© Irene Gold Associates, Inc. All rights to the material in this presentation are reserved.

General Dx

OOR

1. Which part of the case history will yield the most information in a suspected case of Reiter’s disease?

a. Family historyb. Past historyc. Chief complaintd. Sexual history

2. Where is the most likely location to find the presence of tophi in a patient with gout?

a. Fingersb. Pinnac. Kneed. Big toe

3. _____________ is the etiology of Rocky Mountain Spotted Fever.

a. Bacteriab. Virusc. Rickettsia d. Parasite

4. Which of the following arteries is affected during a transient ischemic attack?

a. Carotidb. Coronaryc. Femoral d. Radial

5. __________ alteration of blood flow may result in the inability to understand language.

a. Posterior communicating artery

b. Anterior cerebral arteryc. Cerebral arteryd. Carotid artery

6. While the patient is supine with the head extended off of the table the doctor brings the head into extension, rotation, and lateral flexion. Which of the following is being evaluated?

a. Axillary arteryb.Vertebral arteryc. Jugular veind.Anterior cerebral

artery

7. A 22 year old female was working out in a gym and suddenly faints, this is most likely due to ___.

a. Subclavian Steal syndrome

b. Spontaneous Pneumothorax

c. Myocardial Infarctiond. Marfan’s Syndrome

8. Upon taking bilateral blood pressure readings you find that there is a difference of 10-15% from one side to the other. Which of the following is a probable cause?

a. Venous insufficiencyb.Arterial insufficiencyc. Congestive Heart

Failured.Coarctation of the Aorta

9. A female patient presents with hard circular lumps in her hands and difficulty in swallowing. Given these findings what is the most likely diagnosis?

a. Systemic lupus erythematosus

b. Sclerodermac. Amyotrophic lateral

sclerosisd. Parkinson’s disease

10. A 35 year old female patient presents with complaints of joint pain and polyarthritis. Upon performing Murphy’s sign you find that the patient has pain. What is most likely cause?

a. Systemic lupus erythematosus

b. Sclerodermac. Posterolateral

sclerosisd. Parkinson’s disease

11. Examination of the patient reveals yellowing of the skin. Ophthalmic examination reveals yellow sclera. Which organ is at fault?

a. Gallbladderb. Kidneyc. Pancreasd. Liver

12. Which of the following best defines the diagnosis of anisocoria?

a. Dilated and fixed pupilsb. Constricted and

unresponsive pupilsc. Unequal pupil sized. Absent red light reflex

13. A female patient presents with complaints of gaining weight without trying, intolerance to cold temperatures, and course/dry hair and nails. What is an additional clinical finding that is most likely present?

a. Sweatingb. Periorbital edemac. Exophthalmosisd. Hyperpigmented mouth

14. ______ is the cause of ptosis, miosis, and anhydrosis on one side of the face?

a. CN III lesionb. Pancoast tumorc. Cluster headached. Temporal Arteritis

15. Upon Ophthalmo-scopic examination you note the presence of A-V nicking, flame and splinter hemorrhages, and cotton wool exudates. What is the most likely cause of these findings?

a. Hypertensive retinopathy

b. Diabetic retinopathyc. Retinal detachmentd. Papilledema

16. The diaphragmatic domes appear flat and lower in which of the following conditions?

a. Pneumoniab. Pancoast Tumorc. Tuberculosisd. Emphysema

17. ______________ is the most common cause of a sensorineural hearing loss.

a. Otitis externab. Meniere’s diseasec. Otitis mediad. Presbycussis

18. Upon laboratory examination you find that the patient has a decreased TSH, a decreased T3, decreased T4, and decreased growth hormone. Which of the following is the cause of these lab results?

a. Hypopituitary b. Hyperpituitaryc. Hypothyroidd. Hyperthyroid

19. Which of the following findings is commonly associated with viral otitis media?

a. Perforated tympanic membrane

b. Retracted tympanic membrane

c. Eustachian tube blockage

d. Pinna pain

20. A riboflavin deficiency is likely to cause which of the following conditions to occur?

a. Leukoplakiab. Glossitisc. Cheilosisd. Macroglossia

21. _________ is commonly associated with human immunodeficiency virus.

