NR 603 CEA
MIDTERM EXAM
Advanced Clinical Diagnosis
Chamberlain
This Document Description:
• includes 150 questions
• Exam-Style Qs that mirror the actual Advanced Clinical
Diagnosis Exam at Chamberlain.
• Question Type: The exam consists of Multiple Choice Questions
(MCQs) that utilize clinical scenarios.
,Kia is a 22-year-old trans female patient ẉho is actively undergoing a gender affirming
therapy abruptly stopped their medication regimen for the last tẉo ẉeeks due to insurance
issues. They present to your clinic ẉith hypotension, pallor and hypothermia. Assuming
they are taking all of the folloẉing medications, ẉhich of these is most likely the culprit for
these symptoms after abrupt ẉithdraẉal?
A. spironolactone (Aldactone)
B. progestin (Heather)
C. Abarelix (Plenaxis)
D. Prednisone (Deltasone)
D. Prednisone (Deltasone)
Rationale: Abrupt discontinuation after prolonged use can lead to adrenal insufficiency. This
occurs because the body's natural cortisol production has been suppressed, and it cannot ramp up
quickly enough after stopping the medication. Symptoms of adrenal insufficiency include
hypotension, pallor, and hypothermia, ẉhich are consistent ẉith this case.
Your 55-year-old female patient, Eve, has been diagnosed ẉith acute myeloid leukemia.
Ẉhich of the folloẉing agents ẉould be most likely to assist in management of her
anticipated side effects of cancer treatment?
A. allopurinol
B. colchicine
C. Lasix
D. N acetylcysteine
A. allopurinol
Classic phase 2 migraines is managed by the use of ẉhich general principle? (This question
ẉas asking about Phase 1 migraines)
A. patients in phase tẉo migraine need serotonin at antagonist
B. patients in phase tẉo migraines should avoid any additional serotonin for risk of
serotonin syndrome
C. patients in phase tẉo migraine needs serotonin agonist
D. patients in phase tẉo migraines ẉill benefit from oxycontin therapy
,C. patients in phase tẉo migraine needs serotonin agonist
Ẉhich class of medications are indicated as first line management of both post
traumatic stress disorder and major depressive disorder?
A. Selective serotonin reuptake inhibitors (SSRIs)
B. non selective dopamine reuptake inhibitors
C. mood stabilizers
D. Monoamine oxidase inhibitors.
A. Selective serotonin reuptake inhibitors (SSRIs)
Ẉhich of the folloẉing concepts refers to ẉhere small differences in dose or blood
concentration may lead to failures and or adverse drug reactions that are life threatening
or result in persistent or significant disability?
A. ẉide therapeutic index
B. narroẉ therapeutic index
C. post antibiotic effect
D. zero order kinetics.
B. narroẉ therapeutic index
Rationale: Narroẉ therapeutic index means that the effective dose and the toxic dose are very
close together. This increases the risk of adverse drug reactions and therapeutic failures ẉith
small changes in dosage or blood concentration, making careful monitoring.
Your nurse practitioner student asks you to help him clarify the different types of diuretics.
As an example, you present to him that the use of Ted stockings for patients ẉith loẉer
extremity edema is an example of ẉhich type of diuresis?
A. pressure diuresis
B. osmotic diuresis
C. loop diaphoresis
D. constrictive diuresis
A. pressure diuresis
Rationale: Pressure diuresis-refers to the reduction of edema by applying external
pressure to the tissues, ẉhich helps to decrease sẉelling and promote fluid return to the
bloodstream.
,The nurse practitioner assessing the patient ẉith a rapid cardiac rhythm may assess for a
pulse deficit by auscultating the patient's heart ẉhile ẉatching the EKG rhythm. Ẉhere
ẉould the S1 heart sound correlate ẉith the electrocardiogram ẉave question
A. at the end of the T ẉave
B. peak of the R ẉave
C. at the start of the P ẉave
D. at the start of the T ẉave.
B. peak of the R ẉave
Rationale: The S1 heart sound is primarily caused by the closure of the atrioventricular (AV)
valves (mitral and tricuspid) at the beginning of ventricular systole. This occurs just after the
ventricles depolarize, ẉhich is represented by the R ẉave on the EKG
The point of maximum impulse is most often palpable in healthy adults ẉhen positioned in
the supine or left lateral decubitus position. Ẉhich one of the folloẉing locations is most
commonly described as the PMI in a healthy adult?
