Midterm Flashcards

0
Q

A 14-year-old male presents with shortness of breath, wheezing and a cough productive of small amounts of thick, stringy, viscous sputum. These symptoms are exacerbated by exertion, such as climbing the stairs. Examination reveals prolonged expiration.
Entry data: Pulse: 90 bpm Blood pressure: 130/85 Temp: 99.6°F
Respiration: 26/min

Which of the following is the most likely cause of the symptoms?
A. Emphysema
B. Chronic tuberculosis
C. Bronchiogenic carcinoma
D. Asthmatic bronchitis
A

D. Asthmatic bronchitis

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1
Q
(Using previous case study)...
Which of the following screening tests is the most appropriate initial screening procedure?
A. Chest x-ray
B. Blood chemistry screen
C. Thoracic thermography
D. Lung biopsy
A

A. Chest x-ray

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2
Q
(Using previous case study)...
Which of the following is the most likely level of a reflex spinal involvement?
A. Upper cervical
B. Upper thoracic
C. Lower thoracic 
D. Upper lumbar
A

C. Lower thoracic

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3
Q
(Using previous case study)...
What is the possible nature of this condition?
A. Metabolic
B. Autoimmune
C. Neoplastic (tumor)
D. Degenerative
A

B. Autoimmune

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4
Q
Splinter hemorrhage of the nail is associated with...
A. Iron deficiency anemia
B. Psoriasis
C. Subacute bacterial endocarditis
D. Zinc deficiency
A

C. Subacute bacterial endocarditis

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5
Q
OPQRST falls under which major patient history category? 
A. Family history
B. Past medical history
C. Present problem
D. Social history
A

C. Present problem

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6
Q

The classic sequence of a case history is…
A. Chief complaint, past medical history, present illness
B. Chief complaint, present illness, past medical history
C. Present illness, chief complaint, past medical history
D. Present illness, past medical history, chief complaint

A

B. Chief complaint, present illness, past medical history

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7
Q

The third heart sound occurs physiologically due to…
A. Mitral and tricuspid valve closure
B. Aortic and pulmonary valve closure
C. Active blood flow from the atria to the ventricles
D. Passive blood flow from the atria to the ventricles

A

D. Passive blood flow from the atria to the ventricles

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8
Q

Cor pulmonale is…
A. Pulmonary pathology due to right-sided heart failure
B. Left ventricular failure
C. Right ventricular enlargement due to pulmonary pathology
D. Bilateral ventricular enlargement

A

C. Right ventricular enlargement due to pulmonary pathology

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9
Q
Structural abnormalities of the chest may be associated with...
A. Pneumonia
B. Asthma
C. Bronchial asthma
D. TB
A

D. TB

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10
Q
Patient presented with barrel chest, tachypnea and clubbing of the fingernails. Which of the following percussive notes will be heard over the lung?
A. Resonant
B. Flat
C. Tympanic 
D. Hyperresonant
A

D. Hyperresonant

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11
Q
Which of the following valvular lesions can cause drop attacks (blackouts)?
A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid stenosis
D. Pulmonic stenosis
A

B. Aortic stenosis

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12
Q
Start at the superior vena cava a drop of blood will follow the following valvular sequence:
A. Mitral, tricuspid, aortic, pulmonic
B. Tricuspid, pulmonic, mitral, aortic
C. Tricuspid, aortic, pulmonic, mitral
D. Tricuspid, pulmonic, aortic, mitral
A

B. Tricuspid, pulmonic, mitral, aortic

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13
Q
Constant low back pain which is unrelieved by position, activity or rest is most likely the result of which of the following?
A. Muscular strain
B. Visceral disease
C. Disc herniation
D. Osteoarthritis
A

B. Visceral disease

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14
Q
A condition most commonly caused by systemic hypertension is...
A. Right ventricular hypertrophy
B. Pericarditis
C. Bacterial endocarditis
D. Left ventricular hypertrophy
A

D. Left ventricular hypertrophy

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15
Q

Aortic valve stenosis may produce which of the following?
A. Systolic murmur
B. Diastolic murmur
C. Both

A

A. Systolic murmur

16
Q

All are true with regard to percussion except…
A. The heart and liver are flat
B. The normal lung tissue is resonant
C. The gastric air bubble will be tympanic
D. All statements are true

A

A. The heart and liver are flat

Heart and liver are actually “dull”

17
Q
All the following usually accompany emphysema except...
A. Spooning of the fingernails
B. Hyperresonant note upon percussion
C. Increased red blood cells
D. Decreased respiratory excursions
A

A. Spooning of the fingernails

Spooning occurs with iron deficiency anemia

18
Q
While taking x-ray, which of the following pathologies necessitates an increase in exposure technique?
A. Acromegaly
B. TB
C. Hyperthyroidism
D. Emphysema
A

A. Acromegaly

19
Q

Which of the following questions would help substantiate a diagnosis of a rib fracture?
A. Is there a family history of fragile ribs?
B. Do you smoke?
C. Do you also have back pain?
D. Does deep breathing or coughing aggravate the pain?
E. Have you broken ribs before?

