A 29-year-old woman comes to your office. As you take the history, you notice that she is speaking very quickly, and jumping from topic to topic so rapidly that you have trouble following her. You are able to find some connections between ideas, but it is difficult. Which describes this thought process?

Correct Answer: B

Rationale: The correct answer is B: Flight of ideas. Flight of ideas is a symptom commonly seen in manic episodes, where thoughts are rapidly moving from one idea to another, making it challenging to follow the conversation. In this scenario, the patient's fast and erratic speech pattern with disjointed ideas aligns with the classic presentation of flight of ideas. Derailment (A) refers to a sudden shift in the topic without any apparent connection, which is not the case here. Circumstantiality (C) involves providing unnecessary detail before reaching the main point, which does not fit the description provided. Incoherence (D) refers to speech that is illogical and incomprehensible, which is not the primary feature presented in the scenario.

Correct Answer: D

Rationale: The correct answer is D because trigger finger can be caused by Dupuytren's disease, ganglion of the tendon sheath, or rheumatoid arthritis. Dupuytren's disease can lead to the formation of nodules in the palm that can affect finger movement. Ganglion of the tendon sheath can cause tendon swelling and lead to triggering of the finger. Rheumatoid arthritis can result in inflammation of the tendon sheaths, causing trigger finger. Therefore, all of the above conditions are part of the differential diagnosis for trigger finger. Choices A, B, and C are incorrect individually because trigger finger can be associated with each condition separately.

Correct Answer: C

Rationale: The true leg length should be measured between the ASIS (anterior superior iliac spine) and the medial malleolus. This is because the ASIS is a prominent bony landmark on the pelvis, representing the top of the femur, and the medial malleolus is the bony prominence on the inner side of the ankle, representing the bottom of the tibia. Measuring between these points provides an accurate representation of the actual length of the leg. Choice A (Greater trochanter to lateral malleolus) is incorrect because the greater trochanter is not the starting point for measuring leg length. Choice B (Umbilicus and lateral malleolus) is incorrect as the umbilicus is not a reliable reference point for leg length measurement. Choice D (Anterior inferior iliac spine and medial malleolus) is incorrect because the AIIS is not typically used as a reference point for leg length measurement.

Correct Answer: D

Rationale: In Erb's palsy, the upper trunk (C5-C6) of the brachial plexus is affected. This leads to weakness or paralysis of the shoulder and elbow muscles. The C5-C6 nerve roots are commonly injured during childbirth trauma. The other choices are incorrect because Erb's palsy specifically involves the upper trunk, not the lower trunk (C8-T1), both upper and lower trunks, or the middle trunk (C7). Therefore, the correct answer is D.

Correct Answer: D

Rationale: The correct answer is D: Wound contracture. When a burn patient is splinted in a comfortable position for grafted burns to heal, there is a risk of wound contracture due to prolonged immobility. Wound contracture refers to the tightening and shrinking of the skin and underlying tissues, leading to restricted joint movement and functional impairment. This complication can result in long-term disability and decreased quality of life for the patient. Choices A, B, and C are incorrect: A: Tendon rupture is not a typical complication of splinting a burn patient in a comfortable position. B: Skin breakdown may occur if the splint is too tight or if there is excessive pressure on certain areas, but it is not the primary risk associated with this scenario. C: Mechanical falls are unrelated to the positioning of the burn patient for graft healing.