M2 HEENT Flashcards
Microscopy is used in primary care to identify which of the following conditions?
a. Dermatophytes
b. Virus
c. Bacteria
d. parasites
e. all of the above
e. all of the above
Patient complains fo “red, itchy rash, raised rash” on his anterior and posterior arms present for past 6 months. skin hx negative except change in work condition. Now works around varnish. Wears protective eyewear and gloves. Usually wears short sleeved shirt due to being a hot environment. What is likely the diagnosis?
a. Atopic dermatitis
b. Psoriasis
c. Contact dermatitis
d. Cellulitis
c. Contact dermatitis
most common occupational cutaneous condition
In adolescence, which glands are responsible for increased axillary perspiration and potential body odor?
a. Sebaceous gland
b. Apocrine gland
c. Eccrine gland
d. Ceruminous glands
b. Apocrine gland
located primarily in axillary and genital areas, remain dormant until puberty.
Which of the following are considered normal physical assessment findings during pregnancy?
a. hyperpigmentation of the face, diffuse redness of the palms, hands and soles of feet, and dark pigmented line midline of the abdomen
b. Hypopigmentation of the face, paleness of palms hands and soles of the feet and decreased hair growth
c. Diffuse redness of the palms, hand and soles of the feet, dark pigmented line midline of the abdomen, nevi become smaller and less noticeable
d. Hyperpigmentation of the face, skin lightens around the nipples and areolae, and nail growth slows.
a. hyperpigmentation of the face, diffuse redness of the palms, hands and soles of feet, and dark pigmented line midline of the abdomen
d/t increased vascularity and increased estrogen production.
70% of women may develop hyperpigmentation around face melasma = mask of pregnancy
What would alert the provider to consider the differential diagnosis of maltreatment after the assessment of an older adults’s skin?
a. Excessive xerosis of the skin
b. senile purpura
c. Ecchymosis on unexposed areas
d. skin tears on the anterior surface of the hands
c.. Ecchymosis on unexposed areas
xerosis = dryness
all other options are considered normal findings
It is important to be aware of common differential diagnosis of acne. Identify the least likely differential diagnosis for acne?
a. Rosacea
b. Perioral dermatitis
c. contact dermatitis
d. Drug-induced acne
e. bacterial folliculitis
c. contact dermatitis
All of the following are components of inspection during the skin examination except?
a. odors
b. hygiene
c. lesions
d. temperature
d. temperature
The mental health conditions of SI has been identified in patients with which of the following skin dx?
a. Hand eczema
b. Psoriasis
c. Acne
d. Atopic dermatitis
b. Psoriasis (statiscally higher rates of suicidal ideation)
- higher depression/anxiety rates with with leg ulcers and -hand eczema
Identify the ethnic group that has the highest prevalence of squamous cell carcinoma?
a. White
b. Hispanic
c. African Americans
d. asians
c. African Americans
Which history question is the most comprehensive to assess sun protection practices of a patient?
a. how often do you apply sunscreen?
b. Do you use sunscreen?
c. How do you protect your skin from the sun?
d. Do you wear a hat while in the sun?
c. How do you protect your skin from the sun?
In most cases of lymphadenopathy, the enlarged lymph nodes are found in which region?
a. Cervical
b. Supraclavicular
c. Inguinal
d. Axillae
a. Cervical
over half of localized lymphadenopthy cases involve lymph nodes in the head and neck
Which region of lymphadenopathy would always require further investigation of and follow-up?
a. Cervical
b. Supraclavicular
c. inguinal
d. Axillae
b. Supraclavicular
palpable supraclavicular, infraclavicular, iliac, epitrochlear, or popliteal lymph nodes should be considered abnormal
All all characteristics of a lymph node that would warrant further investigation except?
a. hard
b. fixed
c. 2cm in diameter
d. tender
d. tender
Abnormal finding include: Hard, fixed, >1cm (pinky)
located in abnormal regions, generalized, unilateral
and associated with fever, wt. loss, and night sweats
Lymphemdema improves with elevation of the limb?
a. yes always
b. sometimes
c. no, never
b. sometimes
Elevation of the limb may improve swelling in the early staged but not as the condition progresses
A complete lymphatic exam includes all except?
a. all lymph nodes
b. spleen
c. general survey
d. pulses
d. pulses
spleen = giant lymph node. left upper quadrant lateral to stomach b/w 9/11 rib
Which is true regarding shotty lymph nodes?
a. They are due to lymphedema
b. they are often large (>10cm)
c. They are often benign
d. They are often d/t malignancy
c. They are often benign
Shotty lymph nodes = cluster of small lymph nodes that are often benign and associated with a viral infection.
common in children
Which are considered part of the lymphatic system?
a. spleen, thyroid, lymph nodes
b. Peyer’s patches, thymus, and spleen
c. Lymph nodes, tonsils, and liver
d. Appendix, gall bladder, MALT
b. Peyer’s patches, thymus, and spleen
When palpating the abdomen of a 20 yr old, with fatigue. Clinician noticed presence of tenderness in left lower upper quadrant with deep palpation. Which is likely the structure that is causing the tenderness?
a. Appendix
b. Liver
c. Spleen
d. Thymus
c. Spleen
The clinician notes enlarged right epitrochlear lymph nodes. what further assessment is needed o determine a possible cause?
a. Ask history questions regarding recent ear infection or sore throat
b. Assess the patients abdomen, noting tenderness
c. carefully examine cervical lymph nodes, checking for any enlargement
d. Examine the patient’s arm and hand assessing for signs of infection.
d. Examine the patient’s arm and hand assessing for signs of infection.
