H & P Lecture #4

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  • 1/60 Questions

    Which of the following is defined as a deposit of uric acid crystals characteristic of chronic tophaceous gout?

    • Cutaneous cyst
    • Tophi
    • Keloid
    • Rheumatoid nodules
    • Basal cell carcinoma
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About This Quiz


H & P lecture #4, covers exam abnormalities. . . I also got a lot of information from Bates, I don't know how much detail we need to know out of Bates, but its better to be safe than sorry! :)

H & P Lecture #4 - Quiz

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  • 2. 

    Which of the following is described as a raised nodule that is a common, slow-growing malignancy?

    • Chrondrodermatitis helicis

    • Rheumatoid nodules

    • Tophi

    • Basal cell carcinoma

    • Keloid

    Correct Answer
    A. Basal cell carcinoma
    Explanation
    Basal cell carcinoma is described as a raised nodule that is a common, slow-growing malignancy. It is the most common type of skin cancer and typically appears as a pearly or waxy bump on the skin. It is usually found on areas of the body that are frequently exposed to the sun, such as the face, neck, and arms. Basal cell carcinoma is known for its slow growth and is rarely life-threatening, but it should still be treated promptly to prevent further damage to the skin.

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  • 3. 

    Which of the following is described as a dome-shaped lump in the dermis forms a benign closed form sac attached to the epidermis, and is also called a sebaceous cyst?

    • Basal cell carcinoma

    • Cutaneous cyst

    • Chrondrodermatitis helicis

    • Tophi

    • Keloid

    Correct Answer
    A. Cutaneous cyst
    Explanation
    A cutaneous cyst is described as a dome-shaped lump in the dermis that forms a benign closed form sac attached to the epidermis. It is also known as a sebaceous cyst. This type of cyst is formed when the sebaceous gland becomes blocked, leading to the accumulation of sebum. The cyst is typically filled with a cheesy, foul-smelling material and may cause pain or discomfort. Treatment options include drainage or surgical removal of the cyst.

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  • 4. 

    Which of the following is characterized by softening and fissuring of the angles of the mouth?

    • Actinic chelitis

    • Herpes simplex

    • Angioedema

    • Angular chelitis

    • Hereditary hemorrhagic syndrome

    Correct Answer
    A. Angular chelitis
    Explanation
    Angular chelitis is characterized by softening and fissuring of the angles of the mouth. This condition is commonly caused by a fungal or bacterial infection, which leads to inflammation and cracking of the skin at the corners of the mouth. It is often associated with factors such as poor oral hygiene, nutritional deficiencies, or denture use. Treatment typically involves addressing the underlying cause, such as antifungal or antibiotic medications, and improving oral hygiene practices.

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  • 5. 

    Which of the following is defined as a firm, nodular, hypertrophic mass of scar tissue that extends beyond the area of injury?

    • Cutaneous cyst

    • Tophi

    • Keloid

    • Rheumatoid nodules

    • Basal cell carcinoma

    Correct Answer
    A. Keloid
    Explanation
    A keloid is a firm, nodular, hypertrophic mass of scar tissue that extends beyond the area of injury. Unlike a normal scar, which remains within the boundaries of the original wound, a keloid grows and spreads beyond the site of the injury. It is characterized by its raised, thickened, and often shiny appearance. Keloids can be caused by various factors such as trauma, surgery, burns, or even minor skin injuries. They are more commonly seen in individuals with darker skin types and can be itchy, painful, and cosmetically bothersome. Treatment options for keloids include corticosteroid injections, cryotherapy, laser therapy, and surgical removal.

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  • 6. 

    Which of the following is characterized by small red spots that result when blood escapes from capillaries into tissues, such as when you bite your cheek?

    • Fordyce spots

    • Herpes simplex

    • Koplik's spots

    • Aphthous ulcer

    • Petechiae

    Correct Answer
    A. Petechiae
    Explanation
    Petechiae is characterized by small red spots that result from blood escaping from capillaries into tissues. This can occur when there is trauma or injury, such as biting your cheek. Fordyce spots, herpes simplex, Koplik's spots, and aphthous ulcers are not associated with this specific characteristic.

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  • 7. 

    Your patient Dorota comes in, complaining of a headache that is very tight and pressing frontally. It has been gradually getting worse since yesterday. She explains that she was up all night typing quizzes while studying for midterms. She has had some slight photophobia, and the only thing that seems to make it feel better is when her wonderful husband Aaron massages her head while she relaxes in between midterms. What is your diagnosis?

    • Cluster headache

    • Tension headache

    • Migraine headache

    • Acute glaucoma

    • Subarachnoid hemorrhage

    Correct Answer
    A. Tension headache
    Explanation
    Based on the information provided, the patient's headache is described as tight and pressing frontally, gradually worsening since yesterday. This is consistent with the symptoms of a tension headache. The fact that the patient was up all night studying and typing quizzes suggests that the headache may be related to stress and muscle tension. The slight photophobia and relief with head massage also support the diagnosis of a tension headache.