A

D. Does deep breathing or coughing aggravate the pain?

20
Q
Which of the following chest conditions is associated with hemoptysis (coughing of blood)?
A. Bronchial asthma
B. Acute bronchitis
C. Bronchogenic carcinoma 
D. Pneumonia
A

C. Bronchogenic carcinoma

21
Q
Butterfly rash of the face without any other lab findings may suggest...
A. Lupus
B. Subacute bacterial endocarditis
C. Systemic lupus erythematosis
D. Acromegaly
A

A. Lupus

22
Q
Giovanni is a 25-year-old male complaining of acute abdominal discomfort for the last several days. Initial evaluation revealed that he has a tinge of yellowish discoloration in his sclera. Examination reveals tenderness in the right upper quadrant. Which of the following systems may be suspected as a cause of jaundice in Giovanni's case?
A. Hemopoietic system
B. Gastrointestinal system
C. Genitourinary system
D. Cardiovascular system
A

A. Hemopoietic system

23
Q
The apex beat is normally located at...
A. Mid scapular line
B. Mid clavicular line 
C. Interior axillary line
D. Midaxillary line
A

B. Mid clavicular line

At 5th intercostal space

24
Q
Pulmonic valve stenosis may lead to...
A. Right atrium enlargement
B. Left atrium enlargement
C. Right ventricle enlargement
D. Left ventricle enlargement
A

C. Right ventricle enlargement

25
Q

Vitilago is a skin disorder characterized by…
A. Excessive secretion of melanocytes
B. Degeneration and lack of secretion of melanocytes
C. Malignant transformation of the melanocytes
D. All of the above

A

B. Degeneration and lack of secretion of melanocytes

26
Q
Examination of a 60-year-old male with chest and mid thoracic pain reveals clubbing of the fingernails, cyanosis of the lips and oral mucosa, and hypertrophy of both sternocleidomastoid muscles. Based on this information, the most commonly involved system is the \_\_\_\_\_\_\_\_\_ system.
A. Vascular
B. Respiratory
C. Cardiac
D. Endocrine
A

B. Respiratory

27
Q

The second heart sound is caused by _________ and is associated with _________.
A. Aortic and pulmonic valve closure / beginning of systole
B. Aortic and pulmonic valve closure / beginning of diastole
C. Mitral and tricuspid valve closure / beginning of systole
D. Mitral and tricuspid valve closure / beginning of diastole

A

B. Aortic and pulmonic valve closure / beginning of diastole

28
Q
Which of the following is not considered a quality of pain?
A. Burning
B. Sharp
C. Intermittent
D. Throbbing
A

C. Intermittent

29
Q
The character of a cardiac pain is usually...
A. Knife like
B. Pressure
C. Burning
D. Shooting
A

B. Pressure

30
Q
All are true concerning normal values of vital signs except...
A. Blood pressure is 140/80
B. Pulse rate is 60-90
C. Respiratory rate is 10-20
D. Temperature is 98.6°F
A

A. Blood pressure is 140/80

31
Q

All of the following are associated with bronchial asthma except…
A. Decreased mucus secretion of the bronchial mucosas
B. Chest wheezing
C. Smooth muscle contraction of the bronchial mucosal
D. Decreased respiratory excursion

A

A. Decreased mucus secretion of the bronchial mucosas

32
Q
The part of the heart that occupies most of the anterior surface is...
A. Right ventricle
B. Left ventricle
C. Right atrium
D. Left atrium
A

A. Right ventricle

33
Q
Hypersecretion of the pituitary gland before puberty will cause...
A. Cretinism 
B. Dwarfism
C. Acromegaly
D. None of the above
A

D. None of the above

Acromegaly occurs after puberty

34
Q

The role of diagnosis in chiropractic practice is…
A. To identify areas of subluxation
B. To identify area of precaution concerning the patient’s overall health
C. To refer the patient in a timely manner if warranted
D. All are true

A

D. All are true

35
Q
Chest pain that is exacerbated by exercise and is relieved by rest is most likely due to...
A. Pericarditis
B. Diaphragmatic irritation
C. Coronary ischemia
D. Pleurisy
A

C. Coronary ischemia (not having enough blood through the coronary arteries)

36
Q
Which of the five percussive notes is the only one that is pathological?
A. Tympanic 
B. Resonant
C. Hyperresonant
D. Dull
E. Flat
A

C. Hyperresonant

37
Q
The sound that is normally heard over the periphery of the lung during auscultation of an asthmatic patient is...
A. Bronchial
B. Bronchiovesicular
C. Vesicular 
D. Localized wheezing
E. Generalized wheezing
A

E. Generalized wheezing