gd oor 912
TRANSCRIPT
© Irene Gold Associates, Inc. All rights to the material in this presentation are reserved.
General Dx
OOR
1. Which part of the case history will yield the most information in a suspected case of Reiter’s disease?
a. Family historyb. Past historyc. Chief complaintd. Sexual history
2. Where is the most likely location to find the presence of tophi in a patient with gout?
a. Fingersb. Pinnac. Kneed. Big toe
3. _____________ is the etiology of Rocky Mountain Spotted Fever.
a. Bacteriab. Virusc. Rickettsia d. Parasite
4. Which of the following arteries is affected during a transient ischemic attack?
a. Carotidb. Coronaryc. Femoral d. Radial
5. __________ alteration of blood flow may result in the inability to understand language.
a. Posterior communicating artery
b. Anterior cerebral arteryc. Cerebral arteryd. Carotid artery
6. While the patient is supine with the head extended off of the table the doctor brings the head into extension, rotation, and lateral flexion. Which of the following is being evaluated?
a. Axillary arteryb.Vertebral arteryc. Jugular veind.Anterior cerebral
artery
7. A 22 year old female was working out in a gym and suddenly faints, this is most likely due to ___.
a. Subclavian Steal syndrome
b. Spontaneous Pneumothorax
c. Myocardial Infarctiond. Marfan’s Syndrome
8. Upon taking bilateral blood pressure readings you find that there is a difference of 10-15% from one side to the other. Which of the following is a probable cause?
a. Venous insufficiencyb.Arterial insufficiencyc. Congestive Heart
Failured.Coarctation of the Aorta
9. A female patient presents with hard circular lumps in her hands and difficulty in swallowing. Given these findings what is the most likely diagnosis?
a. Systemic lupus erythematosus
b. Sclerodermac. Amyotrophic lateral
sclerosisd. Parkinson’s disease
10. A 35 year old female patient presents with complaints of joint pain and polyarthritis. Upon performing Murphy’s sign you find that the patient has pain. What is most likely cause?
a. Systemic lupus erythematosus
b. Sclerodermac. Posterolateral
sclerosisd. Parkinson’s disease
11. Examination of the patient reveals yellowing of the skin. Ophthalmic examination reveals yellow sclera. Which organ is at fault?
a. Gallbladderb. Kidneyc. Pancreasd. Liver
12. Which of the following best defines the diagnosis of anisocoria?
a. Dilated and fixed pupilsb. Constricted and
unresponsive pupilsc. Unequal pupil sized. Absent red light reflex
13. A female patient presents with complaints of gaining weight without trying, intolerance to cold temperatures, and course/dry hair and nails. What is an additional clinical finding that is most likely present?
a. Sweatingb. Periorbital edemac. Exophthalmosisd. Hyperpigmented mouth
14. ______ is the cause of ptosis, miosis, and anhydrosis on one side of the face?
a. CN III lesionb. Pancoast tumorc. Cluster headached. Temporal Arteritis
15. Upon Ophthalmo-scopic examination you note the presence of A-V nicking, flame and splinter hemorrhages, and cotton wool exudates. What is the most likely cause of these findings?
a. Hypertensive retinopathy
b. Diabetic retinopathyc. Retinal detachmentd. Papilledema
16. The diaphragmatic domes appear flat and lower in which of the following conditions?
a. Pneumoniab. Pancoast Tumorc. Tuberculosisd. Emphysema
17. ______________ is the most common cause of a sensorineural hearing loss.
a. Otitis externab. Meniere’s diseasec. Otitis mediad. Presbycussis
18. Upon laboratory examination you find that the patient has a decreased TSH, a decreased T3, decreased T4, and decreased growth hormone. Which of the following is the cause of these lab results?
a. Hypopituitary b. Hyperpituitaryc. Hypothyroidd. Hyperthyroid
19. Which of the following findings is commonly associated with viral otitis media?
a. Perforated tympanic membrane
b. Retracted tympanic membrane
c. Eustachian tube blockage
d. Pinna pain
20. A riboflavin deficiency is likely to cause which of the following conditions to occur?
a. Leukoplakiab. Glossitisc. Cheilosisd. Macroglossia
21. _________ is commonly associated with human immunodeficiency virus.
