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Exam (elaborations)

Apea Exam Proctored E

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An enlarged liver with a smooth tender edge may suggest: - ANSWERSright sided heart failure An enlarged liver with a firm, non tender edge may suggest: - ANSWERSCirrhosis, hematochromotosis (increase iron intake in the blood and lymphoma An enlarged liver that is firm or hard and has an irregular edge or surface - ANSWERSHepatocellular carcinoma S/S associated with diabetic gastroparesis may include: - ANSWERSVomiting of undigested food Weight loss Erratic glucose levels GERD What is sarcopenia and what causes it? - ANSWERSSarcopenia = age related loss of skeletal muscle mass Causes: -inactivity -protein imbalance -mitochondrial dysfunction -insulin resistance -oxidative stress -increased inflammatory factors -loss of motor units as muscle ages Psoas sign - ANSWERSRLQ pain with extension of right thigh indicative of appendicitis Rovsing's sign - ANSWERSPain in RLQ with palpation of LLQ indicative of appendicitis Obturator's sign - ANSWERSRLQ on internal rotation of right thigh indicative of appendicitis Murphy's sign - ANSWERSpain with palpation of the RUQ during inspiration, indicative of cholecystitis acute pancreatitis - ANSWERSinflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acinar cells into the parenchyma of the organ Pain is localized in the abdomen, can be epigastric and may radiate to the posterior trunk biliary colic - ANSWERSpain in the gallbladder caused by gallstones obstructing bile flow Pain in the epigastric or RUQ and may radiate to right shoulder or scapula pain in epigastric region - ANSWERSSuggests indigestion, heartburn or stomach cancer Referred pain from biliary tree - ANSWERSright shoulder or right posterior chest Referred pain of duodenal or pancreatic origin - ANSWERSreferred to back Heartburn - ANSWERSA retrosternal sensation of burning felt in waves and arising upward toward the neck. Stool that appears bloody, mucoid, or with pus may indicate: - ANSWERSCrohn's disease Thin, pencil-like stool "Apple core " can be associated with what? - ANSWERSLesion of the sigmoid colon hard dry stool - ANSWERSconstipation red streaked stool - ANSWERSPresence of hemorrhoids anal fissure - ANSWERSa small linear tear in the skin of the anal opening that can cause severe pain during a bowel movement A patient was instructed to point to the location of his pain. He pointed to just below the sternal clavicular notch, which likely indicates. - ANSWERSEsophageal dysphasia Pain associated with located with diabetic gastroparesis - ANSWERSLocated in the upper abdomen Pain associated with oropharyngeal dysphasia - ANSWERSLocated in cervical neck region What is pain located in esophageal varices ? - ANSWERSRetrosternal When inspecting the abdomen of a 60-year-old male, dilated veins were noted, especially in the mid and upper abdomen. This condition is associated with. - ANSWERShepatic cirrhosis caput medusae - ANSWERSDilated veins around the umbilicus, associated with cirrhosis of the liver. Secondary to portal hypertension When performing a digital rectal exam, a soft, pediculated lesion is palpated. This finding is most likely - ANSWERSRectal polyp Pediculated—> attached to the base by means of a stalk

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