CHAPTER10
10.Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On
examination, you noted a bruit heard over the thyroid. This is suggestive of:
a
.
hypothyroidism.
b
.
hyperthy
...
CHAPTER10
10.Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On
examination, you noted a bruit heard over the thyroid. This is suggestive of:
a
.
hypothyroidism.
b
.
hyperthyroidism.
c
.
thyroid cancer.
d
.
thyroid cyst.
ANS: B
Because of hypermetabolic states such as hyperthyroidism, a bruit may be heard as a result of the
increased blood flow to the area. Auscultating a bruit is not symptomatic of hypothyroidism,
cancer, or a cyst. A nodule is more indicative of cancer.
15.During a physical examination of a 30-year-old Chinese man, you notice a slight asymmetry of his
face. The cranial nerve examination is normal. Your best action is to:
a
.
ask the patient if this characteristic runs in his family.
b
.
perform monofilament testing on the face.
c
.
consult with the physician regarding the laboratory tests needed.
d
.
record the finding in the patient’s chart.
ANS: D
It is not abnormal to have some slight asymmetry of the face that does not require further
questioning, tests, or unnecessary laboratory work, but it does require a notation in the chart that
could be referenced for future concerns.
16. A bruit, or blowing sound, over the skull or temporal region of an adult indicates a:
a
.
degenerative change.
b
.
hyperthyroid storm.
c
.
skull fracture.
d
.
vascular anomaly.
ANS: D
Temporal bruits can indicate a vascular anomaly such as an arterial obstruction, aneurysm, or
vascular neoplasm. Audible bruits are not associated with degenerative changes or skull fracture.
Hyperthyroid storm would cause tachycardia and palpations but not usually a bruit.
18. Coarse, dry, and brittle hair is associated with which metabolic disorder?
a Hypothyroidism
.
b
.
Diabetes mellitus
c
.
Addison disease
d
.
Cushing syndrome
ANS: A
Hypothyroidism affects hair texture, resulting in coarse, dry, and brittle changes.
23.The thyroid gland should:
a
.
be slightly left of midline.
b
.
have a clear vascular sound.
c
.
move when the patient swallows.
d
.
tug with each heartbeat.
ANS: C
It is a normal finding for the thyroid gland to move with swallowing; however, being off center
may indicate a nodular growth or enlargement. The thyroid gland should not be slightly left of
midline. Vascular sounds indicate hypermetabolic states such as hyperthyroidism, and a tug with
each heartbeat is a sign of an aortic aneurysm
29.Nuchal rigidity is most commonly associated with:
a
.
thyroiditis.
b
.
meningeal irritation.
c
.
Down syndrome.
d
.
cranial nerve V damage
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