skin, hair & nails, abdomen, breasts & regional lymphs

Question 1

select the best description of the secretions of the eccrine glands:

a) thick, milky
b) dilute saline solution
c) protective lipid substance
d) keratin

Answer 1

b) dilute saline solution

Question 2

naevus is the medical term for:

a) a freckle
b) a birthmark
c) an infected hair follicle
d) a mole

Answer 2

d) a mole

Question 3

to assess for early jaundice, you will assess:

a) sclera and hard palate
b) nail beds
c) lips
d) all visible skin surfaces

Answer 3

d) all visible skin surfaces

Question 4

checking for skin temp is best accomplished by using:

a) palmar surface of the hands
b) ventral surface of the hands
c) fingertips
d) dorsal surface of the hands

Answer 4

d) dorsal surface of the hands

Question 5

skin turgor is assessed by picking u a large fold of skin on the anterior chest under the clavicle. this is done to determine the presence of:

a) oedema
b) dehydration
c) vitiligo
d) scleroderma

Answer 5

b) dehydration

Question 6

Select the lesion description that is most complete :

a) raised, irregular lesion the size of 10c, located on dorsum of L hand
b) open lesion with no drainage or odour approx. 1cm diameter
c) pedunculated lesion below L scapula with consistent red colour, no drainage or odour
d) dark brown, raised lesion with irregular border, on dorsum of R foot, 3cm in size with no drainage

Answer 6

d) dark brown, raised lesion with irregular border, on dorsum of R foot, 3cm in size with no drainage

Question 7

the normal angle between the nail base and the nail is:

a) 60 b) 100
c) 160 d) 180

Answer 7

c) 160`

Question 8

the capillary beds should refill after being depressed in:

a) 2sec
c) 1-2sec
d) time is not significant as long as colour returns

Answer 8

c)1-2sec

Question 9

During a routine visit, Mr Bond, 78 y/o asks about small, round, flat, brown macules on the hands. Your best response after examining the area is:

a) ‘These are the result of sun exposure and do not require treatment’
b) ‘These are related to exposure to the sun. they may become cancerous.’
c) “These are the skin tags that occur with aging. No treatment required’
d) “Im glad you bought this to my attention. I will arrange a biopsy’

Answer 9

a) ‘These are the result of sun exposure and do not require treatment’

Question 10

An area of smooth, rubbery, raised tissue near a scar is called:

a) lichenification
b) plaque
c) atrophy
d) keloid

Answer 10

d) keloid

Question 11

flattening of the angle between the nail and its base is:

a) found in subacute bacterial endocarditis
b) a description of spoon shaped nails
c) related to calcium deficiency
d) described as clubbing

Answer 11

d) described as clubbing

Question 12

the configuration for individual lesions arranged in circles or arc, as occurs with ringworm, is called:

a) linear
b) clustered
c) annular
d) gyrate

Answer 12

c) annular

Question 13

the A in the ABCDE rule stands for:

a) accuracy
b) appearance
c) asymmetric
d) attenuated

Answer 13

c) asymmetric

Question 14

a risk factor for melanoma is:

a) brown eyes
b) darkly pigmented skin
c) skin that freckles or burns before tanning
d) use of sunscreen products

Answer 14

c) skin that freckles or burns before tanning

Question 15

T/F:

yellowing of the skin, sclera and mucous membranes develops after the 3rd-4th day of life

Answer 15

T

Question 16

T/F:

yellowing occurs because of the decreased no. of RBC that haemolyse after birth

Answer 16

False - they increase

Question 17

T/F:

jaundice on the 1st day of life may indicate haemolytic disease

Answer 17

True

Question 18

T/F:

the haemoglobin in the RBC is metabolised by the liver and spleen but its pigment is not converted into bilirubin

Answer 18

False - It is converted

Question 19

T/F:

jaundice after 2 weeks old may indicate biliary tract obstruction

Answer 19

True

Question 20

Mix and match

a) epidermis
b) dermis
c) subcutaneous layer

1 - basal cell layer 
2 - aids protection by cushioning 
3 - collagen 
4 - adipose tissue 
5 - uniformly thin 
6 - stratum corneum 
7 - elastic tissue

Answer 20

1 = a 
2 = c 
3 = b
4 = c
5 = a 
6 = a 
7 = b

Question 21

select the sequence of techniques used during an examination of the abdomen

a) percussion, inspection, palpation, auscultation
b) inspection, palpation, percussion, auscultation
c) inspection, auscultation, percussion, palpation
d) auscultation, inspection, palpation, percussion

Answer 21

c) inspection, auscultation, percussion, palpation

Question 22

which of the following may be noted through inspection of the abdomen?

a) fluid waves and abdomen contour
b) umbilival eversion and Murphy’s sign
c) venous pattern, peristalitic waves and abdominal contour
d) peritoneal irritation, general tympany and peristaltic waves

Answer 22

c) venous pattern, peristalitic waves and abdominal contour

Question 23

RUQ tenderness may indicate pathology in the:

a) liver, pancreas or ascending colon
b) liver and stomach
c) sigmoid colon, spleen or rectum
d) appendix or ileocaecal valve

Answer 23

a) liver, pancreas or ascending colon

Question 24

hyperactive bowel sounds are:

a) high pitched
b) rushing
c) tinkling
d) all of the above

Answer 24

d) all of the above

Question 25

the absence of bowel sounds is established after listening for:

a) 1 full min
b) 3 full mins
c) 5 full mins
d) none of the above

Answer 25

c) 5 full mins

Question 26

auscultation of the abdomen may reveal bruits of which of these arteries:

a) aortic, renal. iliac and femoral
b) jugular, aortic, carotid and femoral
c) pulmonic, aortic and portal
d) renal, iliac, internal jugular and basilic

