LDL Total cholesterol HDL [Triglycerides5

The answer is b. (Fauci, 14 e, p 1158.) Mucormycosis is a rare fungal disease limited to persons with preexisting illness and may be seen in poorly controlled diabetic patients. Patients present with fever, nasal congestion, sinus pain, diplopia, and coma. Physical examination may reveal a necrotic nasal turbinate, reduced ocular motion, proptosis, and blindness. CT scan or MRI will reveal the extent of sinus involvement prior to surgery. 279. The answer is a. (Tierney, 39 e, pp...

The answer is b Seidel 4e p 481 An acquired arteriovenous

Fistula may be diagnosed by the presence of a continuous murmur and a palpable thrill over an area of previous trauma. The large pulse pressure is an indication that a large portion of the cardiac output is bypassing the systemic vascular resistance through the fistula. 171. The answer is d. (Fauci, 4 e, p 1234. Seidel, p 445.) Squatting to standing and the Valsalva maneuver both decrease right ventricular filling and decrease venous return, thereby increasing the murmurs of hyper-trophic...

Choose 1 Diagnosis

A 31-year-old woman is resuscitated after a motor vehicle accident but does not respond to painful stimuli. She occasionally yawns, coughs, and has spontaneous eye opening and movement. She maintains a sleep-wake cycle. (CHOOSE 1 DIAGNOSIS) Items 392-395 For each patient with neurologic deficit, choose the most likely diagnosis. 392. A 61-year-old man presents with flaccid paralysis, atrophy, fas-ciculations, and hyporeflexia.

The answers are 303d 304g 305b 306h 307a

(Kutty, 3 e, pp 762-765.) Most patients with CML have the Philadelphia chromosome t(9,22) and the bcr abl fusion protein. Mucosa-associated lymphoid tissue (MALT) tumor has been shown to be secondary to H. pylori. Squamous cell carcinomas of the anus, penis, and cervix have been linked to human papillomavirus (HPV). Hepatitis B and C and hemochro-matosis are the major risk factors for hepatocellular carcinoma. Other risk factors include aflatoxin exposure and being from the Far East or Africa...

Chvostek and Trousseau Signs suggest hypocalcemia

POLYCYSTIC OVARIAN DISEASE (Stein-Leventhal syndrome, PCOD) amenorrhea, obesity, hirsutism, elevated LH FSH ratio (> 3) Occipital lesions secondary to AIDS, herpes, tumor Increased serum sodium Decreased urine osmolality A man with gynecomastia + small testes + tall stature + female hair distribution think KLINEFELTER SYNDROME A patient with pigmented mucosa of the gums + hypokalemia + pigmentation of skin creases think ADDISON'S DISEASE Hypogonadism + anosmia KALLMAN SYNDROME...

Notice

Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the...

Items 308309

For each patient with a lung mass, select the most likely malignancy. d. Squamous cell carcinoma of the lung e. Small cell carcinoma of the lung f. Bronchioalveolar carcinoma of the lung 308. A 54-year-old woman presents with a lung mass. She has no history of tobacco use and has worked as a seamstress all her life. She has no family history of lung cancer. (CHOOSE 1 MALIGNANCY) 309. A 39-year-old woman with a tobacco history has a centrally located lung mass and a serum sodium of 121 meq L....

Items 398401

For each patient with a gait disturbance, choose the most likely kind of gait disturbance. 398. A 60-year-old man ambulates with his upper torso stooped forward. His feet shuffle and he has lost his arm swing. (CHOOSE 1 GAIT) 399. A 55-year-old woman walks by lifting one foot further off the ground than the other. (CHOOSE 1 GAIT) 400. A 62-year-old man walks with his feet widely spaced steps occur with each foot lifted abruptly and too high and brought down in a stamping manner. (CHOOSE 1 GAIT)...

Questions

DIRECTIONS Each of the numbered items or incomplete statements in this section is followed by answers or by completion of the statements. Select the one lettered answer or completion that is best in each case. 1. Which of the following is the most important first step in the diagnostic and treatment process a. A thorough history and physical examination 2. Which of the following is the most accurate method of obtaining a temperature in the pediatric population a. Use a rectal thermometer placed...