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  • 8. 

    Which of the following is the result of excessive exposure to sunlight, where the lip loses its normal redness and becomes scaly, thickened, and slightly everted?

    • Angular chelitis

    • Actinic chelitis

    • Angioedema

    • Herpes simplex

    • Hereditary hemorrhagic syndrome

    Correct Answer
    A. Actinic chelitis
    Explanation
    Actinic chelitis is the correct answer because it refers to a condition caused by excessive exposure to sunlight. It is characterized by the lip losing its normal redness and becoming scaly, thickened, and slightly everted. Angular chelitis, angioedema, herpes simplex, and hereditary hemorrhagic syndrome do not specifically relate to the symptoms described.

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  • 9. 

    Which of the following produces recurrent and painful vesicular eruptions of the lips and surrounding skin?

    • Herpes zoster

    • Herpes simplex

    • Angioedema

    • Actinic chelitis

    • Peutz-Jeghers syndrome

    Correct Answer
    A. Herpes simplex
    Explanation
    Herpes simplex is a viral infection that causes recurrent and painful vesicular eruptions of the lips and surrounding skin. It is characterized by the formation of small, fluid-filled blisters that can be painful and can recur periodically. The virus is highly contagious and can be transmitted through direct contact with the affected area.

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  • 10. 

    Which of the following describes a round or oval ulcer that is white or yellow-ish gray and surrounded by a halo of reddened mucosa?

    • Aphthous ulcer

    • Leukoplakia

    • Thrush

    • Petechiae

    • Fordyce spots

    Correct Answer
    A. Aphthous ulcer
    Explanation
    Aphthous ulcers are round or oval ulcers that are white or yellow-ish gray in color and are surrounded by a halo of reddened mucosa. This description matches the characteristics of an aphthous ulcer. Leukoplakia refers to white patches on the oral mucosa, thrush is a fungal infection characterized by white patches, petechiae are small red or purple spots caused by bleeding, and Fordyce spots are small, yellowish-white bumps on the oral mucosa.

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  • 11. 

    Which of the following dizziness symptoms is described as the feeling of being faint or lightheaded?

    • Vertigo

    • Presyncope

    • Dysequilibrium

    • Psychiatric dizziness

    • Multifactorial

    Correct Answer
    A. Presyncope
    Explanation
    Presyncope is the correct answer because it refers to the feeling of being faint or lightheaded, which is a common symptom of dizziness. Vertigo, on the other hand, is a spinning sensation, while dysequilibrium refers to a sense of unsteadiness or imbalance. Psychiatric dizziness and multifactorial are not specific symptoms of dizziness, but rather describe the underlying causes or factors contributing to dizziness. Therefore, presyncope best matches the description given in the question.

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  • 12. 

    Which of the following is a thickened white patch that can occur anywhere in the oral mucosa resulting from frequent chewing of tobacco, and can lead to cancer?

    • Aphthous ulcer

    • Koplik's spots

    • Petechiae

    • Candidiasis

    • Leukoplakia

    Correct Answer
    A. Leukoplakia
    Explanation
    Leukoplakia is a thickened white patch that can occur anywhere in the oral mucosa due to frequent chewing of tobacco. It is a precancerous condition that can potentially lead to cancer. Aphthous ulcer is a painful sore, Koplik's spots are small white spots on the inside of the cheeks, Petechiae are small red or purple spots caused by bleeding, and Candidiasis is a fungal infection. Therefore, the correct answer is Leukoplakia.

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  • 13. 

    CASE STUDY #2 CC: “My ear hurts” HPI: A 10 year-old male presents to your clinic with his mother and tells you he’s had L ear pain for 3 days.  He felt “warm” but mother didn’t take his temp at home.   ROS: admits to decreased appetite and runny nose with yellow discharge; admits to sneezing; denies coughing; states that some of his friends have similar symptoms PMHx: noncontributory PSHx: none SH: has never smoked PE: –General: A&Ox3, WD/WN adolescent male, appears mildly ill –VS: BP 100/60 mm Hg, HR 80 bpm, RR 24 bpm, temp 100.5 degrees F HEENT: H: NC/AT E: PERRLA bilat E: EACs patent, R TM erythematous and bulging, L TM pearly with good light reflex. N: Sinuses nontender, nasal mucosa pink T: oral mucosa pink without tonsilar enlargement or exudates Neck: supple, with shotty anterior cervical LAD, no TMGWhat diagnosis do you suspect?!

    • Mastoiditis

    • Serous effusion

    • Otitis media

    • Otitis externa

    • Perforated TM

    Correct Answer
    A. Otitis media
    Explanation
    Based on the information provided in the case study, the most likely diagnosis is otitis media. The patient presents with ear pain, decreased appetite, runny nose with yellow discharge, sneezing, and a mild fever. On physical examination, the right tympanic membrane is erythematous and bulging, which are typical signs of otitis media. The other options can be ruled out based on the absence of relevant symptoms or physical findings.

