Diminished radial pulses may be seen in patients with which of the following?

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Question 1 of 9

Diminished radial pulses may be seen in patients with which of the following?

Correct Answer: C

Rationale: Diminished radial pulses may be seen in patients with arterial emboli. Arterial emboli are blood clots that travel through the bloodstream and get lodged in a blood vessel, blocking blood flow to a certain area. When an embolus affects the arteries supplying the arm, it can lead to diminished pulses in the affected arm, such as the radial pulse in the wrist. This diminished pulse is due to decreased blood flow to the area beyond the blockage caused by the embolus. This distinguishes arterial emboli from the other options listed, as aortic insufficiency, hyperthyroidism, and early "warm" septic shock typically do not cause isolated diminished radial pulses.

Question 2 of 9

A 50-year-old body builder is upset by a letter of denial from his life insurance company. He is very lean but has gained 2 pounds over the past 6 months. You personally performed his health assessment and found no problems whatsoever. He says he is classified as "high risk" because of obesity. What should you do next?

Correct Answer: D

Rationale: Since the life insurance company is classifying the body builder as "high risk" due to obesity, it is important to assess whether his weight gain is primarily fat accumulation around the waist. Measuring his waist circumference can provide valuable information about the distribution of body fat. Abdominal obesity, indicated by an increased waist measurement, is a significant risk factor for health issues such as heart disease, diabetes, and metabolic syndrome. By measuring his waist, you can determine if his weight gain is indeed a cause for concern in terms of health risks, rather than just considering the overall weight gain. This information can help you provide more targeted advice on how to address any potential health concerns related to the weight gain.

Question 3 of 9

On visualization of the penis he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and the analysis is unremarkable. You send the boy with his mother to the emergency room for further workup. What is the most likely diagnosis for this young man's symptoms?

Correct Answer: C

Rationale: The presentation of severe testicular pain with a red, tense scrotum, and absent cremasteric reflex on one side is highly concerning for testicular torsion. Testicular torsion is a urologic emergency that occurs when the spermatic cord twists, leading to compromised blood flow to the testicle. The affected testicle can become ischemic and necrotic within hours, necessitating prompt diagnosis and intervention to avoid permanent damage or loss of the testicle.

Question 4 of 9

Diminished radial pulses may be seen in patients with which of the following?

Correct Answer: C

Rationale: Diminished radial pulses may be seen in patients with arterial emboli. Arterial emboli are blood clots that travel through the bloodstream and get lodged in a blood vessel, blocking blood flow to a certain area. When an embolus affects the arteries supplying the arm, it can lead to diminished pulses in the affected arm, such as the radial pulse in the wrist. This diminished pulse is due to decreased blood flow to the area beyond the blockage caused by the embolus. This distinguishes arterial emboli from the other options listed, as aortic insufficiency, hyperthyroidism, and early "warm" septic shock typically do not cause isolated diminished radial pulses.

Question 5 of 9

When you enter your patient's examination room, his wife is waiting there with him. Which of the following is most appropriate?

Correct Answer: A

Rationale: The most appropriate action in this situation is to ask the patient if it's okay to carry out the visit with both people in the room. This shows respect for the patient's autonomy and privacy. Some patients may feel more comfortable discussing personal information without a family member present, while others may prefer having their spouse or family member involved in the conversation. By asking for the patient's preference, you are ensuring that they have the opportunity to control who is present during the consultation and are upholding their right to confidentiality.

Question 6 of 9

A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this?

Correct Answer: D

Rationale: The group of lymph nodes that lie just behind the sternocleidomastoid muscles bilaterally are known as the posterior cervical lymph nodes. These lymph nodes are part of the superficial cervical lymph node chain, which is involved in draining lymph from the head and neck region. In the case described, the presence of sore throat, fever, and enlarged tonsils with exudates suggests a likely upper respiratory tract infection or tonsillitis, leading to the enlargement of the nearby lymph nodes. The posterior cervical lymph nodes are commonly examined in cases of upper respiratory infections and tonsillitis due to their proximity to the area of infection and inflammation.

Question 7 of 9

Frank is a 24-year-old man who presents with multiple burning erosions on the shaft of his penis and some tender inguinal adenopathy. Which of the following is most likely?

Correct Answer: B

Rationale: The presentation of multiple burning erosions on the shaft of the penis along with tender inguinal adenopathy is indicative of genital herpes caused by the herpes simplex virus (HSV). Primary herpes simplex infection typically presents with painful ulcers and lymphadenopathy. The ulcers are often shallow with well-defined borders and can be associated with systemic symptoms such as fever and malaise. In contrast, primary syphilis is characterized by a painless chancre at the site of infection, usually on the genitals. Chancroid can also present with painful ulcers, but it is less common in developed countries. Gonorrhea typically presents with urethral discharge, dysuria, or other symptoms of urethritis, rather than erosions on the penis shaft.

Question 8 of 9

Very sensitive methods for detecting hearing loss include which of the following?

Correct Answer: D

Rationale: Audiometric testing is a very sensitive method for detecting hearing loss. It involves a series of tests that measure a person's ability to hear sounds at various frequencies and volumes. These tests can detect even subtle changes in hearing ability and provide detailed information on the type and degree of hearing loss. The whisper test and finger rub test are basic screening tests and are not as sensitive or comprehensive as audiometric testing. The tuning fork test is also used in evaluating hearing loss, but it is not as accurate or sensitive as audiometric testing. Overall, audiometric testing is considered the gold standard for diagnosing hearing loss due to its high sensitivity and ability to provide detailed information on the individual's hearing capabilities.

Question 9 of 9

The following information is recorded in the health history: "The patient completed 8th grade. He currently lives with his wife and two children. He works on old cars on the weekend. He works in a glass factory during the week." Which category does it belong to?

Correct Answer: C

Rationale: The information provided pertains to the patient's educational background, living situation, family status, and work activities. This type of information falls under the personal and social history category, as it provides important context about the patient's lifestyle, living conditions, and social support network. Personal and social history is essential for understanding the patient's overall well-being and can impact their health and healthcare needs.

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