The answer is d Seidel 4e pp 432433 A precordial thrill is a

Palpable murmur that may accompany heart disease. It is always considered pathologic and may be felt during systole i.e., AS, VSD, MR, patent ductus arteriosus (PDA), tetralogy of Fallot or diastole (i.e., AI, MS). The presence of a thrill characterizes a murmur as at least grade 4 in intensity. 162. The answer is b. (Seidel, 4 e, pp 467-471.) Mitral stenosis (MS) is characterized by an opening snap just prior to a low-pitched, rumbling diastolic murmur. Aortic regurgitation is a high-pitched...

Answers

The answer is a. (Seidel, 4 e, p 1.) A thorough history and physical examination is the core of the diagnostic and treatment process. Any further assessment with blood work and the other tests listed must be integrated with the initial information compiled in the history and physical examination. The H& P is always the most important first step in any diagnostic and treatment process. 2. The answer is a. (Sapira, p 101.) Measurement of axillary temperature alleviates the need to insert a...

The answer is b Fauci 14e p 1446 Kartagener syndrome is the

Inheritable disorder of dextrocardia, chronic sinusitis (with the formation of nasal polyps), and bronchiectasis. Patients may also present with situs inversus. The disorder is due to a defect that causes the cilia within the respiratory tract epithelium to become immotile. Cilia of the sperm are also affected. 115. The answer is d. (Fauci, 14 e, pp 1466-1468.) Primary pulmonary hypertension (PPH) is of unknown etiology and primarily affects women in their thirties or forties. The underlying...

Choose 1 Disorder

A 43-year-old man presents with cirrhosis. Slit-lamp examination reveals a yellow-brown ring in the limbus of the cornea. The patient has recently developed an unsteady gait, tremors, and involuntary chorea-like movements. (CHOOSE 1 DISORDER) Items 225-226 For each patient with jaundice, choose the most likely liver disorder. c. Crigler-Najjar type 1 syndrome d. Crigler-Najjar type 2 syndrome 225. A 23-year-old man presents with mild, persistent jaundice. The serum bilirubin is always <...

Criteria for Allergic Bronchopulmonary Aspergillosis Abpa mnemonic Escape A escape ABPA

Skin reactivity to Aspergillus antigen Pulmonary infiltrates Elevated serum IgE levels The most sensitive physical sign of pulmonary embolism sinus tachycardia Livedo reticularis + shortness of breath following fracture of femur fat emboli Blue bloater chronic bronchitis CHEST EXAMINATION PHYSICAL FINDINGS Disease Trachea Fremitus Percussion Sounds

Items 103105

For each patient with nystagmus, choose the most appropriate kind(s) of nystagmus. 103. A newborn has congenital , nystagmus. (SELECT 1 KIND OF 104. A 19-year-old man presents for his precollege medical clearance and is found to have nystagmus when asked to gaze to the extreme far left. (SELECT 1 KIND OF NYSTAGMUS) 105. A 49-year-old man is ventilator-dependent and comatose following a motor vehicle accident. (SELECT c. Nystagmus that disappears with convergence e. Asymmetric lateral nystagmus

Items 145146

For each chest description, choose the appropriate skeletal deformity. 145. A 4-year-old boy has a marked depression of the sternum below the clavicular-manubrium junction. (CHOOSE 1 DEFORMITY) 146. A 9-year-old girl has a chest deformity in which the sternum protrudes from the thorax. (CHOOSE 1 DEFORMITY) 144. Posterior mediastinum (CHOOSE 2 MASSES)

Items 185188

For each patient with a heart murmur, choose the most likely heart lesion responsible for the murmur. i. Hypertrophic cardiomyopathy j. Mitral valve prolapse k. Ventricular septal defect l. Atrial septal defect m. Idiopathic calcific aortic stenosis 185. A 50-year-old man presents with syncope while dancing at his high school reunion party. His blood pressure is normal but pulse pressure is narrow. Heart examination reveals a crescendo-decrescendo systolic murmur heard best at the 2nd left...

