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  1. 1. General Diagnosis All material in this presentation is a copyright of Irene Gold Associates, Inc. All Rights Reserved. OAR
  2. 2. 1. An 8 year old young boy presents with a red itchy eye lid and granulations seen on the rim of the lid. Which of the following fits this description? a. Blepharitis b. Hordoleum c. Myxedema d. Pinquecula 2. Which of the following conditions is most likely to cause Horner's Syndrome? a. Lytic metastasis b. Pancoast tumor c. Gastric carcinoma d. Hodgkins disease
  3. 3. 3. A patient who presents with Xanthomas should be investigated for which of the following? a. Sjogren's disease b. Rheumatoid arthritis c. Arterial disease d. Hyperthyroidism 4. A female patient presents with muscle fatigue, irritability, and exophthalmosis bilaterally. Which of the following is the best diagnosis? a. Cushings Disease b. Brain Tumor c. Nephritic Syndrome d. Graves Disease
  4. 4. 5. Which of the following cranial nerves is associated with ptosis? a. CN 3 b. CN 4 c. CN 6 d. CN 9 6. Which of the following examinations will yield the most information if the patient is complaining about tinnitus? a. Eye b. Abdominal c. Nose and Throat d. Head and Neck
  5. 5. 7. A patient was diagnosed with an acute otitis media infection a few weeks ago and is now experiencing frequent dizziness. Which of the following is the best diagnosis? a. Benign Paroxysmal Positional Vertigo b. Vestibular Lesion c. Cerebellar Lesion d. Menieres Disease 8. The patient complains about dizziness when they roll out of bed or change positions in the middle of the night. Which of the following is descriptive of the problem? a. Vestibular Lesion b. Cerebellar Lesion c. Acoustic Neuroma d. Semicircular Canal Lesion
  6. 6. 9. A patient presents with complaints of feeling like he is rotating. He cannot hear as well as he used to, and he also has a constant ringing in his ears. Which of the following is the best diagnosis? a. Meniere's Disease b. Inner Ear Infection c. Middle Ear Infection d. Acoustic Neuroma 10. Upon otoscopic examination you note that the patient has bulging of the tympanum with redness and dilation of blood vessels. Which of the following is most likely? a. Otitis media b. Otitis externa c. Otosclerosis d. Eustachian tube block
  7. 7. 11. A 12 year old boy presents with a past health history of chronic allergies. When you perform an examination of his nasal passages you find smooth round nodules. What is the best diagnosis? a. Nasal Polyps b. Atrophic rhinitis c. Viral rhinitis d. Deviated septum 12. A 35 year old male patient presents with an enlarged skull, mandible, hands and feet. The most likely diagnosis is ____? a. Acromegaly b. Gigantism c. Pagets disease d. Congenital problem
  8. 8. 13.Which of the following laboratory tests correlates with a diagnosis of Graves Disease? a. Increased TSH b. Increased Thyroxine c. Decreased Thyroxine d. Decreased Triiodothyronine 14. In the case history which of the following would be an appropriate follow up question for a patient with suspected migraine headaches a. Does it come on at night? b. Do you have any tear formation during the headache? c. Does it come on at the end of the day? d. Do you have any warning signs one is coming?
  9. 9. 15. Which of the following conditions produces a hyperresonant percussive note over the chest wall? a. Pleurisy b. Atelectasis c. Emphysema d. Asthma 16. Which of the following is the normal breath sound heard while auscultating the lung at the midclavicular line below the border of the heart? a. Vesicular b. Tracheal c. Bronchial d. Bronchovesicular
  10. 10. 17. Which of the following is the first sign seen with bronchogenic carcinoma? a. Hemoptysis b. Hoarseness c. Coughing d. Orthopnea 18. An African American female presents with a cough and dyspnea. She states that she occasionally has night sweats. Upon radiographic examination bilateral hilar lymphadenopathy is observed. This best describes _____. a. Hodgkins lymphoma b. Sarcoidosis c. Tuberculosis d. Bronchogenic Carcinoma
  11. 11. 19.A young boy has a cough that is worse at night , occasionally there is bloody mucus that appears. This is most likely due to ____? a. Asthma b. Cystic Fibrosis c. Pneumonia d. Pertussis 20.A female patient complains of chest pain and tightness on her right breast near the sternum. She also has had a cough for the past two months. Which of the following is the most likely diagnosis? a. Carcinoma b. Angina pectoris c. Costochondritis d. Intercostal neuralgia
  12. 12. 21.Which of the following is present in Hodgkins lymphoma? a. Sternberg cells b. Atypical lymphocytes c. Paul Bunnel cells d. Aschoff bodies 22. Jugular venous pulsations are associated with which of the following presentations? a. Tricuspid regurgitation b. Left ventricular hypertrophy c. Aortic stenosis d. Venous hum
