The following information is recorded in the health history: 'I feel really tired.' Which category does it belong to?

Correct Answer: A

Rationale: The correct answer is A: Chief complaint. The chief complaint is the main reason for the patient seeking medical attention. In this case, "I feel really tired" is a subjective symptom that is bothering the patient and prompting them to seek help. It is the primary concern that needs to be addressed first. B: Present illness focuses on the current symptoms and how they developed, not just a general feeling of tiredness. C: Personal and social history pertains to the patient's background and lifestyle, not their immediate health concerns. D: Review of systems involves a systematic inquiry about specific symptoms or issues, not a general statement like feeling tired.

Correct Answer: A

Rationale: The correct answer is A: Feeling anxious. In the review of systems, psychiatric symptoms are typically documented under the psychiatric system. Anxiety is a common psychiatric symptom that falls under this category. It is important to differentiate psychiatric symptoms from physical symptoms like ringing in the ears (choice B), skin rash (choice C), and joint stiffness (choice D) which are typically documented under other systems such as the neurological or dermatological systems. Symptoms like feeling anxious are subjective experiences related to mental health, making them more likely to be included in the psychiatric system.

Correct Answer: B

Rationale: The correct answer is B: 20/20. In the Snellen chart, the first number represents the distance at which the test is performed (usually 20 feet) and the second number represents the distance at which a person with normal vision can read the same line. A person with 20/20 vision can read at 20 feet what a person with normal vision can read at 20 feet. Therefore, a result of 20/20 indicates normal visual acuity. Choices A, C, and D all indicate vision impairment as they represent the ability to read at a distance closer than 20 feet compared to a person with normal vision.

Correct Answer: D

Rationale: The correct answer is D: Intracranial hypertension. This condition presents with chronic headaches that are worse in the morning, associated with nausea, vomiting, blurred vision, and papilledema on neurological examination. The increased intracranial pressure causes these symptoms. Migraine (A), cluster headache (B), and tension-type headache (C) typically do not present with papilledema or blurred vision.

Correct Answer: B

Rationale: The correct answer is B: Congestive heart failure. This diagnosis is likely due to the patient's history of hypertension, presenting symptoms of shortness of breath, orthopnea, bilateral pedal edema, crackles at lung bases, and jugular venous distention. These findings are classic signs of congestive heart failure, indicating impaired heart function leading to fluid accumulation in the lungs and peripheral tissues. Chronic obstructive pulmonary disease (choice A) typically presents with a history of smoking, productive cough, and wheezing, not consistent with this patient's presentation. Pulmonary embolism (choice C) would present with sudden onset dyspnea and chest pain, not gradual symptoms as seen here. Renal failure (choice D) can cause fluid retention, but the combination of symptoms and signs in this patient points more towards congestive heart failure.