Items 310311

For each cell abnormality, choose the most appropriate name of the abnormality. f. Hypersegmented polymorphonuclear leukocytes 310. These nuclear remnants are seen in circulating red blood cells in asplenic patients. (CHOOSE 1 NAME FOR THE ABNORMALITY) 311. Oxidized hemoglobin denatures and forms these inclusions or precipitants. (CHOOSE 1 NAME FOR THE ABNORMALITY)

Items 335336

For each patient with joint pain, choose the best diagnosis. c. Systemic lupus erythematosus 335. A 69-year-old man taking hydralazine for hypertension presents with joint pain and chest pain. On cardiac examination, the patient has a pericardial rub. (CHOOSE 1 DIAGNOSIS) 336. A 17-year-old woman complains of intermittent ankle pain and swelling, photosensitivity, and oral ulcers. On physical examination, joints are normal but a peri-cardial rub is audible. (CHOOSE 1 DIAGNOSIS)

Physical Diagnosis

PreTest Self-Assessment and Review Fourth Edition Assistant Professor of Medicine Medicine Clerkship Director UMDNJ-New Jersey Medical School Newark, New Jersey Attending Physician Division of Gastroenterology Bayshore Community Hospital Holmdel, New Jersey McGraw-Hill tFSVS Medical Publishing Division la nil PreTest Series New York St. Louis San Francisco Auckland Bogot Caracas Lisbon London Madrid Mexico City Milan Montreal New Delhi San Juan Singapore Sydney Tokyo Toronto A Division of The...

The answer is c Fauci 14e pp 13951396 Dissection of the

Aorta occurs when the intima is interrupted so that blood enters the wall of the aorta and separates its layers, forming a second lumen. It is almost always fatal if left undiagnosed, but with prompt treatment most patients survive. Anything that weakens the media can lead to dissection, but hypertension is the most common risk factor. Aortic dissection is a major cause of morbidity and mortality in Marfan syndrome. Other etiologies of dissection include cystic medial necrosis (described in...

Info

A 49-year-old woman is brought to the emergency room after suddenly losing consciousness. Her husband states that the patient was in good health until 2 h ago, when she suddenly complained of a severe headache. After one episode of vomiting, the patient lost consciousness. The husband states that there were no seizure-like movements and no incontinence. The patient did not take any medications, smoke, drink, or use illicit drugs. On physical examination, the patient has a regular heart...

A score of 07 is mild BPH 819 is moderate BPH and 2035 is severe BPH

The answer is b. (Fauci, 14 e, p 1544.) IgA nephropathy (Berger's) is the most commonly encountered form of focal glomerulonephritis worldwide, and patients will often have microhematuria. It may follow an upper respiratory tract infection or physical exertion. Bladder cancer is a common cause of asymptomatic microhematuria but is usually found in patients over the age of 50. Risk factors for bladder neoplasia include aniline, rubber, other organic solvents, industrial dyes, and tobacco...

Syndrome Associated With Hypospadia

The answer is b. (Seidel, 4 e, pp 665-668. Tierney, 39 e, pp 1141-1142.) Germ cell tumors are the most common tumors in men between 20 and 35 years of age. A man who presents with a testicular mass and an elevated serum a-fetoprotein (AFP) level most likely has non-seminomatous testicular cancer. The elevated AFP implies yolk sac or nonseminomatous elements. Patients with seminomas (more common than nonseminomas) often have elevations in human chorionic gonadotropin (hCG). All germ cell...

Terms of

A 21-year-old man presents to your office for a preemployment physical examination. He is 6 ft 3 in. tall and weighs 70 kg. Heart examination is remarkable for a midsystolic click and a grade 2 systolic murmur that increases with Valsalva maneuver. The patient has an arm span that exceeds his height and has long, slender fingers. The thumb sign (Steinberg sign) is positive. Which of the following is the most likely diagnosis 6. A nursing home patient is transferred to the hospital for possible...

Obstetrics and Gynecology

DIRECTIONS Each of the numbered items or incomplete statements in this section is followed by answers or by completion of the statements. Select the one lettered answer or completion that is best in each case. 452. A 23-year-old woman presents with fever and bilateral lower quadrant abdominal pain for two days. She complains of the onset of a mucopurulent vaginal discharge with her menses, which she states is yellowish in color. She has a new sexual partner and uses a nonbar-rier method of...

