Which of the following pairs of ischemic symptoms versus vascular supply is correct?

Correct Answer: D

Rationale: Ischemic symptoms in the upper calf are indicative of peripheral artery disease affecting the tibial or peroneal arteries. These arteries are responsible for supplying blood to the lower leg and foot region, hence causing symptoms such as pain, cramping, or numbness in the upper calf area. Symptoms in the lower calf would typically be associated with more proximal arterial segments like femoral or iliac arteries. So, option D correctly matches the ischemic symptoms with the appropriate vascular supply.

Correct Answer: A

Rationale: The presentation of pain that is markedly worse when the left arm is drawn across the chest (adduction) is characteristic of a rotator cuff tear. This is because when the arm is adducted, it puts stress on the torn rotator cuff tendons, causing pain. In contrast, subacromial bursitis typically presents with pain during overhead movements, acromioclavicular joint involvement may present with pain localized to the joint itself, and adhesive capsulitis (frozen shoulder) typically presents with pain and stiffness that worsens with all movements.

Correct Answer: D

Rationale: Metrorrhagia refers to abnormal bleeding between menstrual periods. This can manifest as spotting or heavier bleeding outside of the regular menstrual cycle. It is important to differentiate metrorrhagia from other types of abnormal bleeding such as menorrhagia (excessive flow), oligomenorrhea (infrequent bleeding), and polymenorrhea (fewer than 21 days between menses) in order to address and diagnose the underlying cause accurately.

Correct Answer: B

Rationale: The vertebral bodies of the spine involve cartilaginous joints. Cartilaginous joints are connected by cartilage, which allows for slight movement and flexibility. In the spine, the cartilaginous joints between vertebral bodies are called intervertebral discs. These discs act as shock absorbers and provide cushioning between each vertebra, helping to prevent bone-on-bone contact. In Mark's case, the presence of a bulging disc suggests that there is an issue with the cartilaginous joint between his vertebral bodies, leading to the compression of a spinal nerve and causing the burning pain down his right leg and slight foot drop.

Correct Answer: C

Rationale: A positive transillumination test is a key finding that would lead you to suspect a hydrocele as the cause of scrotal swelling. In a hydrocele, the scrotal fluid transilluminates well, meaning that when a light is shone through the scrotum, it will appear as a fluid-filled sac with a clear glow. This is a characteristic feature of a hydrocele and helps differentiate it from other causes of scrotal swelling, such as hernias or testicular tumors. Presence of bowel sounds in the scrotum (Choice A) would be concerning for a hernia rather than a hydrocele. Being unable to palpate superior to the mass (Choice B) may suggest a large hydrocele but is not specific to diagnosing a hydrocele. The normal thickness of the skin of the scrotum (Choice D) can be found in various scrotal conditions and is not specific

Correct Answer: C

Rationale: To determine whether a murmur is systolic or diastolic, you should judge the relative length of systole and diastole by auscultation. Systolic murmurs occur during systole, which is the phase of the cardiac cycle when the heart is contracting and pushing blood out of the chambers. Diastolic murmurs occur during diastole, which is the phase when the heart is relaxing and filling with blood. By carefully listening to the timing of the murmur in relation to the cardiac cycle, you can determine if it is systolic or diastolic. Palpating the carotid pulse (Choice A) or radial pulse (Choice B) can help assess the pulse characteristics, but it does not directly determine whether a murmur is systolic or diastolic. Correlating the murmur with a bedside heart monitor (Choice D) may provide additional information about heart rate or rhythm, but it does not specifically indicate

Correct Answer: C

Rationale: The pectoral lymph node group, also known as the Level III lymph nodes, is the most commonly involved in breast cancer metastasis. These lymph nodes are located along the lower border of the pectoralis minor muscle and are an important regional drainage site for breast tissue. Therefore, in cases of breast cancer, the pectoral lymph nodes are frequently affected due to their proximity to the breast tissue.

Correct Answer: D

Rationale: The symptoms described in the scenario point towards pleural pain. The examination findings of normal breath sounds, no abnormalities with percussion and palpation of the chest, and a normal heart sound (S1 and S2) suggest that the issue is more likely related to the pleura rather than the heart or major blood vessels. Pleural pain is typically sharp and worsens with deep breathing or coughing. This differs from angina pectoris, which is chest pain caused by reduced blood flow to the heart muscles due to coronary artery disease. Pericarditis involves inflammation of the pericardium, the membrane surrounding the heart, and usually presents with chest pain that is relieved by sitting up and leaning forward. Dissecting aortic aneurysm is a life-threatening condition characterized by severe, tearing chest pain that can radiate to the back. In this case, the lack of significant abnormalities on cardiac and vascular examination points towards ple

Correct Answer: D

Rationale: Ischemic symptoms in the upper calf are indicative of peripheral artery disease affecting the tibial or peroneal arteries. These arteries are responsible for supplying blood to the lower leg and foot region, hence causing symptoms such as pain, cramping, or numbness in the upper calf area. Symptoms in the lower calf would typically be associated with more proximal arterial segments like femoral or iliac arteries. So, option D correctly matches the ischemic symptoms with the appropriate vascular supply.