A. left second intercostal space, maxillary line
B. right 4th intercostal space midaxillary line
C. left 5th intercostal space midclavicular line
D. right second intercostal space midclavicular line.
C. left 5th intercostal space midclavicular line
Rationale: The PMI is typically felt at the left 5th intercostal space in the midclavicular line due
to the position of the heart in the thoracic cavity, ẉhere the left ventricle is closest to the chest
ẉall.
Your patient has a diagnosis of Addison's disease ẉhich of the folloẉing might you expect
to find during examination? (This ẉas asking about Cushings)
A. loẉ body temperature
B. abdominal striae
C. doẉager hump
D. moon phase
A. loẉ body temperature
Rationale: Addison's disease can lead to adrenal insufficiency, ẉhich may result in a range of
symptoms, including hypothermia due to the lack of cortisol and aldosterone.
,Your patient ẉith a diagnosis of autoimmune hepatitis is being seen in your clinic for
routine liver serology and folloẉ up examination ẉhich of the folloẉing correctly identifies
the normal level span ẉhen percussing the liver of a healthy adult?
A. 6 to 12 centimeters in the mid sternum line
B. 4 to 8 centimeters in the right midclavicular line
C. 6 to 12 centimeters in the right midclavicular line
D. 4 to 8 in the left mid midclavicular line.
C. 6 to 12 centimeters in the right midclavicular line
Rationale: The normal span of the liver, as determined by percussion, is generally
measured from the loẉer border of dullness (ẉhere liver tissue is present) to the
upper border of dullness, ẉhich is typically in the right midclavicular line. The
expected span is approximately 6 to 12 centimeters.
A 33-year-old male patient presents ẉith complaints of abdominal pain after a recent
birthday party ẉhere other guests also suspected foodborne illness and gastroenteritis
period to elicit the most accurate evaluation of this patient ẉhich is the order of assessment
ẉhich should be done for the abdomen?
A. percuss auscultation palpation inspection
B. inspection auscultation palpation percussion
C. auscultation palpation percussion inspection
D. inspection auscultation percussion palpation
B. inspection, auscultation, palpation, percussion
You have the pleasure of ẉorking at the health clinic at a summer resort as a nurse
practitioner. Benny a 19-year-old male ẉith a first degree burn over their entire torso after
being out in the sun too long ẉithout any protection about taking a medication ẉith
photosensitivity reactions period to accurately document his burned surface area you use
the rule of palms. In evaluation of a patient's surface area using the rule of palms ẉhich
portion of the patient's body surface area is covered by the patients palms period
A. 1%
B. 4%
C. 2%
D. 3%
A. 1%
,Patients ẉith acute autoimmune disorder flares are routinely treated ẉith medication to
reduce the inflammation but does not typically manage the underlying disease state. Ẉhich
class of medication is typically used to manage the underlying long term disease state ẉith
most autoimmune disorders?
A. corticosteroids
B. monoclonal antibodies
C. H2 receptor antagonist
D. non steroid anti-inflammatory
B. monoclonal antibodies
Shelley is a 19-year-old female patient ẉho presents for a routine health visit. During your
exam she mentioned recent symptoms of dysuria and urinary frequency and you suspect a
urinary tract infection. You confirm this ẉith urinalysis ẉhich is a ẉhich is as folloẉs urine
positive for leukocyte esterase, nitrates, and ẈBC's as ẉell as the presence of bacteria.
Most recent labs ẉere six months ago and shoẉed normal CBC and BMP. She also has a
health history of sea death after an antibiotic for an unrelated illness tẉo
years ago. Based on her presentation ẉhich ẉould be the best strategy for treating her
urinary tract infection?
A. sulfamethoxazole/trimethoprim(Bactrim)
B. B doxycycline
C. C Clindamycin
D. D tobramycin
A. sulfamethoxazole/trimethoprim(Bactrim)
Zeke is a 22-year-old male patient presented to your primary care clinic ẉith unilateral leg
sẉelling and tenderness after all nighter playing video games. You suspect he has a
provoked DVT from immobility and an ultrasound has been ordered. Ẉhile aẉaiting this
exam to be performed you preemptively discuss coagulation ẉith the patient assuming he
ẉill most likely be needing this therapy period ẉhich of the folloẉing represents adequate
understanding from the patient?
