RA & LA 1 - 6

You are seeing a 10 year old child who is brought in for a rash. You examine the child and note several reddish papules on the palms and soles of the feet. What aspect of the patient history aligns with your most likely diagnosis, based on the description of the rash and its location? Select the best answer.

You are seeing a 37 year old woman for a chief complaint of hair loss. You gently grasp about 60 hairs and pull firmly away from the scalp and observe the presence of telogen bulbs on all hairs that are pulled out. You note the __________test is ___________ and correctly recognize this as _______________.

An adult female patient presents for a chief complaint of frequent sunburns and recent development of sores in the mouth. She denies any recent changes to outdoor activities or skin protection practices, and note she never used to get sunburns. On exam, in addition to several oral ulcers, you note a malar rash. Based on this constellation of symptoms, you suspect:

You correctly diagnose a rash of scaly papules localized to the elbows of a patient as:

Nail pitting

Transverse linear depressions of the nail plate of one nail on left hand.

Nail pitting

White nail plate having a ground-glass appearance, distal band is reddish and no visible lunula on all fingers.

You are seeing a 27 year old non smoker for a chief complaint of a cough. They report that the cough is sometimes associated with a wheeze, worse at night, and when they are cleaning. They first noticed cough and shortness of breath when they joined the swim team at school a few months ago. They deny any dizziness, heartburn, or fever. Currently, they are asymptomatic and you auscultate clear breath sounds on exam. Based on this information alone, what is the most likely diagnosis?

Egophany, bronchophony and whispered pectoriloquy are indications of which of the following options below?

You are seeing a 72 year old male patient with a long history of tobacco use, for a chief complaint of a cough. Which one of the following symptoms would be most concerning and lead you to highly suspect the possibility of a malignancy?

You are seeing a 22 year old male for a chief complaint of chest pain. On physical exam you note tenderness with palpation at the pectoral muscles and clear breath sounds. Based on these findings alone, what diagnosis can you rule out?

The best technique to distinguish pneumothorax from bronchitis when xray is not available would be:

Which of the following are considered the "cardinal techniques" of the physical examination"?

Mr. Norris is a 56 yo male and has come to clinic for a full physical. His waist circumference measures 45 inches. Which of the following is the most appropriate response?

A 57 year old post-menopausal woman presents with increasing frequency of epistaxis and bleeding gums. Which of the following medications might be contributing directly to her symptoms? Think simple here- this is not a pharmacology test.

While examining an adult patient for left ear pain, you elicit ear pain when you pull on the left ear to insert your otoscope speculum. This pain causes which of the following differentials to rise to the top of your list? (Which of the options is the most likely diagnosis based on pain w pulling on the ear?)

To diagnose acute sinusitis, which of the techniques below is most appropriate to elicit tenderness from the affected sinuses?

You are evaluating a patient presenting for eye pain and visual changes after being involved in a fight. You note periorbital swelling and echymosis on the right side of the face. What examination technique would best evaluate the function of the ocular muscles?

On examination of a thyroid gland you detect a left sided thyroid nodule. The patient displays symptoms of hyperthyroidism so you order a thyroid scan. If your suspicions are correct, what would you expect to see on the thyroid scan results?

Mr. Smith is a 56 y.o. white male with a 40 pack year history of smoking cigarettes and he continues to smoke a pack a day. He has complaints of severe pain in his left upper calf when walking that resolves at rest. You are concerned he may have peripheral artery disease and you send him for ankle-brachial index (ABI) testing. Which of the following ABI results would indicated severe PAD?

You listen to the heart with the patient sitting upright, then have him change to a supine position, and finally have him turn onto his left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position?

You are screening people at the mall as part of a health fair. The first person who comes for screening has a blood pressure of 166/100. How would you categorize this?

Which of the following is true of a grade IV (four) intensity murmur?

In a healthy patient, when you are conducting the eye exam with the opthalmoscope, which setting would you start with?

You are seeing a patient complaining of eye pain and decreased vision. You use your penlight to shine a light at an oblique angle across the eye and note a crescent-shaped shadow on the opposite side of the iris. You know this patient may be at increased risk of which disorder?

You note a gray ring around the cornea of a 72 year old male patient. What is your diagnosis?

Healthy normal finding on ear exam is

On ear exam, perforated tympanic membrane looks like

Serous otitis looks like _____ on ear exam

inflamed vessels are generalized throughout the conjunctiva

inflamed vessels are localized around the iris

Generalized yellow hue of the conjunctiva

Marked pallor of the conjunctiva

When examining the thyroid gland of a 32 year old nonpregnant woman, you note generalized enlargement of the gland. This finding is consistent with which of the following conditions?

You place the otoscope light source directly on the maxilla and note an orange glow on the hard palate when the patient opens their mouth. This indicates which of the following findings:

When examining the Abdomen which order of techniques is most correct?

Which of the following are best examined with the patient lying supine?

Meredith is a 63 year old woman who presents to the clinic with worsening epigastric pain. She states "I have smoked ½ ppd for 30 years. I drink a bottle of wine by myself each Friday and Saturday night." This statement belongs in which category of the SOAP note?

You place your stethoscope on a patient's back over the area of the Right Upper Lung field and you auscultate a continuous, scratchy sound, much like the sound of walking on snow. You would note this as which of the following findings:

You are seeing a patient with COPD and you want to auscultate the apices. You know that: (Select the correct choice)

You note a pulse ox reading of 87% on a well-appearing 72 year old woman. Your next best action is which of the following below:

You are utilizing the technique of rib excursion to assess a patient with chest pain and dyspnea. You note a unilateral decrease in excursion on the left side. Which of the following would you expect to find on chest ray? (Select the best option.)

Paleness of the conjunctiva, skin, and nail beds reflects an absence of ______________ and is a sign of ________________.

You note a bluish color to a patient's finger and toe nails. You know that this pigmentation represents _________________ condition and is due to the presence of _____________.

Emotional Stress may activate the _______________ sweat glands, located in the _______________ region of the body.

You note fine, soft, unpigmented hairs on the cheeks and face of a 42 year old woman. You note this finding as _________________ hairs, a(n) _________________ finding

You are seeing a patient with a long history of uncontrolled COPD. What would you expect to find on examination of the nails?

When auscultating the heart, you believe you are hearing a mitral systolic murmur and possibly an S 3 heart sound. Which of the following positions would best bring out these “left sided” sounds?

If a carotid bruit is auscultated which of the following is the next step in examining the patient?

Xiphoid process

Apex

Sternal angle

Mitral

The Apex

Sternal Notch

Aortic

Base of heart

Triscuspid

Pulmonic

On exam, the skin of the patient’s lower extremities is pale, cool, thin, and shiny. The patient’s nails are thickened, and there is little hair growth on the extremities. From these findings which of the following is most likely to be the diagnosis?