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  • 14. 

    Amanda comes in complaining of nasal congestion and discharge, fever, and facial pain above her cheek. She says it has been aching and throbbing for two days, and hurts worse when she coughs or sneezes. You decide to prescribe her a decongestant and antibiotic, what diagnosis are you treating?

    • Cluster headache

    • Tension headache

    • Migraine headacha

    • Sinusitis headache

    • Strep type A infection of the sinuses

    Correct Answer
    A. Sinusitis headache
    Explanation
    The given symptoms of nasal congestion, discharge, fever, and facial pain above the cheek are indicative of sinusitis. Sinusitis is an inflammation or infection of the sinuses, which can cause pain and pressure in the face. The fact that the pain worsens when coughing or sneezing suggests that there is increased pressure in the sinuses. Therefore, prescribing a decongestant and antibiotic would be appropriate for treating sinusitis.

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  • 15. 

    Which of the following is described as a chalky white patch with irregular margins caused by a deposition of hyaline material within the layers of the TM that sometimes follows a severe case of otitis media?

    • Acute otitis media

    • Serous effusion

    • Bullous myringitis

    • Perforation of the eardrum

    • Tympanosclerosis

    Correct Answer
    A. Tympanosclerosis
    Explanation
    Tympanosclerosis is described as a chalky white patch with irregular margins caused by a deposition of hyaline material within the layers of the tympanic membrane (TM). This condition can occur as a result of a severe case of otitis media, where inflammation and damage to the TM lead to the deposition of hyaline material. It is characterized by a white, opaque appearance on the TM and can cause hearing loss or a decrease in middle ear mobility.

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  • 16. 

    Which of the following are deep purple lesions that can be raised or flat on the palate, and are common in patients with AIDS?

    • Chancre of syphillis

    • Kaposi's sarcoma

    • Koplik's spots

    • Leukoplakia

    • Fordyce spots

    Correct Answer
    A. Kaposi's sarcoma
    Explanation
    Kaposi's sarcoma is a correct answer because it is a type of cancer that can cause deep purple lesions on the palate. It is commonly seen in patients with AIDS due to their weakened immune system. These lesions can be raised or flat and are one of the characteristic symptoms of Kaposi's sarcoma in HIV/AIDS patients.

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  • 17. 

    Which of the following is described as holes in the eardrum that usually result from purulent infections of the middle ear and can be classified as central or marginal perforations?

    • Tympanosclerosis

    • Perforation of the eardrum

    • Serous effusion

    • Acute otitis media

    • Bullous myringitis

    Correct Answer
    A. Perforation of the eardrum
    Explanation
    Perforation of the eardrum is described as holes in the eardrum that usually result from purulent infections of the middle ear. These holes can be classified as central or marginal perforations. Tympanosclerosis refers to the hardening of the eardrum, serous effusion refers to the accumulation of fluid in the middle ear, acute otitis media refers to an infection of the middle ear, and bullous myringitis refers to a viral infection of the eardrum.

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  • 18. 

    Which of the following is described as pigmented spots on the lips that are more prominent than freckling of the surrounding skin?

    • Chancre of syphillis

    • Peutz-Jeghers syndrome

    • Hereditary hemorrhagic telangiectasia

    • Herpes simplex

    • Angioedema

    Correct Answer
    A. Peutz-Jeghers syndrome
    Explanation
    Peutz-Jeghers syndrome is described as pigmented spots on the lips that are more prominent than freckling of the surrounding skin. This genetic disorder is characterized by the development of hamartomatous polyps in the gastrointestinal tract and mucocutaneous hyperpigmentation, particularly on the lips, buccal mucosa, and perianal area. These pigmented spots, known as melanotic macules, are dark brown to black in color and can vary in size. They are typically larger and more prominent than freckles, which are usually smaller and lighter in color.

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  • 19. 

    Which of the following rare (but very important) disease presents as a dull red throat with gray exudate on the uvula, pharynx, and tongue?

    • Mumps

    • Pharyngitis

    • Diphtheria

    • Rubella

    • Strep throat

    Correct Answer
    A. Diphtheria
    Explanation
    Diphtheria presents as a dull red throat with gray exudate on the uvula, pharynx, and tongue. This is a characteristic symptom of the disease. Mumps, Pharyngitis, Rubella, and Strep throat do not typically present with this specific symptom.

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  • 20. 

    Which of the following dizziness symptoms is described as a spinning sensation along with nystagmus and ataxia?

    • Vertigo

    • Presyncope

    • Dysequilibrium

    • Psychiatric dizziness

    • Multifactorial

    Correct Answer
    A. Vertigo
    Explanation
    Vertigo is the correct answer because it is characterized by a spinning sensation, along with nystagmus (involuntary eye movements) and ataxia (lack of muscle coordination). Vertigo is a specific type of dizziness that is often caused by problems in the inner ear or the vestibular system, which is responsible for maintaining balance and spatial orientation. Other options like presyncope, dysequilibrium, psychiatric dizziness, and multifactorial do not specifically describe the spinning sensation, nystagmus, and ataxia associated with vertigo.

