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When hollow organs (stomach, colon) forcefully contract or become distended. Solid organs (liver, spleen) can also generate this type of pain when they swell against their capsules
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
A. Visceral pain
Explanation Visceral pain refers to the type of pain that originates from the internal organs. It is caused by the forceful contraction or distension of hollow organs such as the stomach or colon. Additionally, solid organs like the liver or spleen can also generate this type of pain when they swell against their capsules. Therefore, the correct answer is visceral pain.
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2.
Usually gnawing, cramping, or aching and is often difficult to localize
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
A. Visceral pain
Explanation Visceral pain refers to pain that originates from the internal organs and is often described as gnawing, cramping, or aching. It is difficult to localize because the internal organs have a less well-defined sensory innervation compared to the skin or muscles. This type of pain is typically felt deep within the body and is often associated with conditions such as organ inflammation, stretching, or obstruction. Parietal pain, on the other hand, is localized and originates from the parietal peritoneum, the lining of the abdominal cavity. Referred pain is felt in an area different from the actual source of the pain.
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3.
When there is inflammation from the hollow or solid organs that affect the parietal peritoneum
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
B. Parietal pain
Explanation Parietal pain refers to the pain that arises from the inflammation of the parietal peritoneum, which is the outer lining of the abdominal cavity. This type of pain is typically localized and sharp, as the parietal peritoneum is densely innervated by sensory nerves. In contrast, visceral pain arises from the inflammation of hollow or solid organs and is often described as dull, vague, and poorly localized. Referred pain, on the other hand, is felt in a different area of the body than the source of the pain. Therefore, in the given scenario, parietal pain is the most appropriate term to describe the pain resulting from inflammation of the parietal peritoneum.
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4.
An example of this kind of pain would be Appendicitis
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
B. Parietal pain
Explanation Parietal pain refers to pain that originates from the parietal peritoneum, the outer layer of the abdominal cavity. It is usually described as sharp, localized, and well-defined. Appendicitis is an example of parietal pain because it causes inflammation and irritation of the parietal peritoneum, resulting in sharp pain in the lower right abdomen. Visceral pain, on the other hand, arises from the internal organs and is often described as dull and poorly localized. Referred pain is pain that is felt in a different area of the body than the actual source of the pain.
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5.
An example of this pain would be gallbladder pain in the shoulder
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
C. Referred pain
Explanation Referred pain refers to pain that is felt in a different area of the body than the actual source of the pain. In this case, the example of gallbladder pain in the shoulder is a classic example of referred pain. The gallbladder is located in the upper abdomen, but the pain is felt in the shoulder because the nerves that transmit pain signals from the gallbladder also innervate the shoulder area. This phenomenon occurs because the brain has difficulty localizing the exact source of the pain, leading to the perception of pain in a different area.
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6.
More severe and is usually easily localized
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
B. Parietal pain
Explanation Parietal pain refers to pain that originates from the parietal peritoneum, which is the outer layer of the abdominal cavity. This type of pain is usually more severe and can be easily localized to a specific area. Unlike visceral pain, which arises from the internal organs and is often described as dull or vague, parietal pain is sharper and more intense. Referred pain, on the other hand, is felt in a different area of the body than where the actual problem is located. Therefore, parietal pain is the most appropriate answer as it matches the given description.
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7.
An example of this kind of pain is Hepatitis
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
A. Visceral pain
Explanation Visceral pain refers to the pain that originates from the internal organs, such as the liver, kidneys, or intestines. Hepatitis is an inflammation of the liver, and it can cause a dull, aching pain in the upper right abdomen, which is characteristic of visceral pain. This type of pain is often described as deep, poorly localized, and may be accompanied by other symptoms like nausea or vomiting. Therefore, the correct answer for this question is visceral pain.
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8.
This pain originates at different sites but shares innervation from the same spinal level
A.
Visceral pain
B.
Parietal pain
C.
Referred pain
Correct Answer
C. Referred pain
Explanation Referred pain is the correct answer. Referred pain occurs when pain is felt in a different area of the body than the actual source of the pain. This happens because the nerves that carry pain signals from different parts of the body converge on the same spinal level. So, even though the pain originates in different sites, it is felt in a different area that shares innervation from the same spinal level.
