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Internal Disease > Test 2 - 2 > Flashcards

Test 2 - 2 Flashcards

1
Q

50.2 Cytomegaly (because pituitary gland hyperactivity) is characterized by enlarged size of hands and foots and always starts in adolescence or later

a) first statement is true and the second statement is false
b) first statement is false and the second statement is true
c) both statements are true

A

c) both statements are true

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2
Q
  1. 2 Cushing syndrome is characterized by the following signs and symptoms except:

a) hirsutism
b) myosis
c) ecchymoses
d) hypertension

A

b) myosis

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3
Q

48.2 Posterior tibial artery is located:

a) behind medial malleolus
b) behind lateral malleolus
c) in popliteal fossa
d) in line with the lateral edge of extensor of toe

A

a) behind medial malleolus

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4
Q

47.2 Lower extremities arterial insufficiency is characterized by:

a) pain exacerbating on walking
b) pale skin
c) absence of pulse over posterior tibial artery
d) edema around malleoli
e) b+c+d
f) a+b+c

A

f) a+b+c

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5
Q

46.2 Lower extremities venous insufficiency is characterized by:

a) dark blue skin discoloration
b) legs edema
c) pale skin in supine position
d) gangrene of toes
e) a+b
f) a+b+d

A

e) a+b

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6
Q

45.2 Routine arteries examination includes palpation of arteries listed below, except for:

a) brachial artery
b) thoracic aorta
c) abdominal aorta
d) popliteal artery
e) b+c

A

b) thoracic aorta

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7
Q

44.2 Femoral lymph nodes are considered normal in size up to:

a) 0,2 cm
b) 1,0 cm
c) 2 cm
d) any enlargement of femoral lymph nods is considered pathological

A

b) 1,0 cm

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8
Q

43.2 Lower extremity edema are pathognomonic for liver diseases (1) and results from decrease of albumin serum concentration and low oncotic pressure (2).

a) first statement is true and the second statement is false
b) first statement is false and the second statement is true
c) both statements are true
d) both statements are false

A

b) first statement is false and the second statement is true

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9
Q

42.2 Chronic liver diseases can be accompanied by:

a) jaundice
b) breast development
c) spider angiomata
d) all of the above

A

d) all of the above

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10
Q

41.2 The presence of costo-vertebral angle tenderness on right side indicates:

a) hepatomegaly
b) splenomegaly
c) kidney infectiond) stomach ulcer

A

c) kidney infection

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11
Q

40.2 Jaundice is a yellow discoloration of the skin caused by:

a) liver diseases
b) decreased serum bilirubin concentration
c) kidney insufficiency
d) chronic, severe cigarette smoking
e) a+d

A

a) liver diseases

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12
Q

39.2 Acute abdomen (also called surgical abdomen) is characterized by:

a) silent abdomen on auscultation
b) superficial muscle tightening on palpation (muscular defence)
c) rebound tenderness (Blumberg’s sing)
d) a+c
e) a+b+c

A

e) a+b+c
a) silent abdomen on auscultation
b) superficial muscle tightening on palpation (muscular defence)
c) rebound tenderness (Blumberg’s sing)

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13
Q

38.2 Ascites is an abnormal accumulation of fluid in:

a) guts
b) peritoneal cavity
c) subcutaneous tissue of abdominal skin
d) a+b

A

b) peritoneal cavity

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14
Q

37.2 Assessing of fluid wave (in ascites examination) is:

a) more reliable than shifting dullness technique
b) a confirmatory test of low reliability
c) requires abdominal puncture

A

b) a confirmatory test of low reliability

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15
Q

36.2 There are some possible limitations of shifting dullness technique, except for:

a) small amounts of fluid
b) previous abdominal surgery
c) presence of hepatomegaly
all answers are true

A

c) presence of hepatomegaly

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16
Q

35.2 Assessment for shifting dullness on percussion is not a reliable technique in detecting ascites (1) and the absence of shifting indicates the presence of fluid as a cause of abdominal distension (2).

a) first statement is true and the second statement is false
b) first statement is false and the second statement is true
c) both statements are true
d) both statements are false

A

d) both statements are falseAssessment for shifting dullness on percussion is not a reliable technique in detecting ascites (1) and the absence of shifting indicates the presence of fluid as a cause of abdominal distension (2).