a. Candidiasisb. Chancroid soresc. Yellow frothy discharged. Hepatitis C

22. Which of the following is not a risk factor for candidiasis?

a. Diverticulitisb. Pregnancyc. Decreased intestinal

florad. Leukoplakia

23. A smooth and glossy tongue seen with deficiency of B vitamins is caused by which of the following?

a. Pernicious anemiab. Hemolytic anemiac. Sickle cell anemiad. Iron deficiency anemia

24. A large beefy tongue is seen with ____.

a. Hypothyroidismb. Hyperthyroidismc. Hypercortisolismd. Hypocortisolism

25. Upon performing a physical exam you note a bruit is present over the temporal artery. Which of the following is indicated?

a. Strokeb. Giant cell arteritisc. Migraine headached. Subclavian Steal

syndrome

26. Orchitis is most commonly caused by which of the following ?

a. Measlesb. Mumpsc. Varicellad. Hemophilus

27. A barrel appearance of the thorax will be noted in a patient affected by which of the following?

a. Pneumoniab. Emphysema c. Pneumothoraxd. Atelectasis

28. What is the proper location to transilluminate the frontal sinuses?

a. Superior/lateral aspect of the orbit

b. Middle of the eyebrowc. Medial orbit below the

eyebrowd. 1” superior to the

eyebrow medially

29. _________ breathing is associated with metabolic acidosis.

a. Cheyne stokesb. Kussmaul’sc. Biot’sd. Brady’s

30. Which of the following is the percussive note of the major portion of the lung fields?

a. Dullb. Flatc. Tympanicd. Resonate

31. As you perform bronchophony you note clear sounds as the patient says “99”. What is the pathology that causes this finding?

a. Emphysemab. Pneumoniac. Bronchitisd. Bronchiectasis

32. Increased tactile fremitus is seen with ____.

a. Emphysemab. Pneumothoraxc. Atelectasisd. Pneumonia

33. Hyper-resonance and decreased tactile fremitus on one side of the chest is seen with ______.

a. Emphysemab. Pneumoniac. Pneumothoraxd. Atelectasis

34. A patient presents with a low grade fever, productive cough, night sweats, and yellow sputum. This is indicative of ____________.

a. Pneumoniab. Tuberculosisc. Bronchitisd. Bronchogenic

carcinoma

35. Upon thoracic physical examination you note the presence of a friction rub. Which of the following is associated with this finding?

a. Pleurisyb. Pneumothoraxc. Tuberculosisd. Pneumonia

36. Upon orthopedic examination you ask the patient to laterally bend to one side while they are in the standing position. When they perform this maneuver they have pain on the convex side. What is the cause of this pain?

a. Intercostal neuralgiab. Pleurisyc. Pneumothoraxd. Pneumonia

37. A previously healthy 18 year old male suddenly complains of stabbing chest pain that is a 9/10 severity on the pain scale. What is the likely etiology of this complaint?

a. Spontaneous pneumothorax

b. Pleurisyc. Myocardial Infarctiond. TIA

38. __________ is a type I hypersensitivity reaction and also causes a rise in IgE.

a. Cytotoxic reactionb. Lyme’s diseasec. Asthmad. Emphysema

39. Which of the following conditions would contribute to the appearance of a normal sized but low lying liver?

a. Hepatocellular carcinoma

b. Hepatitisc. Emphysemad. Pancoast tumor

40. A 68 year old male presents with a non-productive cough for the past 60 days as well as anorexia and weight loss. What should be suspected?

a. Bronchogenic carcinoma

b. Pneumoniac. Tuberculosisd. Sarcoidosis

41. A rash that breaks out and follows along parallel to the ribs is most likely ________.

a. Tietze syndromeb. Shinglesc. Intercostal neuralgiad. Fungal infection

42. _______ stays dormant in the dorsal root ganglia of the patient.

a. Herpes simplexb. Herpes zosterc. Neurosyphilisd. Hemophilus Ducreyi

43. Upon taking a biopsy from the lung tissue Reed Sternberg cells are present. What is the most likely diagnosis given this finding?

a. Bronchogenic carcinomab. Pancoast tumorc. Miliary tuberculosisd. Hodgkin’s disease

