You are assessing a 59-year-old gas station owner for atherosclerosis in the lower
extremities. In which of the following locations would the patient's pain make you
concerned for this disease process?
Calf
A 57-year
...
You are assessing a 59-year-old gas station owner for atherosclerosis in the lower
extremities. In which of the following locations would the patient's pain make you
concerned for this disease process?
Calf
A 57-year-old maintenance worker comes to your office for evaluation of pain in
his legs. He has smoked two packs per day since the age of 16, but he is otherwise
healthy. You are concerned that he may have peripheral vascular disease. Which of
the following is part of common or concerning symptoms for the peripheral
vascular system?
Intermittent claudication
Linda is a 29-year-old who had excruciating pain which started under her lower
ribs on the right side. The pain eventually moved to her lateral abdomen and then
into her right lower quadrant. Which is most likely, given this presentation?
ovarian cyst
Chris is a 20-year-old college student who has had abdominal pain for 3 days. It
started at his umbilicus and was associated with nausea and vomiting. He was
unable to find a comfortable position. Yesterday, the pain became more severe and
constant. Now, he hesitates to walk, because any motion makes the pain much
worse. It is localized just medial and inferior to his iliac crest on the right. Which
of the following is most likely?
appendiscitis
A daycare worker presents to your office with jaundice. She denies IV drug use,
blood transfusion, and travel and has not been sexually active for the past 10
months. Which type of hepatitis is most likely?
Hepatitis A
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shared via CourseHero.comWhich is the proper sequence of examination for the abdomen?
Inspection, auscultation, percussion, palpation
A 26-year-old sports store manager comes to your clinic, complaining of severe
right-sided abdominal pain for 12 hours. He began having a stomachache
yesterday, with a decreased appetite, but today the pain seems to be just on the
lower right side. He has had some nausea and vomiting but no constipation or
diarrhea. His last bowel movement was last night and was normal. He has had no
fever or chills. He denies any recent illnesses or injuries. His past medical history
is unremarkable. He is engaged. He denies any tobacco or drug use and drinks four
to six beers per week. His mother has breast cancer and his father has coronary
artery disease. On examination he appears ill and is lying on his right side. His
temperature is 100.4 and his heart rate is 110. His bowel sounds are decreased and
he has rebound and involuntary guarding, one third of the way between the anterior
superior iliac spine and the umbilicus in the right lower quadrant. His rectal,
inguinal, prostate, penile, and testicular examinations are normal. What is the most
likely cause of his pain?
Acute appendicitis
Mr. Maxwell has noticed that he is gaining weight and has increasing girth. Which
of the following would argue for the presence of ascites
Tympany which changes location with patient position
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shared via CourseHero.comA 42-year-old florist comes to your office, complaining of chronic constipation for
the last 6 months. She has had no nausea, vomiting, or diarrhea and no abdominal
pain or cramping. She denies any recent illnesses or injuries. She denies any
changes to her diet or exercise program. She is on no new medications. During the
review of systems you note that she has felt fatigued, had some weight gain, has
irregular periods, and has cold intolerance. Her past medical history is significant
for one vaginal delivery and two cesarean sections. She is married, has three
children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her
mother has type 2 diabetes and her father has coronary artery disease. There is no
family history of cancers. On examination she appears her stated age. Her vital
signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are
normal. Her cardiac, lung, and abdominal examinations are also unremarkable. Her
rectal occult blood test is negative. Her deep tendon reflexes are delayed in
response to a blow with the hammer, especially the Achilles tendons. What is the
best choice for the cause of her constipation?
Hypothyroidism
A 76-year-old retired farmer comes to your office complaining of abdominal pain,
constipation, and a low-grade fever for about 3 days. He denies any nausea,
vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of
popcorn at the movies with his grandson, 3 days before his symptoms began. He
denies any other recent illnesses. His past medical history is significant for
coronary artery disease and high blood pressure. He has been married for over 50
years. He denies any tobacco, alcohol, or drug use. His mother died of colon
cancer and his father had a stroke. On examination he appears his stated age and is
in no acute distress. His temperature is 100.9 degrees and his other vital signs are
unremarkable. His head, cardiac, and pulmonary examinations are normal. He has
normal bowel sounds and is tender over the left lower quadrant. He has no rebound
or guarding. His rectal examination is unremarkable and his fecal occult blood test
is negative. His prostate is slightly enlarged but his testicular, penile, and inguinal
examinations are all normal. Blood work is pending. What diagnosis for abdominal
pain best describes his symptoms and signs?
Acute diverticulitis
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