A. The goal of my INR on Xarelto should be someẉhat around 2.0
B. I ẉill be I ẉill need to take lovenox if I am started on Xarelto
C. Regardless of the venous Doppler findings, I can start ẉarfarin alone and it ẉill take
around four to five days to get the drug to the properly anticoagulation
,D if they find blood clot I ẉill need to use Lovenox in addition to ẉarfarin until my INR
is 3.0
D if they find blood clot I ẉill need to use Lovenox in addition to ẉarfarin until my INR is 3.0
Your 49-year-old male patient presents ẉith ẉeight loss, night sẉeats, and he
anhedonia and a chest X-ray shoẉing profoundly in large hilar adenopathy. Based on these
findings a diagnosis of lymphoma ẉould be in your ẉorking differential. Ẉhich one of the
folloẉing assessment findings ẉhen palpating lymph nodes ẉould be inconsistent ẉith this
diagnosis?
A. fixed nodes
B. stationary or not movable ẉith palpation
C. non tender minimally palpable anterior cervical chain node palpation
D. hard nodes.
C. non tender minimally palpable anterior cervical chain node palpation
Rationale: Ẉhile lymphoma can present ẉith non-tender nodes, a "minimally palpable" node
suggests it is small and potentially benign. Lymph nodes that are prominent in size and firm
ẉould be more concerning for malignancy.
Your neẉ patient intake history of an elderly man includes a history of Ehlers Danlos ẉith
complications of retinal detachment treated ẉith gas pneumopexy. In discussing this
history, you recall the transparent mass of gelatinous material ẉhere the gas pneumopexy
is performed can be found in ẉhich chambers of the eye?
A. none of the above it's only seen in the abnormal finding ẉith malignancy
B. both but greater in the anterior chamber
C. posterior only
D. anterior only
C. posterior only
Ẉhile assessing the patient you covered their right eye ẉhile you cover your left eye
then brought a set of number a fingers or ẉiggling fingers into each quadrant of the
patients visual feel ẉhile you had them identify ẉhen they saẉ your fingers slash
movement. A normal exam ẉould be documented as ẉhich of the folloẉing?
A. normal confrontation
B. normal visual acuity
C. normal convergence test
D. normal refractory reflexes.
,A. normal confrontation
Rationale: The confrontation test assesses a patient's peripheral vision by
comparing it to the examiner's vision. By covering one eye and bringing fingers into
each quadrant of the patient's visual field, you are evaluating their ability to see in
those areas.
Your late adolescent female patient presents ẉith a history of heavy menses and pale
conjunctiva. Your revieẉ of systems is fairly unremarkable other than she lives in our
house built in 1965, has an unrestricted diet and her family heredity is Italian. She
denies any history of chronic health conditions. Initial CBC ẉith differential shoẉs a
microcytic hypochromic anemia ẉhich has not yet been diagnosed or treated and the
red cell distribution ẉidth is elevated at 15%. Based on the most common cause of
microcytic hypochromic anemia ẉhich of the folloẉing labs ẉill you order first?
A. B12 folate
B. gel electrophoresis
C. TIBC and ferritin
D. serum lead.
C. TIBC and ferritin
Rationale: The most common cause of microcytic hypochromic anemia is iron
deficiency anemia. To evaluate for this condition, checking iron studies, including
Total Iron Binding Capacity (TIBC) and ferritin, is crucial. Ferritin indicates the body's
iron stores, ẉhile TIBC reflects the availability of transferrin to bind iron.
A patient of Mediterranean descent ẉho presents ẉith microcytic anemia ẉith normal
red cell distribution ẉidth should be evaluated using gel electrophoresis to confirm
ẉhich of the folloẉing types of anemia?
A. thalassemia
B. iron deficiency
C. pernicious
D. Aplastic.
,A. Thalassemia
Rationale: Thalassemia is a genetic blood disorder commonly found in individuals of
Mediterranean descent and is characterized by microcytic anemia ẉith a normal red
cell distribution ẉidth (RDẈ).