44. A child presents with thick accumulations of mucous in the lungs and intestines. Upon inspection you note a barrel chest. They also have pancreatic insufficiency and meconium ileus. What is the diagnosis given these findings?

a. Pneumoniab. Cystic fibrosisc. Nephroblastomad. Emphysema

45. Which of the following is a palpable finding in a patient with cardiomegaly?

a. Bounding apical pulseb. Thrills in the 2nd

intercostal spacec. A bruit over Erb’s pointd. Lateral shift in the

apical pulse

46. Which of the following is the best method of palpating the inferior structure of the liver?

a. Patient supine with deep inspiration

b. Patient supine upon expiration

c. Patient supine upon forced expiration

d. Patient in the lateral recumbent position upon inhalation.

47. Which abdominal examination is performed to determine the difference between excess adipose tissue in the abdomen and ascites?

a. Murphy’s signb. Murphy’s testc. Rovsing’s testd. Fluid wave test

48. What is the most common treatment for myasthenia gravis?

a. Bed restb. Chemotherapyc. Anticholinesterase

antibodiesd. B12 shots

49. During a consultation with a new adult patient you find they have foul smelling bowel movements. Which of the following is likely?

a. Celiac diseaseb. Cystic fibrosisc. Appendicitisd. Gastric ulcer

50. Which of the following presents with Pulsus bisferiens?

a. Aortic regurgitationb. Left ventricular failurec. Mitral stenosisd. Myocardial infarction

51. Following recovery from rheumatic fever which of the following is most likely to be weakened in the patient?

a. Myocardiumb. Pericardiumc. Endocardiumd. Epicardium

52. Which of the following occurs prior to being diagnosed with bacterial endocarditis?

a. Mitral valve prolapseb. Hypertensionc. Rubeola infectiond. Streptococcus infection

53. Auscultating the heart reveals a murmur at the 5th intercostal space mid clavicular line during systole. This murmur is heard at the ____ of the heart and will be ____.

a. Apex; high pitchedb. Apex; low pitchedc. Base; high pitchedd. Base; low pitched

54. A patient who presents with both foot drop and wrist drop is most likely deficient in which of the following?

a. Vitamin B12b. Vitamin B6c. Chromiumd. Folic Acid

55. Which of the following murmurs is present in diastole?

a. Aortic stenosisb. Pulmonic stenosisc. Tricuspid regurgitationd. Mitral stenosis

56. A congenital narrowing proximal to the vertebral artery is known as which of the following?

a. Subclavian steal syndrome

b. Coarctation of the aorta

c. Tetralogy of Fallotd. Marfan’s Syndrome

57. If the patient has difficulty breathing while in the supine position that is relieved when going into the seated or standing position it is called _________.

a. Exertional dyspneab. Orthopneac. Striderd. Hyperpnea

58. A patient has portal hypertension and the appearance of caput medusa. These findings are seen with which of the following?

a. Left sided heart failureb. Right sided heart failurec. Pancreatitisd. Acute appendicitis

59. A patient presents with complaints of recurring chest pain. He describes the pain as a feeling of something heavy sitting on his chest. He doesn’t know what brings it on but tells you he gets the pain while he is at rest. He also tells you that this pain will go away after a few minutes of continued rest. What is the diagnosis?

a. Hemochromatosisb. Simple anginac. Complex anginad.Printzmetal angina

     

60. A patient with crushing chest pain is asked to rest for a few minutes while the ambulance is on the way, and the pain has not subsided within 15 minutes. Which of the following is the best diagnosis?

a. Angina pectorisb. Atypical anginac. Myocardial

infarctiond.Aortic dissection

61. Which of the following is usually detected on a routine physical exam without the use of an ECG?

a. Primary heart blockb. Secondary heart blockc. Atrial fibrillationd. Block of bundle of HIS 

62. ________ is indicated if the patient presents with yellowing of the skin and the buccal mucosa.

a. Polycythemia b. Hemochromatosisc. Osteogenesis Imperfectad. Addison’s Disease

63. Upon analyzing a KUB study, you find that there is a unilateral sclerotic 3mm radiopaque shadow over the psoas muscle. What does this indicate?

