When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?

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Question 1 of 5

When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?

Correct Answer: A

Rationale: When crackles, wheezes, or rhonchi clear with a cough, it is suggestive of bronchitis. Bronchitis is inflammation of the bronchial tubes, often due to a viral infection, leading to the production of excess mucus. The characteristic sounds such as crackles, wheezes, or rhonchi can be heard on auscultation due to the presence of mucus in the airways. The act of coughing helps to clear the mucus from the airways, resulting in the temporary resolution of these abnormal sounds. In contrast, asthma, cystic fibrosis, and heart failure are not typically associated with crackles, wheezes, or rhonchi that clear with a cough.

Question 2 of 5

How much does cardiovascular risk increase for each increment of 20 mm Hg systolic and 10 mm Hg diastolic in blood pressure?

Correct Answer: B

Rationale: Research studies have shown that for every increment of 20 mm Hg in systolic blood pressure and 10 mm Hg in diastolic blood pressure, the cardiovascular risk approximately doubles. Therefore, the cardiovascular risk increases by 50% for each increment of 20 mm Hg systolic and 10 mm Hg diastolic in blood pressure. This underlines the importance of maintaining healthy blood pressure levels to reduce the risk of cardiovascular diseases.

Question 3 of 5

You are listening carefully for S splitting. Which of the following will help?

Correct Answer: A

Rationale: In order to listen carefully for S splitting, one should use the diaphragm with light pressure over the 2nd right intercostal space. S splitting refers to a split of the second heart sound (S2) into its two components - A2 and P2. The A2 component is normally heard as the main heart sound when the aortic valve closes, and the P2 component is heard when the pulmonic valve closes. By placing the diaphragm lightly over the 2nd right intercostal space, one can best auscultate the aortic area and listen for the timing and splitting of the S2 components. Using the bell or applying firm pressure may not allow for optimal detection of S splitting in this specific case.

Question 4 of 5

How often, according to American Cancer Society recommendations, should a woman undergo a screening breast examination by a skilled clinician?

Correct Answer: A

Rationale: According to American Cancer Society recommendations, a woman should undergo a screening breast examination by a skilled clinician every year. Regular breast exams help in early detection of breast cancer, which can significantly improve outcomes and treatment options. Annual screenings are crucial in monitoring changes in breast health and detecting any abnormalities at the earliest stage possible. Therefore, it is advised that women follow this guideline to prioritize their breast health and well-being.

Question 5 of 5

Chris is a 20-year-old college student who has had abdominal pain for 3 days. It started at his umbilicus and was associated with nausea and vomiting. He was unable to find a comfortable position. Yesterday, the pain became more severe and constant. Now, he hesitates to walk, because any motion makes the pain much worse. It is localized just medial and inferior to his iliac crest on the right. Which of the following is most likely?

Correct Answer: D

Rationale: The presentation is highly suggestive of appendicitis, especially given the migration of pain from the periumbilical region to the right lower quadrant (just medial and inferior to the iliac crest). The worsening of pain with motion, along with associated symptoms such as nausea, vomiting, anorexia, and fever, are typical features of appendicitis. The classic presentation of appendicitis is pain starting around the umbilicus (due to visceral innervation) and then shifting to the right lower quadrant (due to irritation of the parietal peritoneum). Surgical intervention is usually required promptly to prevent complications like perforation, which can lead to peritonitis and sepsis.

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