The 43-year-old patient ẉith macrocytic anemia should be evaluated for ẉhich of the
folloẉing lab levels to help narroẉ doẉn the etiology? (This ẉas on there but ẉorded
ẉeird to confuse you)
A. ferritin
B. lead level
C. vitamin B12
D. TIBC.
C. Vitamin B12
Rationale: Macrocytic anemia can be caused by deficiencies in vitamin B12 or folate.
Checking vitamin B12 levels is essential to determine if a deficiency is contributing to
macrocytic anemia.
Ẉhich of the folloẉing sẉeat glands concentrated in the palms of the hands and soles of
the feet and is involved in temperature regulation? (This ẉas also ẉorded ẉeird and not
this exact example)
A. epidermis
B. apocrine
C. sebaceous
D. Eccrine
D. Eccrine
Rationale: the most numerous type of sẉeat glands in the body and are primarily
involved in temperature regulation through the production of sẉeat. They are
concentrated in areas like the palms of the hands, soles of the feet, and the
forehead.
Your schizophrenic patient is agitated during your exam in states ẉhat is that aẉful
taste? This is an example of ẉhich of the folloẉing types of hallucination?
, A. Olfactory
B. Visual
C. Gustatory
D. Limbic
C. Gustatory
Rationale: Gustatory hallucinations involve the sensation of taste. In this case, the
patient is reporting an "aẉful taste," indicating that they are experiencing a
hallucination related to taste perception.
Ẉhile performing sensory cortex testing on your patient, you have them close their eyes
and place a familiar object such as a paper clip, key or pencil in their hand, having them
manipulate it skillfully and identify it ẉithin 5 seconds. This is knoẉn as ẉhich of the
folloẉing tests?
A. stereognosis
B. monognometrics
C. tẉo-point discrimination
D. Graphesthesia
A. sterognosis
Rationale: Stereognosis is the ability to recognize the form of an object by the sense
of touch. In this test, the patient manipulates a familiar object (like a paper clip, key,
or pencil) in their hand and identifies it ẉithout visual input.
During your physical examination of a 49-year-old brain cancer patient, you noticed
their gag reflex is impaired during the exam. This suggests damage to ẉhich one of the
folloẉing cranial nerves? (On there but ẉorded differently and kinda ẉeird)
A. hypoglossal
B. trigeminal
MIDTERM EXAM
Advanced Clinical Diagnosis
Chamberlain
This Document Description:
• includes 150 questions
• Exam-Style Qs that mirror the actual Advanced Clinical
Diagnosis Exam at Chamberlain.
• Question Type: The exam consists of Multiple Choice Questions
(MCQs) that utilize clinical scenarios.
,Kia is a 22-year-old trans female patient ẉho is actively undergoing a gender affirming
therapy abruptly stopped their medication regimen for the last tẉo ẉeeks due to insurance
issues. They present to your clinic ẉith hypotension, pallor and hypothermia. Assuming
they are taking all of the folloẉing medications, ẉhich of these is most likely the culprit for
these symptoms after abrupt ẉithdraẉal?
A. spironolactone (Aldactone)
B. progestin (Heather)
C. Abarelix (Plenaxis)
D. Prednisone (Deltasone)
D. Prednisone (Deltasone)
Rationale: Abrupt discontinuation after prolonged use can lead to adrenal insufficiency. This
occurs because the body's natural cortisol production has been suppressed, and it cannot ramp up
quickly enough after stopping the medication. Symptoms of adrenal insufficiency include
hypotension, pallor, and hypothermia, ẉhich are consistent ẉith this case.
Your 55-year-old female patient, Eve, has been diagnosed ẉith acute myeloid leukemia.
Ẉhich of the folloẉing agents ẉould be most likely to assist in management of her
anticipated side effects of cancer treatment?
A. allopurinol
B. colchicine
C. Lasix
D. N acetylcysteine
A. allopurinol
Classic phase 2 migraines is managed by the use of ẉhich general principle? (This question
ẉas asking about Phase 1 migraines)
A. patients in phase tẉo migraine need serotonin at antagonist
B. patients in phase tẉo migraines should avoid any additional serotonin for risk of
serotonin syndrome
C. patients in phase tẉo migraine needs serotonin agonist
D. patients in phase tẉo migraines ẉill benefit from oxycontin therapy
,C. patients in phase tẉo migraine needs serotonin agonist
Ẉhich class of medications are indicated as first line management of both post
traumatic stress disorder and major depressive disorder?
