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UTA 5220 Module 1 - 5 Study Questions & Correct Answers.
A patient reports spontaneous discharge from her left nipple. How would you determine if the discharge was from one or multiple ducts? Order an ultrasound. Order a mammogram. Compress the nipple and examine with a magnifying glass. Depress the nipple into the well behind the areola and observe discharge. - ✔✔✔ Compress the nipple and examine with a magnifying glass. Mrs. Harris presents to your office with a complaint of a red rash on her breast suggestive of either Paget disease or eczema. Which is a distinguishing factor between these two problems? The location of the lesion on the nipple. The presence or absence of crust. The response to cortisone The pattern of fever - ✔✔✔ The response to cortisone Mrs. Ulman is a 56 - year-old patient who presents to your office for her routine follow-up after having a mastectomy of the right breast 2 years ago. Which statement applies to your examination of this patient? Swelling, thickening, and small lumps at the mastectomy site are expected. The mastectomy site is inspected but not palpated because of pain. If malignancy recurs, it may be at the scar site. There is no need to examine the mastectomy site. - ✔✔✔ If malignancy recurs, it may be at the scar site. Mrs. Yates is a 58 - year-old patient who presents to your office for her yearly physical examination. She asks you how often a mammogram is recommended. The best response by the examiner is: "every year." "every 3 years." "every 5 years." "every year if you have a family history of cancer." - ✔✔✔ "every year." Mrs. Venin brings her 18 - year-old son in for a follow-up examination. You have examined him before due to his enlarged breast tissue, which has not resolved spontaneously. Which action is most appropriate? Refer him to a surgeon for removal. Explain that it may still resolve spontaneously. Ask about history of sexual activity. Ask about illicit or prescription drug use. - ✔✔✔ Ask about illicit or prescription drug use.
Mrs. Harold is a 37 - year-old patient who presents for her yearly physical examination. Which statement made by Mrs. Harold would make the examiner suspect fibrocystic changes? "I have a lump in my breast that is not tender." "My right breast is larger than the left breast." "My nipples are darker than before my baby was born." "I feel lumps before my period." - ✔✔✔ "I feel lumps before my period." Mrs. Black brings her 12 - year-old daughter in with a complaint of a breast mass. On examination, you note unilateral breast enlargement with associated tenderness but no mass. Which action do you take? Refer for mammogram. Refer for biopsy. Ask the mother about her own breast development. Explain that this is an expected finding. - ✔✔✔ Explain that this is an expected finding. Mrs. Newer brings her young child in for a yearly physical examination. On examination, you note a supernumerary nipple. For which other finding do you need to be alert? Papillomatosis Duct ectasia Renal anomalies Ambiguous sex organs - ✔✔✔ Renal anomalies Mrs. Wolf is a 68 - year-old patient who presents to your office with a complaint of breast mass. On examination, you note an irregular hard, fixed breast mass and an inverted nipple. Which of the following would you suspect? Fibroadenoma Intraductal papilloma Fat necrosis Carcinoma - ✔✔✔ Carcinoma Mrs. Bower, a 56 - year-old patient, presents for a yearly physical examination. On examination, you note a fixed mass in the left breast. Given this finding, which area would you palpate for sentinel nodes? Supraclavicular fossa Inner aspect of the upper arm Posterior chest wall along the border of the scapula Anterior chest wall along the pectoral muscles - ✔✔✔ Supraclavicular fossa Mrs. Harmon brings her 16 - year-old son in for a routine examination. On examination, you observe enlarged breast tissue. Which term is used to describe this finding? Ballottement Gynecomastia Peritonitis Phimosis - ✔✔✔ Gynecomastia
