Pd Written Exam 2 Practice Quiz

Decreased turgor refers to the loss of elasticity and firmness in the skin, which is commonly seen in dehydration. When the body lacks adequate fluids, the skin loses its ability to bounce back when pinched or pulled. Edema, on the other hand, refers to the accumulation of excess fluid in the tissues, which would cause swelling rather than decreased turgor. Scleroderma is a chronic autoimmune disease that causes hardening and tightening of the skin, and carotenemia is a condition characterized by yellowish discoloration of the skin due to excessive intake of carotenoids.

Vesicles in a unilateral dermatomal pattern are typical of herpes zoster, also known as shingles. Herpes zoster is a viral infection caused by the reactivation of the varicella-zoster virus, which initially causes chickenpox. The virus remains dormant in the body and can reactivate later in life, causing a painful rash with fluid-filled vesicles that follow a specific nerve pathway. This pattern of vesicles in a unilateral dermatomal distribution is characteristic of herpes zoster.

A subconjunctival hemorrhage can be caused by trauma. This occurs when a blood vessel in the conjunctiva, the clear membrane covering the white part of the eye, breaks and blood leaks into the surrounding tissue. Trauma, such as a direct injury to the eye or rubbing the eye too forcefully, can cause this type of hemorrhage. Conjunctivitis, glaucoma, and acute iritis are eye conditions that can have various causes, but they are not specifically associated with trauma.

A patient who presents with jaundice, spider angiomas (and other telangiectasias), palmar erythema, pruritus, and purpura is likely to have liver disease. These symptoms are commonly associated with liver dysfunction, such as hepatitis, cirrhosis, or liver failure. Jaundice occurs when there is a buildup of bilirubin in the bloodstream, causing yellowing of the skin and eyes. Spider angiomas and palmar erythema are vascular changes that can occur due to liver dysfunction. Pruritus (itching) and purpura (purple spots) can also be manifestations of liver disease. Therefore, liver disease is the most likely explanation for the patient's symptoms.

Crusting refers to the dried residue that forms on the surface of a lesion. It is typically composed of blood, serum, or other bodily fluids that have dried up. This crust or scab forms as a protective layer over the wound or lesion, helping to prevent infection and promote healing. Crusting is commonly seen in conditions such as impetigo, herpes simplex, and eczema.

Metastasis refers to the spread of cancer cells from one part of the body to another. In the given options, the supraclavicular nodes are the most likely to be affected by metastasis of a thoracic or abdominal malignancy. The supraclavicular nodes are located just above the collarbone and are commonly referred to as "Virchow's nodes". These nodes are a common site for metastasis because they receive lymphatic drainage from various organs in the thorax and abdomen. Therefore, the presence of metastatic cancer cells in the supraclavicular nodes can indicate the spread of malignancy from these regions.

Urticaria is the correct answer because it is a condition characterized by the appearance of red, raised, and itchy bumps on the skin, also known as wheals. These wheals can be caused by allergic reactions to certain substances, such as food, medications, or insect bites. Urticaria is commonly known as hives and can vary in size and shape. It is a temporary condition that usually resolves on its own or with the help of antihistamines. Dermatographism, telangectasia, and psoriasis are unrelated conditions and do not match the given description.

The physical exam findings of cool dry skin with rough texture are consistent with hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone, leading to a decrease in metabolic rate. This can result in symptoms such as dry skin, brittle hair, and a rough texture. Additionally, hypothyroidism can also cause cold intolerance, fatigue, and weight gain. Therefore, based on the physical exam findings, hypothyroidism is the most likely diagnosis for this patient.

Lichenification refers to visible and palpable thickening of the epidermis, roughening of the skin, and increased visibility of normal skin furrows. It is often a result of chronic rubbing.

A flat lesion under 1cm is classified as a macule. A macule is a small, flat, and discolored area on the skin that is typically less than 1cm in diameter. It is characterized by a change in color, such as red, brown, or white, but does not involve any elevation or depression of the skin. This distinguishes it from other types of skin lesions, such as papules, plaques, or patches, which may have different characteristics and sizes.

Central cyanosis refers to a bluish discoloration of the skin and mucous membranes due to decreased oxygen levels in the blood. The oral mucosa, lips, and tongue have a rich blood supply and are easily visible, making central cyanosis most evident in these areas. The hands, nails, feet, palpebral conjunctiva, lips, hard palate, undersurface of the tongue, palms, soles, and hands may also show cyanosis, but the oral mucosa, lips, and tongue are the most prominent areas for detecting central cyanosis.

