A 45-year-old woman presents with a complaint of a persistent cough for the past 3 weeks. She denies any fever, chills, or chest pain but reports some shortness of breath. What is the most likely diagnosis?

Correct Answer: A

Rationale: The most likely diagnosis is bronchitis because it presents with a persistent cough lasting more than 2-3 weeks without fever, chest pain, or chills. Shortness of breath can be seen in bronchitis due to airway inflammation. Asthma would typically present with wheezing and can have triggers like allergies. Pneumonia is accompanied by fever, chest pain, and productive cough with yellow or green sputum. Chronic obstructive pulmonary disease (COPD) usually occurs in older patients with a history of smoking and presents with a chronic cough and progressive shortness of breath.

Correct Answer: B

Rationale: The correct answer is B: Hypertensive crisis. The patient's symptoms of headache, blurred vision, and nausea, along with severely elevated blood pressure (200/120 mm Hg), suggest a hypertensive emergency. In this situation, the elevated blood pressure is causing end-organ damage, leading to symptoms. Treatment is urgent to prevent further complications. Choice A: Primary hypertension is unlikely as the sudden onset of severe symptoms and extremely high blood pressure indicate an acute issue rather than chronic primary hypertension. Choice C: Migraine typically presents with specific symptoms like throbbing head pain, sensitivity to light or sound, and may have an aura. The lack of these symptoms and the presence of severely elevated blood pressure make migraine less likely. Choice D: Cluster headaches are characterized by severe, unilateral head pain with associated symptoms like eye redness or tearing. The lack of these specific symptoms and the presence of markedly elevated blood pressure make cluster headache less likely.

Correct Answer: B

Rationale: The correct answer is B: Cool, pale skin. Arterial insufficiency results in decreased blood flow to the extremities, leading to reduced skin temperature and pallor. Cool skin indicates diminished blood supply, while pale skin suggests vasoconstriction. Pitting edema (choice A) is a sign of venous insufficiency, not arterial. Brown discoloration (choice C) is characteristic of chronic venous insufficiency due to hemosiderin deposition. Warm, erythematous skin (choice D) is a sign of inflammation or infection, not arterial insufficiency.

Correct Answer: A

Rationale: The correct answer is A: Cerebellar dysfunction. When a patient sways significantly and loses balance while walking in a straight line, it suggests dysfunction of the cerebellum. The cerebellum is responsible for coordination, balance, and fine motor control. Impairment in the cerebellum can lead to ataxia, which is characterized by uncoordinated movements and difficulty maintaining balance. Vestibular impairment (B) primarily affects the inner ear's balance system, not coordination of movement. Motor weakness (C) typically presents as muscle weakness and affects strength, not balance. Peripheral neuropathy (D) involves damage to peripheral nerves, leading to sensory and motor deficits, but not specifically related to coordination and balance issues like cerebellar dysfunction.

Correct Answer: A

Rationale: The correct answer is A: Cerebellar dysfunction. When a patient staggers and loses balance while walking heel-to-toe, it indicates impairment in coordination and balance control, which are functions of the cerebellum. The cerebellum plays a crucial role in coordinating voluntary movements and maintaining balance. Vestibular dysfunction (B) primarily affects the inner ear's balance system, leading to vertigo and dizziness, not staggering gait. Sensory neuropathy (C) affects sensation, not coordination, and would not cause a specific gait abnormality. Motor weakness (D) would manifest as difficulty with strength and muscle control, not coordination issues seen in cerebellar dysfunction.