The midaxillary nodes are: easy to feel along the upper humerus. along the lateral border of the scapula. low in the axilla. superficial and easy to palpate. - ✔✔✔ superficial and easy to palpate. rs. Tucker brings her infant daughter in for a newborn visit. On examination, you are able to express a clear to milky white fluid from the breast bud. You explain to Mrs. Tucker that this is an expected finding for an infant at which age? Up to 2 months Up to 3 months Up to 4 months Up to 6 months - ✔✔✔ Up to 3 months Mrs. Emilio is a 41 - year-old patient who presents with a complaint of a breast mass. On examination, you note an inflammation of the sebaceous glands in the areola. Which term is used to identify this clinical finding? Retention cysts Galactorrhea Fat necrosis Papillomatosis - ✔✔✔ Retention cysts While palpating the axilla, it is best to place the patient in a: sitting position with the hands over the head. sitting position with the arms flexed at the elbows. supine position with the arms on the hips. lateral position with the arms at the sides. - ✔✔✔ sitting position with the arms flexed at the elbows. Ms. Darren is a 29 - year-old patient who presents with a firm, irregular mass with an area of discoloration. Which of the following diagnoses is associated with these clinical findings? Ductal carcinoma Papillomatosis Retention cyst Fat necrosis - ✔✔✔ Fat necrosis Which of the following is the correct position in which to place the patient for breast palpation? Supine with the arms at the side and a pillow under the neck Supine with the arms over the head and small pillow under the shoulder of the side being assessed Left lateral position with the arm bent backward Sitting slightly forward with the breasts hanging away from the chest with the hands on the hips - ✔✔✔ Supine with the arms over the head and small pillow under the shoulder of the side being assessed
Mr. Hortsman is a 69 - year-old patient who presents to your office for routine follow-up. On examination, you observe gynecomastia. This may be secondary to: a decrease in physical activity. increased lactiferous duct glands. lymphatic engorgement. a decrease in testosterone. - ✔✔✔ Mrs. Casey is a 68 - year-old patient who presents for a yearly physical examination. While performing a breast examination, which finding is expected? The breast tissue has multiple large firm lumps in it. The breast tissue has a granular feel. The tail of Spence is no longer definable. The axillary lymph nodes are enlarged. - ✔✔✔ The breast tissue has a granular feel. Mrs. Tucker is a 52 - year-old patient who presents for her routine yearly physical examination. What do you call the nontender and nonsuppurative bumps seen on the areola? Montgomery tubercles Papilloma Romberg macules Retention cysts - ✔✔✔ Montgomery tubercles A clear-to-yellow viscous nipple discharge that is associated with pregnancy is called: priapism. hypospadias. varicocele. colostrum. - ✔✔✔ colostrum. Which is a nipple-related indication of possible breast malignancy? Contraction Retraction Virchow striation Telangiectasia - ✔✔✔ Retraction Mrs. Ginley is a 43 - year-old mother of a 7 year old and a 5 year old who presents to your office for a routine physical. On examination, you note galactorrhea. Which question is most pertinent to this situation? Did you breast feed your children? What medications do you take? Has anyone in your family had Paget disease? When was your last mammogram? - ✔✔✔ What medications do you take? Mrs. Werner is a 30 - year-old patient who presents to your office. After a thorough clinical examination, you diagnose mastitis. Which factor typically causes this clinical condition? Ductal enlargement
Organism that typically causes mastitis: - ✔✔✔ staphylococcus aureus. Six groups of lymph nodes accessible to palpation: - ✔✔✔ Supraclavicular Midaxillary Lateral axillary Anterior axillary Subclavicular nodes changes in breast tissue with age: - ✔✔✔ <25-stromal and lobular tissue. Fibroadenomas common. 25 - 40 - cyclic mastalgia and nodularity.
