Assessment Final
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Review of material for final exam in Assessment class. Abdomen, Respiratory, male & female genitalia.
- 1.A 42 year old waitress presents to your office for evaluation of shortness of breath. She has had a fever as high as 103F for the last few days and has a cough productive of green sputum. On physical examination, you hear crackles in her lungs. A chest radiograph reveals a consolidation in the left lower lobe. You diagnose her with lobar pneumonia. When you perform tactile fremitus of the left lower thorax, you would expect the fremitus to be:
- A.
Increased
- B.
Decreased
- C.
Unchanged
- D.
Displaced
- 2.What would you expect to hear when percussing the left lower throax of a pt with lobar pneumonia?
- A.
Dull
- B.
Resonant
- C.
Flat
- D.
Hyperresonant
- 3.When performing a test for Egophony on a pt with lobar pneumonia, what would you expect to hear?
- A.
Eeeee
- B.
Aaay
- C.
Ooooo
- D.
Whisper Petriloquoy
- 4.In a patient with lobar pneumonia, you would expect breath sounds on auscultation to reveal:
- A.
Rhonchi
- B.
Egophany
- C.
Decreased Resonance
- D.
Increased Air Movement
- 5.A 65 year old smoker presents for evaluation of dyspnea. He has a 100-pack/year history of tobacco use. The dyspnea is exacerbated by exertion. He denies fever or chills; he has not had recent contact with anyone who is sick. You diagnose chronic obstructive pulmonary disease (COPD). On physical examination of the thorax, you would expect to find:
- A.
Increased AP diameter
- B.
Decreased AP diameter
- C.
No change in AP diameter
- 6.Upon auscultation in a patient with COPD, you would expect to hear:
- A.
Stridor
- B.
Delayed Expiratory Phase
- C.
Pleural Rub
- D.
Late Inspiratory Crackles
- 7.A 19 year old college student presents to the emergency room for sudden onset of dyspnea. The general survey reveals that she is 6 feet 2 inches tall and weighs 135 pounds. She denies fever, chills, cough, and sore throat. She is a nonsmoker. You suspect that she has a pneumothorax. What findings would you expect with percussion of the thorax?
- A.
Decreased resonance on the affected side
- B.
Increased resonance (hyperresonance) on the affected side
- C.
Increased resonance on the nonaffected side
- D.
Dullness
- 8.In a patient with pneumothorax, what findings would you expect with auscultation of the thorax on the affected side?
- A.
Wheezes
- B.
Rhonchi
- C.
Absence of Breath Sounds
- D.
Hyperresonance
- 9.In a healthy adult, the expected measurement of descent of the diaphragm is:
- A.
1-2 cm
- B.
5-6 cm
- C.
7-8 cm
- D.
10-12 cm
- 10.In a healthy adult, the respiratory rate is:
- A.
4 to 14 breaths per minute
- B.
14-16 breaths per minute
- C.
14 - 20 breaths per minute
- D.
26-40 breaths per minute
- 11.What is the preferred order for examination of the abdomen?
- A.
Inspection, auscultation, percussion, palpation
- B.
Percussion, auscultation, palpation, inspection
- C.
Auscultation, inspection, palpation, percussion
- D.
Inspection, palpation, auscultation, percussion
- 12.
- A.
Rebound tenderness
- B.
Involuntary guarding
- C.
Rigidity of the abdomen
- D.
Voluntary guarding
- 13.A 15 year old high school student presents to the clinic with a 1 day history of nausea and anorexia. He describes the pain as generalized yesterday, but today it has localized to his right lower quadrant. You palpate the left lower quadrant and the patient experiences pain in the right lower quadrant. What is the name of this sign?
- A.
Psoas sign
- B.
Obturator sign
- C.
Rovsing’s sign
- D.
Cuteaneuos hyperesthesia
- 14.
- A.
Psoas sign
- B.
CVA (costovertebral angle) tenderness
- C.
Rosving’s sign
- D.
Murphy’s sign
- 15.A 40 year old flight attendant presents to your office for evaluation of abdominal pain. It is worse after eating, especially if she has a meal that is spicy or high in fat. She has tried over the counter antacids, but they have not helped the pain. After examining her abdomen, you strongly suspect cholecystitis. Which sign on examination increases your suspicion for this diagnosis?
- A.
Psoas sign
- B.
Rovsing’s sign
- C.
Murphy’s sign
- D.
Grey Turner’s sign
- 16.A 22 year old celebrity with a known history of intravenous drug use presents to the emergency room for evaluation of a 5 day history of nausea, emesis, and right upper quadrant abdominal pain. On general survey, he appears ill and his skin is distinctly yellow. He has a temperature of 102.5 F and a heart rate of 112 bpm. You provisionally diagnose him with acute hepatitis. What would you expect to find on abdominal examination?
