On examination of the neck, a dome-shaped lesion in the dermis forming a benign closed firm sac attached to the epidermis is noted on the right lateral side of the neck. The type of lesion is known as:

Correct Answer: C

Rationale: Step 1: Identify the characteristics of the lesion described - dome-shaped, in dermis, benign, closed sac attached to epidermis. Step 2: A cutaneous cyst fits all these characteristics - it is a benign closed sac in the dermis with attachment to the epidermis. Step 3: Keloid (A) is an overgrowth of scar tissue, not a closed sac lesion. Tophi (B) are deposits of uric acid crystals, not a sac. Chondrodermatitis (D) is inflammation of cartilage and skin, not a closed sac lesion. Summary: A cutaneous cyst is the correct choice as it matches all the characteristics given, while the other options do not fit the description provided.

Correct Answer: B

Rationale: The correct answer is B: Vomiting and pain. Small bowel obstruction typically leads to vomiting due to the blockage preventing food from passing through. Pain occurs as the intestine tries to push against the obstruction. Nausea and diarrhea (choice A) are more common in large bowel obstructions. Hematemesis and bloody stool (choice C) suggest bleeding in the upper gastrointestinal tract. Indigestion and anorexia (choice D) are not specific to small bowel obstruction. Therefore, the combination of vomiting and pain is indicative of small bowel obstruction.

Correct Answer: C

Rationale: The correct answer is C. During the secondary stage of syphilis, a rash marked by red or reddish-brown, penny-sized lesions over the palms and soles is a common clinical manifestation. This rash, known as a syphilitic rash, is a hallmark symptom of secondary syphilis. The rash can also appear on other parts of the body. It is important to note that syphilis progresses through distinct stages, and the secondary stage typically occurs a few weeks to a few months after the initial infection. Now, let's analyze why the other choices are incorrect: A: Absence of symptoms - This is incorrect as syphilis does present symptoms, especially during the secondary stage. B: Single painless lesion, chancre on the genital area - This is characteristic of the primary stage of syphilis, not the secondary stage. D: Poor muscle coordination - This symptom is associated with the late or tertiary stage of syphilis, not the secondary stage

Correct Answer: B

Rationale: Step-by-step rationale for why B is correct: Janeway lesions, petechiae, and Osler nodes are classic signs of infective endocarditis. Janeway lesions are painless erythematous macules on palms/soles, petechiae are small red/purple spots due to microemboli, and Osler nodes are tender subcutaneous nodules on fingers/toes. These findings indicate systemic embolization and immune complex deposition in infective endocarditis. Other choices are incorrect as they do not typically present with these specific dermatologic findings.

Correct Answer: D

Rationale: The correct answer is D: A bone marrow examination. Acute lymphocytic leukemia is a type of blood cancer that affects the bone marrow's ability to produce normal blood cells. A bone marrow examination is necessary to confirm the diagnosis by analyzing the bone marrow cells for abnormality. A complete blood count (choice A) can show abnormalities in blood cell counts but cannot confirm leukemia. Magnetic resonance imaging (choice B) and nuclear bone scan (choice C) are imaging tests that can show bone abnormalities but are not specific for diagnosing leukemia.