40-begin to involute. cysts and duct ectasia common. 50-increased risk of cancer. Liver: - ✔✔✔ heaviest organ. Metabolizes carbs, fats, proteins. Converts and stores glucose. Can convert amino acids to glucose. Cholesterol is used to form bile salts. Synthesizes fats from carbs to proteins. Stores vitamins and iron. Detox of potentially harmful substances. Antibody production. Conjugation/excretion of steroid hormones. Production of prothrombin, fibrinogen, coag substances. Responsible for production of majority of proteins. Excretory organ-synthesis of bile, secretion of organic wastes into bile, conversion of fat- soluble wastes to water-soluble. Gallbladder: - ✔✔✔ releases bile into cystic duct. Cystic duct and hepatic duct form common bile duct. Bile maintains alkaline pH of small intestine, permits emuslification of fats for lipid absorption. Pancreas: - ✔✔✔ produces digestive juices for breakdown of proteins, fats, carbs. Islet cells produce insulin and glucagon. Spleen: - ✔✔✔ Filters blood and makes lymphocytes and monocytes. Stores and releases blood. Kidneys, ureters, bladder: - ✔✔✔ Right kidney lower than left. Most filtered material (electrolytes, glucose, water, small proteins) is reabsorbed in proximal tubule. Some organic acids actively excreted in distal tubule.
Urinary volume controlled by ADH. Produces renin, which controls aldosterone secretion. Primary source of erythropoietin production in adults. Produces biologically active form of vitamin D. Abdominal section of descending aorta: - ✔✔✔ travels from diaphragm through abdominal cavity to left of midline. At umbilicus, branches into two common iliac arteries. Splenic and renal arteries branch off within abdomen also. Cullen sign: - ✔✔✔ bluish periumbilical discoloration Sister Mary Joseph's nodule: - ✔✔✔ pearl-like, enlarged and sometimes painful umbilical nodule. may be first sign of intraabdominal malignancy. Distention from umbilicus to symphysis may be from: - ✔✔✔ ovarian tumor pregnancy fibroids distended bladder distention of upper half, above umbilicus, may be from: - ✔✔✔ tumor pancreatic cyst gastric dilation asymmetric distention may be from: - ✔✔✔ hernia tumor cysts bowel obstruction muscle/soft tissue hematoma organ enlargement limited abdominal motion with respiration may indicate _________________ in an ill- appearing male adult. - ✔✔✔ peritonitis Percussion of the abdomen: - ✔✔✔ overall tympany and dullness. Lower liver border > than____ may indicate enlargement. - ✔✔✔ 2 - 3cm. Begin liver percussion for lower borders at the: - ✔✔✔ right midclavicular line. usually heard at the costal margin. For upper border of liver, begin percussion at the: - ✔✔✔ right midclavicular line around third intercostal space. Usually at the 5th intercostal space.
hernia esophagitis/GERD peptic ulcer gastritis positive blumberg sign - ✔✔✔ rebound tenderness at site of inflammation positive McBurney sign: - ✔✔✔ rebound tenderness over McBurney's point in lower right quadrant. Iliopsoas muscle test - ✔✔✔ performed when suspected appendicitis. May cause irriation of iliopsoas muscle. lie supine and place hand over lower right thigh. Raise right leg, flex at hip, while you push downward. Liver span at 6 months of age: - ✔✔✔ 2.4-28cm Liver span at 12 months of age: - ✔✔✔ 2.8-3.1cm Liver span at 24 months of age: - ✔✔✔ 3.5-3. Liver span at 3 years of age: - ✔✔✔ 4. Liver span at 4 years of age: - ✔✔✔ 4.3-4. Liver span at 5 years of age: - ✔✔✔ 4.5-4. Liver span at 6 years of age: - ✔✔✔ 4.8-5. Liver span at 8 years of age: - ✔✔✔ 5.1-5. Liver span at at 10 years of age: - ✔✔✔ 5.5-6. sausage shaped mass in left or right UQ may be ________ in ill or lethargic infant/child. - ✔✔✔ intussusception midline suprapubic mass suggests _________ in an infant, where feces fills the rectosigmoid colon. - ✔✔✔ Hirschsprung disease soft mass in LLQ of child of any age is: - ✔✔✔ constipation Most common abdominal tumors palpated in infants and toddlers: - ✔✔✔ neuroblastoma, wilms tumor, lymphoma