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17
Q

34.2 The percussable abdominal organs (in terms of examination of shape and size) in normal patient are:

a) liver
b) kidney
c) stomach
d) small intestine
e) spleen
f) only a+e

A

f) only a+e

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18
Q
  1. 2 Nephrotic syndrome is characterized by:
  2. proteinuria > 3.5 G/24 h
  3. hipoproteinaemia and hipoalbuminaemia
  4. hiperlipidaemia
  5. edema

a) 1, 2, 3
b) 1, 2, 4
c) 1, 2, 3, 4

A

c) 1, 2, 3, 4

  1. proteinuria > 3.5 G/24 h
  2. hipoproteinaemia and hipoalbuminaemia
  3. hiperlipidaemia
  4. edema
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19
Q

32.2 Subject complaining for dysuria, increased frequency, pain during voiding and fever presents symptoms of:

a) renal colic
b) renal cancer
c) urinary tract infection

A

c) urinary tract infection

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20
Q
  1. 2 Urinary tract infection are promoted by:
  2. urinary tract obstruction
  3. vesicoureteral reflux
  4. diabetes
  5. urolithiasis
  6. immunosuppression

a) 1, 2, 3, 4
b) 2, 3, 4, 5
c) 1, 2, 3, 4, 5

A

c) 1, 2, 3, 4, 5

  1. urinary tract obstruction
  2. vesicoureteral reflux
  3. diabetes
  4. urolithiasis
  5. immunosuppression
21
Q
  1. 2 Match sentences:
  2. oliguria A. < 500 ml/24 h
  3. anuria B < 1000 ml/24 h
  4. polyuria C < 100 ml/24 h D > 1000 ml/24 h E > 3000 ml/24 h

a) 1-A, 2-C, 3-D
b) 1-B, 2-C, 3-E
c) 1-A, 2-C, 3-E

A

c) 1-A, 2-C, 3-E

22
Q
  1. 2 Risk factors for nephrolithiasis are:
  2. anatomical changes in urinary tract
  3. hyperparathyroidism
  4. high protein diet
  5. high fluid intake
  6. hot, dry climate

a) 1, 2, 3, 4, 5
b) 2, 4, 5
c) 1, 2, 3, 5
d) 1, 2, 4

A

c) 1, 2, 3, 5

  1. anatomical changes in urinary tract
  2. hyperparathyroidism
  3. high protein diet
  4. hot, dry climate
23
Q

28.2 Typical signs of renal colic are:

1) gripping pain
2) pain radiates to the groins and scrotum
3) positive Rovsing’s sign
4) nausea
5) pain radiaties to the left scapula

a) 1, 3, 4
b) 1, 2, 5
c) 1, 2, 3, 4, 5
d) 1, 2, 4

A

d) 1, 2, 41) gripping pain2) pain radiates to the groins and scrotum 4) nausea

24
Q

27.2 The localization of renal artery auscultation area is:

a) 3 cm below the umbilicus and 3 cm laterally to the central anterior line
b) 5 cm above umbilicus
c) 3-4 cm above the umbilicus and along lateral edge of rectus musclesd) in lumbar region

A

c) 3-4 cm above the umbilicus and along lateral edge of rectus muscles

25
Q

26.2 The total span of the normal liver in mid-clavicular line do not exceed on percussion:

a) 6 cm
b) 10 cm
c) 12 cm
d) 15 cm

A

c) 12 cm

26
Q

25.2 Quiet abdomen on auscultation:

a) reflects an inflammation of the serosa
b) is a normal variant of bowel sounds
c) is pathognomonic for inflammatory process of the intestinal mucosa
d) is a symptom of very low importance in abdominal examination

A

a) reflects an inflammation of the serosa

27
Q

24.2 There is a lot of variability of bowel sounds frequency. Usually they occur every:

a) 1-2 seconds
b) 2-5 seconds
c) 5-10 seconds
d) 10-20 seconds

A

b) 2-5 seconds

28
Q

23.2 Describe principal differences between somatic and visceral abdominal pain.

A

The abdominal organs have two different types of pain perception: via fibers of the autonomic nervous system (ANS) originating from the intestine and peritoneum (visceral pain) and via fibers of the central nervous system (CNS) originating from the abdominal wall, including the parietal peritoneum and mesenteric portion of the small intestine (somatic pain). 

Visceral Pain. The main causes of visceral pain are fast pressure increase in hollow organs, capsule tension, and intensive muscular contractions. Visceral pain is typically felt in or near the median line of the abdomen. Visceral pain of the hollow organs, primarily of the intestine, is generally characterized by colics, i. e., intermittent attacks of pain that vary in intensity, similar to labor pains, with pain-free intervals. Pain associated with visceral pain radiates to regions that belong to the same neurologic segment as the diseased organ.

Somatic pain primarily occurs as a result of irritation of the parietal peritoneum, peritonitis. This pain is localized at the site of maximum inflammation e. g., right lower abdominal region in appendicitis, and is typically continuous.