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  • 21. 

    Which of the following describes a condition of diffuse, non-pitting, tense swelling of the dermis and subcutaneous tissue?

    • Peutz-Jeghers syndrome

    • Angular chelitis

    • Hereditary hemorrhagic telangiectasia

    • Angioedema

    • Actinic chelitis

    Correct Answer
    A. Angioedema
    Explanation
    Angioedema is the correct answer because it is a condition characterized by diffuse, non-pitting, tense swelling of the dermis and subcutaneous tissue. This condition is caused by the rapid swelling of the deeper layers of the skin, often in response to an allergic reaction or an underlying medical condition. It can affect various parts of the body, including the lips, face, throat, and extremities. Unlike pitting edema, which leaves an indentation when pressure is applied, angioedema does not pit.

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  • 22. 

    Which of the following is an early sign of measles characterized by small white specks that resemble grains of salt on a red background on the buccal mucosa near the first and second molars?

    • Petechiae

    • Fordyce spots

    • Leukoplakia

    • Koplik's spots

    • Aphthous ulcer

    Correct Answer
    A. Koplik's spots
    Explanation
    Koplik's spots are an early sign of measles characterized by small white specks on a red background on the buccal mucosa near the first and second molars. This is a distinct feature of measles and can help in early diagnosis of the disease. Petechiae are small red or purple spots on the skin caused by bleeding, Fordyce spots are small yellowish or white bumps on the skin, Leukoplakia is a condition characterized by white patches on the mucous membranes, and Aphthous ulcers are painful sores that form inside the mouth.

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  • 23. 

    Closed-angle and Acute-angle closure glaucoma are two names for the same condition. What is another name for this same condition?

    • Open-angle glaucoma

    • Open-closure glaucoma

    • Narrow-angle glaucoma

    • Narrow-closure glaucoma

    Correct Answer
    A. Narrow-angle glaucoma
    Explanation
    Closed-angle and acute-angle closure glaucoma are both terms used to describe the same condition, which is characterized by a sudden increase in intraocular pressure due to the blockage of the drainage angle of the eye. This blockage causes the iris to push forward, narrowing the angle and obstructing the flow of fluid out of the eye. As a result, pressure builds up and can lead to damage of the optic nerve and vision loss. Therefore, another name for this condition is narrow-angle glaucoma.

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  • 24. 

    Which of the following red eye conditions looks much worse than it really is, and is commonly caused by trauma, bleeding disorders, or a sudden increase in venous pressure (cough, vomit).

    • Narrow-angle glaucoma

    • Acute iritis

    • Conjunctivitis

    • Subconjunctival hemorrhage

    • Pterygium

    Correct Answer
    A. Subconjunctival hemorrhage
    Explanation
    A subconjunctival hemorrhage is a red eye condition that looks much worse than it really is. It is commonly caused by trauma, bleeding disorders, or a sudden increase in venous pressure. This condition occurs when a blood vessel in the conjunctiva, the clear layer that covers the white part of the eye, breaks and causes blood to pool under the conjunctiva. Although it may appear alarming, it is usually harmless and resolves on its own without treatment.

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  • 25. 

    Which of the following describes multiple small red spots on the lips?

    • Angioedema

    • Hereditary hemorrhagic telangiectasia

    • Herpes simplex

    • Peutz-Jeghers syndrome

    • Chancre of syphillis

    Correct Answer
    A. Hereditary hemorrhagic telangiectasia
    Explanation
    Hereditary hemorrhagic telangiectasia is a genetic disorder that causes abnormal blood vessels to form, leading to the development of small red spots on the lips. This condition is characterized by recurrent nosebleeds, telangiectasias (dilated blood vessels), and arteriovenous malformations (abnormal connections between arteries and veins). It is an inherited condition and can also affect other organs in the body, such as the lungs, liver, and brain.

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  • 26. 

    Which of the following are normal sebaceous glands that appear as yellowish spots in the buccal mucosa or on the lips?

    • Petechiae

    • Koplik's spots

    • Fordyce spots

    • Angioedema

    • Leukoplakia

    Correct Answer
    A. Fordyce spots
    Explanation
    Fordyce spots are normal sebaceous glands that appear as yellowish spots in the buccal mucosa or on the lips. Petechiae are small red or purple spots caused by bleeding under the skin. Koplik's spots are small white spots with blue or red borders that are a characteristic sign of measles. Angioedema is swelling caused by fluid buildup in the deep layers of the skin. Leukoplakia is a condition characterized by thick white patches on the mucous membranes.

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  • 27. 

    Which of the following dizziness symptoms is described as being associated with anxiety, panic disorder, and depression?

