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PD > Block Exam > Flashcards

Block Exam Flashcards

1
Q

45 year old male patient complaining of 6 months productive cough associated with intermittent fever noted night time. Chest X-Ray showed infiltrates between ribs 2nd-4th, left. On palpation a 2 x 2 cm movable, non tender mass noted in the inferior angle of the left scapula. Which would be a correct anatomical landmark of the mass?

A

2nd intercostal space, left

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2
Q

45 year old male patient complaining of 6 months productive cough associated with intermittent fever noted
night time. Chest X-Ray showed infiltrates between ribs 2nd-4th, left. On palpation a 2 x 2 cm movable, non
tender mass noted in the inferior angle of the left scapula. What lung lobe would be beneath the palpable
mass?

A

Left upper lobe

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3
Q

A 56 year old,100 Kg, chain smoker consuming 20 pack year, male patient, came to your clinic with sudden onset of shortness of breath noted during lying down and which is relieved upon sitting up and associated with chronic productive cough. Patient has been previously admitted due to cardiomyopathy. Chest X-Ray showed massive pleural effusion on the right. Which is a non cardiorespiratory cause of dyspnea?

  • Pleural effusion
  • Weight of 100 kg
  • Productive cough
  • Cardiomyopathy
A

Weight of 100 kg

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4
Q

A 56 year old,100 Kg, chain smoker consuming 20 pack year, male patient, came to your clinic with sudden onset of shortness of breath noted during lying down and which is relieved upon sitting up and associated with chronic productive cough. Patient has been previously admitted due to cardiomyopathy. Chest X-Ray showed massive pleural effusion on the right. What is causing the shortness of breath in this patient?

  • Weight of 100 kg
  • Cardiomyopathy
  • Pleural effusion
  • Productive cough
A

Pleural effusion

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5
Q

A 56 year old,100 Kg, chain smoker consuming 20 pack year, male patient, came to your clinic with sudden onset of shortness of breath noted during lying down and which is relieved upon sitting up and associated with chronic productive cough. Patient has been previously admitted due to cardiomyopathy. Chest X-Ray showed massive pleural effusion on the right. In this patient, the shortness of breath described is known as what?

A

Orthopnea

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6
Q

You are the intern assigned in the OPD when a 6 years old male was referred to you because of difficulty in breathing. As you were interviewing the parents, you noticed an audible high-pitched inspiratory whistling from the patient. what does this indicate?

A

Upper airway obstruction

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7
Q

In examination of the chest, which of the following techniques will you do after inspection?

A

Test chest expansion

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8
Q

You are assigned to examine a 48 years old male who complains of dyspnea. He is a 30 pack year smoker, and has been admitted previously due to the same condition. The auscultatory findings of the chest is a relatively low pitched sound with a snoring quality. How will you document the finding?

A

Ronchi

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9
Q

Refers to dyspnea caused by overdistention of air spaces distal to terminal bronchioles, with destruction of
alveolar septa, alveolar enlargement, and limitation of expiratory air flow.

A

COPD

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10
Q

What is the expected percussion note in a healthy lung?

A

Resonant

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11
Q

This refers to the sinusoidal, musical, prolonged, relatively high-pitched adventitious breath sounds.

A

Wheeze

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12
Q 
Which among the following is purely an expiratory sound? 
• Vesicular
• Bronchial
• Tracheal
• Bronchovesicular
A

Bronchial

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13
Q

The following are components of transmitted voice sounds in examining the chest except?

  • Whispered pectoriloquy
  • Egophony
  • Bronchophony
  • Forced expiratory time
A

Forced expiratory time

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14
Q

TRUE or FALSE. Chest pain caused by pneumonia is a result of the inflammation of the parietal pleura.

A

TRUE

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15
Q

Anxious patients may manifest with the following clinical presentations except?
• smothered sensation when they try to breathe
• Tingling sensation in fingers and toes
• pins and needles around the lips
• Clubbing of fingers

A

Clubbing of fingers

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16
Q 
Hallmarks of obstructive sleep apnea except? 
• Excessive daytime sleepiness
• Insomnia
• Snoring
• Fatigue
A

Insomnia

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17
Q

Obesity can cause obstructive sleep apnea through which mechanism?
• instability of the brainstem respiratory center
• disordered sleep arousal
• genioglossus malfunction
• Airway collapse due to anatomic changes

A

Airway collapse due to anatomic changes

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18
Q

“I am concerned but not ready to quit now.” Which stage of the change model would this statement belong to?

A

Contemplation

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19
Q

TRUE or FALSE. The nasal spray influenza vaccine containing live attenuated virus is recommended for healthy people between ages of 2 and 49 years.

A

TRUE

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20
Q

Which is a correct statement about vaccine for Streptococcal pneumonia?

  • It is recommended to be given every year.
  • Only PCV13 is recommended for high-risk groups.
  • Smokers and asthmatic adults should be given the vaccine.
  • Infants less than one year old should not be given pneumococcal vaccine
A

Smokers and asthmatic adults should be given the vaccine.

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21
Q

Clubbing of the nails is likely to occur in these conditions except?
• Hyperventilation triggered by anxiety attack
• Lung abscess
• Cystic fibrosis
• Lung cancer

A

Hyperventilation triggered by anxiety attack

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22
Q

. A 40 year old male came in for shortness of breath. He is a known asthmatic. His lips are also cyanotic. What
other physical exam findings would you expect with respiratory distress?

A

retractions of intercostal muscles

23
Q

Delayed expiration phase is found in which condition?

A

COPD

24
Q

Four to five centimeters of the upper trachea can be felt in the neck between the cricoid cartilage and the sternal notch. What anatomic distortion would be created by a massive pneumothorax?