Answer 26

a) aortic, renal. iliac and femoral

Question 27

the range of normal liver span on the R midclav line in adults is:

a) 2-6 cm
b) 4-8 cm
c) 8-12 cm
d) 6 -12 cm

Answer 27

d) 6 -12 cm

Question 28

the LUQ contains the:

a) liver
b) appendix
c) left ovary
d) spleen

Answer 28

d) spleen

Question 29

striae, which occurs when elastic fibres in the reticular layer of the skin are broken following prolonged or rapid stretching after a long duration this colour is:

a) pink
b) blue
c) purple - blue
d) silvery white

Answer 29

d) silvery white

Question 30

Peptic ulcer disease occurs with which of the following:
1 frequent use of non steroidal anti-inflammatory drugs (NSAIDs)
2 alco consumption
3 smoking
4 helicobacter pylori infection

a) 1, 2 and 4
b) 1, 2 and 3
c) none of the above
d) all of the above

Answer 30

d) all of the above

Question 31

Auscultation of the abdomen is begun in the RLQ because:

a) bowel sounds are always normally present here
b) peristalsis through the descending colon is usually active
c) this is the location of the pyloric sphincter
d) vascular sounds are best heard in this area

Answer 31

a) bowel sounds are always normally present here

Question 32

a dull percussion note forwards of the left midaxillary line is:

a) normal, an expected finding during splenic percussion
b) expected between the 8-12 ribs
c) found if the examination follows a large meal
d) indicative of splenic enlargement

Answer 32

d) indicative of splenic enlargement

Question 33

shifting dullness is a test for:

a) ascites
b) splenic enlargement
c) inflammation of the kidney
d) hepatomegaly

Answer 33

a) ascites

Question 34

tenderness during abdominal palpation is expected when palpating:

a) the liver edge
b) the spleen
c) the sigmoid colon
d) the kidneys

Answer 34

c) the sigmoid colon

Question 35

Murphy’s sign is best described as:

a) the pain felt when the hand of the examiner is rapidly removed from an inflamed appendix
b) pain felt when taking a deep breath when the examiner’s fingers are on the approx. location of the inflamed gallbladder
c) a sharp pain felt by the pt when one hand of the examiner is used to thump the other at the costovertebral angle
d) not a valid examination technique

Answer 35

b) pain felt when taking a deep breath when the examiner’s fingers are on the approx. location of the inflamed gallbladder

Question 36

the reservoirs for storing milk in the breast are:

a) lobules
b) alveoli
c) Montgomery’s glands
d) lactiferous sinuses

Answer 36

d) lactiferous sinuses

Question 37

the most common site of breast tumours is:

a) U in Q
b) U out Q
c) L in Q
d) Lout Q

Answer 37

b) U out Q

Question 38

a 13 y/o girl being examined questions her breast asymmetry. the best response is:

a) One breast may grow faster than the other during development
b) I will give you a referral for a mammogram
c) you will probable have fibrocystic disease when your older
d) this may be an indication of hormonal imbalance. we will check in 6mth

Answer 38

a) One breast may grow faster than the other during development

Question 39

when teaching to self examine. the best time to check is:

a) at the onset of period
b) on 14th day of cycle
c) on 4-7th day of cycle
d) just before period

Answer 39

c) on 4-7th day of cycle

Question 40

when should a women should get a mammogram screening:

a) every yr
b) every 2yrs
c) twice a yr

Answer 40

b) every 2yrs

Question 41

what is the best position to inspect the breasts:

a) lying supine with arms at sides
b) leaning forward with hands outstretched
c) sitting with hands pushing onto hips
d) one arm at side and other elevated

Answer 41

c) sitting with hands pushing onto hips

Question 42

a bimanual technique may be the referred approach for a women

a) who is pregnant
b) who is having the 1st breast examination by health provider
c) with pendulous breasts
d) who has felt a change on self examination

Answer 42

c) with pendulous breasts

Question 43

during the examination a 70y/o man you note gynaecomastia. you should:

a) refer for biopsy
b) refer for mammogram
c) review the medications for drug that have gynaecomastia side effects
d) proceed with exam

Answer 43

c) review the medications for drug that have gynaecomastia side effects

Question 44

you detect a mass . identify the description that is most consistent with cancer rather than benign breast disease:

a) round, firm, well demarcated
b) irregular, poorly defined and fixed
c) rubbery, mobile and tender

Answer 44

b) irregular, poorly defined and fixed

Question 45

what would you expect on a pregnant womens breast:

a) peau d’orange
b) nipple retraction
c) unilateral, obvious venous pattern
d) blue vascular pattern over the breasts

Answer 45

d) blue vascular pattern over the breasts

Question 46

which should NOT be referred:

a) 26 y/o with multiple nodules palpated on each breast
b) 48 y/o has a 6mth Hx of reddened and sore L nipple and areaolar area
c) 25 y/o with symmetrical breasts and inversion of nipples since adolescents
d) 64 y/o with ulcerated area at tip of R nipple, no masses, tenderness or nodes palpated

Answer 46

c) 25 y/o with symmetrical breasts and inversion of nipples since adolescents

Question 47

a lump on the breast should be referred . a benign lesion will usually have 3 characteristics. which one is malignant:

a) soft
b) well defined margins
c) freely movable
d) irregular shape

Answer 47

d) irregular shape

Question 48

gynaecomastia is:

a) enlargement of the male breasts
b) presence of mast cells in male breasts
c) cancer of male breasts
d) presence of supernumeracy breast on male chest

Answer 48

a) enlargement of the male breasts

Question 49

which is the 1st physical change associated with puberty in girls:

a) areolar elevation
b) breast bud development
c) height spurt
d) pubic hair development
e) menarche

Answer 49

b) breast bud development