Most common pathogen in pyelonephritis: - ✔✔✔ Gram - bacilli (e. coli and klebsiella) Enterococcus faecalis Most common pathogen in renal abscess: - ✔✔✔ Renal cortex: gram + (staphylococcus aureus and Enterococcus) Medullary abscesses: gram - bacilli (e. coli and klebsiella) Mr. Jones is a 46 - year-old patient-year-old patient who presents to your office with a complaint of fatigue. Which statement made by Mr. Jones suggests a potential risk for viral hepatitis A? "I am a health care worker." "I had a blood transfusion recently." "I have renal failure and have hemodialysis three times a week." "I have recently been overseas." - ✔✔✔ "I have recently been overseas." The examiner auscultates a friction rub in the abdomen of the patient. This finding should make the examiner consider: portal hypertension. renal artery stenosis. inflammation of the peritoneal surface. mesentery artery hypertension. - ✔✔✔ inflammation of the peritoneal surface. A hiatal hernia is best described as: a protrusion of abdominal contents through a weakening in the abdominal wall. a protrusion of the stomach through the esophageal hiatus of the diaphragm. an ulcer in the mucosa of the stomach that herniates into the peritoneal cavity. a herniation of the gallbladder into the cystic duct. - ✔✔✔ a protrusion of the stomach through the esophageal hiatus of the diaphragm. An examiner may wish to use a bimanual technique for abdominal palpation when: palpating superficial organs. validating abdominal tenderness in the infant. meeting muscle resistance while performing deep palpation. determining the presence of excessive peritoneal fluid. - ✔✔✔ meeting muscle resistance while performing deep palpation. Which finding indicates the possibility of liver disease in the neonate? Absence of RLQ bowel sounds Epigastric pulsation Spider nevi Cullen sign - ✔✔✔ Spider nevi
Cullen sign - ✔✔✔ Romberg-Howship sign Ms. Jones reports to your clinic with complaints of crampy pain after eating ice cream. What would you suspect is the cause of this symptom? An ulcer Esophageal reflux Lactose intolerance A hiatal hernia - ✔✔✔ Lactose intolerance An absence of bowel sounds in the right lower quadrant is referred to as the ________________ sign. Cullen Striae Ballance Dance - ✔✔✔ Dance An abnormal accumulation of fluid within the peritoneal cavity is referred to as: ascites. ballance. Cullen sign. singultus - ✔✔✔ ascites A bluish periumbilical discoloration known as ________ is indicative of intraabdominal bleeding. Balance sign Cullen sign Appley sign Romberg-Howship sign - ✔✔✔ Cullen sign Mrs. Cody is 36 weeks pregnant. She tells the examiner she feels like her stomach muscle is splitting. A light protrusion of the abdomen midline is observed. This is recognized as: abdominal dehiscence. swelling of the abdominal aorta. diastasis recti. umbilical herniation. - ✔✔✔ diastasis recti. In which patient would a slight pulsation in the epigastric area be considered a normal inspection finding? A neonate An obese patient A patient with ascites An older patient - ✔✔✔ A neonate
Mr. Yates is a 62 - year-old patient who presents for monthly follow-up examination. You palpate an organ in the left costal margin. Which technique should you use to differentiate between an enlarged left kidney and an enlarged spleen? Auscultation, listening for renal bruit Auscultation, listening for abdominal friction rub Palpation, using indirect fist palpation to assess for tenderness Percussion, listening for dullness - ✔✔✔ Percussion, listening for dullness A 44 - year-old man presents with a complaint of lower left quadrant (LLQ) pain. Which approach would you use in examining his abdomen? Place the patient in a 30 - degree reclining position. Begin with auscultation of the tender area. Ask the patient to hold his breath as you examine the LLQ. Examine all other areas of the abdomen before examing the tender area. - ✔✔✔ Examine all other areas of the abdomen before examing the tender area. Mrs. Tate is going on vacation to a foreign country and wants to know what to do to decrease her change of experiencing "traveler's diarrhea." What should you tell her? Avoid eating eggs. Don't eat peeled fruits and vegetables. Drink water only from drinking fountains. Stay away from street vendor food. - ✔✔✔ Stay away from street vendor food. Which factor is most closely associated