Rinne test is a tuning fork test used to evaluate the hearing ability of an individual. It compares bone conduction (BC) and air conduction (AC) in order to determine the type of hearing loss. In conductive hearing loss, there is a problem with sound transmission through the outer or middle ear, resulting in better BC than AC. Therefore, Rinne test indicates equal or better bone conduction in cases of conductive hearing loss.

Ectropion is a condition in which the lower eyelid is turned outward, causing the palpebral conjunctiva to be exposed. This can lead to dryness, irritation, and redness of the eye. Ptosis refers to drooping of the upper eyelid, entropion is when the eyelid turns inward, and exophthalmos is the protrusion of the eyeball.

Nausea and vomiting are commonly associated with migraine headaches, but they can also be indicative of a subarachnoid hemorrhage. A subarachnoid hemorrhage refers to bleeding in the space between the brain and the thin tissues that cover it. This condition is considered a medical emergency and can cause severe headaches, nausea, and vomiting. It is important to consider this possibility when evaluating a patient presenting with these symptoms, especially if there are no previous migraine history or if the headache is sudden and severe.

A spider angioma is a type of telangiectasia, which is a condition characterized by the dilation of small blood vessels near the surface of the skin. Spider angiomas typically appear as a central red spot surrounded by smaller, radiating blood vessels resembling a spider's legs. They are commonly found on the face, neck, and upper trunk. Petechia refers to small, pinpoint-sized red or purple spots on the skin caused by bleeding underneath the skin. Cherry angioma is a benign skin growth composed of blood vessels, while ecchymosis refers to a larger area of bruising.

Battle's sign is a medical condition characterized by mastoid ecchymosis, which refers to bruising behind the ear, and is often associated with a temporal or basilar skull fracture. This condition typically develops within 48 hours following the injury. Tophi, exostosis, and induration are unrelated to the given symptoms and do not match the description provided.

Xerostomia is the correct answer for the medical term for dry mouth. Xerostomia refers to the condition in which the salivary glands do not produce enough saliva, resulting in a dry and uncomfortable sensation in the mouth. It can be caused by various factors such as medication side effects, certain medical conditions, or simply dehydration.

Petechiae are tiny, reddish or purple non-blanching lesions that are commonly seen in infectious mononucleosis or streptococcus infections. These lesions occur due to bleeding under the skin, resulting from the rupture of small blood vessels called capillaries. Unlike purpura and ecchymosis, which are larger and blanch when pressure is applied, petechiae do not blanch. Excoriation, on the other hand, refers to a superficial injury or abrasion of the skin and is not related to the appearance of these lesions.

If a tonsillar node pulsates, it suggests that you are palpating the carotid artery and not a lymph node. The carotid artery is located in the neck and supplies blood to the brain. It can be felt as a pulsation when palpated, especially if it is close to a lymph node such as the tonsillar node. Lymph nodes, on the other hand, do not normally pulsate. Therefore, if you feel a pulsation in that area, it is more likely to be the carotid artery rather than a lymph node.

If the rise of the soft palate and uvula is not symmetric, it can be suspected that there is a paralysis of CN X (cranial nerve X), also known as the vagus nerve. The vagus nerve is responsible for controlling the movement of the soft palate and uvula, among other functions. Therefore, if there is a lack of symmetry in their rise, it suggests that there may be a problem with the vagus nerve, leading to paralysis.

If a patient reports that their hearing loss is worse in noisy environments, it would be expected that they have sensorineural loss. Sensorineural hearing loss occurs due to damage or dysfunction in the inner ear or the auditory nerve pathways. This type of hearing loss affects the ability to perceive and understand sounds, especially in challenging listening conditions such as noisy environments. Conductive loss, on the other hand, is characterized by difficulties in sound transmission through the outer or middle ear, while Meniere's disease and otitis externa are specific conditions that can cause hearing loss but may not necessarily be associated with worsening in noisy environments.

Heliotrope is a violaceous eruption over the eyelids that is commonly seen in dermatomyositis. It is characterized by a purple discoloration of the upper eyelids, often accompanied by swelling and inflammation. This distinctive rash is one of the classic features of dermatomyositis, a systemic autoimmune disease that affects the muscles and skin. Keloid is a type of raised scar, carotenemia is a condition characterized by yellowish skin due to excessive intake of carotene, and impetigo is a bacterial skin infection. None of these conditions are associated with the specific violaceous eruption seen in dermatomyositis.

Xanthelasma refers to slightly raised, yellowish well-circumscribed plaques that can be seen along the nasal portions of one or both eyelids in patients with lipid disorders. This condition is typically associated with high levels of cholesterol or other lipids in the blood. Xanthelasma is not painful and does not affect vision, but it is considered a cosmetic concern. Treatment options may include lifestyle changes, such as managing cholesterol levels, or surgical removal for cosmetic reasons.