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9.
What is the reflux of food and stomach acid back into the mouth with a brine-like taste
Explanation Reflux of food and stomach acid back into the mouth with a brine-like taste is known as regurgitation. It is the act of bringing swallowed food or liquid back up into the mouth. Vomiting, on the other hand, refers to the forceful expulsion of stomach contents through the mouth. While regurgitation is a more passive process, vomiting involves more active contractions of the stomach muscles. Therefore, regurgitation is the most appropriate term to describe the given scenario.
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10.
What is the spasmodic movement of the chest and diaphragm like vomiting, but no stomach contents are passed
Explanation The spasmodic movement of the chest and diaphragm, similar to vomiting, but without any stomach contents being expelled, is known as retching. It can also be referred to as retch, heave, heaving, dry heave, or dry heaving.
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11.
Blood or coffee ground vomit is known as hematemesis
A.
True
B.
False
Correct Answer
A. True
Explanation Hematemesis refers to the vomiting of blood or vomit that resembles coffee grounds. This condition can be caused by various factors such as gastrointestinal bleeding, ulcers, liver disease, or trauma. It is important to seek medical attention if hematemesis occurs as it can be a sign of a serious underlying condition. Therefore, the given statement that blood or coffee ground vomit is known as hematemesis is true.
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12.
Black or gray stools can indicate liver or gallbladder disease
A.
True
B.
False
Correct Answer
B. False
Explanation White or gray stools indicate liver or gallbladder disease
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13.
Blood in the stool
A.
Hematochezia
B.
Melena
C.
Liver or gallbladder disease
D.
Diarrhea
Correct Answer
A. Hematochezia
Explanation Hematochezia refers to the presence of bright red blood in the stool. It is often caused by bleeding in the lower gastrointestinal tract, such as in the colon or rectum. This can be due to various conditions such as hemorrhoids, anal fissures, diverticulosis, or inflammatory bowel disease. Hematochezia should not be confused with melena, which refers to the presence of dark, tarry stools caused by bleeding higher up in the gastrointestinal tract, such as in the stomach or small intestine. Liver or gallbladder disease and diarrhea are not directly related to the presence of blood in the stool.
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14.
Loose, watery stool
A.
Hematochezia
B.
Melena
C.
Liver or gallbladder disease
D.
Diarrhea
Correct Answer
D. Diarrhea
Explanation Diarrhea is the correct answer because it is characterized by loose, watery stool. Hematochezia and melena refer to the presence of blood in the stool, which is not mentioned in the question. Liver or gallbladder disease may cause changes in stool color or consistency, but the question specifically mentions loose, watery stool. Therefore, diarrhea is the most appropriate explanation for the given symptoms.
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15.
Black, tarry stool
A.
Hematochezia
B.
Melena
C.
Liver or gallbladder disease
D.
Diarrhea
Correct Answer
B. Melena
Explanation Melena refers to the passage of dark, tarry stools, which is an indication of upper gastrointestinal bleeding. It occurs when blood from the upper digestive tract, such as the stomach or small intestine, mixes with the stool during digestion. The black color of the stool is caused by the breakdown of blood in the digestive system. Melena is often associated with conditions such as peptic ulcers, gastritis, esophageal varices, or colorectal cancer. It is important to seek medical attention if melena is present, as it can be a sign of a serious underlying condition.
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16.
White or gray stool
A.
Hematochezia
B.
Melena
C.
Liver or gallbladder disease
D.
Diarrhea
Correct Answer
C. Liver or gallbladder disease
Explanation White or gray stool can be a symptom of liver or gallbladder disease. This is because the liver produces bile, which gives stool its normal brown color. If there is a problem with the liver or gallbladder, it can affect the production or flow of bile, leading to pale or gray-colored stool. This change in stool color can be a warning sign of liver or gallbladder disease and should be evaluated by a healthcare professional.
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17.
A medical provider should always auscultate before palpating or percussing the abdomen
A.
True
B.
