A patient complains of knee pain on your arrival in the room. What should your first sentence be after greeting the patient?

Correct Answer: D

Rationale: The correct answer is D because asking the patient to describe what happened will provide crucial information about the onset, nature, and potential cause of the knee pain. This open-ended question allows the patient to share their experience freely, aiding in accurate diagnosis and appropriate treatment planning. Option A focuses solely on pain intensity, which is important but not as comprehensive as understanding the context of the pain (D). Options B and C are more specific to past injuries and onset time, respectively, which are relevant but not as immediate and all-encompassing as asking the patient to describe the current issue (D).

Correct Answer: C

Rationale: The correct answer is C: Regularly irregular rhythm. This is the appropriate documentation for Ms. Wright's presentation as her pulse demonstrates a pattern of irregularity with every fourth beat sounding different. This indicates a regularly irregular rhythm, where there is a discernible pattern to the irregularity. Rationale: 1. Regular rate and rhythm (Choice A) is incorrect as Ms. Wright's palpitations and the irregularity in her pulse indicate an irregular rhythm. 2. Irregularly irregular rhythm (Choice B) is incorrect as this term is used to describe arrhythmias like atrial fibrillation, which do not have a discernible pattern of irregularity. 3. Bradycardia (Choice D) is incorrect as it refers to a slow heart rate, which is not the primary concern in this scenario where the focus is on the irregular rhythm. In summary, the correct choice (C) accurately describes the specific irregular pattern observed in Ms. Wright's pulse, distinguishing it from

Correct Answer: D

Rationale: The correct answer is D: Dry and rough. In hypothyroidism, there is reduced secretion of sweat and oils, leading to dry skin. The lack of hydration causes the skin to become rough. This correlates with the clinical presentation of fatigue, weight gain, and hair loss, which are common symptoms of hypothyroidism. Choices A and B are incorrect because moisture is reduced in hypothyroidism, resulting in dry skin. Choice C is incorrect because the lack of oils in hypothyroidism leads to rough skin texture, not smooth.

Correct Answer: B

Rationale: The correct answer is B: A sebaceous cyst. A sebaceous cyst typically presents as a lump underneath the skin that can be squeezed to release a cheesy substance, consistent with Jacob's description. The formation of a prominent dimple when gently pinched is characteristic of a cyst, indicating it is filled with fluid or semi-solid material. Sebaceous cysts are usually benign and can grow slowly over time. Incorrect choices: A: An enlarged lymph node - Unlikely as lymph nodes are typically not associated with cheesy discharge or the formation of a dimple when pinched. C: An actinic keratosis - Unlikely as actinic keratosis is a precancerous skin condition caused by sun exposure, not presenting with cheesy discharge or a dimple. D: A malignant lesion - Unlikely as malignant lesions usually do not produce cheesy discharge and are more aggressive in growth compared to a sebaceous cyst.

Correct Answer: B

Rationale: The correct answer is B: Exophthalmos. Exophthalmos refers to protrusion of the eyeball, which is a hallmark sign of thyroid eye disease. This condition commonly presents with forward bulging of one or both eyes due to inflammation and swelling of the eye muscles and tissues behind the eye. It is often associated with hyperthyroidism. A: Ptosis is drooping of the upper eyelid, not protrusion of the eyeball. C: Ectropion is an outward turning of the eyelid, not protrusion of the eyeball. D: Epicanthus is a vertical fold of skin on the upper eyelid near the nose, not protrusion of the eyeball.