a. Candidiasisb. Chancroid soresc. Yellow frothy discharged. Hepatitis C
22. Which of the following is not a risk factor for candidiasis?
a. Diverticulitisb. Pregnancyc. Decreased intestinal
florad. Leukoplakia
23. A smooth and glossy tongue seen with deficiency of B vitamins is caused by which of the following?
a. Pernicious anemiab. Hemolytic anemiac. Sickle cell anemiad. Iron deficiency anemia
24. A large beefy tongue is seen with ____.
a. Hypothyroidismb. Hyperthyroidismc. Hypercortisolismd. Hypocortisolism
25. Upon performing a physical exam you note a bruit is present over the temporal artery. Which of the following is indicated?
a. Strokeb. Giant cell arteritisc. Migraine headached. Subclavian Steal
syndrome
26. Orchitis is most commonly caused by which of the following ?
a. Measlesb. Mumpsc. Varicellad. Hemophilus
27. A barrel appearance of the thorax will be noted in a patient affected by which of the following?
a. Pneumoniab. Emphysema c. Pneumothoraxd. Atelectasis
28. What is the proper location to transilluminate the frontal sinuses?
a. Superior/lateral aspect of the orbit
b. Middle of the eyebrowc. Medial orbit below the
eyebrowd. 1” superior to the
eyebrow medially
29. _________ breathing is associated with metabolic acidosis.
a. Cheyne stokesb. Kussmaul’sc. Biot’sd. Brady’s
30. Which of the following is the percussive note of the major portion of the lung fields?
a. Dullb. Flatc. Tympanicd. Resonate
31. As you perform bronchophony you note clear sounds as the patient says “99”. What is the pathology that causes this finding?
a. Emphysemab. Pneumoniac. Bronchitisd. Bronchiectasis
32. Increased tactile fremitus is seen with ____.
a. Emphysemab. Pneumothoraxc. Atelectasisd. Pneumonia
33. Hyper-resonance and decreased tactile fremitus on one side of the chest is seen with ______.
a. Emphysemab. Pneumoniac. Pneumothoraxd. Atelectasis
34. A patient presents with a low grade fever, productive cough, night sweats, and yellow sputum. This is indicative of ____________.
a. Pneumoniab. Tuberculosisc. Bronchitisd. Bronchogenic
carcinoma
35. Upon thoracic physical examination you note the presence of a friction rub. Which of the following is associated with this finding?
a. Pleurisyb. Pneumothoraxc. Tuberculosisd. Pneumonia
36. Upon orthopedic examination you ask the patient to laterally bend to one side while they are in the standing position. When they perform this maneuver they have pain on the convex side. What is the cause of this pain?
a. Intercostal neuralgiab. Pleurisyc. Pneumothoraxd. Pneumonia
37. A previously healthy 18 year old male suddenly complains of stabbing chest pain that is a 9/10 severity on the pain scale. What is the likely etiology of this complaint?
a. Spontaneous pneumothorax
b. Pleurisyc. Myocardial Infarctiond. TIA
38. __________ is a type I hypersensitivity reaction and also causes a rise in IgE.
a. Cytotoxic reactionb. Lyme’s diseasec. Asthmad. Emphysema
39. Which of the following conditions would contribute to the appearance of a normal sized but low lying liver?
a. Hepatocellular carcinoma
b. Hepatitisc. Emphysemad. Pancoast tumor
40. A 68 year old male presents with a non-productive cough for the past 60 days as well as anorexia and weight loss. What should be suspected?
a. Bronchogenic carcinoma
b. Pneumoniac. Tuberculosisd. Sarcoidosis
41. A rash that breaks out and follows along parallel to the ribs is most likely ________.
a. Tietze syndromeb. Shinglesc. Intercostal neuralgiad. Fungal infection
42. _______ stays dormant in the dorsal root ganglia of the patient.
a. Herpes simplexb. Herpes zosterc. Neurosyphilisd. Hemophilus Ducreyi
43. Upon taking a biopsy from the lung tissue Reed Sternberg cells are present. What is the most likely diagnosis given this finding?