    • Vertigo

    • Presyncope

    • Dysequilibrium

    • Psychiatric dizziness

    • Multifactorial

    Correct Answer
    A. Psychiatric dizziness
    Explanation
    Psychiatric dizziness is the correct answer because it is described as being associated with anxiety, panic disorder, and depression. Vertigo refers to a spinning sensation, Presyncope refers to feeling lightheaded or faint, Dysequilibrium refers to a sense of unsteadiness or imbalance, and Multifactorial refers to dizziness caused by multiple factors. Therefore, Psychiatric dizziness is the most appropriate option that aligns with the given description.

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  • 28. 

    Which of the following is described as a chronic inflammatory lesion on the helix or antihelix that becomes red, ulcerated, and crusty?

    • Cutaneous cyst

    • Tophi

    • Keloid

    • Rheumatoid nodules

    • Chrondrodermatitis helicis

    Correct Answer
    A. Chrondrodermatitis helicis
    Explanation
    Chrondrodermatitis helicis is described as a chronic inflammatory lesion on the helix or antihelix that becomes red, ulcerated, and crusty. It is a condition that affects the cartilage of the ear and is often caused by pressure or trauma to the area. The inflammation leads to the development of a painful nodule or ulcer on the ear, which can become crusty and may bleed. Treatment usually involves avoiding pressure on the affected area and using medications to reduce inflammation.

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  • 29. 

    Which of the following is described as small lumps on the helix or antihelix and is common in chronic RA?

    • Chrondrodermatitis helicis

    • Tophi

    • Rheumatoid nodules

    • Cutaneous cyst

    • Keloid

    Correct Answer
    A. Rheumatoid nodules
    Explanation
    Rheumatoid nodules are small lumps that can develop on the helix or antihelix in individuals with chronic rheumatoid arthritis (RA). These nodules are a characteristic feature of RA and are formed due to the accumulation of inflammatory cells and fibrous tissue. They can vary in size and are usually painless. Rheumatoid nodules can be found in various locations throughout the body, including the ears. Therefore, in individuals with chronic RA, the presence of small lumps on the helix or antihelix is most likely due to rheumatoid nodules.

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  • 30. 

    Which of the following is a yeast infection in the mouth that appears as thick, white plaques, somewhat adherent to the underlying mucosa? (**Hint, TWO correct answers!)

    • Diphtheria

    • Thrush

    • Leukoplakia

    • Aphthous ulcer

    • Candidiasis

    Correct Answer(s)
    A. Thrush
    A. Candidiasis
    Explanation
    Thrush and candidiasis are both yeast infections in the mouth that appear as thick, white plaques. Thrush is caused by the Candida fungus and is commonly seen in infants, elderly individuals, and those with weakened immune systems. Candidiasis, on the other hand, refers to a broader range of infections caused by Candida, including oral thrush. Both conditions can cause discomfort and may require antifungal treatment to resolve.

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  • 31. 

    Which of the following is usually described as the "worst headache of my life," is associated with nausea, vomiting, loss of consciousness, and neck pain?

    • Cluster headache

    • Tension headache

    • Migraine headache

    • Temporal arteritis

    • Subarachnoid hemorrhage

    Correct Answer
    A. Subarachnoid hemorrhage
    Explanation
    A subarachnoid hemorrhage is a type of bleeding that occurs in the space between the brain and the thin tissues that cover it. It is often described as the "worst headache of my life" because it is typically sudden and severe. In addition to the intense headache, other symptoms such as nausea, vomiting, loss of consciousness, and neck pain are commonly associated with a subarachnoid hemorrhage. This condition requires immediate medical attention as it can be life-threatening.

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  • 32. 

    Which of the following eye conditions is described as a pattern of red peripheral conjunctival injection, usually caused by bacterial or viral infection, that causes mild discomfort but no pain, and has ocular discharge present?

    • Subconjunctival hemorrhage

    • Acute uveitis

    • Acute iritis

    • Narrow-angle glaucoma

    • Conjunctivitis

    Correct Answer
    A. Conjunctivitis
    Explanation
    Conjunctivitis is described as a pattern of red peripheral conjunctival injection, usually caused by bacterial or viral infection. It causes mild discomfort but no pain, and has ocular discharge present. Subconjunctival hemorrhage is characterized by blood in the conjunctiva, not redness or infection. Acute uveitis and acute iritis are both conditions that involve inflammation of the uvea, which is the middle layer of the eye, and typically present with pain and discomfort. Narrow-angle glaucoma is a condition characterized by increased pressure in the eye, which can cause severe pain and vision loss. Therefore, the correct answer is conjunctivitis.

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  • 33. 

    Which of the following is the MOST COMMON cause of HYPERthyroidism, and is an autoimmune disease in which antibodies stimulate the thyroid to produce too much thyroid hormone?

    • Hashimoto's Thyroiditis

    • Autoimmune thyroiditis

    • Grave's disease

    • Chronic lymphocytic thyroiditis

    Correct Answer
    A. Grave's disease
    Explanation
    Grave's disease is the most common cause of HYPERthyroidism and is an autoimmune disease where antibodies stimulate the thyroid to produce excessive thyroid hormone. This explanation provides the necessary information without explicitly stating "The correct answer is Grave's disease."