False
Correct Answer
A. True
Explanation Auscultating before palpating or percussing the abdomen is important for a medical provider because it allows them to listen for any abnormal sounds such as bowel sounds or bruits. This can provide valuable information about the functioning of the gastrointestinal system and help in diagnosing any potential issues. Palpation and percussion, on the other hand, involve physically examining the abdomen by feeling for any abnormalities or tapping on it to assess the underlying organs. By auscultating first, the medical provider can ensure that they have gathered all relevant information before proceeding with the other examination techniques.
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18.
The normal frequency of sounds in the abdomen is 5-34 sounds per minute
A.
True
B.
False
Correct Answer
A. True
Explanation The normal frequency of sounds in the abdomen is 5-34 sounds per minute. This means that in a healthy individual, the abdomen produces a range of sounds between 5 and 34 per minute. These sounds, known as bowel sounds, are produced by the movement of the intestines and can be heard with a stethoscope. This range is considered normal and indicates proper functioning of the digestive system.
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19.
Shifting from tympany to dullness with inspiration suggests an enlarged spleen. This indicates:
A.
A positive splenic percussion sign
B.
A negative splenic percussion sign
Correct Answer
A. A positive splenic percussion sign
Explanation Shifting from tympany to dullness with inspiration suggests an enlarged spleen. This is because when the spleen is enlarged, it extends downward and displaces the air-filled bowel loops. As a result, when percussion is performed on the abdomen, there is a change in sound from the normal tympanic (air-filled) sound to a dull sound. This change in sound is known as a positive splenic percussion sign.
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20.
A patient presents to your clinic with radiating abdominal pain somewhat localized to the RLQ. You palpate to check for any abnormalities and discover the patient has rebound tenderness in the LLQ. You would chart that the patient has a positive:
A.
Rovsing’s sign
B.
Psoas sign
C.
Obturator sign
D.
Murphy' sign
Correct Answer
A. Rovsing’s sign
Explanation Rovsing's sign is a clinical finding that indicates appendicitis. It is characterized by the presence of rebound tenderness in the lower left quadrant (LLQ) when pressure is applied to the lower right quadrant (RLQ). This suggests that inflammation in the RLQ is causing pain to radiate to the LLQ. Therefore, based on the patient's symptoms and the presence of rebound tenderness in the LLQ, the correct answer is Rovsing's sign.
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21.
A patient presents to your clinic with radiating abdominal pain somewhat localized to the RLQ. You palpate to check for any abnormalities and discover the patient has pain while flexing their thigh against your hand. This patient is exhibiting a positive:
A.
Rovsing’s sign
B.
Psoas sign
C.
Obturator sign
D.
Murphy's sign
Correct Answer
B. Psoas sign
Explanation The patient in this scenario is exhibiting a positive Psoas sign. The Psoas sign is elicited by flexing the patient's thigh against resistance, which causes pain in the RLQ. This sign is indicative of irritation or inflammation of the psoas muscle, which can be caused by conditions such as appendicitis or retrocecal appendicitis. It is important to consider this sign along with other clinical findings to make an accurate diagnosis and determine the appropriate course of treatment for the patient.
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22.
A patient presents to your clinic with radiating abdominal pain somewhat localized to the RLQ. You palpate to check for any abnormalities and discover the patient has no pain while flexing their thigh and rotating the leg internally at the hip. You deduce that the patient has a negative:
A.
Rovsing’s sign
B.
Psoas sign
C.
Obturator sign
D.
Murphy's sign
Correct Answer
C. Obturator sign
Explanation The Obturator sign is negative in this case because the patient does not experience pain while flexing their thigh and rotating the leg internally at the hip. The Obturator sign is typically positive in cases of appendicitis, where pain is felt in the RLQ when the thigh is flexed and rotated internally due to irritation of the obturator muscle. Since the patient does not experience pain with these movements, it suggests that appendicitis is not the cause of their abdominal pain.
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23.
A patient presents to your clinic with radiating abdominal pain. You palpate to check for any abnormalities and discover the patient has a positive Rovsing's sign and involuntarily guards their abdomen when palpating the RLQ. Your initial thought is that the patient has _____
A.
Appendicitis
B.
Hepatitis
C.
Cholecystitis
D.