a. Bronchogenic carcinomab. Pancoast tumorc. Miliary tuberculosisd. Hodgkin’s disease
44. A child presents with thick accumulations of mucous in the lungs and intestines. Upon inspection you note a barrel chest. They also have pancreatic insufficiency and meconium ileus. What is the diagnosis given these findings?
a. Pneumoniab. Cystic fibrosisc. Nephroblastomad. Emphysema
45. Which of the following is a palpable finding in a patient with cardiomegaly?
a. Bounding apical pulseb. Thrills in the 2nd
intercostal spacec. A bruit over Erb’s pointd. Lateral shift in the
apical pulse
46. Which of the following is the best method of palpating the inferior structure of the liver?
a. Patient supine with deep inspiration
b. Patient supine upon expiration
c. Patient supine upon forced expiration
d. Patient in the lateral recumbent position upon inhalation.
47. Which abdominal examination is performed to determine the difference between excess adipose tissue in the abdomen and ascites?
a. Murphy’s signb. Murphy’s testc. Rovsing’s testd. Fluid wave test
48. What is the most common treatment for myasthenia gravis?
a. Bed restb. Chemotherapyc. Anticholinesterase
antibodiesd. B12 shots
49. During a consultation with a new adult patient you find they have foul smelling bowel movements. Which of the following is likely?
a. Celiac diseaseb. Cystic fibrosisc. Appendicitisd. Gastric ulcer
50. Which of the following presents with Pulsus bisferiens?
a. Aortic regurgitationb. Left ventricular failurec. Mitral stenosisd. Myocardial infarction
51. Following recovery from rheumatic fever which of the following is most likely to be weakened in the patient?
a. Myocardiumb. Pericardiumc. Endocardiumd. Epicardium
52. Which of the following occurs prior to being diagnosed with bacterial endocarditis?
a. Mitral valve prolapseb. Hypertensionc. Rubeola infectiond. Streptococcus infection
53. Auscultating the heart reveals a murmur at the 5th intercostal space mid clavicular line during systole. This murmur is heard at the ____ of the heart and will be ____.
a. Apex; high pitchedb. Apex; low pitchedc. Base; high pitchedd. Base; low pitched
54. A patient who presents with both foot drop and wrist drop is most likely deficient in which of the following?
a. Vitamin B12b. Vitamin B6c. Chromiumd. Folic Acid
55. Which of the following murmurs is present in diastole?
a. Aortic stenosisb. Pulmonic stenosisc. Tricuspid regurgitationd. Mitral stenosis
56. A congenital narrowing proximal to the vertebral artery is known as which of the following?
a. Subclavian steal syndrome
b. Coarctation of the aorta
c. Tetralogy of Fallotd. Marfan’s Syndrome
57. If the patient has difficulty breathing while in the supine position that is relieved when going into the seated or standing position it is called _________.
a. Exertional dyspneab. Orthopneac. Striderd. Hyperpnea
58. A patient has portal hypertension and the appearance of caput medusa. These findings are seen with which of the following?
a. Left sided heart failureb. Right sided heart failurec. Pancreatitisd. Acute appendicitis
59. A patient presents with complaints of recurring chest pain. He describes the pain as a feeling of something heavy sitting on his chest. He doesn’t know what brings it on but tells you he gets the pain while he is at rest. He also tells you that this pain will go away after a few minutes of continued rest. What is the diagnosis?
a. Hemochromatosisb. Simple anginac. Complex anginad.Printzmetal angina
60. A patient with crushing chest pain is asked to rest for a few minutes while the ambulance is on the way, and the pain has not subsided within 15 minutes. Which of the following is the best diagnosis?
a. Angina pectorisb. Atypical anginac. Myocardial
infarctiond.Aortic dissection
61. Which of the following is usually detected on a routine physical exam without the use of an ECG?
a. Primary heart blockb. Secondary heart blockc. Atrial fibrillationd. Block of bundle of HIS
62. ________ is indicated if the patient presents with yellowing of the skin and the buccal mucosa.
a. Polycythemia b. Hemochromatosisc. Osteogenesis Imperfectad. Addison’s Disease
63. Upon analyzing a KUB study, you find that there is a unilateral sclerotic 3mm radiopaque shadow over the psoas muscle. What does this indicate?