A

Push trachea to the opposite side of the pneumothorax (contralateral)

25
Q

Where is fremitus more prominent?

A

Interscapular space

26
Q

Testing for fremitus belongs to which technique?

A

Palpitation

27
Q

Generalized hyperresonance is most likely to be found in which clinical condition?

A

COPD

28
Q

TRUE or FALSE. A patient should not cough before auscultation in order not to affect the presence of obstructive phlegm and to be able to detect mild atelectasis.

A

FALSE

29
Q 
Wheezes are expected findings in the following diseases except? 
• Asthma
• Bronchitis
• Chronic obstructive pulmonary disease
• Upper airway obstruction
A

Upper airway obstruction

30
Q

Egophony is a finding that belongs to which technique of chest and lungs examination?

A

Auscultation

31
Q

This is a pattern of breathing that has periods of deep breathing alternating with periods of apnea. It can be normal in children and older adults. Pathologic causes may include heart failure, uremia and brain injury.

A

Cheyne-Stokes breathing

32
Q

Which chest deformity can be found in multiple rib fractures?

A

Traumatic flail chest

33
Q

Whispered pectoriloquy is a more likely finding in which condition?
• Spontaneous pneumothorax due to ruptured bleb
• Normal lungs
• Pleural effusion due to lung cancer
• Lobar pneumonia with consolidated airless lung

A

Lobar pneumonia with consolidated airless lung

34
Q

Which is a special technique for identification of a fractured rib?
• Anterior and posterior compression of the chest (sternum and thoracic spine)
• Palpation of each rib using a ladder pattern
• Raising and lowering of arms to detect tenderness on movement
• Point tenderness technique

A

Anterior and posterior compression of the chest (sternum and thoracic spine)

35
Q

Dullness on percussion is found in which pulmonary condition?

A

Plueral effusion

36
Q

Chronic cough associated with allergic rhinitis is usually found in this condition.

A

Postnasal drip

37
Q

These statements are correct regarding the Pathology Department EXCEPT:
• clinical pathology oversees a whole range of laboratory divisions, including hematology & immunology
• autopsies are performed in the clinical pathology department
• anatomical pathology study organs and tissues
• clinical pathology typically work with body fluids like blood

A

autopsies are performed in the clinical pathology department

38
Q

This is NOT the correct function for the following Pathology Unit:
• Serology / Immunology is in charge of bacterial culture, virology & mycology
• Blood Bank deals with blood transfusion
• Clinical Chemistry analyzes the various components of blood and body fluids
• Clinical Microscopy identifies & counts the different cells in body fluids
• Hematology counts the different blood cells

A

Serology / Immunology is in charge of bacterial culture, virology & mycology

39
Q

Which among the following is the LEAST among the Purposes & Functions of the Pathology Department? = to
assist the Clinicians in:

  • monitoring follow-up therapy
  • detecting disease through screening
  • determining the prognosis
  • establishing a diagnosis
  • providing guidelines in patient management
A

establishing a diagnosis

40
Q

This type of chromatin is more active than the other:

A

euchromatin

41
Q

The noncoding, intervening sequence of DNA within a gene:

A

Introns

42
Q

The process of gene “silencing”:

A

Histone Methylation

43
Q

Proteins on the extracytoplasmic face may associate with the membrane via:

A

glycosyl phosphatidyl inositol linked protein

44
Q

The lipid bilayer of the cell membrane is relatively impermeable to all EXCEPT the:

  • smallest and/or most hydrophilic molecules
  • largest and/or most hydrophobic molecules
  • largeat and/or most hydrophilic molecules
  • smallest and/or most hydrophobic molecules
A

smallest and/or most hydrophobic molecules

45
Q

Signaling receptors that normally drives the cell’s constitutive degradation:

A

Wnt/Frizzled pathway where activation releases intracellular β-catenin

46
Q

The group of cyclins that regulate the G1-to-S transition by phosphorylating the Rb protein (pRb):

A

Cyclin D-CDK4, cyclin D CDK6, and cyclin E-CDK2.

47
Q

Most preferred site for venipuncture:

A

antecubital fossa

48
Q

After extracting blood from your patient, you handed the blood to the Laboratory. But The Med Tech on duty
complained, because the hemolysed specimen you extracted could increase the following tests, EXCEPT:
• Potassium
• Sodium
• Lactate Dehydrogenase
• Erythrocyte Sedimentation Rate

A

Sodium

49
Q

Causes for Hemolyzed blood specimen:
• vigorous mixing of blood with anticoagulant
• directly dropping blood from syringe tip into bottom of tube
• All
• excessive heat during transport
• forcefully pushing blood out through the needle

A

All

50
Q

A basketball athlete wanted to be tested for Complete Blood Count. He just came from the game with his shirt
soaked with sweat. The result revealed a high Leukocyte count, predominated by Neutrophils. How will you
explain to the patient?
• This is a false increase due to his recent activity.
• He is a silent carrier of a disease and needs to undergo further testing.
• The laboratory needs to apologize for the mistake and must repeat the test.
• He has acute infection, and needs to take antibiotics.

A

This is a false increase due to his recent activity.

51
Q

The following are essential preparations before interviewing a patient except:

  • Review you clinical behavior and appearance
  • Reviewing clinical records
  • Setting goals for the interview
  • Identify the qualifiers of the family members
A

Identify the qualifiers of the family members

52
Q

The following are components of the attributes of symptoms except:

  • exacerbating factors
  • Quality
  • color
  • location
A

Color

53
Q

What is the importance of exploring the sexual history of the Pt?

A

It can be life saving

54
Q

Which among the following is not part of the dimensions of cultural humility?

  • Indiscriminate knowledge
  • Self-awareness
  • Respectful communication
  • Collaborative partnership
A

Indiscriminate knowledge

PD (8 decks)

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