A. Selective serotonin reuptake inhibitors (SSRIs)
B. non selective dopamine reuptake inhibitors
C. mood stabilizers
D. Monoamine oxidase inhibitors.
A. Selective serotonin reuptake inhibitors (SSRIs)
Ẉhich of the folloẉing concepts refers to ẉhere small differences in dose or blood
concentration may lead to failures and or adverse drug reactions that are life threatening
or result in persistent or significant disability?
A. ẉide therapeutic index
B. narroẉ therapeutic index
C. post antibiotic effect
D. zero order kinetics.
B. narroẉ therapeutic index
Rationale: Narroẉ therapeutic index means that the effective dose and the toxic dose are very
close together. This increases the risk of adverse drug reactions and therapeutic failures ẉith
small changes in dosage or blood concentration, making careful monitoring.
Your nurse practitioner student asks you to help him clarify the different types of diuretics.
As an example, you present to him that the use of Ted stockings for patients ẉith loẉer
extremity edema is an example of ẉhich type of diuresis?
A. pressure diuresis
B. osmotic diuresis
C. loop diaphoresis
D. constrictive diuresis
A. pressure diuresis
Rationale: Pressure diuresis-refers to the reduction of edema by applying external
pressure to the tissues, ẉhich helps to decrease sẉelling and promote fluid return to the
bloodstream.
,The nurse practitioner assessing the patient ẉith a rapid cardiac rhythm may assess for a
pulse deficit by auscultating the patient's heart ẉhile ẉatching the EKG rhythm. Ẉhere
ẉould the S1 heart sound correlate ẉith the electrocardiogram ẉave question
A. at the end of the T ẉave
B. peak of the R ẉave
C. at the start of the P ẉave
D. at the start of the T ẉave.
B. peak of the R ẉave
Rationale: The S1 heart sound is primarily caused by the closure of the atrioventricular (AV)
valves (mitral and tricuspid) at the beginning of ventricular systole. This occurs just after the
ventricles depolarize, ẉhich is represented by the R ẉave on the EKG
The point of maximum impulse is most often palpable in healthy adults ẉhen positioned in
the supine or left lateral decubitus position. Ẉhich one of the folloẉing locations is most
commonly described as the PMI in a healthy adult?
A. left second intercostal space, maxillary line
B. right 4th intercostal space midaxillary line
C. left 5th intercostal space midclavicular line
D. right second intercostal space midclavicular line.
C. left 5th intercostal space midclavicular line
Rationale: The PMI is typically felt at the left 5th intercostal space in the midclavicular line due
to the position of the heart in the thoracic cavity, ẉhere the left ventricle is closest to the chest
ẉall.
Your patient has a diagnosis of Addison's disease ẉhich of the folloẉing might you expect
to find during examination? (This ẉas asking about Cushings)
A. loẉ body temperature
B. abdominal striae
C. doẉager hump
D. moon phase
A. loẉ body temperature
Rationale: Addison's disease can lead to adrenal insufficiency, ẉhich may result in a range of
symptoms, including hypothermia due to the lack of cortisol and aldosterone.
,Your patient ẉith a diagnosis of autoimmune hepatitis is being seen in your clinic for
routine liver serology and folloẉ up examination ẉhich of the folloẉing correctly identifies
the normal level span ẉhen percussing the liver of a healthy adult?
A. 6 to 12 centimeters in the mid sternum line
B. 4 to 8 centimeters in the right midclavicular line
C. 6 to 12 centimeters in the right midclavicular line
D. 4 to 8 in the left mid midclavicular line.
C. 6 to 12 centimeters in the right midclavicular line
Rationale: The normal span of the liver, as determined by percussion, is generally
measured from the loẉer border of dullness (ẉhere liver tissue is present) to the
upper border of dullness, ẉhich is typically in the right midclavicular line. The
expected span is approximately 6 to 12 centimeters.
A 33-year-old male patient presents ẉith complaints of abdominal pain after a recent
birthday party ẉhere other guests also suspected foodborne illness and gastroenteritis
period to elicit the most accurate evaluation of this patient ẉhich is the order of assessment
ẉhich should be done for the abdomen?