a. Urolithiasisb. Urethritisc. Cholecystitisd. Cholelithiasis
64. Which organ is implicated if there is a moderate increase in alkaline phosphatase?
a. Liverb. Heartc. Pancreas d. Spleen
67. A patient presents with complaints of polydypsia and polyuria but no polyphagia. Which condition is most likely?
a. Diabetes mellitus type Ib. Diabetes mellitus type IIc. Diabetes Insipidusd. Pancreatitis
66. An elevation of gamma-Glutamyl Transpeptidase and serum glutamic pyruvic transaminase is an indication for which of the following?
a. Myocardial Infarctionb. Pancreatitisc. Hepatitisd. Appendicitis
67. Which of the following can be contracted through the oral/fecal route of transmission?
a. Hepatitis Ab. Hepatitis Bc. Hepatitis Cd. Liver cirrhosis
68. Which of the following conditions will cause pain referral to the right tip of the scapula?
a. Pancreatitisb. Cholelithiasisc. Splenomegalyd. Hepatitis
69. Which of the following will result in increased serum glucose levels?
a. Cholecystitisb. Pancreatic cancerc. Acute appendicitisd. Ovarian cancer
70. Which of the following terms is used to describe periumbilical ecchymosis?
a. Grey turner signb. Cullen’s signc. Puddle signd. Minor’s sign
71. An increased amount of ADH will present with which of the following findings?
a. Increased specific gravity
b. Glucosuriac. Cloudy urined. Proteinuria 1.
72. A patient that has been diagnosed with hyperparathyroidism will most likely be affected by which of the following?
a. Urethritis b. Big bulging eyesc. Renal calculid. Increased bone density
73. What is associated with the over proliferation of helicobacter pylori bacteria?
a. Systemic infectionb. Septic arthritisc. Gastric refluxd. Peptic ulcer
74. An elderly female patient presents with complaints of left lower quadrant pain and chronic constipation. What is the most likely etiology of this presentation?
a. Appendicitisb. Inadequate fiber in the
dietc. Hypersensitivity to
glutend. Duodenal ulcer
75. Which of the following is the most common component are kidney stones?
a. Uric acid b. Calcium uratesc. Nitratesd. Calcium oxalates
76. Which of the following casts are normally found upon urinalysis?
a. Fattyb. Waxyc. RBCd. Hyaline
77. Which of the following conditions could lead to investigate pernicious anemia in the patient?
a. Duodenal ulcerb. Appendicitisc. Pancreatitisd. Hepatitis
78. A female patient who recently gave birth presents with complaints of incontinence when she laughs. What type of incontinence is described?
a. Urgeb. Stressc. Overflowd. Physiologic
79. A woman who is pregnant for the first time presents with bilateral pitting edema in the lower extremities. What other signs are related to this condition?
a. Hypertension; proteinuria; seizures
b. Hypertension; proteinuria; vomiting
c. Hypotension; proteinuria; seizuresa. Hypotension; proteinuria;
vomiting
80. Pelvic inflammatory disease will not present with ______.
a. Cervical dischargeb. Bloody dischargec. Feverd. Purulent discharge
81. A patient states that she is unable to urinate. While you are performing your examination the patient has a yellow discharge that is expelled. What is the most appropriate follow up step?
a. Catheterizationb. Surgical consultationc. Bacterial cultured. Hair analysis
82. A 36 year old male patient presents with gynecomastia. Which of the following is the most likely cause of this presentation?