with a decrease in liver size and hepatic blood flow? Decline in cardiac output Slowed metabolic rate Decreased glomerular filtration rate Impaired nutrient absorption - ✔✔✔ Decline in cardiac output Which technique is used to confirm the presence of abdominal ascites? Auscultation of fluid movement within the abdominal cavity Palpation of rebound tenderness Palpation of pitting edema on the abdomen Percussion of dullness over dependent areas of the abdomen - ✔✔✔ Percussion of dullness over dependent areas of the abdomen A 5 - week-old male infant is brought to the clinic with a 2 - day history of projectile vomiting. For which finding should the examiner be particularly alert? Abdominal pain with palpation Palpation of a small, round mass Auscultation of tinkering bowel sounds Auscultation of a bruit over the renal artery - ✔✔✔ Palpation of a small, round mass Mr. Goldberg is a 45 - year-old patient who presents to your office. Which finding is indicative of peritoneal irritation or appendicitis?
Cullen sign - ✔✔✔ ballottement Mr. Graham is a 56 - year-old patient who presents to your office with a complaint of knifelike pain and epigastric tenderness. Knifelike pain may indicate: ulcer. liver/biliary disease. aortic aneurysm. pancreatitis. - ✔✔✔ pancreatitis. Abdominal pain that has a colic quality may indicate: ulcer. renal stone. aortic aneurysm. pancreatitis. - ✔✔✔ renal stone. Abdominal bruits may indicate: renal stone. pancreatitis. ulcer. aortic aneurysm. - ✔✔✔ aortic aneurysm. Burning pain in the abdomen may indicate: pancreatitis. aortic aneurysm. ulcer. renal stone. - ✔✔✔ ulcer PERITONITIS - ✔✔✔ P-pain: front, back, sides, shoulder E-electrolytes fall; shock ensues R-rigidity or rebound of anterior abdominal wall I-immobile abdomen and patient T-Tenderness with involuntary guarding O-obstruction N-nausea and vomiting I-increasing pulse rate, decreasing BP T-temp falls and then rises; tachycardia I-increasing girth of abdomen visceral pain - ✔✔✔ deep,. dull, diffuse pain epigastric, periumbilical, hypogastric intraabdominal, extraperitoneal organs, referred. Do not want to lie still, restless and move about, colickly pain. Can be biliary obstruction, ureterolithiasis, obstruction, gastroenteritis, early peritonitis.
parietal (peritoneal or somatic) pain - ✔✔✔ more localized and sharp. originates from intraabdominal and intraperitoneal organs. Usually lie still and do not want to move. Can be localized peritonitis from appendictis, rupture, perforation. pain from small intestine is always felt: - ✔✔✔ in epigastric and umbilical areas CHF can cause pain in the: - ✔✔✔ RUQ Two drugs commonly associated with abdominal pain: - ✔✔✔ erythromycin tetracycline Grey Turner Sign - ✔✔✔ ecchymosis of flanks from hemoperitoneum and pancreatitis F's of distention: - ✔✔✔ Fat Fluid Feces Fetus Flatus Fibroid Full bladder False pregnancy Fatal tumor If absent BS, suspect: - ✔✔✔ peritonitus or ileus 5 areas of defecation process where interference can cause disturbance in motility and cause clinical problems: - ✔✔✔ 1. peristaltic reflex
- spinal arc
- relaxation of anal sphincter
- contraction of voluntary muscle w/defecation
- autonomic and cortical control of defecation. having fewer than ____ BM per week is considered constipation. - ✔✔✔ 3 In adults, unintended weight loss of >______% in 6 - 12 months can be underlying cancer. - ✔✔✔ 5 New onset constipation in adults over 40 is: - ✔✔✔ suspicious for colon lesions Constipation in infants can be early sign of: - ✔✔✔ congenital hypothyroidism hardened stools are seen in: - ✔✔✔ renal acidosis and diabetes insipidus
