Advanced Health Assessment Midterm
Review 2024-2025. All Questions &
Answers.
______is an allergic inflammation of the nasal airways. It occurs when an allergen, such
as pollen, dust or animal dander is inhaled by an individual with a sensitized immune
system. In such individuals; the allergen triggers the production of the antibody
immunoglobulin E (IgE), which binds to mast cells and basophils containing histamine.
allergic rhinitis
decompensation
deficiency
degeneration - ansallergic rhinitis
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the
left eye. It started this morning. He denies any trauma or injury. There is no visual
disturbance. Upon physical examination, there is a red raised area at the margin of the
eyelid that is tender to palpation; no tearing occurs with palpation of the lesion. Based
on this description, what is the most likely diagnosis?
Xanthelasma
Hordeolum
Dacryocystitis
Chalazion - ansHordeolum
A 15-month-old is brought to you for a fever of 38.6 degrees Celsius and fussiness. The
ear examination is as follows: external ear, normal appearance and no tenderness with
manipulation; canal, normal diameter without evidence of inflammation; tympanic
membrane, bulging, erythematous, and opaque. Insufflation is deferred due to pain.
What is your diagnosis?
Otitis externa
Cholesteatoma
Ruptured tympanic membrane
,Otitis media - ansOtitis media
There is no inflammation of the outer ear, including the canal, thus excluding otitis
externa. Cholesteatoma is a painless white lesion behind the TM. There is no drainage
from the TM; thus, rupture is unlikely. This is a classic description of otitis media. Many
examiners will forego insufflation if the diagnosis is clear, because this can cause
discomfort in an already uncomfortable ear.
A 15-year-old high school sophomore and her mother come to your clinic because the
mother is concerned about her daughter's weight. You measure her daughter's height
and weight and obtain a BMI of 19.5 kg/m2. Based on this information, which of the
following is appropriate?
Refer the patient to a nutritionist and a psychologist because the patient is anorexic.
Reassure the mother that this is a normal body weight.
Give the patient information about exercise because the patient is obese.
Give the patient information concerning reduction of fat and cholesterol in her diet
because she is obese. - ansReassure the mother that this is a normal body weight.
The patient has a normal BMI; the range for a normal BMI is 18.5 to 24.9 kg/m2. You
may be able to give the patient and her mother the lower limit of normal in pounds for
her daughter's height, or instruct her in how to use a BMI table.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week
history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
Infection
Inflammation
Allergic
Vascular - ansAllergic
This description is most consistent with allergic rhinitis.
A 17-year-old high school student is brought in to your emergency room in a comatose
state. His friends have accompanied him and tell you that they have been shooting up
heroin tonight and they think their friend may have had too much. The patient is
unconscious and cannot protect his airway, so he is intubated. His heart rate is 60 and
he is breathing through the ventilator. He is not posturing and he does not respond to a
sternal rub. Preparing to finish the neurologic examination, you get a penlight.
,What size pupils do you expect to see in this comatose patient?
Asymmetric pupils
Irregularly shaped pupils
Pinpoint pupils
Large pupils - ansPinpoint pupils
A 19-year old-college student presents to the emergency room with fever, headache,
and neck pain/stiffness. She is concerned about the possibility of meningococcal
meningitis. Several of her dorm mates have been vaccinated, but she hasn't been.
Which of the following physical examination descriptions is most consistent with
meningitis?
Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full
range of motion
Head is normocephalic and atraumatic, fundi with sharp discs, neck with paraspinous
muscle spasm and limited range of motion to the right
Head is normocephalic and atraumatic, fundi with blurred disc margins, neck tender to
palpation, unable to perform range of motion
Head is normocephalic and atraumatic, fundi with blurred disc margins, neck supple
with full range of motion - ansHead is normocephalic and atraumatic, fundi with blurred
disc margins, neck tender to palpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and lack of
range of motion are consistent with neck stiffness, which in this scenario is likely to be
caused by meningeal inflammation. Later, you will learn about Kernig's and Brudzinski's
signs, which are helpful in testing for meningeal irritation on examination.
