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A patient presents with sudden-onset severe scrotal pain, swelling, and erythema. Physical examination reveals a tender, swollen, and high-riding testicle. What is the most likely diagnosis?
- A. Testicular torsion
- B. Epididymitis
- C. Testicular trauma
- D. Testicular tumor
Correct Answer: A
Rationale: Given the sudden-onset severe scrotal pain, swelling, and erythema, along with the physical examination findings of a tender, swollen, and high-riding testicle, the most likely diagnosis is testicular torsion. Testicular torsion occurs when the spermatic cord twists, leading to compromised blood flow to the testicle, causing ischemia and severe pain. It is considered a surgical emergency that requires prompt diagnosis and intervention to salvage the affected testicle. Prompt surgical detorsion is necessary to prevent irreversible testicular damage. While epididymitis, testicular trauma, and testicular tumors can also present with scrotal pain and swelling, the presence of a high-riding testicle in this context is highly suggestive of testicular torsion.
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Ms. Cruz is the supervisor of a hospital on night shift. Several nurses did not report due to Jeepney strike. When the supervisor is executing proper allocation of nurses to the PRIORITY wards to address this concern, she is observing what type of principle?
- A. Beneficence
- B. Non-maleficence
- C. Justice
- D. Fidelity
Correct Answer: C
Rationale: In this situation, the principle of justice is being observed by the supervisor, Ms. Cruz. Justice in healthcare ethics involves fairness and equality in the distribution of resources, including the allocation of staff to provide care. By prioritizing the allocation of nurses to the PRIORITY wards to ensure that essential care is delivered despite the shortage caused by the Jeepney strike, Ms. Cruz is upholding the principle of justice by ensuring that each patient receives equal and fair access to healthcare services. This decision aligns with the ethical responsibility to provide care in a just and fair manner.
A patient presents with unilateral facial paralysis, inability to close the eye on the affected side, and loss of taste sensation on the anterior two-thirds of the tongue. Which of the following conditions is most likely responsible for this presentation?
- A. Bell's palsy
- B. Ramsay Hunt syndrome
- C. Glossopharyngeal neuralgia
- D. Acoustic neuroma
Correct Answer: B
Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.
The last fire in the hospital was due to a malfunctioning equipment. The Fire extinguisher was nowhere to be found. What should have been practiced?
- A. A dedicated fire extinguisher must be in every strategic Place
- B. Place one fire extinguisher between two units.
- C. A fire extinguisher can be replaced with fire sensors.
- D. Borrowing fire extinguishers may be tolerated if on the same floor
Correct Answer: A
Rationale: The correct practice in this situation would be to have a dedicated fire extinguisher in every strategic location throughout the hospital. Having fire extinguishers readily available in key areas ensures that they can be accessed quickly in case of a fire emergency. Placing one fire extinguisher between two units may not be sufficient as it may not be easily accessible in the event of a fire. Fire extinguishers should not be replaced with fire sensors as these serve different functions. Additionally, borrowing fire extinguishers may not be a safe or reliable practice, as they should be properly maintained and placed according to safety standards. Therefore, having dedicated fire extinguishers in every strategic location is the best practice to ensure the safety and well-being of individuals in the hospital.
A patient presents with knee pain and swelling following a fall onto a flexed knee. Physical examination reveals a palpable effusion and tenderness along the joint line. McMurray's test elicits pain and clicking with passive knee flexion and internal rotation. Which condition is most likely?
- A. Patellar tendinitis
- B. Medial meniscus tear
- C. Lateral collateral ligament (LCL) sprain
- D. uadriceps tendon rupture
Correct Answer: B
Rationale: The presentation of knee pain and swelling following a fall onto a flexed knee, along with a palpable effusion and tenderness along the joint line, is highly suggestive of a meniscus injury. The McMurray's test specifically evaluates for meniscal tears. In this case, the presence of pain and clicking with passive knee flexion and internal rotation indicates a medial meniscus tear as the most likely diagnosis. Patellar tendinitis usually presents with anterior knee pain that is worsened by activities such as jumping or running. Lateral collateral ligament (LCL) sprain typically presents with lateral knee pain and instability. Quadriceps tendon rupture would present with significant weakness and inability to fully extend the knee, which is not described in this scenario.
Which of the following diagnostic tests is most appropriate for evaluating a woman with suspected cervical dysplasia?
- A. Pap smear
- B. Endometrial biopsy
- C. Colposcopy with biopsy
- D. Transvaginal ultrasound
Correct Answer: C
Rationale: Colposcopy with biopsy is the most appropriate diagnostic test for evaluating a woman with suspected cervical dysplasia. Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to examine the cervix for any abnormal areas. If abnormal tissue is identified during colposcopy, a biopsy will be taken to confirm the presence of cervical dysplasia and determine the severity. This allows for a more accurate diagnosis and appropriate management of the condition. Pap smear, although a screening test for cervical dysplasia, may not provide a definitive diagnosis and may require further evaluation with colposcopy and biopsy. Endometrial biopsy and transvaginal ultrasound are not indicated for evaluating cervical dysplasia specifically.