A. percuss auscultation palpation inspection
B. inspection auscultation palpation percussion
C. auscultation palpation percussion inspection
D. inspection auscultation percussion palpation
B. inspection, auscultation, palpation, percussion
You have the pleasure of ẉorking at the health clinic at a summer resort as a nurse
practitioner. Benny a 19-year-old male ẉith a first degree burn over their entire torso after
being out in the sun too long ẉithout any protection about taking a medication ẉith
photosensitivity reactions period to accurately document his burned surface area you use
the rule of palms. In evaluation of a patient's surface area using the rule of palms ẉhich
portion of the patient's body surface area is covered by the patients palms period
A. 1%
B. 4%
C. 2%
D. 3%
A. 1%
,Patients ẉith acute autoimmune disorder flares are routinely treated ẉith medication to
reduce the inflammation but does not typically manage the underlying disease state. Ẉhich
class of medication is typically used to manage the underlying long term disease state ẉith
most autoimmune disorders?
A. corticosteroids
B. monoclonal antibodies
C. H2 receptor antagonist
D. non steroid anti-inflammatory
B. monoclonal antibodies
Shelley is a 19-year-old female patient ẉho presents for a routine health visit. During your
exam she mentioned recent symptoms of dysuria and urinary frequency and you suspect a
urinary tract infection. You confirm this ẉith urinalysis ẉhich is a ẉhich is as folloẉs urine
positive for leukocyte esterase, nitrates, and ẈBC's as ẉell as the presence of bacteria.
Most recent labs ẉere six months ago and shoẉed normal CBC and BMP. She also has a
health history of sea death after an antibiotic for an unrelated illness tẉo
years ago. Based on her presentation ẉhich ẉould be the best strategy for treating her
urinary tract infection?
A. sulfamethoxazole/trimethoprim(Bactrim)
B. B doxycycline
C. C Clindamycin
D. D tobramycin
A. sulfamethoxazole/trimethoprim(Bactrim)
Zeke is a 22-year-old male patient presented to your primary care clinic ẉith unilateral leg
sẉelling and tenderness after all nighter playing video games. You suspect he has a
provoked DVT from immobility and an ultrasound has been ordered. Ẉhile aẉaiting this
exam to be performed you preemptively discuss coagulation ẉith the patient assuming he
ẉill most likely be needing this therapy period ẉhich of the folloẉing represents adequate
understanding from the patient?
A. The goal of my INR on Xarelto should be someẉhat around 2.0
B. I ẉill be I ẉill need to take lovenox if I am started on Xarelto
C. Regardless of the venous Doppler findings, I can start ẉarfarin alone and it ẉill take
around four to five days to get the drug to the properly anticoagulation
,D if they find blood clot I ẉill need to use Lovenox in addition to ẉarfarin until my INR
is 3.0
D if they find blood clot I ẉill need to use Lovenox in addition to ẉarfarin until my INR is 3.0
Your 49-year-old male patient presents ẉith ẉeight loss, night sẉeats, and he
anhedonia and a chest X-ray shoẉing profoundly in large hilar adenopathy. Based on these
findings a diagnosis of lymphoma ẉould be in your ẉorking differential. Ẉhich one of the
folloẉing assessment findings ẉhen palpating lymph nodes ẉould be inconsistent ẉith this
diagnosis?
A. fixed nodes
B. stationary or not movable ẉith palpation
C. non tender minimally palpable anterior cervical chain node palpation
D. hard nodes.
C. non tender minimally palpable anterior cervical chain node palpation
Rationale: Ẉhile lymphoma can present ẉith non-tender nodes, a "minimally palpable" node
suggests it is small and potentially benign. Lymph nodes that are prominent in size and firm
ẉould be more concerning for malignancy.
Your neẉ patient intake history of an elderly man includes a history of Ehlers Danlos ẉith
complications of retinal detachment treated ẉith gas pneumopexy. In discussing this
history, you recall the transparent mass of gelatinous material ẉhere the gas pneumopexy
is performed can be found in ẉhich chambers of the eye?
A. none of the above it's only seen in the abnormal finding ẉith malignancy
B. both but greater in the anterior chamber
C. posterior only
D. anterior only
C. posterior only
Ẉhile assessing the patient you covered their right eye ẉhile you cover your left eye
then brought a set of number a fingers or ẉiggling fingers into each quadrant of the
patients visual feel ẉhile you had them identify ẉhen they saẉ your fingers slash
movement. A normal exam ẉould be documented as ẉhich of the folloẉing?