Pediatrics and Neonatology

The answer is b. (Behrman, 16 e, pp 1385-1399. Hay, 14 e, pp 496-497.) The five congenital heart disorders listed in the answer (the five T's) cause right-to-left shunts and subsequent cyanosis. Tetralogy of Fallot is the most common type of cyanotic heart lesion and consists of Pulmonary stenosis, RVH, an Overriding aorta, and VSD (PROV). Children present with dyspnea, cyanosis after the neonatal period, irritability, easy fati-gability, and retarded growth and development. Physical...

Terms of Use

A 17-year-old patient presents with severe pruritus that is worse at night. Upon examination of the skin, areas of excoriated papules are observed in the interdigital area. Family members report similar symptoms. Which of the following is the most likely diagnosis 51. A 35-year-old woman who had been camping in Wisconsin 2 wk ago develops an erythematous rash on her inner thigh. The macular lesion is 10 cm in diameter and had a distinct red border with central clearing. Two days ago, a...

The answer is c Seidel 4e pp 532533 Normal liver span is 612 cm in the MCL and 48 cm in the midsternal line MSL Micro

Nodular cirrhosis is typically uniform throughout the liver and the nodules are < 3 mm in size. It is due to a metabolic insult such as alcohol use. The nodules of macronodular cirrhosis, which are less uniform, are > 3 mm in size and are due to drugs or infection. 204. The answer is c. (Fauci, 14 e, pp 1626-1629. Sapira, p 273.) Diabetic patients, especially those with poor control, may develop delayed gastric emptying (autonomic dysfunction). Often patients will have a succussion splash...

Infectious Diseases

DIRECTIONS Each of the numbered items or incomplete statements in this section is followed by answers or by completion of the statements. Select the one lettered answer or completion that is best in each case. 426. A 25-year-old heterosexual man develops a urethral discharge and dysuria 5 days after having unprotected sexual intercourse with a new partner. Physical examination reveals meatal erythema. There are no penile lesions and no inguinal lymphadenopathy. A purulent ure-thral discharge is...

The answer is a Fauci 14e pp 14511455 Massive lifethreatening hemoptysis is 100 cc of blood in 24 h The most common

Cause for nonmassive hemoptysis (< 30 cc day) in smokers and nonsmoking patients with a normal chest radiograph is bronchitis. Chronic bronchitis is characterized by excessive secretions manifested by a productive cough, often purulent or bloody, for 3 mo or more for 2 consecutive years in the absence of any other disease to explain the symptoms. Patients are often obese and cyanotic (blue bloater). The mnemonic is BBB Bronchitis Blue Bloater. 117. The answer is a. (Fauci, 14 e, pp...

The answer is d Fauci 14e pp 21162118 Gynecomastia is

Seen in 50-60 of adolescent boys and usually occurs during Tanner stages 2 or 3. It is usually painful and may be unilateral or bilateral. It gradually appears and gradually disappears within 1 year of onset. Pubertal changes that occur during Tanner stages 2 and 3 include growth spurt, growth of testes and penis, spermarche, acne, axillary perspiration, and appearance of pubic hair. The boy in this case should be reassured and followed monthly. If the gynecomastia does not resolve, it will be...

Hematology and Oncology

Purpuric rash abdominal pain glomerulonephritis in a child young patient HENOCH-SCHONLEIN PURPURA HSP Purpura livedo reticularis after a coronary angiogram think CHOLESTEROL ATHEROEMBOLIC DISEASE Purpura livedo reticularis hepatitis B abdominal pain after meals footdrop HTN think POLYARTERITIS NODOSA THROMBOTIC THROMBOCYTOPENIC PURPURA TTP mnemonic FAT RN 2. Anemia, microangiopathic hemolytic schistocytes 5. Neurologic abnormalities confusion, aphasia, headache, coma, seizures HEMOLYTIC UREMIC...

Causes of Hematuria mnemonic Switch Gps

Stones, Sickle cell disease, Scleroderma, SLE, Sulfonamides Wegener's granulomatosis Infections, Instrumentation, Iatrogenic, Interstitial nephritis Trauma, TB, Tumor, TTP, Tubulointerstitial disease Cryoglobulinemia, Cyclophosphamide Hemolytic uremic syndrome, Henoch-Schonlein purpura, Hemophilia Papillary necrosis, Polycystic kidney disease, Polyarteritis nodosa Schistosomiasis, Sponge disease medullary Most common organisms responsible for URINARY TRACT INFECTIONS UTIs mnemonic SEEK PP...