Mega Quiz- Assessment
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All the questions
- 1.An 80 year old woman presents to your clinic for evaluation of palpations and shortness of breath. You obtain an electrocardiogram, which reveals an irregularly irregular rhythm without discrete p waves. You diagnosis her with atrial fibrillation. The most likely physical finding upon auscultation of her heart is
- A.
An irregulary irregular rhythm
- B.
A rapid regular rhythm
- C.
A midsystolic click
- D.
Bigeminy
- 2.A 61 year old hairdresser presents for evaluation of shortness of breath. You examine her jugular venous pulse (JVP) and listen to her heart. You diagnosis her with right-sided heart failure. Your JVP measurement is most likely to be:
- A.
1 cm above the sternal angle
- B.
3 cm above the sternal angle
- C.
6 cm above the sternal angle
- D.
1 cm below the sternal angle
- 3.A 22 year old waitress presents to your clinic for evaluation of pain in her chest. She appears to be anxious. The pain is worse with physical exertion, such as climbing stairs. She does not smoke, use alcohol or illicit drugs, or consume excessive amounts of caffeine. You auscultate her heart and diagnosis mitral valve prolapsed. What did you hear to make this diagnosis ?
- A.
An opening snap
- B.
A midsystolic click
- C.
A diastolic rumble
- D.
A holo-systolic murmur
- 4.What could you ask a patient to do to accentuate the findings of a mitral valve prolapsed?
- A.
Perform a Valsalva maneuver
- B.
Squat
- C.
Hop on one foot
- D.
Kneel
- 5.A 73 year old retired publisher presents to your clinic for a routine checkup. He has a history of class III congestive heart failure, hypertension, and hyperlipidemia. He is doing well and is taking his medication as prescribed. On examination of his cardiovascular system, what would you expect to find?
- A.
PMI in the fifth interspace, midclavicular line, 8 cm lateral to the midsternal line
- B.
PMI in the fifth interspace, anterior axillary line
- C.
PMI in the third interspace, midclavicular line
- D.
PMI in the eight interspace, anterior axillary line
- 6.Which of the following describes the S2 heart sound?
- A.
Occurs during atrial contraction
- B.
Produced by the closure of the mitral & tricuspid valve
- C.
Occurs after the mitral valve opens; rapid ventricular filling
- D.
Produced by closure of the aortic & pulmonic valve
- 7.Which of the following describes the S3 heart sound?
- A.
Occurs during atrial contraction
- B.
Produced by the closure of the mitral & tricuspid valves
- C.
Occurs after the mitral valve opens; rapid ventricular filling
- D.
Produced by closure of the aortic & pulmonic valves
- 8.Which of the following describes the S4 heart sound?
- A.
Occurs during atrial contraction
- B.
Produced by the closure of the mitral & tricuspid valves
- C.
Occurs after the mitral valve opens; rapid ventricular filling
- D.
Produced by closure of the aortic & pulmonic valves
- 9.Which of the following descriptions best describes a GRADE 1 murmur?
- A.
Loud; may be associated with a thrill
- B.
Very faint
- C.
May be heard when the stethoscope is entirely off the chest
- 10.Which of the following descriptions best describes a GRADE 6 murmur?
- A.
Loud; may be associated with a thrill
- B.
Very faint
- C.
May be heard when the stethoscope is entirely off the chest
- 11.Which of the following descriptions best describes a GRADE 4 murmur?
- A.
Loud; may be associated with a thrill
- B.
Very faint
- C.
May be heard when the stethoscope is entirely off the chest
- 12.When auscultating a patients heart sounds you hear an Early diastolic decreased murmur. This would be indicative of what?
- A.
Aortic stenosis
- B.
Mitral regurgitation
- C.
Mitral valve stenosis
- D.
Aortic Regurgitation
- 13.When auscultating a patients heart sounds you hear a Pan-systolic plateau murmur. This would be indicative of what?
- A.
Aortic stenosis
- B.
Mitral regurgitation
- C.
Mitral valve stenosis
- D.
Aortic Regurgitation
- 14.When auscultating a patients heart sounds you hear a Midsystolic crescendo-decrescendo murmur. This would be indicative of what?
- A.
Aortic stenosis
- B.
Mitral regurgitation
- C.
Mitral valve stenosis
- D.
Aortic Regurgitation
- 15.A 68-year-old retired kindergarten teacher presents to your office for evaluation of swelling in her right arm. On questioning her further, you discover that she has had a recent mastectomy for right-sided ductal carcinoma in situ. What is you most likely diagnosis?
- A.
Orthostatic edema
- B.
Lymphedema
- C.
Lipedema
- D.
Chronic venous insufficiency
- 16.A 55-year-old construction worker presents for evaluation of swelling in his feet. He has smoked 2 packs of cigarettes daily since the age of 15. He has noticed pain in both legs when walking, which is relieved with resting for 10 minutes. On physical examination, his dorsalis pedis pulses are decreased bilaterally in comparison with his femoral pulses. His feet are cool to the touch when compared with his upper legs. He has no pedal edema. What is your most likely diagnosis?