- A.
Liver edge is tender and 4 to 5 finger breadths below RCM
- B.
Liver edge is nonpalpable
- C.
Liver edge is tender and 1 finger breadth below the RCM
- D.
Liver edge is non tender and 4 to 5 finger breadths below the RCM
- 17.What is Rovsings sign?
- A.
Pain in the right lower quadrant during palpation of the left lower quadrant
- B.
Pain is elicited by gently picking up a fold of abdominal skin anteriorly without pinching it
- C.
Rebound tenderness
- D.
Pain elicited when the patient’s right thigh is flexed at the hip with the knee bent, and the leg is internally rotated at the hip
- 18.A 25 year old truck driver presents to the ER for evaluation of pain in his left groin. He has noticed that the pain increases after lifting several boxes, each weighing more than 100 lbs, to fill up his truck. He has had this pain intermittently over the past 5 years, but it has gone away on its own. He is here because the pain has not gone away, and he is becoming nauseated. He denies fever, chills, constipation, or diarrhea. He denis urethral discharge; he is married and states he is faithful to his wife. On physical examination of the left testicular area, you note there is a buldge when you palpate the inguinal canal as you ask the patient to strain. You listen to the left testicular area and hear bowel sounds. Your most likely diagnosis is:
- A.
Appendicitis
- B.
Testicular torsion
- C.
Hernia
- D.
Pelvic inflammatory disease
- 19.A 19 year old college athlete presents to the student health center for evaluation of penile pain. He is sexually active and his last sexual encounter was one week ago. He has had more than 5 partners in his lifetime to date. You inspect his penis and see a cluster of small vesicles and a few swallow ulcerated areas. Your diagnosis based on this history and the physical examination is:
- A.
Carcinoma of the penis
- B.
Venereal Wart
- C.
Syphilitic chancre
- D.
Genital herpes
- 20.A 15 year old high school student wishing to join the school’s football and basketball teams presents to your office for a sports physical. As a part of the physical, you perform a hernia check. You notice that his right scrotum is markedly larger than his left. He denies pain or tenderness, as well as fever, night sweats, and weight loss. On palpitation, you feel a fluid filled mass in the scrotum but can’t get above the mass with your fingers. What is your most likely diagnosis?
- A.
Hydrocele
- B.
Testicular tumor
- C.
Varicocele
- D.
Epidermoid inclusion cyst
- 21.A 18 year old high school student presents to his family doctor’s office for evaluation of acute onset of pain in the left testicle. He has had no problems until this morning. The pain has been intermittent, sharp, and radiates into the left groin. On physical examination, the testicle feels swollen and is tender to palpation. What is your most likely diagnosis
- A.
Epididymytis
- B.
Testicular torsion
- C.
Acute orchitis
- D.
Testicular cancer
- 22.What is Phimosis?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
- 23.What is Paraphimosis?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
- 24.What is Balanitis?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
- 25.What is Cryptorchidism?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
- 26.What is hypospadius?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
- 27.A 19 y/o sexually active college student presents for evaluation of a vaginal discharge. She has been in a monogamous relationship since becoming sexually active and is married to her partner. She denies that he has been unfaithful. She denies fever or shills. She states that the discharge is thick, white, and curd like and although there is no bad odor, she does experience some itching. Upon physical examination of the vagina, you see an inflamed vulva, with a slightly red vaginal mucosa. The discharge is thick and white. There is no cervical motion tenderness. The uterus is normal in size without adnexal masses. Based on this information, what is your most likely diagnosis?
- A.
Bacterial vaginosis
- B.
Trichomonas vaginalis infection
- C.
Candida vaginitis
- D.
Pelvic inflammatory disease
- 28.A 35 y/o woman presents for evaluation of several new lesions on her vagina. She denies any previous medical problems. She is sexually active. She has had four pregnancies and has given birth to two children. She has had more than ten sexual partners in her lifetime. She is currently divorced but involved in a new relationship with a man whose past sexual history is unknown. On physical examination of the external vagina, you see cauliflower-like lesions scattered on the labia. These are nontender to palpation; the largest is 1 cm in diameter. The remainder of the pelvic exam is unremarkable, and there is no vaginal discharge. Based on this information, what is your most likely diagnosis?
- A.
Epidermoid inclusion cysts
- B.
Venereal warts
- C.
Genital herpes
- D.
Syphilitic chancre
- 29.
- A.
Leiomyoma or fibroid
- B.
Cervical cancer
- C.
Uterine cancer
- D.
Cystocele
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