Gen Dx questions

Question 1

Upon examination, your pt’s trachea is left of midline. WOTF is the most likely diagnosis:

a. pneumothorax on the left
b. pleural adhesions on the right
c. a large atelectasis on the left
d. a lung tumor on the left

Answer 1

C. A large atelectasis on the left

Question 2

WOTF is NOT a likely cause of increased boy temperature?

a. infection
b. malignancy
c. hypothyroidism
d. hyperthyroidism

Answer 2

C. hypothyroidism

Question 3

Pancreatitis may cause hemoperitoneum. During abdominal inspection, you may observe a bluish discoloration around the umbilicus, which is referred to as:

a. Cullen’s sign
b. Chandelier’s sign
c. Chadwick’s sign
d. Blumberg’s sign

Answer 3

A. Cullen’s sign

Question 4

A pale optic disc is seen with:

a. optic atrophy
b. cataract
c. papilledema
d. retinal detachment

Answer 4

A. Optic atrophy

Question 5

When asked to point to the location of their pain your pt takes their clenched fist and places it over their chest. This is referred to as:

a. Blumberg’s sign
b. Levine’s sign
c. Rovsing’s sign
d. Cullen’s sign

Answer 5

B. Levine’s sign

Question 6

Atrophy of the intrinsic muscles of the hand is most likely due to a nerve root lesion at what level?

a. C5-C6
b. C4-C5
c. C8-T1
d. C3-C4

Answer 6

C. C8-T1

Question 7

Past pointing either to the finger or the nose is indicative of dysfunction of which area?

a. Flocculonodular node
b. Tonsil
c. Vermis and paravermal region
d. Lateral hemisphere

Answer 7

C. Vermis and paravermal region

Question 8

Which tremor is most closely associated with chronic alcoholism?

a. resting
b. intention
c. red nuclear
d. postural

Answer 8

B. Intention

Question 9

Which tremor is likely to improve when the arms are held out in front of the individual?

a. resting
b. intention
c. red nuclear
d. postural

Answer 9

B. Intention

Question 10

Hemiballismus describes unilateral sudden violent flinging movements of the proximal limb muscles. Sub-cortical degeneration of which nuclei is the most likely cause?

a. Substantia nigra
b. Putamen
c. Globus pallidus
d. Subthalamus

Answer 10

D. Subthalamus

Question 11

Which type of headache, when described by the pt, is unrelenting and constant?

a. migraine
b. pressure
c. psychotic
d. cluster

Answer 11

C. Psychotic

Question 12

While performing routine cardiac auscultation, you hear an irregular heartbeat with occasional skipped beats. WOTF diagnostic tests will supply the most clinically helpful information?

a. standard 12 lead ECG
b. echocardiography
c. 24 hour Holter monitoring
d. cardiac enzymes

Answer 12

C. 24 hour Holter monitoring

Question 13

A Positive Rinne Test is indicative of:

a. conduction deafness
b. sensorineural deafness
c. normal
d. bone conduction is greater than air conduction

Answer 13

C. normal

Question 14

A small elevation on the rim of the ear that is also considered the equivalent of the tip of a mammalian ear is referred to as:

a. tophus ear
b. chondrodermatitis helicis
c. darwin’s tubercle
d. sebaceous cyst

Answer 14

C. Darwin’s tubercle

Question 15

An acute localized infection of the glands of eye lashes is called:

a. chalezion
b. internal sty
c. external sty
d. blepharitis

Answer 15

D. Blepharitis

Question 16

Protein in the urine is most likely to be caused by pathology in WOTF organs?

a. liver
b. pancreas
c. kidney
d. spleen

Answer 16

C. Kidney

Question 17

Urobilinogen is formed in WOTF organs?

a. liver
b. stomach
c. intestines
d. bladder

Answer 17

C. Intestines

Question 18

Leukocyte esterase in the urine most likely indicates WOTF?

a. blood in the urine
b. urinary tract infection
c. protein in the urine
d. kidney dysfunction

Answer 18

B. UTI (urinary tract infection)

Question 19

Chronic iron deficiency anemia is most likely to cause red blood cells to become:

a. hyperchromic, microcytic
b. hypochromic, macrocytic
c. hyperchromic, macrocytic
d. hypochromic, microcytic

Answer 19

D. hypochromic, microcytic

Question 20

WOTF is the most specific for an insulinoma?

a. serum glucose
b. glycosolated hemoglobin
c. c-peptide
d. serum lipase

Answer 20

C. C-peptide

Question 21

Elevated RDW means the red blood cells are WOTF?

a. all macrocytic
b. all microcytic
c. deficient in iron
d. varied in size

Answer 21

D. varied in size

Question 22

WOTF is the “gold standard” test for measuring gastric pH?

a. The Heidelberg capsule
b. Endoscopy
c. The Brandenburg capsule
d. Fecal pH minus 2.7