As a component of their assessment, clinicians should ask individuals who are immunocompromised about?
a. daily use of industrial antibacterial cleansers
b. Hand-washing, food safety, and travel precautions
c. their ability to abstain from sexual intimacy and intercourse
d. their ability to remain isolated from family and friends
c. their ability to abstain from sexual intimacy and intercourse
immunocompromised patients need to take proper precautions to prevent infections
a
The physical exam of thyroid gland in adults normally reveals that the thyroid gland is..
a. directly above the cricoid and thyroid cartilage
b. midline and moves with swallowing
c. nodular and tender
d. nonpalpable and nonmobile
b. midline and moves with swallowing
when assessing thyroid must ask pt to swallow while keeping your fingers in position
In Older adults, one of the more common signs of hyperthyroidism is
a. new-onset atrial fibrillation
b. palpable non-tender mass of the anterior neck
c. vomiting and abdominal pain
d. weight gain and increased appetite
a. new-onset atrial fibrillation
older adults with mild hyperthyroidism have isolated symptoms that include a. fib, unexplained wt. loss, decreased appetite, weakness. which warrants further attention
Which problem is associated with thyroid hypofunction?
a. Exophthalmos
b. graves disease
c. Myexdema
d. Thyroid storm
c. Myexdema (non-pitting edema)
other include, fatigue, weakness, dyspnea, intolerance of cold, brady, relaxed tendon reflexes, dry coarse skin, hair loss,
caused by auto-immune (hashimoto’s) or iodine deficiency. Will have increased TSH
Who needs an imaging study as part of his or her diagnostics workup? The patient with
a. headaches triggered by lack of sleep
b. onset of migraines at 60 yrs
c. recurrent migraines for 3-5 years
d. sinus infection concurrent with migraines
b. onset of migraines at 60 yrs
Red flags that indicate HA may be secondary to disorder and require imaging would be (SNOOP)
S-unexplained symptom
N-alter neurologic condition, ataxia, diplopia
O- New onset over the age of 50yrs
O-sudden onset
P-pattern change (daily?, postural change?)
A patient presents with the chief complaint of headache, Which symptom elicited during the history would be a red flag for urgent consultation or referral
a. Onset of intense pain was immediate and debilitating
b. throbbing, aching over 24hrs
c. Unilateral pain with sensitivity to light and sound
d. Waves of nausea during headache, vomited once
a. Onset of intense pain was immediate and debilitating
sudden onset is considered a red flag for secondary cause (SNOOP)
A 6-month infant is brought to the clinic with new onset of vomiting, Which physical exam finding is most reassuring.
a. bulging anterior and posterior fontanel
b. closure of all fontanels
c. depressed anterior fontanel
d. flat anterior fontanel an closed posterior fontanel
d. flat anterior fontanel an closed posterior fontanel
anterior fontanel closes by age 15-18 months
posterior closes by 2-3 months
Parents of a newborn are concerned because their baby’s head appears misshapen. Which response is most accurate?
a. Asymmetry of a newborn’s head is likely r/t internal bleeding
b. asymmetry of a newborn’s head requires CT scan evaluation
c. Molding of the head after vaginal birth is a common finding
d. Molding of the head after vaginal birth will take months to resolve
c. Molding of the head after vaginal birth is a common finding
usually resolves 3-5 days after birth
When individuals present with signs and symptoms of head and neck disorders, which of these risk factors for head and neck cancer would need to be assessed as part of their history.
a. alcohol and tobacco use
b. occupational exposure
c. infection with HPV
d. Poor oral health
e. all the above
e. all the above
Which should prompt immediate transport of an athlete with a concussion for emergency evaluation?
a. accurate but slowed mental processing
b. decreasing level of consciousness
d. headache and nausea
d. inability to recall injury
b. decreasing level of consciousness
imaging is only a concern with neurological change or concern for skull fx
Standardized assessment of concussion immediately after injury should include testing of
a. coordination, balance, and sensation
b. exertional maneuvers and strength
c. orientation if time, person, and place
e. all the above
e. all the above
Patient hits head on a rock. Their is a concern for a skull fracture. What symptoms are indicative of skull fracture select all that apply
a. confusion
b. vomiting
c. severe pain at site
d. clear fluid from ears or nose
c. severe pain at site
d. clear fluid from ears or nose
only a change in neurostatus or concern for skull fracture warrants imaging other symptoms of skull fx are bruising around site or under eyes (battle sign), pupil changes, vision changes, slurred speech
The Vision of an individual with type 1 diabetes has decreased significantly within the last 2 weeks. HbA1c is 12.5%. The most likely ocular finding is? a. cataracts b diabetic retinopathy c.glaucome d. macular degeneration
b diabetic retinopathy
uncontrolled DM (HbA1c >7%) is the primary risk factor for diabetic retinopathy. Progress rapidly. Damages retina and lead to vision impairment
Type 1 DM pt newly diagnosed need comprehensive, dilated eye exam within 5 yrs of onset
Type 2DM need comprehensive dilated exam at time of onset