A 21-year-old engineering student comes to your office, complaining of leg and back
pain and of tripping when he walks. He states this started 3 months ago with back and
buttock pain but has since progressed to feeling weak in his left leg. He denies any
bowel or bladder symptoms. He can think of no specific traumatic incidences but he was
a defensive lineman in high school and junior college. His past medical history is
unremarkable. He denies tobacco use or alcohol or drug abuse. His parents are both
healthy. On examination he is tender over the lumbar spine and he has a positive
straight-leg raise on the left. His Achilles tendon deep reflex is decreased on the left.
While watching his gait you notice he has to pick his left foot up high in order not to trip.
What abnormality of gait does he most likely have?
Parkinsonian gait
, Steppage gait
Spastic hemiparesis
Sensory ataxia - ansSteppage gait
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new, located in the wrists and fingers bilaterally, with some subjective fever. The patient
denies a rash; she also denies recent travel or camping activities. She has a family
history significant for rheumatoid arthritis. Based on this information, which of the
following pathologic processes would be the most correct?
Infectious
Inflammatory
Hematologic
Traumatic - ansInflammatory
The description is most consistent with an inflammatory process, although all the other
etiologies should be considered. Lyme disease is an infection which commonly causes
arthritis, hemophilia is a hematologic condition which can cause bleeding in the joints,
and trauma can obviously cause joint pain. Your clinical reasoning skills are important
for sorting through all of the data to arrive at the most likely conclusion.
A 23-year-old graduate student comes to your clinic for evaluation of a urethral
discharge. As the provider, you need to get a sexual history. Which one of the following
questions is inappropriate for eliciting the information?
Are you sexually active?
When was the last time you had intimate physical contact with someone, and did that
contact include sexual intercourse?
Do you have sex with men, women, or both?
How many sexual partners have you had in the last 6 months? - ansAre you sexually
active?
This is inappropriate because it is too vague. Given the complaint, you should probably
assume that he is sexually active. Sometimes patients may respond to this question
with the phrase No, I just lie there. A specific sexual history will help you to assess this
patient's risk for other sexually transmitted infections
Review 2024-2025. All Questions &
Answers.
______is an allergic inflammation of the nasal airways. It occurs when an allergen, such
as pollen, dust or animal dander is inhaled by an individual with a sensitized immune
system. In such individuals; the allergen triggers the production of the antibody
immunoglobulin E (IgE), which binds to mast cells and basophils containing histamine.
allergic rhinitis
decompensation
deficiency
degeneration - ansallergic rhinitis
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the
left eye. It started this morning. He denies any trauma or injury. There is no visual
disturbance. Upon physical examination, there is a red raised area at the margin of the
eyelid that is tender to palpation; no tearing occurs with palpation of the lesion. Based
on this description, what is the most likely diagnosis?
Xanthelasma
Hordeolum
Dacryocystitis
Chalazion - ansHordeolum
A 15-month-old is brought to you for a fever of 38.6 degrees Celsius and fussiness. The
ear examination is as follows: external ear, normal appearance and no tenderness with
manipulation; canal, normal diameter without evidence of inflammation; tympanic
membrane, bulging, erythematous, and opaque. Insufflation is deferred due to pain.
What is your diagnosis?
Otitis externa
Cholesteatoma
Ruptured tympanic membrane
,Otitis media - ansOtitis media
There is no inflammation of the outer ear, including the canal, thus excluding otitis
externa. Cholesteatoma is a painless white lesion behind the TM. There is no drainage
from the TM; thus, rupture is unlikely. This is a classic description of otitis media. Many
examiners will forego insufflation if the diagnosis is clear, because this can cause
discomfort in an already uncomfortable ear.
A 15-year-old high school sophomore and her mother come to your clinic because the
mother is concerned about her daughter's weight. You measure her daughter's height
and weight and obtain a BMI of 19.5 kg/m2. Based on this information, which of the
following is appropriate?
Refer the patient to a nutritionist and a psychologist because the patient is anorexic.
Reassure the mother that this is a normal body weight.
Give the patient information about exercise because the patient is obese.