A raised, fluid-filled lesion that is 1 cm or larger is classified as a bulla. A bulla is a large blister or vesicle that contains clear fluid. It is larger than a vesicle and typically measures more than 1 cm in diameter.

If sudden unilateral vision loss is painless, a problem should be suspected in the retinal wall. The retina is responsible for capturing and transmitting visual information to the brain, and any damage or issue in the retinal wall can lead to vision loss. Since the question specifies that the vision loss is painless, it suggests that the problem is not related to the cornea (which can cause pain) or the anterior chamber or canal of Schlemm (which are not directly involved in vision). Therefore, the most likely location for the problem is the retinal wall.

If a person is unable to visualize the red reflex, it is likely due to lens opacity. This means that there is cloudiness or opaqueness in the lens of the eye, which can interfere with the passage of light and prevent the red reflex from being visible. Lens opacity can be caused by various factors such as cataracts or other conditions that affect the clarity of the lens.

The swinging flashlight test (aka direct/consensual response) is used to detect an afferent pupillary defect in the optic nerve. This test involves shining a light into one eye and then quickly moving it to the other eye. If there is a defect in the optic nerve, the pupils will not constrict equally in response to the light, indicating an afferent pupillary defect. The other options, testing the near reaction, visual acuity, and convergence, do not specifically assess for an afferent pupillary defect in the optic nerve.

In sensorineural hearing loss, the Weber test lateralizes to the unaffected ear. This is because sensorineural hearing loss is caused by damage to the inner ear or auditory nerve, resulting in a decrease in sound perception. When the Weber test is conducted, the sound will be perceived louder in the unaffected ear as it is better able to transmit sound signals to the brain.

Reversible sensory symptoms are not considered a "red flag" in a headache history. Red flags are warning signs that may indicate a more serious underlying condition. Reversible sensory symptoms, such as tingling, numbness, or temporary loss of sensation, are often associated with migraines or tension headaches and are not typically indicative of a more severe or dangerous condition. However, it is important to note that any persistent or concerning symptoms should still be evaluated by a healthcare professional to rule out any potential underlying causes.

Epistaxis must be differentiated from hemoptysis because although both involve the presence of blood, they originate from different parts of the body. Epistaxis refers to nosebleeds, which occur when there is bleeding from the nose. On the other hand, hemoptysis refers to coughing up blood from the respiratory tract, typically from the lungs. It is important to distinguish between the two as they have different causes and may require different treatment approaches.

A smooth tongue and often sore tongue that has lost its papillae might suggest a deficiency in riboflavin. Riboflavin, also known as vitamin B2, is essential for maintaining healthy skin, nails, hair, and mucous membranes, including the tongue. A deficiency in riboflavin can lead to a condition called glossitis, which is characterized by a smooth, red, and painful tongue. This condition occurs due to the lack of riboflavin's involvement in maintaining the integrity of the tongue's papillae. Therefore, a deficiency in riboflavin is the most likely explanation for the given symptoms.

The differentiation between streptococcus infection and infectious mononucleosis can be made based on the location of inflamed lymph nodes. In strep throat, the anterior cervical lymph nodes are inflamed, while in mononucleosis, the posterior cervical nodes are inflamed. This information is helpful in distinguishing between the two conditions.

Trichotillomania is a condition characterized by the compulsive urge to pull out one's own hair, resulting in hair loss. Unlike alopecia areata, tinea capitis, and alopecia totalis, trichotillomania is not caused by any normal or pathological processes within the patient's body. Instead, it is considered a psychological disorder that involves the repetitive behavior of hair pulling.

(Due to sun exposure associated with actinic cheilitis)

Observing medial crescentic shadows of the iris using light from the temporal side can estimate the risk for narrow angle glaucoma. Narrow angle glaucoma is a condition where the drainage angle between the iris and cornea becomes blocked, leading to increased eye pressure. The presence of medial crescentic shadows indicates a narrow angle, suggesting a higher risk for developing this type of glaucoma.

Allergic rhinitis can cause pale or bluish nasal mucosa. This condition is characterized by inflammation of the nasal passages due to an allergic reaction. When the nasal passages are inflamed, the blood vessels in the mucosa may constrict, leading to a pale appearance. Additionally, the inflammation can cause a decrease in blood flow, resulting in a bluish coloration.

If the tympanic membrane is amber, it could reasonably be suspected that the person has otitis media with effusion. Otitis media with effusion is a condition where there is fluid buildup in the middle ear, causing the tympanic membrane to appear amber. This condition is typically not associated with pain or other symptoms and can be caused by factors such as allergies, respiratory infections, or Eustachian tube dysfunction.

