A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The pain is
associated with nausea and vomiting and occurs 1 to
... [Show More] 2 hours after eating greasy foods. Which one of the
following physical examination descriptions would be most consistent with the diagnosis of
cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant, without rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with inspiration, to the point of
stopping inspiration, and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without rebound or guarding.
Correct Answer- C) Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or guarding.
When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?
A) Bronchitis
B) Simple asthma
C) Cystic fibrosis
D) Heart failure Correct Answer- A. Bronchitis
A patient with longstanding COPD was told by another practitioner that his liver was enlarged and this
needed to be assessed. Which of the following would be reasonable to do next?
A) Percuss the lower border of the liver
B) Measure the span of the liver
C) Order a hepatitis panel
D) Obtain an ultrasound of the liver Correct Answer- A) Percuss the lower border of the liver
Mr. Patel is a 64-year-old man who was told by another care provider that his liver is enlarged. Although
he is a life-long smoker, he has never used drugs or alcohol and has no knowledge of liver disease.
Indeed, on examination, a liver edge is palpable 4 centimeters below the costal arch. Which of the
following would you do next?
A) Check an ultrasound of the liver
B) Obtain a hepatitis panel
C) Determine liver span by percussion
D) Adopt a "watchful waiting" approach Correct Answer- c. Determine liver span by percussion
You are palpating the abdomen and feel a small mass. Which of the following would you do next?
A) Ultrasound
B) Examination with the abdominal muscles tensed
C) Surgery referral
D) Determine size by percussion Correct Answer- B) Examination with the abdominal muscles tensed
Mr. Kruger is an 84-year-old man who presents with a smooth lower abdominal mass in the midline
which is minimally tender. There is dullness to percussion up to 6 centimeters above the symphysis
pubis. What does this most likely represent?
A) Sigmoid mass
B) Tumor in the abdominal wall
C) Hernia
D) Enlarged bladder Correct Answer- D) Enlarged bladder
Which of the following is consistent with obturator sign?
A) Pain distant from the site used to check rebound tenderness
B) Right hypogastric pain with the right hip and knee flexed and the hip internally rotated
C) Pain with extension of the right thigh while the patient is on her left side or while pressing her knee
against your hand with thigh flexion
D) Pain that stops inhalation in the right upper quadrant Correct Answer- B) Right hypogastric pain with
the right hip and knee flexed and the hip internally rotated
A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked
two packs per day since the age of 16, but he is otherwise healthy. You are concerned that he may have
peripheral vascular disease. Which of the following is part of common or concerning symptoms for the
peripheral vascular system?
A) Intermittent claudication
B) Chest pressure with exertion
C) Shortness of breath
D) Knee pain Correct Answer- A) Intermittent claudication
You are a student in the vascular surgery clinic. You are asked to perform a physical examination on a
patient with known peripheral vascular disease in the legs. Which of the following aspects is important
to note when you perform your examination?
A) Size, symmetry, and skin color
B) Muscle bulk and tone
C) Nodules in joints
D) Lower extremity strength Correct Answer- A) Size, symmetry, and skin color
As the internal diameter of a blood vessel changes, the resistance changes as well. Which of the
following descriptions depicts this relationship?
A) Resistance varies linearly with the diameter.
B) Resistance varies proportionally to the second power of the diameter.
C) Resistance varies proportionally to the third power of the diameter.
D) Resistance varies proportionally to the fourth power of the diameter. Correct Answer- D) Resistance
varies proportionally to the fourth power of the diameter. [Show Less]