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  • 34. 

    You have a patient who comes in complaining of a headache for the past 48 hours. He went out drinking recently, and he thinks this might be what provoked his headache. He thought it was just a hangover, but then it got progressively worse, and is throbbing and achy. He describes sensory and motor auras, phonophobia, photophobia, nausea, and vomiting. He says he is the most comfortable laying down in his bedroom, with the lights off. What is your diagnosis?

    • Cluster headache

    • Tension headache

    • Migraine headache

    • Acute glaucoma

    • Subarachnoid hemorrhage

    Correct Answer
    A. Migraine headache
    Explanation
    Based on the patient's symptoms of throbbing and achy headache, sensory and motor auras, phonophobia, photophobia, nausea, and vomiting, along with the trigger of drinking alcohol, the most likely diagnosis is a migraine headache. Migraines are often triggered by various factors, including alcohol consumption. The symptoms described, such as sensory and motor auras, sensitivity to light and sound, nausea, and vomiting, are consistent with a migraine. The patient's preference for lying down in a dark room also aligns with typical migraine behavior.

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  • 35. 

    Which of the following symptoms of dizziness is described as imbalance when walking?

    • Vertigo

    • Presyncope

    • Dysequilibrium

    • Psychiatric dizziness

    • Multifactorial

    Correct Answer
    A. Dysequilibrium
    Explanation
    Dysequilibrium is the correct answer because it refers to a symptom of dizziness characterized by imbalance when walking. This means that individuals experiencing dysequilibrium may feel unsteady or have difficulty maintaining their balance while walking. Vertigo refers to a spinning sensation, presyncope refers to feeling lightheaded or faint, psychiatric dizziness refers to dizziness caused by mental health issues, and multifactorial refers to dizziness caused by multiple factors.

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  • 36. 

    Which of the following correctly describes the peripheral vertigo called benign positional vertigo?

    • Suddent dizziness due to a central brainstem lesion such as atherosclerosis.

    • Sudden onset of dizziness lasting hours to weeks with nausea, vomiting, and nystagmus.

    • Sudden onset of dizziness when moving head; accompanied by nystagmus and may or may not have nausea and vomiting.

    • Sudden dizziness typically associated with other neurological deficits.

    • Sudden dizziness typically associated with recent upper respiratory infection.

    Correct Answer
    A. Sudden onset of dizziness when moving head; accompanied by nystagmus and may or may not have nausea and vomiting.
  • 37. 

    A ____________ headache is not associated with any underlying pathology, and is the most common type of headache. A _____________ headache can be attributed to an underlying pathologic condition, but are a much rarer form of headaches.

    • Secondary, primary

    • Primary, secondary

    • Migraine, cluster

    • Tension, cluster

    • Primary, cluster

    Correct Answer
    A. Primary, secondary
    Explanation
    A primary headache is not associated with any underlying pathology and is the most common type of headache. On the other hand, a secondary headache can be attributed to an underlying pathologic condition but is much rarer.

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  • 38. 

    Which of the following conditions is usually caused by viral URIs or by sudden changes in atmospheric pressure where the Eustachain tube cannot equalize air pressure, so the air is partially absorbed into that blood stream and fluid accumulates behind the TM?  (Hint** Symptoms include fullness, popping, mild conductive hearing loss, and pain).

    • Tympanosclerosis

    • Serous effusion

    • Bullous myringitis

    • Perforation of the eardrum

    • Acute otitis media

    Correct Answer
    A. Serous effusion
    Explanation
    Serous effusion is usually caused by viral upper respiratory infections (URIs) or sudden changes in atmospheric pressure. In this condition, the Eustachian tube is unable to equalize air pressure, causing air to be partially absorbed into the bloodstream and fluid to accumulate behind the tympanic membrane (TM). Symptoms of serous effusion include fullness, popping, mild conductive hearing loss, and pain.

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  • 39. 

    Which of the following are true about Hashimoto's thyroiditis? (**Hint, choose three!)

    • One of the most common causes of hypothyroidism

    • One of the most common causes of hyperthyroidism

    • Autoimmune disease in which the immune system attacks and destroys the thyroid gland

    • Autoimmune disease in which antibodies stimulate the thyroid to produce too much thyroid hormone

    • Causes the gland to make insufficient thyroid hormones (low T3 and T4)

    Correct Answer(s)
    A. One of the most common causes of hypothyroidism
    A. Autoimmune disease in which the immune system attacks and destroys the thyroid gland
    A. Causes the gland to make insufficient thyroid hormones (low T3 and T4)
    Explanation
    Hashimoto's thyroiditis is an autoimmune disease in which the immune system attacks and destroys the thyroid gland. This leads to the gland producing insufficient thyroid hormones, resulting in hypothyroidism. It is not a cause of hyperthyroidism, where the thyroid produces too much thyroid hormone. Therefore, the three true statements about Hashimoto's thyroiditis are: it is one of the most common causes of hypothyroidism, it is an autoimmune disease in which the immune system attacks and destroys the thyroid gland, and it causes the gland to make insufficient thyroid hormones (low T3 and T4).

