Which of the following is true regarding breast self-examination?

Correct Answer: C

Rationale: The statement that a high proportion of breast masses are detected by breast self-examination is true. Studies have shown that only a small percentage of breast cancers are actually detected by women themselves through self-examination. In fact, most breast cancers are detected through clinical breast exams and mammograms. Therefore, while it is still important for women to be breast aware and report any changes they notice to their healthcare provider, the practice of routine breast self-examinations is no longer universally recommended. Instead, the focus has shifted towards regular clinical breast exams and mammograms based on individual risk factors.

Correct Answer: B

Rationale: Paraphimosis is a condition where the foreskin is retracted behind the glans penis and cannot be returned to its original position. This can lead to swelling and constriction of the penis, causing pain and potential damage to the tissue due to decreased blood flow. Phimosis (Choice A) refers to a tight prepuce that cannot be retracted over the glans penis. Balanitis (Choice C) is inflammation of the glans penis, often associated with poor hygiene or infections. Balanoposthitis (Choice D) refers to inflammation of both the glans penis and the foreskin.

Correct Answer: C

Rationale: The clinical presentation described in the question is consistent with mitral valve prolapse (MVP). MVP is characterized by the improper closure of the mitral valve leaflets during systole, leading to the prolapse of one or both leaflets into the left atrium. The classic auscultatory findings in MVP include a mid-systolic click followed by a late systolic murmur. The click is the result of sudden tensing of the chordae tendineae as the mitral valve prolapses, and the murmur occurs as blood leaks backward (mitral regurgitation) due to imperfect valve closure.

Correct Answer: C

Rationale: The statement that a high proportion of breast masses are detected by breast self-examination is true. Studies have shown that only a small percentage of breast cancers are actually detected by women themselves through self-examination. In fact, most breast cancers are detected through clinical breast exams and mammograms. Therefore, while it is still important for women to be breast aware and report any changes they notice to their healthcare provider, the practice of routine breast self-examinations is no longer universally recommended. Instead, the focus has shifted towards regular clinical breast exams and mammograms based on individual risk factors.

Correct Answer: D

Rationale: The patient's symptoms point towards pneumonia. Pneumonia is characterized by infection and inflammation in the lung tissue, leading to symptoms such as decreased air movement, crackles on auscultation, dullness on percussion, increased fremitus on palpation, and abnormal breath sounds like egophony and whispered pectoriloquy. These findings are consistent with consolidation of the lung, which occurs in pneumonia as a result of fluid, inflammatory cells, and tissue debris filling the alveoli. The presence of nasal turbinates edema indicates a possible upper respiratory tract infection that may have preceded the development of pneumonia. Spontaneous pneumothorax would typically present with sudden-onset chest pain and dyspnea but would not typically cause findings of lung consolidation. Chronic obstructive pulmonary disease (COPD) and asthma are characterized by different patterns of lung damage and symptoms, such as chronic inflammation, airflow obstruction, and hyper

Correct Answer: B

Rationale: When using an interpreter to facilitate an interview, it is recommended that the interpreter be positioned next to the patient. This allows the examiner to maintain eye contact with the patient and observe their nonverbal cues, while also being able to hear the interpreter clearly. Placing the interpreter between the examiner and the patient may create a barrier to communication and make it difficult for all parties to observe each other's expressions and body language. Having the interpreter behind the examiner could make it challenging to fully see the patient's lips and nonverbal cues, which are essential in communication. Placing the interpreter in a corner of the room may also lead to decreased engagement and interaction among the participants. Therefore, positioning the interpreter next to the patient provides the most effective communication flow and allows for better observation and understanding during the interview.

Correct Answer: C

Rationale: A right homonymous hemianopsia refers to a visual field defect in which the patient is unable to see objects in the right half of the visual field in both eyes. In the case described, the stroke patient is unable to see your fingers on his entire right side with either eye covered, which is consistent with a right homonymous hemianopsia. This type of visual field defect typically occurs as a result of damage to the optic tract or optic radiation on one side of the brain, which affects the processing of visual information from the opposite visual field. It is important to note that bitemporal hemianopsia, right temporal hemianopsia, and binasal hemianopsia involve different patterns of visual field loss and are not fitting descriptions for the presented scenario.

Correct Answer: D

Rationale: The patient in this scenario presents with symptoms suggestive of an anorectal disorder. The presence of an irregular, firm mass on the posterior side of the rectum, along with frank blood seen on the glove after a digital rectal examination, raises suspicion for an underlying anorectal cancer. Anorectal cancer can present with symptoms such as rectal bleeding, changes in bowel habits, palpable masses, and weight loss. In this case, the findings of an irregular mass and rectal bleeding are concerning for a malignant process such as anorectal cancer. Further evaluation with imaging studies and biopsy would be warranted for confirmation and to guide appropriate management.

Correct Answer: C

Rationale: Family history of osteoporosis is a significant risk factor, as genetics play a key role in determining a person's risk for developing osteoporosis. Having a close relative, such as an aunt, with severe osteoporosis increases this woman's risk as there is a strong genetic component to the disease. Factors such as obesity (choice A), late menopause (choice B), and delayed menarche (choice D) do not directly increase the risk of osteoporosis, unlike having a familial history of the condition.