A mother brings her 11 month old to you because her mother-in-law and others have told her that her baby is jaundiced. She is eating and growing well and performing the developmental milestones she should for her age. On examination you indeed notice a yellow tone to her skin from head to toe. Her sclerae are white. To which area should your next questions be related?

Correct Answer: B

Rationale: Since the baby is exhibiting jaundice, which is a condition characterized by the yellowing of the skin, it is important to inquire about the family history of liver diseases. Jaundice can be a sign of liver dysfunction or disease, so understanding the family history of liver diseases can provide valuable insights into potential underlying causes for the baby's jaundice. In this case, it is crucial to explore this area further to determine if there may be any genetic predispositions or familial conditions that could be contributing to the baby's presentation of jaundice.

Correct Answer: C

Rationale: Diplopia occurring when one eye is covered is a condition known as monocular diplopia. This symptom is typically not caused by problems within the eye itself, such as irregularities in the cornea or lens. Instead, monocular diplopia with one eye covered is more likely to be an indication of a neurological issue, often involving the brainstem. Lesions or damage in the brainstem can disrupt the normal coordination of eye movements, leading to the perception of double vision when one eye is closed. Weakness of CN III (oculomotor nerve) or CN IV (trochlear nerve) may cause diplopia when both eyes are open, but it would not typically manifest as monocular diplopia.

Correct Answer: A

Rationale: Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, specifically around the stapes bone. In cases of otosclerosis, the bone conduction is greater than air conduction on the affected side, which is seen in the scenario described. The Weber test localizes to the affected ear, meaning the patient hears the sound of the tuning fork better in the left ear in this case. This is because the abnormal bone growth can restrict the movement of the ossicles, leading to a conductive hearing loss. Otosclerosis typically affects one ear, and its presentation aligns with the results of the hearing tests performed in this case.

Correct Answer: D

Rationale: The symptoms described in the scenario point towards pleural pain. The examination findings of normal breath sounds, no abnormalities with percussion and palpation of the chest, and a normal heart sound (S1 and S2) suggest that the issue is more likely related to the pleura rather than the heart or major blood vessels. Pleural pain is typically sharp and worsens with deep breathing or coughing. This differs from angina pectoris, which is chest pain caused by reduced blood flow to the heart muscles due to coronary artery disease. Pericarditis involves inflammation of the pericardium, the membrane surrounding the heart, and usually presents with chest pain that is relieved by sitting up and leaning forward. Dissecting aortic aneurysm is a life-threatening condition characterized by severe, tearing chest pain that can radiate to the back. In this case, the lack of significant abnormalities on cardiac and vascular examination points towards ple

Correct Answer: A

Rationale: A hyperresonant percussion note is a more intense and booming sound heard during percussion of the thorax. This can occur when there is an increased amount of air present in the chest cavity. In the case of a large pneumothorax, which is the presence of air in the pleural space causing partial or complete collapse of the lung, the percussion note would be hyperresonant due to the increased air content in the thoracic cavity. Lobar pneumonia, pleural effusion, and empyema would typically produce dull or flat percussion notes due to the presence of fluid or solid material in the pleural space.