  13. 13. 23.Which of the following would cause Pulsus paradoxus? a. Rib fracture b. COPD c. Constrictive Pericarditis d. Bronchogenic carcinoma 24.Which of the following is a normal finding about S2? a. Splitting on Inhalation b. It is loudest at the apex c. It is an abnormal pulmonary sound d. Splitting on exhalation
  14. 14. 25.Which of the following murmurs is best heard with the patient in the left lateral decubitus position? a. Aortic valve b. Pulmonic valve c. Tricuspid valve d. Mitral valve 26.Which of the following is a likely cause of right sided heart failure? a. Cor pulmonale b. Rheumatic fever c. Hypertension d. Hyperlipidemia
  15. 15. 27.A patient that has had a history of right sided heart failure should be advised about which of the following? a. Eliminate all exercise b. Maintain stable body weight c. Always sleep semi recumbent d. Use caution when undergoing dental procedures 28. If a patient presents with edema of the left lower extremity, which of the following is most likely affected? a. Arteries b. Veins c. Capillaries d. Lymphatics
  16. 16. 29. An atrial couplet precedes which of the following heart problems? a. Atrial fibrillation b. Mitral stenosis c. Right Ventricle hypertrophy d. Left Ventricle failure 30.A female with chest pain enters the ER and when the lab work is interpreted the patient has an elevated CK-MB. Which of the following conditions presents with this laboratory finding? a. Angina pectoris b. Printzmetal angina c. Myocardial infarction d. Left sided heart failure
  17. 17. 31.Where does ventricular depolarization occur on an electrocardiogram? a. P wave b. QRS complex c. S-T segment d. U wave 32.The patient presents with epigastric pain that refers to the lower thoracic spine. Which of the following conditions should be investigated? a. Appendicitis b. Pancreatitis c. Hepatitis d. Cholecystitis
  18. 18. 33. While performing an abdominal exam you do not hear any bowel sounds after auscultating for 5 minutes. Which of the following is indicated? a. Paralytic ileus b. Irritable bowel syndrome c. Regional ileitis d. Constipation 34.Which of the following is indicated with an elevated ESR? a. Myocardial infarction b. Multiple myeloma c. Tissue damage d. Temporal arteritis
  19. 19. 35.A female drug addict that is chronically sick and has a large and tender liver is most likely infected by which of the following? a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Cirrhosis 36. What do you find associated with anemia that presents with jaundice: a. B-12 deficiency b. Hemolysis c. Anemia of chronic disease d. Bone marrow disorder
  20. 20. 37.Which of the following tests is appropriate to run to monitor a patient with diabetes mellitus? a. HbA1C b. Fasting serum glucose c. Glucose tolerance test d. Urinary glucose test 38. A 40 year old female patient presents with 7/10 right upper quadrant pain after eating spicey pepperoni pizza. She also has nausea and vomiting but the pain is not relieved by vomiting. Which of the following is the cause of this finding? a. Kidney stones b. Gall stones c. Bladder stones
  21. 21. 39. A 45 year old overweight female has right scapula pain 60 minutes after eating fried chicken. This would most likely be seen with ____. a. Nephrolithiasis b. Cholelithiasis c. Diverticulitis d. Regional ileitis 40. Which of the following is associated with a decrease in urine output? a. Diabetes Insipidus b. Diabetes Mellitus c. Hypertension d. Renal tumor
  22. 22. 41. A patient has abdominal pain 2 hours after eating. He also reports having black tarry appearing stools. Which of the following is the most likely diagnosis? a. Gastric ulcer b. Duodenal ulcer c. Pyloric stenosis d. Reflux esophagitis 42. A female patient with fatigue and weakness presents with a tan appearance but denies she has ever been tanning her skin. Which of the following conditions should be suspected? a. Hepatitis b. Hemochromatosis c. Cushings disease d. Graves disease
  23. 23. 43.Which of the following conditions is associated with a child that has previously had rheumatic fever? a. Glomerulonephritis b. Nephrotic syndrome c. Pyelonephritis d. Cystitis 44.Urethritis will present with which of the following findings? a. Nitrites in urine b. Nitrates in urine c. Fatty casts in urine d. Urinary hesitancy
  24. 24. 45. A patient with low back pain and cystitis will have a pain referral pattern to the___________ region. a. Flank b. Scapular c. Suprapubic d. Groin 46. Which of the following is a valid test to tell if the epididymis is fluid filled? a. Transillumination b. Palpation c. Auscultation d. Percussion
  25. 25. 47. Which of the following is a method of measuring a patients pain level? a. Algometry b. Audiometer c. Romergs test d. Hoovers test 48.A male patient presents with a blue sac around his perianal region and bright red blood when he has a bowel movement. Which of the following is the correct diagnosis? a. Hernia b. Fissure in ano c. Hemorrhoids d.