White collar professionals Upper class men - ✔✔✔ Low economic groups Which of the following statements regarding the impact of gender on health care is true? Individuals treated by male clinicians have lower mortality rates than those treated by female clinicians. Male family practice clinicians order more laboratory tests than do their female counterparts. Male clinicians are more likely to provide diet and exercise counseling to obese men than are female clinicians. Female clinicians write more prescriptions for pain medications than do their male counterparts. - ✔✔✔ Male clinicians are more likely to provide diet and exercise counseling to obese men than are female clinicians. Over a period of 3 years, the mother of three young children has repeatedly been instructed by the health care provider to get the children immunized; however, the children are still not immunized. The answer to which of the following questions would help the health care provider understand this situation? "When are you going to get your children immunized?" "What are your beliefs about immunizations?" "We have asked you to get your children immunized. Why has this not been done?" "Don't you understand that your children may get ill without immunizations?" - ✔✔✔ "What are your beliefs about immunizations?" The use of physical characteristics to predict health care beliefs about an individual: is encouraged when conducting a health interview. provides insight into appropriate treatment. helps develop rapport. is erroneous thinking on the part of the health care provider. - ✔✔✔ is erroneous thinking on the part of the health care provider. Which is the best description of cultural humility? Viewing each individual as a unique person and the center of care Identifying one's own ethnocentricity and tendencies to bias Using a social context perspective when interacting with ethnic minorities Being aware of one's own limitations in knowledge and cultural perspective along with openness to new perspectives - ✔✔✔ Being aware of one's own limitations in knowledge and cultural perspective along with openness to new perspectives What occurs in the first cognitive phase of stereotyping? Recognition of an individual as from a different ethnic group Plan of interaction is developed based on previous beliefs and experiences An individual is categorized into a social group Negative emotions are triggered by the patient's behavior - ✔✔✔ An individual is categorized into a social group
Stereotyping occurs in two phases. In the first phase, a stereotype becomes activated when an individual is categorized into a social group. When this occurs, the beliefs and feelings (prejudices) come to mind about what members of that particular group are like. Over time, this first phase occurs without effort or awareness. Which of the following correctly describes lineal cultural value orientation? Interpersonal relationships are subject to the environment. A son's goals are not as important as his father's. Outside social relationships are more important than family. Expression of self is the individual's main goal. - ✔✔✔ A son's goals are not as important as his father's. Ms. Sanchez is a 16 - year-old female adolescent. Her mother has recently died and she was told by her father to quit school so she could take care of her two younger brothers. Since her cultural value orientation is collateral, she will be most likely to: run away to her aunt's house. quit school and take care of her brothers. continue in school until she graduates. talk to her minister and follow his advice. - ✔✔✔ quit school and take care of her brothers. A young Native American/American Indian child with severe abdominal pain and fever is brought to the clinic by his mother and grandmother. On examination, you find a foul- smelling cloth wrapped around the child's abdomen. If not removed, the cloth will interfere with the completion of the examination. Of the following, which action best demonstrates cultural sensitivity? Ask about its purpose and then remove the cloth. Ignore the cloth. Ask permission to remove the cloth. Inform the family that the cloth will be replaced immediately after the abdominal exam. - ✔✔✔ Ask about its purpose and then remove the cloth. A habitual activity passed along by family members is: ritual. custom. beliefs. the norm. - ✔✔✔ custom. Which is a health care disparity identified in the 2011 CDC Health Disparities and Inequalities Report? A higher percentage of black women died from coronary heart disease before age 75 than white women. A higher infant mortality rate among non-Hispanic white women than non-Hispanic black women. A higher percentage of white men over 50 died from coronary artery disease than black men.