Answer 22

A. The Heidelberg capsule

Question 23

A 7 year old female present with lethargy, increased thirst, and increased urination. The most likely diagnosis is:

a. hyperglycemia
b. hypoglycemia
c. pancreatitis
d. kidney dysfunction

Answer 23

A. Hyperglycemia

Question 24

A young adult complains of anxiety, palpitation, sweating, and slight tremor. The symptoms are relieved by eating. WOTF is the most likely cause of these symptoms?

a. hyperglycemia
b. hypoglycemia
c. pancreatitis
d. mononucleosis

Answer 24

B. Hypoglycemia

Question 25

An overweight 44 year old female reports she has been having episodes of epigastric pain that starts mild then increases to a severe level, stays for a while, then slowly diminishes. The episodes sometimes follow eating high-fat foods. WOTF is the most likely cause of her distress? a. gastric ulcer b. duodenal ulcer c. celiac disease d. cholecystitis

Answer 25

D. Cholecystitis

Question 26

Low back pain with causalgia pain radiating down the leg to the big toe would be indicative of a lesion at? a. L5/S1 b. L3/L4 c. S1/S2 d. piriformis syndrome

Answer 26

A. L5/S1

Question 27

Angina like pain, pain into the jaw and left arm, and a complete cardiac workup that is negative in indicative of? a. hiatal hernia b. cervical angina c. cervical sympatherticotonia d. hiatal angina

Answer 27

B. Cervical angina

Question 28

Pt complains of having difficult time in reading. Pt says his eyes can not focus anymore. Shining light to either eye partially constrict both pupils (direct and consensual). The lesion is in: a. optic nerve b. optic tract c. edinger westphal d. ciliary ganglion

Answer 28

B. Optic tract

Question 29

Pt complains of being sloppy and un-coordinated with his hands. MRI films show a spinal cord lesion. Pt denies any motor weakness. Romberg's test is positive. WOTF lesion will result in a sensory ataxia? a. dorsal column lesion b. ventral funiculus lesion c. spinothalamic tract lesion d. ventral horn lesion

Answer 29

A. Dorsal column lesion

Question 30

A frontal lobe cortical lesion left the pt with a flexed upper extremity on the contralateral side. This is due to a disinhibition of the: a. rubrospinal tract b. corticospinal tract c. vestibulospinal tract d. spinothalamic tract

Answer 30

A. Rubrospinal tract

Question 31

A 62 year old complains of not hearing people well. You perform Weber's test and the sound lateralizes to the right ear. This is a: a. left facial nerve lesion b. left trigeminal nerve lesion c. conduction deafness in the left ear d. sensorineural deafness in the left ear

Answer 31

D. Sensorineural deafness in the left ear

Question 32

WOTF would you observe in a 35 year old male pt with hyperlipoproteinemia? a. kayser-fleischer ring b. bilateral ptosis c. café au lait macules d. corneal arcus

Answer 32

D. Corneal arcus

Question 33

WOTF would you observe in a pt with generalized peritonitis? a. localized asymmetrical distension of the abdomen b. gentle rise of the abdomen on inspiration and fall in expiration c. absent abdominal movement d. scaphoid abdomen

Answer 33

C. Absent abdominal movement

Question 34

WOTF unusual features of the face is associated with Parkinson's disease? a. hirsutism b. prominent eyes c. lack of facial expression d. pallor

Answer 34

C. Lack of facial expression

Question 35

Which rib articulates with the sternum at the angle of Louis? a. 1st b. 2nd c. 3rd d. 4th

Answer 35

B. 2nd

Question 36

During palpation for thoracic expansion, at what level of the ribs do you place your thumbs? a. 7th b. 8th c. 9th d. 10th

Answer 36

D. 10th

Question 37

For the examination of the liver, in which region of the abdomen do you initially place your 2 hands side by side on the abdomen? a. left inguinal b. right lumbar c. right hypochondriac d. hypogastric

Answer 37

C. Right hypochondriac

Question 38

A 30 year old female pt complains of cramping pain in the RLQ of the abdomen. She had low grade fever, malaise, weight loss, loss of energy, intermittent non-bloody diarrhea and joint pain. Examination revealed a palpable tender mass in the RLQ. Lab tests showed raised ESR and C-Reactive protein, with macrocytosis and normochromia. Give the diagnosis. a. irritable bowel syndrome b. chron's disease c. ulcerative colitis d. celiac disease

Answer 38

B. Chron's disease

Question 39

An autoimmune disease whose pathogenesis is destruction of the acetylcholine receptors in the post-synaptic membrane would usually present with WOTF? a. unilateral partial ptosis with miosis b. unilateral partial ptosis with mydriasis c. bilateral partial ptosis d. none of the above

Answer 39

C. Bilateral partial ptosis

Question 40

Your pt is manifesting Rovsing's sign. Which body system is most likely impaired? a. gastrointestinal b. neurological c. endocrine d. cardiovascular

Answer 40

A. Gastrointestinal