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1. A young man feels something in his scrotum and Varicocle
comes to you for clarification. On your examination, Varicoceles are common
you note what feels like a "bag of worms" in the left in normal men. They are
scrotum, superior to the testicles. Which of the follow- often found in the left
ing is most likely? scrotum or bilaterally and
A) Hydrocele of the spermatic cord should normally resolve
B) Varicocele in the supine position.
C) Testicular carcinoma This is because they rep-
D) A normal vas deferens resent varicosities within
the scrotum. These require
further investigation if they
occur only on the right
side or do not resolve in
the supine position. They
can contribute to infertili-
ty because the testicles are
unable to achieve a cool
enough temperature for
sperm production, due to
increased blood flow from
the varicocele. A hydrocele
would be a painless mass
on the spermatic cord and
the vas deferens is palpat-
ed as part of the spermat-
ic cord. You should lightly
pinch the scrotum medial-
ly and move laterally un-
til you feel the spermat-
ic cord pass between your
fingers.
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2. Which of the following changes are expected in vision Ans: D
as part of the normal aging process? The lens loses its elastic-
A) Cataracts ity over time as part of
B) Glaucoma the normal aging process,
C) Macular degeneration and the eye is less able
D) Blurring of near vision to accommodate and fo-
cus on near objects; there-
fore, the patient will be ex-
pected to have blurring of
near vision.
3. A 68-year-old mechanic presents to the emergency Constrictive pericarditis
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 follow-
ing conditions is a potential cause of elevated JVP?
A) Left-sided heart failure
B) Mitral stenosis
C) Constrictive pericarditis
D) Aortic aneurysm
4. Which of the following lymph node groups is most D.) Central
commonly involved in breast cancer?
A) Lateral
B) Subscapular
C) Pectoral
D) Central
5. You are beginning the examination of the skin on a D) Dry and rough
25-year-old teacher. You have previously elicited that
she came to the office for evaluation of fatigue, weight
gain, and hair loss. You strongly suspect that she has
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hypothyroidism. What is the expected moisture and
texture of the skin of a patient with hypothyroidism?
A) Moist and smooth
B) Moist and rough
C) Dry and smooth
D) Dry and rough
6. Mrs. Hill is a 28-year-old African-American with a his- A. It is likely to be related to
tory of SLE (systemic lupus erythematosus). She has her lupus
noticed a raised, dark red rash on her legs. When you
press on the rash, it doesn't blanch. What would you
tell her regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any problems.
7. You are palpating the abdomen and feel a small mass. b) examination with
Which of the following would you do next? the abdominal muscles
A) Ultrasound tensed.
B) Examination with the abdominal muscles tensed
C) Surgery referral
D) Determine size by percussion
8. You are evaluating a 40-year-old banker for coronary B) Peripheral Artery Dis-
heart disease risk factors. He has a history of hyper- ease
tension, which is well-controlled on his current med-
ications. 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?