Nokea
Why is it important to inquire about the age of the first period when taking a sexual history from female patients?
- A. It helps to determine the patient's current level of physical fitness.
- B. It provides insight into the patient's reproductive health and potential risks.
- C. It indicates the patient's dietary habits.
- D. It is irrelevant to sexual health assessments.
Correct Answer: B
Rationale: The correct answer is B because knowing the age of the first period can give insight into the patient's reproductive health and potential risks. Early or late onset of menstruation can be indicators of hormonal imbalances, reproductive disorders, or potential fertility issues. This information is crucial for assessing the patient's overall gynecological health and guiding appropriate interventions.
Choice A is incorrect because the age of the first period is not directly related to determining the patient's current level of physical fitness. Choice C is incorrect because the age of the first period does not indicate the patient's dietary habits. Choice D is incorrect because the age of the first period is relevant to sexual health assessments as it provides valuable information about the patient's reproductive health.
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A 65-year-old patient presents with confusion, tremors, and bradykinesia. What is the most likely diagnosis?
- A. Alzheimer's disease
- B. Huntington's disease
- C. Parkinson's disease
- D. Multiple sclerosis
Correct Answer: C
Rationale: The correct diagnosis is C: Parkinson's disease. The symptoms of confusion, tremors, and bradykinesia are classic features of Parkinson's disease, a neurodegenerative disorder affecting movement. The typical onset age aligns with the patient's age. Alzheimer's disease (A) primarily affects memory and cognition, Huntington's disease (B) presents with involuntary movements and cognitive decline, and Multiple sclerosis (D) involves the immune system attacking the central nervous system causing a variety of symptoms. Parkinson's is the most appropriate choice based on the symptom presentation and age of the patient.
Symptoms of heartburn and regurgitation are associated with:
- A. Hiatal hernia
- B. Gastroesophageal reflux
- C. Peptic ulcer disease
- D. Esophageal cancer
Correct Answer: B
Rationale: The correct answer is B: Gastroesophageal reflux. Heartburn and regurgitation are classic symptoms of GERD, where stomach acid flows back into the esophagus. This causes a burning sensation in the chest and sour taste in the mouth. Hiatal hernia (A) can contribute to GERD but is not directly associated with these symptoms. Peptic ulcer disease (C) typically presents with stomach pain, not heartburn. Esophageal cancer (D) may present with difficulty swallowing and weight loss, not just heartburn and regurgitation. Therefore, choice B is the most appropriate answer.
You are conducting a pupillary examination on a 34-year-old man. You note that both pupils dilate slightly. Both are noted to constrict briskly when the light is placed on the right eye. What is the most likely problem?
- A. Optic nerve damage on the right
- B. Optic nerve damage on the left
- C. Efferent nerve damage on the right
- D. Efferent nerve damage on the left
Correct Answer: C
Rationale: The correct answer is C: Efferent nerve damage on the right. When both pupils dilate but only the right pupil constricts briskly in response to light, it indicates a problem with the efferent pathway controlling the right eye's pupillary constriction. This suggests damage to the parasympathetic fibers of the oculomotor nerve (CN III) that innervate the pupillary sphincter muscle. Choices A and B (optic nerve damage) do not involve pupil constriction. Choice D (efferent nerve damage on the left) would not explain the brisk constriction in the right eye.
A young man comes to you with an extremely pruritic rash over his knees and elbows which has come and gone for several years. It seems to be worse in the winter and improves with some sun exposure. On examination, you notice scabbing and crusting with some silvery scale, and you are observant enough to notice small "pits" in his nails. What would account for these findings?
- A. Eczema
- B. Pityriasis rosea
- C. Psoriasis
- D. Tinea infection
Correct Answer: C
Rationale: The correct answer is C: Psoriasis. The key clinical features described, such as pruritic rash with scabbing, crusting, silvery scale, and nail pitting, are classic signs of psoriasis. The presence of small "pits" in the nails, known as nail pitting, is a common finding in psoriasis. The worsening of symptoms in winter and improvement with sun exposure is also typical of psoriasis. Eczema (choice A) typically presents with red, inflamed, and weeping skin lesions. Pityriasis rosea (choice B) presents with a herald patch followed by smaller similar lesions. Tinea infection (choice D) presents with scaling, redness, and itching but does not typically cause nail pitting. In this case, the combination of symptoms and nail pitting point to psoriasis as the most likely diagnosis.
Which is the most effective pattern of palpation for breast cancer?
- A. Beginning at the nipple, make an ever-enlarging spiral.
- B. Divide the breast into quadrants and inspect each systematically.
- C. Examine in lines resembling the back and forth pattern of mowing a lawn.
- D. Beginning at the nipple, palpate outward in a stripe pattern.
Correct Answer: B
Rationale: The correct answer is B. Dividing the breast into quadrants and inspecting each systematically is the most effective pattern of palpation for breast cancer because it ensures thorough coverage of the entire breast, making it easier to detect any abnormalities. This method allows for a structured approach, reducing the likelihood of missing any potential signs of cancer.
A: Beginning at the nipple and making an ever-enlarging spiral may not cover all areas of the breast equally, potentially leading to missed abnormalities.
C: Examining in lines resembling mowing a lawn may also result in uneven coverage and potentially missing crucial areas.
D: Beginning at the nipple and palpating outward in a stripe pattern may not provide comprehensive coverage of the entire breast, increasing the risk of overlooking abnormalities.