Correct Answer: C

Rationale: The clinical presentation described in the case, including recurrent episodes of dizziness, nausea with vomiting, tinnitus, nystagmus, and normal gait, is suggestive of Menière's disease. Menière's disease is a disorder of the inner ear characterized by episodes of vertigo, fluctuating hearing loss, tinnitus, and aural fullness. The presence of tinnitus, episodic vertigo lasting for several hours, and nystagmus are key features that point towards Menière's disease. The Weber test result (localization to the right ear) can also be seen in Menière's disease due to sensorineural hearing loss in the affected ear. This set of symptoms and findings is more consistent with Menière's disease than the other options provided. Benign paroxysmal positional vertigo (BPPV) typically presents with brief episodes of vertigo triggered by changes in

Correct Answer: D

Rationale: When a woman over the age of 40 presents with a breast mass, the risk of the mass being cancerous is around 40%. This risk is higher in older women compared to younger women. It is important for Mrs. Patton to undergo further evaluation, which may include imaging tests, a biopsy, and consultation with a specialist to confirm the diagnosis and determine the appropriate treatment. It is crucial to address breast masses promptly to ensure timely management and optimal outcomes.

Correct Answer: D

Rationale: The presence of late inspiratory crackles in the lower third of the chest that were not present previously is suggestive of pulmonary edema, a common finding in patients with heart failure. Heart failure can lead to fluid accumulation in the lungs, causing crackles on auscultation. These crackles are typically heard at the lung bases and can be more prominent during inspiration. Other clinical features of heart failure may include orthopnea, paroxysmal nocturnal dyspnea, lower extremity edema, and fatigue. Therefore, in this case, the most likely explanation for the patient's shortness of breath with late inspiratory crackles is heart failure.

Correct Answer: B

Rationale: Asymmetric blood pressures (BPs) refer to a significant difference in blood pressures between the two arms. This is commonly seen in conditions like congenital narrowing of the aorta, also known as coarctation of the aorta. In this condition, there is a localized narrowing of the aorta, leading to higher blood pressure in the upper extremities compared to the lower extremities. This results in a significant asymmetry in blood pressure readings between the arms. It is crucial to identify this sign as it can have important diagnostic and treatment implications.

Correct Answer: D

Rationale: When assessing a patient for peripheral vascular disease in the arms, it is important to examine the pulses in the upper extremities. The pulses to be assessed in this context include the radial pulse (located on the wrist at the base of the thumb) and the brachial pulse (located in the upper arm near the elbow). These pulses provide important information about blood flow and circulation in the arms. Changes in the strength, regularity, or absence of these pulses can indicate potential issues related to peripheral vascular disease. While the femoral and popliteal pulses (Choice A) are important for assessing the lower extremities, and the dorsalis pedis and posterior tibial pulses (Choice B) are also crucial for evaluating peripheral vascular disease in the legs, the radial and brachial pulses are specifically relevant for assessing the arms. The carotid pulse (Choice C) is important for evaluating the vascular status of