Give the patient information concerning reduction of fat and cholesterol in her diet
because she is obese. - ansReassure the mother that this is a normal body weight.
The patient has a normal BMI; the range for a normal BMI is 18.5 to 24.9 kg/m2. You
may be able to give the patient and her mother the lower limit of normal in pounds for
her daughter's height, or instruct her in how to use a BMI table.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week
history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
Infection
Inflammation
Allergic
Vascular - ansAllergic
This description is most consistent with allergic rhinitis.
A 17-year-old high school student is brought in to your emergency room in a comatose
state. His friends have accompanied him and tell you that they have been shooting up
heroin tonight and they think their friend may have had too much. The patient is
unconscious and cannot protect his airway, so he is intubated. His heart rate is 60 and
he is breathing through the ventilator. He is not posturing and he does not respond to a
sternal rub. Preparing to finish the neurologic examination, you get a penlight.
,What size pupils do you expect to see in this comatose patient?
Asymmetric pupils
Irregularly shaped pupils
Pinpoint pupils
Large pupils - ansPinpoint pupils
A 19-year old-college student presents to the emergency room with fever, headache,
and neck pain/stiffness. She is concerned about the possibility of meningococcal
meningitis. Several of her dorm mates have been vaccinated, but she hasn't been.
Which of the following physical examination descriptions is most consistent with
meningitis?
Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full
range of motion
Head is normocephalic and atraumatic, fundi with sharp discs, neck with paraspinous
muscle spasm and limited range of motion to the right
Head is normocephalic and atraumatic, fundi with blurred disc margins, neck tender to
palpation, unable to perform range of motion
Head is normocephalic and atraumatic, fundi with blurred disc margins, neck supple
with full range of motion - ansHead is normocephalic and atraumatic, fundi with blurred
disc margins, neck tender to palpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and lack of
range of motion are consistent with neck stiffness, which in this scenario is likely to be
caused by meningeal inflammation. Later, you will learn about Kernig's and Brudzinski's
signs, which are helpful in testing for meningeal irritation on examination.
A 21-year-old engineering student comes to your office, complaining of leg and back
pain and of tripping when he walks. He states this started 3 months ago with back and
buttock pain but has since progressed to feeling weak in his left leg. He denies any
bowel or bladder symptoms. He can think of no specific traumatic incidences but he was
a defensive lineman in high school and junior college. His past medical history is
unremarkable. He denies tobacco use or alcohol or drug abuse. His parents are both
healthy. On examination he is tender over the lumbar spine and he has a positive
straight-leg raise on the left. His Achilles tendon deep reflex is decreased on the left.
While watching his gait you notice he has to pick his left foot up high in order not to trip.
What abnormality of gait does he most likely have?
Parkinsonian gait
, Steppage gait
Spastic hemiparesis
Sensory ataxia - ansSteppage gait
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new, located in the wrists and fingers bilaterally, with some subjective fever. The patient
denies a rash; she also denies recent travel or camping activities. She has a family
history significant for rheumatoid arthritis. Based on this information, which of the
following pathologic processes would be the most correct?
Infectious
Inflammatory
Hematologic
Traumatic - ansInflammatory
The description is most consistent with an inflammatory process, although all the other
etiologies should be considered. Lyme disease is an infection which commonly causes
arthritis, hemophilia is a hematologic condition which can cause bleeding in the joints,
and trauma can obviously cause joint pain. Your clinical reasoning skills are important
for sorting through all of the data to arrive at the most likely conclusion.
A 23-year-old graduate student comes to your clinic for evaluation of a urethral
discharge. As the provider, you need to get a sexual history. Which one of the following
questions is inappropriate for eliciting the information?
Are you sexually active?
When was the last time you had intimate physical contact with someone, and did that
contact include sexual intercourse?
Do you have sex with men, women, or both?
How many sexual partners have you had in the last 6 months? - ansAre you sexually
active?
This is inappropriate because it is too vague. Given the complaint, you should probably
assume that he is sexually active. Sometimes patients may respond to this question
with the phrase No, I just lie there. A specific sexual history will help you to assess this
patient's risk for other sexually transmitted infections
