Assignment: Complaining of Abdominal Pain
Assignment: Complaining of Abdominal Pain
Question 1. 1. Mr. Maxwell has noticed that he is gaining weight and has increasing girth. Which of the following would argue for the presence of ascites? (Points : 1)
Bilateral flank tympany
Dullness which remains despite change in position
Dullness centrally when the patient is supine
Tympany which changes location with patient position
Question 2. 2. A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a low-grade fever for about three days. He denies any nausea, vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of popcorn at the movies with his grandson, three days before his symptoms began. He denies any other recent illnesses. His past medical history is significant for coronary artery disease and high blood pressure. He has been married for over fifty years. He denies any tobacco, alcohol, or drug use. His mother died of colon cancer and his father had a stroke. On examination, he appears his stated age and is in no acute distress. His temperature is 100.9 degrees and his other vital signs are unremarkable. His head, cardiac, and pulmonary examinations are normal. He has normal bowel sounds and is tender over the left lower quadrant. He has no rebound or guarding. His rectal examination is unremarkable and his fecal occult blood test is negative. His prostate is slightly enlarged but his testicular, penile, and inguinal examinations are all normal. Blood work is pending.
What diagnosis for abdominal pain best describes his symptoms and signs? (Points : 1)
Question 3. 3. A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked two packs per day since the age of sixteen, but is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning symptoms for the peripheral vascular system? (Points : 1)
Chest pressure with exertion
Shortness of breath
Question 4. 4. An elderly woman with a history of coronary bypass comes in with severe, diffuse, abdominal pain. Strangely, during your examination, the pain is not made worse by pressing on the abdomen. What do you suspect? (Points : 1)
Question 5. 5. Which is the proper sequence of examination for the abdomen? (Points : 1)
Auscultation, inspection, palpation, percussion
Inspection, percussion, palpation, auscultation
Inspection, auscultation, percussion, palpation
Auscultation, percussion, inspection, palpation
Question 6. 6. Josh is a 14-year-old boy who presents with a sore throat. On examination, you notice dullness in the last intercostal space in the anterior axillary line on his left side with a deep breath. What does this indicate? (Points : 1)
His spleen is definitely enlarged and further workup is warranted.
His spleen is possibly enlarged and close attention should be paid to further examination.
His spleen is possibly enlarged and further workup is warranted.
His spleen is definitely normal.
Question 7. 7. Which of the following is consistent with obturator sign? (Points : 1)
Pain distant from the site used to check rebound tenderness
Right hypogastric pain with the right hip and knee flexed and the hip internally rotated
Pain with extension of the right thigh while the patient is on her left side or while pressing her knee against your hand with thigh flexion
Pain that stops inhalation in the right upper quadrant (RUQ)
Question 8. 8. A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms? (Points : 1)
Femoral pulse, popliteal pulse
Dorsalis pedis pulse, posterior tibial pulse
Radial pulse, brachial pulse
Question 9. 9. You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which of the following locations would the patient’s pain make you concerned for this disease process? (Points : 1)
Question 10. 10. Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which has been occurring for two days. He does note a dark, granular substance resembling the coffee left in the filter after brewing. What do you suspect? (Points : 1)
Bleeding from a diverticulum
Bleeding from a peptic ulcer
Bleeding from a colon cancer
Bleeding from cholecystitis