a. Urolithiasisb. Urethritisc. Cholecystitisd. Cholelithiasis 

64. Which organ is implicated if there is a moderate increase in alkaline phosphatase?

a. Liverb. Heartc. Pancreas d. Spleen

67. A patient presents with complaints of polydypsia and polyuria but no polyphagia. Which condition is most likely?

a. Diabetes mellitus type Ib. Diabetes mellitus type IIc. Diabetes Insipidusd. Pancreatitis

66. An elevation of gamma-Glutamyl Transpeptidase and serum glutamic pyruvic transaminase is an indication for which of the following?

a. Myocardial Infarctionb. Pancreatitisc. Hepatitisd. Appendicitis

67. Which of the following can be contracted through the oral/fecal route of transmission?

a. Hepatitis Ab. Hepatitis Bc. Hepatitis Cd. Liver cirrhosis 

68. Which of the following conditions will cause pain referral to the right tip of the scapula?

a. Pancreatitisb. Cholelithiasisc. Splenomegalyd. Hepatitis

69. Which of the following will result in increased serum glucose levels?

a. Cholecystitisb. Pancreatic cancerc. Acute appendicitisd. Ovarian cancer

70. Which of the following terms is used to describe periumbilical ecchymosis?

a. Grey turner signb. Cullen’s signc. Puddle signd. Minor’s sign

71. An increased amount of ADH will present with which of the following findings?

a. Increased specific gravity

b. Glucosuriac. Cloudy urined. Proteinuria      1.

72. A patient that has been diagnosed with hyperparathyroidism will most likely be affected by which of the following?

a. Urethritis b. Big bulging eyesc. Renal calculid. Increased bone density

73. What is associated with the over proliferation of helicobacter pylori bacteria?

a. Systemic infectionb. Septic arthritisc. Gastric refluxd. Peptic ulcer 

74. An elderly female patient presents with complaints of left lower quadrant pain and chronic constipation. What is the most likely etiology of this presentation?

a. Appendicitisb. Inadequate fiber in the

dietc. Hypersensitivity to

glutend. Duodenal ulcer

75. Which of the following is the most common component are kidney stones?

a. Uric acid b. Calcium uratesc. Nitratesd. Calcium oxalates 

76. Which of the following casts are normally found upon urinalysis?

a. Fattyb. Waxyc. RBCd. Hyaline

77. Which of the following conditions could lead to investigate pernicious anemia in the patient?

a. Duodenal ulcerb. Appendicitisc. Pancreatitisd. Hepatitis     

78. A female patient who recently gave birth presents with complaints of incontinence when she laughs. What type of incontinence is described?

a. Urgeb. Stressc. Overflowd. Physiologic

79. A woman who is pregnant for the first time presents with bilateral pitting edema in the lower extremities. What other signs are related to this condition?

a. Hypertension; proteinuria; seizures

b. Hypertension; proteinuria; vomiting

c. Hypotension; proteinuria; seizuresa. Hypotension; proteinuria;

vomiting 

80. Pelvic inflammatory disease will not present with ______.

a. Cervical dischargeb. Bloody dischargec. Feverd. Purulent discharge

81. A patient states that she is unable to urinate. While you are performing your examination the patient has a yellow discharge that is expelled. What is the most appropriate follow up step?

a. Catheterizationb. Surgical consultationc. Bacterial cultured. Hair analysis

82. A 36 year old male patient presents with gynecomastia. Which of the following is the most likely cause of this presentation?

