The following information is recorded in the health history: 'Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea.' Which category does it belong to?

Correct Answer: D

Rationale: The correct answer is D: Review of systems. In a health history, the review of systems involves asking about specific symptoms related to different body systems. In this case, the information provided relates to symptoms associated with the cardiovascular system. The patient denying chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea indicates a review of symptoms related to the cardiovascular system. Choices A, B, and C are incorrect because the information provided does not pertain to the patient's primary reason for seeking care (chief complaint), the current symptoms and duration (present illness), or personal and social history.

Correct Answer: B

Rationale: The correct answer is B because the general survey component of the physical examination focuses on observations related to the patient's appearance, behavior, and mobility. This step is crucial in gathering initial information about the patient's overall health status and can provide important clues for further evaluation. Assessing the patient's appearance can reveal signs of distress, nutritional status, or hygiene. Observing behavior can indicate mental status or emotional state. Mobility assessment can identify physical limitations or abnormalities. A, C, and D are incorrect: A: Assessing the patient's chief complaint is part of the focused history taking, not the general survey component. C: Documenting findings from a review of systems is part of the comprehensive history taking, not the general survey. D: Evaluating vital signs is a separate component of the physical examination and not part of the general survey.

Correct Answer: A

Rationale: The correct answer is A: Rib fracture. Rationale: 1. The patient's presentation with chest pain, tenderness, and bruising after a motorcycle accident is highly suggestive of a traumatic injury like a rib fracture. 2. Rib fractures are common in blunt chest trauma and can cause significant pain with breathing and movement. 3. Tenderness over the affected area and pain on palpation are typical findings in rib fractures. 4. The vital signs of a stable blood pressure and tachycardia are consistent with a rib fracture without significant hemodynamic instability. Summary of incorrect choices: B: Pneumothorax - Less likely in this case as there is no mention of decreased breath sounds or respiratory distress. C: Pericarditis - Unlikely given the acute presentation after trauma and absence of classic pericarditis symptoms. D: Myocardial infarction - Not likely in a young patient with trauma and no risk factors for heart disease.

Correct Answer: B

Rationale: The most likely diagnosis for the 52-year-old man presenting with crushing chest pain radiating to his left arm, along with a history of hypertension and diabetes mellitus, is myocardial infarction (MI). The elevated blood pressure and pulse rate are indicative of the heart's increased workload and potential cardiac compromise. The classic presentation of chest pain radiating to the left arm suggests cardiac involvement. MI is a serious condition that requires immediate medical attention. Angina is a possibility but is less likely given the severity and duration of the pain. Aortic dissection typically presents with severe tearing chest pain and different vital sign abnormalities. Pulmonary embolism usually presents with sudden onset shortness of breath and tachypnea, not crushing chest pain.

Correct Answer: B

Rationale: The most likely diagnosis for a 40-year-old woman presenting with ptosis, fatigue, and weakness of proximal upper limb muscles is myasthenia gravis (B). Myasthenia gravis is an autoimmune disorder characterized by muscle weakness that worsens with activity and improves with rest. Ptosis and proximal muscle weakness are classic features of myasthenia gravis due to antibodies targeting the acetylcholine receptors at the neuromuscular junction, leading to impaired muscle contraction. Multiple sclerosis (A) presents with neurological symptoms such as sensory deficits, vision changes, and coordination issues. Guillain-Barré syndrome (C) manifests as ascending muscle weakness and can have autonomic involvement. Lambert-Eaton syndrome (D) is characterized by muscle weakness that improves with activity, the opposite of myasthenia gravis.