Which of the following symptoms is most likely to be documented under the psychiatric system in the review of systems?

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: 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.

Correct Answer: B

Rationale: The correct answer is B: Myocardial infarction. Given the patient's age, risk factors (hypertension, diabetes), and symptoms (severe chest pain radiating to left arm), myocardial infarction is the most likely diagnosis. In myocardial infarction, there is a blockage of blood flow to the heart muscle leading to tissue damage. Angina (choice A) is similar but is usually relieved by rest or medication. Aortic dissection (choice C) presents with sudden, severe chest or back pain. Pulmonary embolism (choice D) typically presents with sudden shortness of breath and chest pain worsened by breathing.

Correct Answer: A

Rationale: The correct answer is A: Hypovolemia. Weak and thready pulses are indicative of decreased blood volume, which is a characteristic of hypovolemia. When there is not enough blood circulating in the body, peripheral pulses may become weak and difficult to palpate. Other choices are incorrect because: B: Hypervolemia would typically present with bounding pulses due to excess fluid volume. C: Arterial occlusion would result in absent or diminished pulses, not weak and thready pulses. D: Peripheral edema would not directly affect the strength or quality of peripheral pulses.