a. Addison’s diseaseb. Cushing syndromec. Inguinal herniad. Testicular cancer

83. A pediatric patient presents with tortuous dilation of the spermatic veins. What is the diagnosis?

a. Spermatoceleb. Varicocelec. Hydroceled. Hernia

84. Upon palpation of the testicle you find a single nodule that is painless to the patient. What should be suspected?

a. Hydroceleb. Varicocelec. Testicular cancerd. Epididymitis

85. A painless, moveable, small lump superior to the testicle is most likely a ___________________.

a. Hydroceleb. Spermatocelec. Varicocele d. Prostatitis 

86. Loss of the median sulcus of the prostate upon digital examination is most likely to be caused by _________.

a. Acute Prostatitisb. Prostatic carcinomac. Benign prostatic

Hyperplasiad. Chronic Prostatitis

87. Prostatic carcinoma will present with which of the following palpatory findings?

a. Smooth; non tenderb. Tender; softc. Firm; non tenderd. Hard; nodular

88. A hard, moveable non-painful lymph node is palpated above the left clavicle. This is most likely a ______.

a. Virchow’s nodeb. Haygarth's nodec. Pancoast tumord. Bouchard’s node

89. A patient presents with thrombocyto-penia and Petechiae at the ankles. What is the most likely diagnosis?

a. Stasis dermatitisb. Liver cirrhosisc. Pancreatitisd. Congestive heart

failure    1.

90. A bacterial infection will produce the following change in the white blood cells?

a. Neutrophiliab. Lymphocytosisc. Monocytosisd. Basophilia

91. Lymphocytosis is a common finding in a patient with a/an____.

a. Bacterial infectionb. Chronic infectionc. Allergiesd. Viral infection 

92. Which of the following conditions presents with microcytic, target cells.

a. Sickle cell anemiab. Thalassemiac. Aplastic anemiad. Iron deficiency anemia

93. Laboratory examination reveals the presence of decreased RBC’s that are microcytic and hypochromic. What is the diagnosis?

a. Iron deficiency anemiab. Megaloblastic anemiac. Sickle cell anemiad. Aplastic anemia 

94. A patient with chronic iron deficiency anemia will present with which of the following combinations of laboratory findings?

a. Decreased iron; decreased TIBC

b. Decreased iron; increased TIBC

c. Decreased copper; decreased TIBC

d. Decreased copper; increased TIBC

95. Prolonged periods of fasting will produce excess ______ in the urine.

a. Glucoseb. Proteinc. Ketonesd. Urobilinogen

96. _____ is the best laboratory test to monitor the health of the kidney.

a. CPKb. CK-MMc. Creatined. Creatinine

97. A deficiency in ___________ will cause chronic muscle cramping.

a. Proteinb. Potassiumc. Phosphorusd. Vitamin C 

98. When performing Weber’s test the sound lateralizes to the right ear. While performing the Rinne test you note there is a positive in the right ear. This indicates _____ deafness.

a. Right sensorineuralb. Left sensorineuralc. Right conductived. Left conductive

99. An increase in CK-MM will likely indicate which of the following diseases?

a. Myocardial infarctionb. Muscular dystrophyc. Stroked. Kidney stones

  

100. Staphylococcus aureus infection is responsible for which of the following conditions?

a. Meningitisb. Toxic Shock Syndromec. Rheumatic feverd. Glomerulonephritis

101. Which of the following conditions will cause a blood pressure of 190/130 and cotton wool exudates in the eyes?

a. Malignant hypertensionb. Benign renal

hypertensionc. Systolic hypertensiond. Myocardial infarction 

102. You shine the light in the right eye and the right pupil contracts, but the left pupil does not contract. You deduce from this finding that CN___ on the ___ is at fault.

a. II; rightb. III; rightc. II; leftd. III; left

103. The reason for performing Hallpike’s maneuver on a patient is to determine ____.

a. Vertigob. Proprioceptionc. Cervical sprain/straind. Balance 

104. A young child presents with torsion of the spermatic cord. Which of the following is correct?

a. It would feel like a bag of worms and the patient should be placed on bed rest.

b. There is a congenital anomaly and the child needs to go to a pediatrician.

c. The patient should be sent to the emergency room immediately.

d. The sacrum should be adjusted.

105. Which of the following is a true statement about Raynaud’s phenomenon?

a. Brought on by emotional stress.

b. Turns the hands red then blue then pale.

c. Occurs as a primary disease.

d. It is generally unilateral. 

106. Cystic fibrosis most commonly affects which of the following glands?

a. Mucous glandsb. Sebaceousc. Apocrined. Eccrine(sweat)

107. The patient with thrombocytopenia purpura would also have?

a. Gastric carcinomab. Petechiae and stasis

dermatitisc. Cirrhosis of the liverd. Petechiae and

mucosal bleeding