Nokea
Where should the uterine fundus be palpable at 12 weeks?
- A. At the level of the umbilicus
- B. At the level of the symphysis pubis
- C. Midway between the symphysis and umbilicus
- D. Below the symphysis pubis
Correct Answer: B
Rationale: At 12 weeks of gestation, the uterine fundus should be palpable at the level of the symphysis pubis. This is because the uterus rises approximately 1 cm above the symphysis pubis each week during the first trimester. By 12 weeks, it should be palpable at this level.
Choice A (At the level of the umbilicus) is incorrect because the fundus is not expected to reach the level of the umbilicus until around 20 weeks.
Choice C (Midway between the symphysis and umbilicus) is incorrect as this would typically occur around 16-18 weeks.
Choice D (Below the symphysis pubis) is also incorrect because by 12 weeks, the fundus should have risen above the symphysis pubis.
You may also like to solve these questions
Which of the following anatomic landmark associations is correct?
- A. 2nd intercostal space for needle insertion in tension pneumothorax
- B. T6 for lower margin of endotracheal tube
- C. Sternal angle marks the 4th rib
- D. 5th intercostal space for chest tube insertion
Correct Answer: D
Rationale: The correct answer is D because the 5th intercostal space is the recommended location for chest tube insertion to drain the pleural space effectively. This space is ideal as it allows for adequate drainage without causing injury to vital structures.
A: The 2nd intercostal space is actually used for needle decompression in tension pneumothorax.
B: T6 is the level at which the tip of the endotracheal tube should ideally lie to ensure proper placement and ventilation.
C: The sternal angle corresponds to the 2nd rib, not the 4th rib, making this association incorrect.
In summary, choice D is correct as it aligns with the standard practice for chest tube insertion, while choices A, B, and C are incorrect due to their association with different anatomic landmarks and procedures.
A 45-year-old electrical engineer presents to your clinic, complaining of spots on his scrotum. He first noticed the spots several months ago, and they have gotten bigger. He denies any pain with urination or with sexual intercourse. He has had no fever, night sweats, weight gain, or weight loss. His past medical history consists of a vasectomy 10 years ago and mild obesity. He is on medication for hyperlipidemia. He denies any tobacco or illegal drug use and drinks alcohol socially. His mother has Alzheimer's disease and his father died of leukemia. On examination he appears relaxed and has unremarkable vital signs. On visualization of his penis, he is circumcised and has no lesions on his penis. Visualization of his scrotum shows three yellow nodules 2-3 millimeters in diameter. During palpation they are firm and nontender. What abnormality of the male genitalia is this most likely to be?
- A. Condylomata acuminata
- B. Syphilitic chancre
- C. Peyronie's disease
- D. Epidermoid cysts
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cysts. These cysts typically present as firm, non-tender nodules on the scrotum, consistent with the patient's presentation. The history of gradual growth without associated symptoms supports this diagnosis. Additionally, the lack of pain with urination or sexual intercourse rules out sexually transmitted infections like condylomata acuminata (choice A) and syphilitic chancre (choice B). Peyronie's disease (choice C) involves penile curvature and fibrous plaques, not scrotal nodules. In summary, the patient's presentation, physical examination findings, and absence of specific symptoms point towards epidermoid cysts as the most likely diagnosis.
Dr. Smith is obtaining informed consent from Mr. Jones to perform a colonoscopy. Which element of decision-making capacity is impaired in this case?
- A. Understanding
- B. Appreciation
- C. Ability to express a choice
- D. None of the above
Correct Answer: B
Rationale: The correct answer is B: Appreciation. In this scenario, Mr. Jones may understand the information presented about the colonoscopy, but he may not fully appreciate the implications and consequences of undergoing the procedure. Appreciation involves the ability to understand the personal relevance of the information provided. This is crucial in ensuring that the individual can make a truly informed decision.
A: Understanding is not impaired as Mr. Jones may comprehend the information presented.
C: Ability to express a choice is not necessarily impaired in this case, as Mr. Jones may still be able to verbalize his decision.
D: None of the above is incorrect because Appreciation is indeed impaired in this situation.
Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47-year-old premenopausal woman?
- A. Hirsutism
- B. Gynecomastia
- C. Oligomenorrhea
- D. Acne
Correct Answer: D
Rationale: Rationale for correct answer D: Acne is NOT a typical finding of hyperprolactinemia in a 47-year-old premenopausal woman because hyperprolactinemia usually presents with symptoms related to hormonal imbalance, such as irregular menstrual cycles (oligomenorrhea), breast changes (gynecomastia), and excess body hair (hirsutism). Acne is not directly associated with elevated prolactin levels.
Summary of incorrect choices:
A: Hirsutism - Hirsutism is a common finding in hyperprolactinemia due to hormonal imbalances.
B: Gynecomastia - Gynecomastia can occur in hyperprolactinemia due to the suppression of testosterone.
C: Oligomenorrhea - Oligomenorrhea is a typical finding in hyperprolactinemia due to disruptions in the menstrual cycle.
Mr. W. is a 51-year-old auto mechanic who comes to the emergency room wanting to be checked out for the symptom of chest pain. As you listen to him describe his symptom in more detail, you say "Go on," and later, "Mm-hmmm." This is an example of which of the following skilled interviewing techniques?
- A. Echoing
- B. Nonverbal communication
- C. Facilitation
- D. Empathic response
Correct Answer: C
Rationale: Facilitation involves using verbal and nonverbal cues to encourage the patient to continue talking. In this scenario, saying "Go on" and "Mm-hmm" indicates active listening and prompts Mr. W. to elaborate on his symptoms. This technique helps gather more information and shows empathy without imposing personal assumptions or judgments. Echoing involves repeating the patient's last words, nonverbal communication refers to gestures and body language, and an empathic response involves acknowledging and validating the patient's feelings. In this case, the best fit is facilitation as it encourages further discussion without interrupting or steering the conversation.