The presence of drusen during a fundoscopic exam is a characteristic finding in dry macular degeneration. Drusen are yellow deposits that accumulate under the retina and are a hallmark of this condition. Dry macular degeneration is a common age-related eye disease that causes a gradual loss of central vision. It is characterized by the deterioration of the macula, the part of the retina responsible for sharp central vision. This condition typically progresses slowly and does not involve leaking blood vessels, which is a characteristic feature of wet macular degeneration.

Nystagmus refers to the involuntary rhythmic movement of the eyes, which can be an indicator of various conditions. In this case, the correct answer is labyrinthine disorders. Labyrinthine disorders affect the inner ear, which plays a crucial role in maintaining balance and spatial orientation. Nystagmus can occur as a result of damage or dysfunction in the inner ear, leading to abnormal eye movements. Therefore, the presence of nystagmus can suggest the presence of labyrinthine disorders.

A unilateral headache that can be localized behind the eye is likely to be a cluster headache. Cluster headaches are characterized by severe, excruciating pain that is usually felt on one side of the head, often around or behind the eye. These headaches typically occur in clusters or cycles, with frequent attacks over a period of weeks or months, followed by periods of remission. Other symptoms may include redness or watering of the eye, nasal congestion, and restlessness. Unlike migraines or tension headaches, cluster headaches are usually shorter in duration but more intense in pain.

Horizontal diplopia refers to double vision where the images are horizontally displaced from each other. This can occur due to a palsy or paralysis of certain cranial nerves. CN III (oculomotor nerve) controls the movement of the eye muscles responsible for horizontal and vertical eye movements. CN VI (abducens nerve) controls the lateral rectus muscle, which moves the eye outward. Therefore, palsy of CN III or CN VI can result in horizontal diplopia.

The correct answer is VI. Paralysis of the sixth cranial nerve, also known as the abducens nerve, causes the eyes to be unable to move laterally towards the side of the affected eye. In right lateral gaze, the right eye should move laterally, but if the sixth cranial nerve is paralyzed, it will be unable to do so. However, in left lateral gaze, the left eye should move laterally, which is not affected by the paralysis of the sixth cranial nerve.

A grayish white opacity being visible superficially indicates the presence of corneal scarring during a fundoscopic exam.

If the tympanic membrane is red or bloody, it should raise suspicion for a basilar skull fracture. This is because a basilar skull fracture can cause damage to the structures of the middle ear, including the tympanic membrane. The presence of blood or redness in the tympanic membrane suggests that there may be a rupture or injury to the membrane, which can be caused by the fracture. It is important to consider this possibility and seek medical attention to properly diagnose and treat a basilar skull fracture.

Biting the inside of the cheek can cause petechiae. Petechiae are small, pinpoint-sized red or purple spots that appear on the skin or mucous membranes, such as the inside of the cheek. These spots occur when tiny blood vessels called capillaries burst, leading to bleeding under the skin. Biting the cheek can cause trauma to the blood vessels, resulting in petechiae formation.

Acoustic neuroma is a benign tumor that grows on the vestibular nerve, which is responsible for transmitting balance and spatial information from the inner ear to the brain. As the tumor grows, it can compress the nerve and disrupt its function, leading to symptoms such as hearing loss, dizziness, and imbalance. Nystagmus, an involuntary rhythmic movement of the eyes, is typically not visible in acoustic neuroma because the tumor affects the vestibular nerve rather than the structures responsible for generating nystagmus.

Unilateral blindness is not a cause of anisocoria because anisocoria refers to unequal pupil size in both eyes, while unilateral blindness only affects one eye. Anisocoria can be caused by conditions such as Horner's syndrome, oculomotor nerve paralysis, and syphilis, but unilateral blindness alone does not result in unequal pupil size.

The Rosenbaum eye chart is a tool used to determine whether a patient needs reading glasses. By having the patient read the chart from a distance of 20 feet, it can be determined if they have difficulty seeing the smaller print, indicating a need for reading glasses. This chart is specifically designed for testing near vision and is commonly used in optometry practices.

Onycholysis refers to the detachment of the nail from the nail bed. Bronchiectasis is a possible cause of onycholysis as it is a chronic lung condition that can lead to chronic inflammation and infection. This chronic inflammation and infection can cause damage to the nail bed, leading to onycholysis. Congenital heart disease, cirrhosis, and nail biting are not typically associated with onycholysis.

The symptoms described, including severe pain, dilated and fixed pupil, steamy and cloudy cornea, and diffuse redness, are consistent with narrow angle glaucoma. This condition occurs when the drainage angle in the eye becomes blocked, causing a sudden increase in intraocular pressure. This can lead to vision loss and intense pain. Conjunctivitis and subconjunctival hemorrhage would not cause these specific symptoms, while open angle glaucoma typically presents with a gradual onset and different clinical findings.