Pancreatitis
Correct Answer
A. Appendicitis
Explanation Based on the information provided, the patient's positive Rovsing's sign (pain in the RLQ when palpating the LLQ) and guarding of the abdomen suggest appendicitis. These signs are commonly associated with inflammation of the appendix, which can cause radiating abdominal pain. Hepatitis, cholecystitis, and pancreatitis may present with abdominal pain, but they do not typically produce a positive Rovsing's sign or involuntary guarding.
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24.
What sign describes rebound tenderness indicating appendicitis
A.
Blumberg's sign
B.
Murphy’s Sign
C.
Gray Turner’s Sign
D.
Cullen’s Sign
Correct Answer
A. Blumberg's sign
Explanation Blumberg's sign is a medical sign used to assess for rebound tenderness, which is an indication of appendicitis. Rebound tenderness refers to the pain experienced when pressure is applied to the abdomen and then suddenly released. If a patient experiences increased pain upon release of the pressure, it suggests inflammation of the peritoneum, which is a characteristic symptom of appendicitis. Blumberg's sign is named after the surgeon Charles Blumberg, who first described this sign.
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25.
A sign associated with acute cholecystitis
A.
Blumberg's sign
B.
Murphy’s Sign
C.
Gray Turner’s Sign
D.
Cullen’s Sign
Correct Answer
B. MurpHy’s Sign
Explanation Murphy's Sign is a clinical finding associated with acute cholecystitis, which is the inflammation of the gallbladder. It is characterized by pain and tenderness in the right upper quadrant of the abdomen, particularly when the patient takes a deep breath while the examiner's hand is placed below the right costal margin. This sign is indicative of an inflamed gallbladder being palpated and is often used to help diagnose acute cholecystitis.
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26.
A patient presents to your clinic with abdominal pain. You do a full pain assessment workup and begin to palpate the patient's abdomen. While palpating, you perform a test to check for pain on inspiration while your fingers are placed under the patient's right costal margin next to the rectus abdominalis. You are looking for what sign?
A.
Blumberg's sign
B.
Murphy’s Sign
C.
Gray Turner’s Sign
D.
Cullen’s Sign
Correct Answer
B. MurpHy’s Sign
Explanation Murphy's sign is a test used to check for pain or tenderness in the right upper quadrant of the abdomen, specifically under the right costal margin next to the rectus abdominalis muscle. It is performed by palpating this area and asking the patient to take a deep breath. If the patient experiences pain or stops breathing due to pain, it is considered a positive Murphy's sign. This sign is commonly associated with acute cholecystitis, an inflammation of the gallbladder.
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27.
This sign takes 24–48 hours to materialize
A.
Blumberg's sign
B.
Murphy’s Sign
C.
Gray Turner’s Sign
D.
Cullen’s Sign
Correct Answer
C. Gray Turner’s Sign
Explanation Gray Turner's sign refers to the presence of bruising on the flanks, typically occurring 24-48 hours after the onset of severe abdominal pain. This sign is associated with retroperitoneal hemorrhage, which can be caused by conditions such as pancreatitis or trauma. The delayed appearance of bruising is due to the time it takes for blood to track from the site of bleeding to the flanks. Therefore, the given correct answer suggests that Gray Turner's sign takes 24-48 hours to materialize.
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28.
______ is a sign of retroperitoneal hemorrhage
A.
Blumberg's sign
B.
Murphy’s Sign
C.
Gray Turner’s Sign
D.
Cullen’s Sign
Correct Answer
C. Gray Turner’s Sign
Explanation Gray Turner's sign is a sign of retroperitoneal hemorrhage. Retroperitoneal hemorrhage refers to bleeding that occurs in the retroperitoneal space, which is the area behind the abdominal cavity. Gray Turner's sign is characterized by the presence of bruising or discoloration around the flanks, specifically the lower back area. This sign indicates that there is bleeding within the retroperitoneal space, which can be caused by various conditions such as trauma, pancreatitis, or ruptured abdominal aortic aneurysm.
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29.
A patient presents to your clinic with radiating abdominal pain. You notice that the patient has a bluish periumbilical discoloration on their abdomen. Your initial assessment is that the patient may have _______.
A.
Acute appendicitis
B.
Acute hepatitis
C.