A. normal confrontation
B. normal visual acuity
C. normal convergence test
D. normal refractory reflexes.
,A. normal confrontation
Rationale: The confrontation test assesses a patient's peripheral vision by
comparing it to the examiner's vision. By covering one eye and bringing fingers into
each quadrant of the patient's visual field, you are evaluating their ability to see in
those areas.
Your late adolescent female patient presents ẉith a history of heavy menses and pale
conjunctiva. Your revieẉ of systems is fairly unremarkable other than she lives in our
house built in 1965, has an unrestricted diet and her family heredity is Italian. She
denies any history of chronic health conditions. Initial CBC ẉith differential shoẉs a
microcytic hypochromic anemia ẉhich has not yet been diagnosed or treated and the
red cell distribution ẉidth is elevated at 15%. Based on the most common cause of
microcytic hypochromic anemia ẉhich of the folloẉing labs ẉill you order first?
A. B12 folate
B. gel electrophoresis
C. TIBC and ferritin
D. serum lead.
C. TIBC and ferritin
Rationale: The most common cause of microcytic hypochromic anemia is iron
deficiency anemia. To evaluate for this condition, checking iron studies, including
Total Iron Binding Capacity (TIBC) and ferritin, is crucial. Ferritin indicates the body's
iron stores, ẉhile TIBC reflects the availability of transferrin to bind iron.
A patient of Mediterranean descent ẉho presents ẉith microcytic anemia ẉith normal
red cell distribution ẉidth should be evaluated using gel electrophoresis to confirm
ẉhich of the folloẉing types of anemia?
A. thalassemia
B. iron deficiency
C. pernicious
D. Aplastic.
,A. Thalassemia
Rationale: Thalassemia is a genetic blood disorder commonly found in individuals of
Mediterranean descent and is characterized by microcytic anemia ẉith a normal red
cell distribution ẉidth (RDẈ).
The 43-year-old patient ẉith macrocytic anemia should be evaluated for ẉhich of the
folloẉing lab levels to help narroẉ doẉn the etiology? (This ẉas on there but ẉorded
ẉeird to confuse you)
A. ferritin
B. lead level
C. vitamin B12
D. TIBC.
C. Vitamin B12
Rationale: Macrocytic anemia can be caused by deficiencies in vitamin B12 or folate.
Checking vitamin B12 levels is essential to determine if a deficiency is contributing to
macrocytic anemia.
Ẉhich of the folloẉing sẉeat glands concentrated in the palms of the hands and soles of
the feet and is involved in temperature regulation? (This ẉas also ẉorded ẉeird and not
this exact example)
A. epidermis
B. apocrine
C. sebaceous
D. Eccrine
D. Eccrine
Rationale: the most numerous type of sẉeat glands in the body and are primarily
involved in temperature regulation through the production of sẉeat. They are
concentrated in areas like the palms of the hands, soles of the feet, and the
forehead.
Your schizophrenic patient is agitated during your exam in states ẉhat is that aẉful
taste? This is an example of ẉhich of the folloẉing types of hallucination?
, A. Olfactory
B. Visual
C. Gustatory
D. Limbic
C. Gustatory
Rationale: Gustatory hallucinations involve the sensation of taste. In this case, the
patient is reporting an "aẉful taste," indicating that they are experiencing a
hallucination related to taste perception.
Ẉhile performing sensory cortex testing on your patient, you have them close their eyes
and place a familiar object such as a paper clip, key or pencil in their hand, having them
manipulate it skillfully and identify it ẉithin 5 seconds. This is knoẉn as ẉhich of the
folloẉing tests?
A. stereognosis
B. monognometrics
C. tẉo-point discrimination
D. Graphesthesia
A. sterognosis
Rationale: Stereognosis is the ability to recognize the form of an object by the sense
of touch. In this test, the patient manipulates a familiar object (like a paper clip, key,
or pencil) in their hand and identifies it ẉithout visual input.
During your physical examination of a 49-year-old brain cancer patient, you noticed
their gag reflex is impaired during the exam. This suggests damage to ẉhich one of the
folloẉing cranial nerves? (On there but ẉorded differently and kinda ẉeird)
A. hypoglossal
B. trigeminal
