You are examining an elderly man and notice the following: Decreased
vibration sense in the feet and ankles, diminished gag reflex, right patellar
... [Show More] reflex
less than the left, and diminished abdominal reflexes. Which of these is
abnormal?
• Decreased vibration sense
• Diminished gag reflex
• Diminished right patellar reflex compared to the left
• Diminished abdominal reflexes
•
A 68-year-old retired farmer presents 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?
• Actinic keratosis
• Seborrheic keratosis
• Basal cell carcinoma
• Squamous cell carcinoma
• A 14-year-old junior high school student is brought in by his mother and
father because he seems to be developing breasts. The mother is upset because
she read on the Internet that smoking marijuana leads to breast enlargement in
males. The young man adamantly denies using any tobacco, alcohol, or drugs.
He has recently noticed changes in his penis, testicles, and pubic hair pattern.
Otherwise, his past medical history is unremarkable. His parents are both in good
health. He has two older brothers who never had this problem. On examination,
you see a mildly overweight teenager with enlarged breast tissue that is slightly
tender on both sides. Otherwise his examination is normal. He is agreeable to
taking a drug test.
What is the most likely cause of his gynecomastia?
• Breast cancer
• Imbalance of hormones of puberty
• Drug use
• Question Points: 1.0 / 1.0
• Question Points: 1.0 / 1.0
• Question Points: 1.0 / 1.0
• Alcohol use
• A 17-year-old female presents to your office, complaining of a clear discharge
from her right breast for 2 months. She states that she noticed it when she and
her boyfriend were “messing around” and he squeezed her nipple. She continues
to have this discharge anytime she squeezes that nipple. She denies any trauma
to her breasts. Her past medical history is unremarkable. She denies any
pregnancies. Both of her parents are healthy. She denies using tobacco or illegal
drugs and drinks three to four beers a week. On examination, her breasts are
symmetric with no skin changes. You are able to express clear discharge from
her right nipple. You feel no discrete masses and her axillae are normal. The
remainder of her heart, lung, abdominal, and pelvic examinations are
unremarkable. A urine pregnancy test is negative.
What cause of nipple discharge is the most likely in her circumstance?
• Benign breast abnormality [Show Less]