29
Q

22.2 Differentiation between air, fluid or fat collection as a cause of abdominal enlargement is possible on visual inspection (1) and requires standing of the investigator at the patient’s head (2).

a) first statement is true and the second statement is false
b) first statement is false and the second statement is true
c) both statements are true
d) both statements are false

A

d) both statements are false

30
Q

21.2 Global abdominal distension can be caused by:

a) fluid collection
b) air collection
c) fat collection
d) single organomegaly (e.g. hepatomegaly)
e) a+b+c are true
f) a+b+c+d are true

A

e) a+b+c are true

31
Q

20.2 Bending the patient’s knees during an abdominal examination is helpful, because:

a) it allows to relax abdominal musculature
b) it is more comfortable for the patient
c) it relaxes bowels, which are normally tensed in supine positiond) it is helpful only in very fat patients

A

a) it allows to relax abdominal musculature

32
Q

18.2 The examination of abdomen comprises four components: observation, percussion, palpation and auscultation. Find the wrong statement:

a) routine exam focuses on palpation; when there are no abdominal complaints other components can be omitted
b) auscultation should be performed before percussion and palpation
c) percussion is of lower importance; the localization of organs in abdomen is routinely elicited from X-ray exam
d) percussion over bowels reveals a dull note

A

b) auscultation should be performed before percussion and palpation

33
Q

17.2 Hypothyroidism is characterized by the following signs and symptoms except for:

a) tachycardia
b) hoarse voice
c) myxedema
d) constipation

A

a) tachycardiaI need to check that one since I am not sure

34
Q

16.2 Tachyarrhythmia is a typical symptom of thyreotoxicosis (1) and ventricular extrasystolia is the most common type of arrhythmia in this case.

a) first statement is true and the second statement is false
b) first statement is false and the second statement is true
c) both statements are true
d) both statements are false

A

a) first statement is true and the second statement is false

35
Q

15.2 Nodules within the thyroid gland

a) are variant of normal status
b) are doubtlessly pathologic and require further examination
c) reflect the malignancy
d) are usually not found because the most common appearance of the thyroid gland pathology is its overall homogenous enlargement

A

b) are doubtlessly pathologic and require further examination

36
Q

14.2 Describe the localization of the thyroid gland.

A

The thyroid gland is located at the front of the neck just below the Adam’s apple (larynx). It is butterfly-shaped and consists of two lobes located either side of the windpipe (trachea). A normal thyroid gland is not usually outwardly visible or able to be felt if finger pressure is applied to the neck.-soft + enlarged in Graves-hard in Hashimoto + cancer - tender in thyroiditis

37
Q

13.2 The parotid glands are located on either side of the lower neck (1) and their entries in the mouth can not be visible (2).

a) first statement is true and the second statement is false
b) first statement is false and the second statement is true
c) both statements are true
d) both statements are false

A

d) both statements are false

38
Q

12.2 The normal pharynx has a dull red color (1) and is frequently covered with white exudates (2).

a) first statement is true and the second statement is false
b) first statement is false and the second statement is true
c) both statements are true
d) both statements are false

A

a) first statement is true and the second statement is false

39
Q

11.2 The absence of transillumination of the maxillary sinus reflects:

a) the thickening of mucosa covering the upper mouth
b) the presence of fluid in the sinus
c) the absence of transillumination reflects the physiological status

A

b) the presence of fluid in the sinus

40
Q

10.2 Symptoms associated with chronic sinusitis include the following, except for:

a) facial pain
b) nasal discharge
c) nasal congestion
d) nasal bleeding
e) headache

A

d) nasal bleeding

41
Q

8.2 External ear structures examination is focused on observation. Particular attention should be paid to:

a) skin changes (e.g. malignancies)
b) changes in shape of external ear structures (e.g. congenital malformations)
c) discharge from the external ear canald) all of the above

A

d) all of the above

42
Q

7.2 Malignant lymph nodes in contrast to infected ones usually are:

a) tender
b) enlarged
c) firm
d) fixed
e) only b+c+d are true

A

e) only b+c+d are true

43
Q

6.2 List at least 4 groups of lymph nodes located on the head and the neck.

A

Occipital ParotidSubmandibularSubmental

44
Q

5.2 Left-side hydrothorax is highly probable to occur in:

a) tuberculosis
b) acute pancreatitis
c) rupture of gastric ulcer
d) right-side pneumothorax
e) all statements are true

A

b) acute pancreatitis

45
Q
  1. Describe the technique of accessing papillary response to light.
A

Observe the pupil size and shape at rest, looking for anisocoria (one pupil larger than the other)Observe the direct response (constriction of the illuminated pupil)Observe the consensual response (constriction of the opposite pupil)Repeat with the opposite pupil.

46
Q
  1. What is Valsalva maneuver?
A

The effort to breath out forcibly while the mouth and nose are firmly closed or the vocal cords pressed together. Rise blood pressure followed by sharp drop and then a second sharp rise in blood pressure.

47
Q
  1. Conjunctiva is a:

a) white outer covering of the eyeball
b) central opening in the iris of the eye
c) thin transparent membrane covering sclera and inner surface of the eyelids

A

c) thin transparent membrane covering sclera and inner surface of the eyelids

48
Q
  1. Yellow appearance of sclera reflects:

a) inadequate oxygenation of hemoglobin
b) hyperbilirubinemia
c) damage of cranial nerve 7

A

b) hyperbilirubinemia

Internal Disease (5 decks)

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