uestion: An 18-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions … suddenly
... [Show More] on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?
Question: A 19-year-old construction worker presents for evaluation of a rash. He notes that it … on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, … more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis?
Question: You are examining a child with severe cerebral palsy. When you suddenly move his foot dorsally, a sustained “beating” of the foot against your hand ensues. What does this represent?
Question: A patient presents with a daily headache which has … over the past several months. On funduscopic examination, you notice that the disk edge is indistinct and the veins do not pulsate. Which is most likely?
Question: A patient complains of epistaxis. Which other cause should … considered?
Question: A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these?
Question: You are … about a positive test finding you have just … on physical examination of your patient. You go on to do more examination, laboratory work, and diagnostic tests, only to find that there is no sign of the disease you thought would correlate with the finding. This same experience happens several times. What should you conclude?
Question: A 50-year-old woman presents with a new complaint of headache. The patient states, “this is worst headache of my life”. Her concurrent conditions include hypertension. Her history includes habitual ER visits for various complaints and panic attacks. Her most recent ER visit was last week. Today her BP is 200/110 with a HR of 95. Of the following diagnoses, which etiology has the highest priority?
Question: A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his palms and notice that every few seconds his palms suddenly move toward the What does this indicate?
Question: A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is … all over the head and is of moderate It … to last minutes, but this time it has … for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has … over-the-counter medication; it has … the pain but not taken it away. Based on this description, what is your most likely diagnosis?
Question: A 62-year-old smoker complains of “coughing up small amounts of blood,” so you consider hemoptysis. Which other diagnoses should also … as an etiology for the complaint?
Question: You ask a patient to hold her arms up, with her palms up, and then to close her eyes. The right arm begins to move downward after a few seconds and her thumb rotates upward. This is most likely a problem with which part of the nervous system?
Question: When assessing for mitral stenosis, you should place the patient in what position?
Question: A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The canal is … and erythematous, with some white debris in the canal. The rest of the examination is normal. What diagnosis would you assign this patient?
Question: When assessing for nystagmus the nurse practitioner instructs the patient to:
Question: A 58-year-old teacher presents to your clinic with a complaint of breathlessness with The patient has no chronic conditions and does not take any medications, herbs, or supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular review of systems?
Question: Which is true of examination of the olfactory nerve?
Question: During the physical examination, which is the best position to place the patient when auscultating for S1, S2, and murmurs?
Question: For which of the following patients would a comprehensive health history be appropriate?
Question: Identify the abnormal assessment findings in this image.
Question: A 21-year-old college senior presents to your clinic, complaining of shortness of breath and a nonproductive nocturnal cough. She states she … to feel this way only with extreme exercise, but lately she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema and her father has high blood pressure. She is an only child. She denies smoking and illegal drug use but drinks three to four alcoholic beverages per weekend. She is a junior in finance at a local university and she has recently … a job as a bartender in town. On examination she is in no acute distress and her temperature is 98.6. Her blood pressure is 120/80, her pulse is 80, and her respirations are 20. Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is … air movement and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs. Which disorder of the thorax or lung does this best describe?
Question: A patient is … a visual acuity of 20/100 in her left eye. Which of the following is true?
Question: While examining a 43-year-old Hispanic female patient, you discover skin findings as represented in this image. She denies history of any known or … adult illnesses or medical conditions. What associated concurrent medical condition should you suspect?
Question: Glaucoma is the leading cause of blindness in African-Americans and the second leading cause of blindness overall. What features would be noted on funduscopic examination?
Question: A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally. Which of the following diagnoses is still a potential concern?
Question: A 7-year-old boy is performing poorly in school. His teacher is … because he is frequently seen “staring off into space” and not paying attention. If this is a seizure, it most likely represents which type?
Question: You have just asked a patient how he feels about his emphysema. He becomes silent, folds his arms across his chest and leans back in his chair, and then replies, “It is what it is.” How should you respond?
Question: A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this?
Question: A 55–year-old smoker complains of chest pain and gestures with a closed fist over her sternum to describe it. Which of the following diagnoses should you consider because of her gesture?
Question: A 65-year-old woman presents to the clinic with an eye complaint. The medical assistant documents the visual acuity: Corrected right 20/40; Corrected left 20/60; Bilateral 20/60. The nurse practitioner surmises the following:
Question: The following information is best placed in which category? “The patient has had three cesarean sections.”
Question: A 17-year-old high school student is brought in to your emergency room in a comatose state. His friends have accompanied him and tell you that they have been shooting up heroin tonight and they think their friend may have had too much. The patient is unconscious and cannot protect his airway, so he is intubated. His heart rate is 60 and he is breathing through the ventilator. He is not posturing and he does not respond to a sternal rub. Preparing to finish the neurologic examination, you get a penlight. What size pupils do you expect to see in this comatose patient? [Show Less]