasm over
the paraspinous muscles on the left side of the neck, and pain when you make
the patient do active range of motion of the cervical spine .What is the most
likely cause of this neck pain?
A 28-year-old graduate student comes to your clinic for
evaluation of pain “all over .” With further questioning, she is able to relate that the pain
is worse in the neck, shoulders, hands, low back, and knees .She denies
swelling in her joints; she states that the pain is worse in the morning; there
is no limitation in her range of motion .On physical examination, she has
several points on the muscles of the neck, shoulders, and back that are tender
to palpation; muscle strength and range of motion are normal .Which of the
following is likely the cause of her pain?
A 68-year-old retired banker comes to your clinic for evaluation
of left shoulder pain .He swims for 30 minutes daily, early in the morning .He
notes a sharp, catching pain and a sensation of something grating when he tries
overhead movements of his arm .On physical examination, you note tenderness
just below the tip of the acromion in the area of the tendon insertions .The
drop arm test is negative, and there is no limitation with shoulder shrug .The
patient is not holding his arm close to his side, and there is no tenderness to
palpation in the bicipital groove when the arm is at the patient\’s side, flexed to 90
degrees, and then supinated against resistance .Based on this description, what
is the most likely cause of his shoulder pain?
A high school soccer player “blew out his knee” when the opposing
goalie\’s head and shoulder struck his flexed knee while the goalie was
diving for the ball .All of the following structures were involved in some way
in his injury, but which of the following is actually an extra-articular
structure?
Ray works a physical job and notes pain when he attempts to lift
his arm over his head .When you move the shoulder passively, he has full range
of motion without pain and there is no gross swelling or tenderness .What type
of joint disease does this most likely represent?
Mark is a contractor who recently injured his back .He was told
he had a “bulging disc” to account for the burning pain down his right leg and slight
foot drop .The vertebral bodies of the spine involve which type of joint?
Which of the following synovial joints would be an example of a
condylar joint?
A 58-year-old man comes to your office complaining of bilateral
back pain that now awakens him at night .This has been steadily increasing for
the past 2 months .Which one of the following is the most reassuring in this
patient with back pain?
Marion presents to your office with back pain associated with
constipation and urinary retention .Which of the following is most likely?
Louise, a 60-year-old, complains of left knee pain associated
with tenderness throughout, redness, and warmth over the joint .Which of the
following is least helpful in determining if a joint problem is inflammatory?
Pain, swelling, loss of both active and passive motion, locking,
and deformity would be consistent with which of the following?
You are working in a college health clinic and seeing a young
woman with a red, painful, swollen DIP joint on the left index finger .There
are also a few papules, pustules, and vesicles on reddened bases, located on
the distal extremities .This would be consistent with which of the following?
An obese 55-year-old woman went through menarche at age 16 and
menopause 2 years ago .She is concerned because an aunt had severe osteoporosis
.Which of the following is a risk factor for osteoporosis?
A 38-year-old woman comes to you and has multiple small joints
involved with pain, swelling, and stiffness .Which of the following is the most
likely explanation?
Mrs .Fletcher comes to your office with unilateral pain during
chewing, which is chronic .She does not have facial tenderness or tenderness of
the scalp .Which of the following is the most likely cause of her pain?
A man\’s wife is upset because when she hugs him with her hands on his
left shoulder blade, “it feels creepy .” This came on gradually after a
recent severe left-sided rotator cuff tear .How long does it usually take to
develop muscular atrophy with increased prominence of the scapular spine
following a rotator cuff tear?
Phil comes to your office with left “shoulder pain .” You find that the pain
is markedly worse when his left arm is drawn across his chest (adduction)
.Which of the following would you suspect?
Two weeks ago, Mary started a job which requires carrying
40-pound buckets .She presents with elbow pain worse on the right .On
examination, it hurts her elbows to dorsiflex her hands against resistance when
her palms face the floor .What condition does she have?
A high school football player injured his wrist in a game .He is
tender between the two tendons at the base of the thumb .Which of the following
should be considered?
Mrs .Fletcher complains of numbness of her right hand .On
examination, sensation of the volar aspect of the web of the thumb and index
finger and the pulp of the middle finger are normal .The pulp of the index
finger has decreased sensation .Which of the following is affected?
A 50-year-old woman presents with “left hip pain” of several weeks
duration .There is marked tenderness when you press over her proximal lateral
thigh .What do you think she has?
Sarah presents with left lateral knee pain and has some locking
in full extension .There is tenderness over the medial joint line .When the
knee is extended with the foot externally rotated and some valgus stress is
applied, a click is noted .What is the most likely diagnosis?
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