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  • 40. 

    Which of the following is described as a firm, button-like lesion that ulcerates and may become crusted?

    • Aphthous ulcer

    • Kaposi's sarcoma

    • Fordyce spots

    • Koplik's spots

    • Chancre of syphillis

    Correct Answer
    A. Chancre of syphillis
    Explanation
    A chancre of syphilis is described as a firm, button-like lesion that ulcerates and may become crusted. Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. The primary stage of syphilis is characterized by the development of a painless sore called a chancre at the site of infection. The chancre typically appears as a small, raised bump that can evolve into an ulcer with a firm, button-like texture. If left untreated, syphilis can progress to more serious stages and cause a wide range of complications.

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  • 41. 

    Which of the following types of headaches is associated with unilateral lacrimation, rhinorrhea, miosis, ptosis, eyelid edema, conjunctival injection, and arises episodically for hours at a time, but then goes into remission for weeks or months? (**Hint: this type of headache tends to be provoked by alcohol, and there doesn't seem to be anything that makes it feel better!)

    • Cluster headache

    • Tension headache

    • Migraine headache

    • Acute glaucoma

    • Subarachnoid hemorrhage

    Correct Answer
    A. Cluster headache
    Explanation
    Cluster headaches are associated with unilateral lacrimation, rhinorrhea, miosis, ptosis, eyelid edema, and conjunctival injection. They occur episodically for hours at a time and then go into remission for weeks or months. Alcohol can provoke cluster headaches, and there is no known way to relieve the pain. Therefore, the correct answer is cluster headache.

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  • 42. 

    CASE STUDY #1 CC: Right eye pain A 60 year old male construction worker presents to your office complaining of pain in his right eye for 24 hours. He states that the pain is severe, aching, and deep, and he has noticed a decrease in his vision. ROS: He denieswearing contact lenses or having any work-related exposures. He denies recent URI or history of allergies, as well as N/V, diaphoresis, and abd pain. PMH: Hypertension Surgical history: none SH: smokes 3 ppd x 40 years Meds: Lisinopril 10 mg/day PE: General: A&Ox3, holding head in his hands in moderate discomfort VS: BP 160/95 mmHg, HR 90 bpm, RR 12 breaths/min, Temp 98.4 degrees F HEENT: H: NC/AT Eyes: VA 20/100 OD, 20/20 OS; R pupil dilated and fixed; R cornea cloudy; R fundus difficult to visualize.  Ophtho exam on L is WNL. Ears: EACs patent, TMs with good light reflex and normal landmarks N: nasal mucosa without erythema or discharge; sinuses nontender to palpation and percussion T: oral mucosa pink, good dentition, pharynx without exudates Neck: supple, no LAD (lymphadenopathy), no TMG (thyro-megaly) What do you think is the most appropriate diagnosis for this patient?!

    • Conjunctivitis

    • Chronic glaucoma

    • Acute glaucoma

    • Corneal abrasion

    • Vitreous hemorrhage

    Correct Answer
    A. Acute glaucoma
    Explanation
    The most appropriate diagnosis for this patient is acute glaucoma. The patient presents with severe, aching, and deep pain in his right eye, along with a decrease in vision. The right pupil is dilated and fixed, and the cornea is cloudy. These findings suggest increased intraocular pressure, which is characteristic of acute glaucoma. The other options, such as conjunctivitis, chronic glaucoma, corneal abrasion, and vitreous hemorrhage, do not fit the patient's symptoms and physical exam findings.

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  • 43. 

    A full and torturous retinal artery, with increased light reflex is called ___________ wiring, and an artery that is so opaque that no blood is visible within it at all is called ____________ wiring.

    • Copper, shiny

    • Silver, copper

    • Bronze, silver

    • Copper, silver

    Correct Answer
    A. Copper, silver
    Explanation
    A full and torturous retinal artery, with increased light reflex is called copper wiring, and an artery that is so opaque that no blood is visible within it at all is called silver wiring.

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  • 44. 

    Which of the following is not considered a "secondary" headache?

    • Migraine headache

    • Acute glaucoma

    • Subarachnoid hemorrhage

    • Sinusitis

    • Temporal arteritis

    Correct Answer
    A. Migraine headache
    Explanation
    Migraine headache is not considered a "secondary" headache because it is a primary headache disorder. Secondary headaches are caused by an underlying medical condition or injury, whereas primary headaches occur without any identifiable cause. Migraine headaches are typically recurrent and can be triggered by various factors such as stress, hormonal changes, certain foods, and environmental factors. They are characterized by severe throbbing pain, often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. Therefore, migraine headache is the correct answer as it does not fall under the category of secondary headaches.