- A.
Deep vein thrombosis
- B.
Arterial insufficiency
- C.
Venous insufficiency
- D.
Peripheral neuropathy
- 17.A 62-year-old accountant presents for evaluation of a rash on his lower legs. He has had this rash for several months. He denies fever or chills. The skin itches. He has tried OTC creams without success. He has smoked ½ pack of cigarettes daily for the past 20 years. On physical examination, the skin of his lower legs is hyperpigmented and bluish-red. He has a shallow ulcer on his right medial calf. His dorsalis pedis pulses are 2+ bilaterally, and he has normal hair distribution on his lower legs. These findings are most compatible with which one?
- A.
Deep vein thrombosis
- B.
Tinea pedis
- C.
Arterial insufficiency
- D.
Venous insufficiency
- 18.A 55-year-old- nursing assistant presents to your office because of persistent swelling in her feet. She is a nonsmoker. Her medical history is noncontributory. She has never had any surgeries. She works two 8-hour shifts daily, 6 days weekly. On physical examination, her BP is 110/60 mm/Hg; her cardiovascular examination is normal; and her legs have 2+ pitting edema bilaterally without rashes, thickening, or ulceration of the skin. What is your most likely diagnosis?
- A.
Orthostatic edema
- B.
Lymphedema
- C.
Lipedema
- D.
Chronic venous insufficiency
- 19.What kind of edema would you see with Right sided heart failure?
- A.
Dependent edema; sacral edema when patient is supine; may see increased JVD, enlarged liver, enlarged heart;
- B.
Edema in the loose subcutaneous tissues of the eyelids; may also appear in the feet and legs
- C.
Localized edema; involves one or both legs
- D.
Edema of the dependent areas; no cardiac or hepatic signs
- 20.A 50-year-old physician presents for evaluation of pain in his right shoulder. The pain has been intermittent for the past 20 years, but over the past 3 weeks, it has been present daily. He has tried OTC analgesics, but they do not relieve the symptoms. 5 years ago, he fell on the icy pavement and landed on his shoulder. You perform a physical examination maneuver, because you suspect a rotator cuff tear. What is the name of this test?
- A.
Drop arm test
- B.
McMurray’s test
- C.
Anterior drawer test
- D.
Tinel’s test
- 21.A 35-year-old factory worker presents to your office for evaluation of pain in his left arm. He denies any acute trauma or injury. His job involves inspecting jars, and he has to test the opening and closing of the jar lids. He denies fever or chills. On physical examination, there is no swelling over the elbow. You palpate the olecranon process, and he has tenderness on the left lateral epicondyle but not on the medial epicondyle. Based on this information, what is your most likely diagnosis?
- A.
Olecranon bursitis
- B.
Osteoarthritis
- C.
Lateral epicondylitis
- D.
Epicondylar fracture
- 22.A 27-year-old software specialist presents to your office for evaluation of numbness and pain in his fingers. He has noticed that the numbness increases as the day goes on; at first he noticed it only at the end of the day, but now it is present upon awakening. It is present in both his hands. The pain started several months ago and is not relieved by OTC analgesics. The patient’s family history is significant for HTN and cerebrovascular disease. On physical examination, his BP is 110/70 mmHg and his thenar eminence is atrophic. Which tests would you perform to confirm your initial hypothesis of carpal tunnel syndrome
- A.
Tinel’s test
- B.
Anterior drawer test
- C.
McMurray’s test
- D.
Allen test
- 23.A 35-year-old postal worker presents to your office for evaluation of pain in her joints. She states that the pain is worse in her fingers and wrists; both hands are affected. She notices that it takes her longer than 1 hour to get moving in the morning because she is so stiff. For the past few weeks, she has been having fevers, some as high as 100.5℉. You notice that she has fusiform swelling in her fingers and wrists bilaterally and that the PIP and MCP joints are tender to palpation. Based on the history and physical examination findings, what is your most likely diagnosis?
- A.
Osteoarthritis
- B.
Rheumatoid arthritis
- C.
Gouty arthritis
- D.
Ankylosing spondylitis
- 24.A 55-year-old executive assistant presents to your office for evaluation of pain in her wrist. She states that the pain has been present daily. She has taken OTC analgesics for the pain, which seem to help. She denies fever, chills, or rashes. On physical examination, she has pain and tenderness over the right wrist but not the left. She has a hard dorsolateral nodule on the DIP joint of her right middle finger. The MCP joints are normal. What is your most likely diagnosis?
- A.
Gouty arthritis
- B.
Rheumatoid arthritis
- C.
Systemic lupus erythematosus
- D.
Osteoarthritis
- 25.A 13-year-old junior high school student is brought into your office by her mother for evaluation of unequal shoulder height. Her mother first noticed this problem 2 weeks ago. There is no history of birth trauma or recent injury. On physical examination, there is a lateral curvature to the spine. The curvature is more pronounced with forward flexion. Based on this information, what is your most likely diagnosis?
- A.
Normal spinal curvature
- B.
Kyphosis
- C.
Scoliosis
- D.
Lumbar lordosis
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