a. Addison’s diseaseb. Cushing syndromec. Inguinal herniad. Testicular cancer
83. A pediatric patient presents with tortuous dilation of the spermatic veins. What is the diagnosis?
a. Spermatoceleb. Varicocelec. Hydroceled. Hernia
84. Upon palpation of the testicle you find a single nodule that is painless to the patient. What should be suspected?
a. Hydroceleb. Varicocelec. Testicular cancerd. Epididymitis
85. A painless, moveable, small lump superior to the testicle is most likely a ___________________.
a. Hydroceleb. Spermatocelec. Varicocele d. Prostatitis
86. Loss of the median sulcus of the prostate upon digital examination is most likely to be caused by _________.
a. Acute Prostatitisb. Prostatic carcinomac. Benign prostatic
Hyperplasiad. Chronic Prostatitis
87. Prostatic carcinoma will present with which of the following palpatory findings?
a. Smooth; non tenderb. Tender; softc. Firm; non tenderd. Hard; nodular
88. A hard, moveable non-painful lymph node is palpated above the left clavicle. This is most likely a ______.
a. Virchow’s nodeb. Haygarth's nodec. Pancoast tumord. Bouchard’s node
89. A patient presents with thrombocyto-penia and Petechiae at the ankles. What is the most likely diagnosis?
a. Stasis dermatitisb. Liver cirrhosisc. Pancreatitisd. Congestive heart
failure 1.
90. A bacterial infection will produce the following change in the white blood cells?
a. Neutrophiliab. Lymphocytosisc. Monocytosisd. Basophilia
91. Lymphocytosis is a common finding in a patient with a/an____.
a. Bacterial infectionb. Chronic infectionc. Allergiesd. Viral infection
92. Which of the following conditions presents with microcytic, target cells.
a. Sickle cell anemiab. Thalassemiac. Aplastic anemiad. Iron deficiency anemia
93. Laboratory examination reveals the presence of decreased RBC’s that are microcytic and hypochromic. What is the diagnosis?
a. Iron deficiency anemiab. Megaloblastic anemiac. Sickle cell anemiad. Aplastic anemia
94. A patient with chronic iron deficiency anemia will present with which of the following combinations of laboratory findings?
a. Decreased iron; decreased TIBC
b. Decreased iron; increased TIBC
c. Decreased copper; decreased TIBC
d. Decreased copper; increased TIBC
95. Prolonged periods of fasting will produce excess ______ in the urine.
a. Glucoseb. Proteinc. Ketonesd. Urobilinogen
96. _____ is the best laboratory test to monitor the health of the kidney.
a. CPKb. CK-MMc. Creatined. Creatinine
97. A deficiency in ___________ will cause chronic muscle cramping.
a. Proteinb. Potassiumc. Phosphorusd. Vitamin C
98. When performing Weber’s test the sound lateralizes to the right ear. While performing the Rinne test you note there is a positive in the right ear. This indicates _____ deafness.
a. Right sensorineuralb. Left sensorineuralc. Right conductived. Left conductive
99. An increase in CK-MM will likely indicate which of the following diseases?
a. Myocardial infarctionb. Muscular dystrophyc. Stroked. Kidney stones
100. Staphylococcus aureus infection is responsible for which of the following conditions?
a. Meningitisb. Toxic Shock Syndromec. Rheumatic feverd. Glomerulonephritis
101. Which of the following conditions will cause a blood pressure of 190/130 and cotton wool exudates in the eyes?
a. Malignant hypertensionb. Benign renal
hypertensionc. Systolic hypertensiond. Myocardial infarction
102. You shine the light in the right eye and the right pupil contracts, but the left pupil does not contract. You deduce from this finding that CN___ on the ___ is at fault.
a. II; rightb. III; rightc. II; leftd. III; left
103. The reason for performing Hallpike’s maneuver on a patient is to determine ____.
a. Vertigob. Proprioceptionc. Cervical sprain/straind. Balance
104. A young child presents with torsion of the spermatic cord. Which of the following is correct?
a. It would feel like a bag of worms and the patient should be placed on bed rest.
b. There is a congenital anomaly and the child needs to go to a pediatrician.
c. The patient should be sent to the emergency room immediately.
d. The sacrum should be adjusted.
105. Which of the following is a true statement about Raynaud’s phenomenon?
a. Brought on by emotional stress.
b. Turns the hands red then blue then pale.
c. Occurs as a primary disease.
d. It is generally unilateral.
106. Cystic fibrosis most commonly affects which of the following glands?
a. Mucous glandsb. Sebaceousc. Apocrined. Eccrine(sweat)
107. The patient with thrombocytopenia purpura would also have?
a. Gastric carcinomab. Petechiae and stasis
dermatitisc. Cirrhosis of the liverd. Petechiae and
mucosal bleeding