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  • 45. 

    Which of the following describes the condition of Horner's syndrome?

    • The dilated pupil is fixed to light and near effort. Ptosis of the upper eyelid and lateral deviation is almost always present.

    • One pupil is larger, regular, and has a slowed or absent reaction to light. Slow accommodation causes blurred vision and DTRs are often decreased.

    • The affected pupil, although small, reacts briskly to light and near effort. Ptosis of the eyelid, with loss of sweating on the forehead, and the affected iris is lighter than the normal eye.

    • Small, irregular pupils that accommodate but do not react to light.

    • Greater in bright light, the larger pupil cannot constrict properly because of an impaired PNS, and in dim light, the smaller pupil cannot dilate properly because of an impaired SNS

    Correct Answer
    A. The affected pupil, although small, reacts briskly to light and near effort. Ptosis of the eyelid, with loss of sweating on the forehead, and the affected iris is lighter than the normal eye.
    Explanation
    This answer describes the condition of Horner's syndrome. It states that the affected pupil is small but reacts briskly to light and near effort. It also mentions the presence of ptosis of the eyelid, loss of sweating on the forehead, and a lighter iris in the affected eye compared to the normal eye.

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  • 46. 

    Which of the following is a viral infection characterized by painful hemorrhagic vesicles that appear on the TM, the ear canal, or both?  (**Hint--Symptoms include earache, blood-tinged discharge from the ear, and conductive hearing loss)

    • Perforated eardrum

    • Tympanosclerosis

    • Acute otitis media

    • Bullous myringitis

    • Serous effusion

    Correct Answer
    A. Bullous myringitis
    Explanation
    Bullous myringitis is a viral infection characterized by painful hemorrhagic vesicles that appear on the TM (tympanic membrane), the ear canal, or both. The symptoms mentioned in the hint, including earache, blood-tinged discharge from the ear, and conductive hearing loss, are commonly associated with bullous myringitis. Perforated eardrum, tympanosclerosis, acute otitis media, and serous effusion are different conditions and do not present with the specific symptoms mentioned.

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  • 47. 

    Which of the following describes the condition of Adie's (tonic) pupil?

    • One pupil is larger, regular, and has a slowed or absent reaction to light. Slow accommodation causes blurred vision and DTRs are often decreased.

    • Small, irregular pupils that accommodate but do not react to light.

    • Greater in bright light, the larger pupil cannot constrict properly because of an impaired PNS, and in dim light, the smaller pupil cannot dilate properly because of an impaired SNS

    • The dilated pupil is fixed to light and near effort. Ptosis of the upper eyelid and lateral deviation is almost always present.

    • The affected pupil, although small, reacts briskly to light and near effort. Ptosis of the eyelid, with loss of sweating on the forehead, and the affected iris is lighter than the normal eye.

    Correct Answer
    A. One pupil is larger, regular, and has a slowed or absent reaction to light. Slow accommodation causes blurred vision and DTRs are often decreased.
    Explanation
    Adie's (tonic) pupil is characterized by one pupil being larger, regular, and having a slowed or absent reaction to light. This condition also causes slow accommodation, leading to blurred vision. Additionally, deep tendon reflexes (DTRs) are often decreased in individuals with Adie's pupil.

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  • 48. 

    Which of the following is a condition that often has no symptoms, no shadow when testing the depth of the anterior shadow, but increased IOP leads to damage to the optic nerve and vision loss over time?  (**Hint, this condition is not a common cause of red eye)

    • Acute iritis

    • Open-angle glaucoma

    • Conjunctivits

    • Subconjunctival Hemorrhage

    • Narrow-angle glaucoma

    Correct Answer
    A. Open-angle glaucoma
    Explanation
    Open-angle glaucoma is a condition that often has no symptoms and does not show a shadow when testing the depth of the anterior shadow. However, increased intraocular pressure (IOP) can lead to damage to the optic nerve and gradual vision loss over time. Unlike narrow-angle glaucoma, which can cause sudden symptoms and is a common cause of red eye, open-angle glaucoma progresses slowly and is not typically associated with redness or acute symptoms. Therefore, open-angle glaucoma is the correct answer in this context.

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  • 49. 

    Which of the following benign conditions is associated with normal aging (but can be seen in young people sometimes), is a grayish-white arc near the edge of the cornea, and can suggest hyperlipidemia?  (**Hint--there are THREE correct answers!)

    • Pterygium

    • Corneal arcus

    • Cataracts

    • Senile arcus

    • Arcus senilis

    Correct Answer(s)
    A. Corneal arcus
    A. Senile arcus
    A. Arcus senilis
    Explanation
    Corneal arcus, senile arcus, and arcus senilis are all correct answers because they are all associated with normal aging. These conditions present as a grayish-white arc near the edge of the cornea and can suggest hyperlipidemia. They may also be seen in young people occasionally.

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  • Aug 08, 2024
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  • Oct 06, 2009
    Quiz Created by
    Saraholson7

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