Acute cholecystitis
D.
Acute pancreatitis
Correct Answer
D. Acute pancreatitis
Explanation The presence of a bluish periumbilical discoloration on the abdomen is known as Cullen's sign, which is indicative of acute pancreatitis. Acute pancreatitis is inflammation of the pancreas that can cause severe abdominal pain that radiates to the back. The bluish discoloration occurs due to the leakage of pancreatic enzymes into the surrounding tissues, leading to tissue damage and subsequent bruising. This sign is a result of retroperitoneal bleeding associated with pancreatitis and is a key finding in diagnosing the condition.
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30.
A patient presents with bluish periumbilical discoloration due to subcutaneous intraperitoneal hemorrhage. This finding exhibits a positive:
A.
Blumberg's sign
B.
Murphy’s Sign
C.
Gray Turner’s Sign
D.
Cullen’s Sign
Correct Answer
D. Cullen’s Sign
Explanation Cullen's sign refers to the bluish discoloration around the umbilicus, which is caused by subcutaneous intraperitoneal hemorrhage. This sign is indicative of severe internal bleeding and can be seen in conditions such as pancreatitis or ruptured ectopic pregnancy. It is named after the physician Thomas Stephen Cullen who first described it.
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31.
This sign can indicate acute pancreatitis (check all that apply)
A.
Blumberg's sign
B.
Murphy's sign
C.
Gray Turner's sign
D.
Cullen's Sign
Correct Answer(s)
C. Gray Turner's sign D. Cullen's Sign
Explanation Gray Turner's sign and Cullen's sign are both physical examination findings that can indicate acute pancreatitis. Gray Turner's sign refers to the presence of ecchymosis (bruising) in the flanks, while Cullen's sign refers to the presence of ecchymosis around the umbilicus. These signs are indicative of retroperitoneal hemorrhage, which can occur as a complication of acute pancreatitis. Blumberg's sign and Murphy's sign, on the other hand, are not associated with acute pancreatitis.
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32.
This sign can indicate appendicitis (check all that apply)
A.
Blumberg's sign
B.
Murphy's sign
C.
Gray Turner's sign
D.
Cullen's sign
E.
Rovsing’s sign
F.
Psoas sign
G.
Obturator sign
Correct Answer(s)
A. Blumberg's sign E. Rovsing’s sign F. Psoas sign G. Obturator sign
Explanation Blumberg's sign, Rovsing’s sign, Psoas sign, and Obturator sign are all physical examination tests used to assess for appendicitis. Blumberg's sign is elicited by applying pressure to the lower right abdomen and then quickly releasing it, causing pain and tenderness. Rovsing’s sign is the presence of right lower quadrant pain when pressure is applied to the left lower quadrant. Psoas sign is pain in the right lower quadrant when the patient's right hip is extended. Obturator sign is pain in the right lower quadrant when the patient's right hip and knee are flexed and the leg is internally rotated. These signs can indicate inflammation or irritation of the appendix, suggesting appendicitis.
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33.
As a practitioner, you can perform a rectal and pelvic exam on a patient to check for appendicitis.
A.
True
B.
False
Correct Answer
A. True
Explanation A rectal and pelvic exam can be performed to check for appendicitis because the appendix is located in the lower right abdomen, near the rectum and pelvis. By conducting these exams, a practitioner can assess for signs of inflammation or tenderness in the area, which may indicate appendicitis. However, it is important to note that these exams alone are not sufficient to diagnose appendicitis definitively, and further tests such as imaging or blood tests may be required for confirmation.
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34.
______ is a sign of intraperitoneal hemorrhage
A.
Blumberg's sign
B.
Murphy’s Sign
C.
Gray Turner’s Sign
D.
Cullen’s Sign
Correct Answer
D. Cullen’s Sign
Explanation Cullen's sign is a sign of intraperitoneal hemorrhage. It is characterized by the presence of periumbilical ecchymosis, which is a bluish discoloration around the belly button. This sign is caused by the leakage of blood into the peritoneal cavity, which then spreads to the surrounding tissues, including the area around the belly button. It is often associated with conditions such as pancreatitis or ruptured ectopic pregnancy.
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