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Peripheral arterial disease
You are evaluating a 40-year-old banker for coronary heart disease risk
factors. He has a history of hypertension, which is well-controlled on
his current medications. He does not smoke; he does 45 minutes of
aerobic exercise five times weekly. You are calculating his 10-year
coronary heart disease risk. Which of the following conditions is
considered to be a coronary heart disease risk equivalent?
A) Hypertension
B) Peripheral arterial disease
C) Systemic lupus erythematosus
D) Chronic obstructive pulmonary disease (COPD)
palpable
You are conducting a workshop on the measurement of jugular venous
pulsation. As part of your instruction, you tell the students to make sure
that they can distinguish between the jugular venous pulsation and the
carotid pulse. Which one of the following characteristics is typical of
the carotid pulse?
A) Palpable
B) Soft, rapid, undulating quality
C) Pulsation eliminated by light pressure on the vessel
D) Level of pulsation changes with changes in position
,Constrictive pericarditis
A 68-year-old mechanic presents to the emergency room for shortness
of breath. You are concerned about a cardiac cause and measure his
jugular venous pressure (JVP). It is elevated. Which one of the following
conditions is a potential cause of elevated JVP?
A) Left-sided heart failure
B) Mitral stenosis
C) Constrictive pericarditis
D) Aortic aneurysm
Aortic stenosis, with pressure overload of the left ventricle
You are palpating the apical impulse in a patient with heart disease and
find that the amplitude is diffuse and increased. Which of the following
conditions could be a potential cause of an increase in the amplitude
of the impulse?
A) Hypothyroidism
B) Aortic stenosis, with pressure overload of the left ventricle
C) Mitral stenosis, with volume overload of the left atrium
D) Cardiomyopathy
,lupus
You are assessing a patient with diffuse joint pains and want to make
sure that only the joints are the problem, and that the pain is not related
to other diseases. Which of the following is a systemic cause of joint
pain?
A) Gout
B) Osteoarthritis
C) Lupus
D) Spondylosis
lyme disease
A 19-year-old college sophomore comes to the clinic for evaluation of
joint pains. The student has been back from spring break for 2 weeks;
during her holiday, she went camping. She notes that she had a red
spot, shaped like a target, but then it started spreading, and then the
joint pains started. She used insect repellant but was in an area known
to have ticks. She has never been sick and takes no medications
routinely; she has never been sexually active. What is the most likely
cause of her joint pain?
, foot arched
An 85-year-old retired housewife comes with her daughter to establish
care. Her daughter is concerned because her mother has started to fall
more. As part of her physical examination, you ask her to walk across
the examination room. Which of the following is not part of the stance
phase of gait?
A) Foot arched
B) Heel strike
C) Mid-stance
D) Push-off
straight leg-raise
A 32-year-old warehouse worker presents for evaluation of low back
pain. He notes a sudden onset of pain after lifting a set of boxes that
were heavier than usual. He also states that he has numbness and
tingling in the left leg. He wants to know if he needs to be off of work.
What test should you perform to assess for a herniated disc?
mechanical low back pain
A 33-year-old construction worker comes for evaluation and treatment
of acute onset of low back pain. He notes that the pain is an aching
located in the lumbosacral area. It has been present intermittently for
several years; there is no known trauma or injury. He points to the left
lower back. The pain does not radiate and there is no numbness or
tingling in the legs or incontinence. He was moving furniture for a
friend over the weekend. On physical examination, you note muscle
spasm, with normal deep tendon reflexes and muscle strength. What is
the most likely cause of this patient's low back pain?