Clinical Examination Quiz

Gastrointestinal examination includes which of the following

What condition results in loud P2 component of the S2 heart sound?

Anorexia is one of the following

Physical examination of the patient is part of the

For most elective (nonemergency) cases the correct sequence of patient management is:

A 75-year-old man is brought to the hospital because of a syncopal episode. There was no incontinence or post-event confusion. On examination, his blood pressure is 140/80 mm Hg, pulse 72/min with no postural changes. His second heart sound is diminished and there is a systolic ejection murmur that radiates to the carotids. With the Valsalva maneuver, the murmur decreases in length and intensity. Select answer

A 75-year-old woman with hypertension develops fatigue and dyspnea on exertion. Her blood pressure is 160/60 mm Hg and pulse is 80/min. The second heart sound is diminished and there is an early diastolic murmur that radiates from the right sternal border to the apex. Your clinical diagnosis is aortic regurgitation. Select answer.

Dullness to percussion on the chest wall can indicate which of the following pathologies?

Hypertension falls under which category of past history?

A 63-year-old woman develops exertional angina and has had two episodes of syncope. Examination shows a systolic ejection fraction murmur with radiation to the carotids and a soft S2. Which of the following is the most likely diagnosis?

Following findings will be detected in a patient with right middle lobe consolidation

Sternocleidomastoid muscle is inserted on:

Patients position during the abdominal examination should be

Which term describes the probability that a nondiseased person has a negative test result

Which technique of examination let’s physician detect swelling?

Main function of deep anterior muscle of neck is:

Subjective data consists o

A 73-year-old man has angina pectoris on exertion, but an angiogram reveals noncritical stenosis of the coronary arteries. This occurs most frequently with which of the following valvular heart diseases?

Pain during the acute appendicitis commonly is located in one of the following areas:

A negative test result in the presence of pathology is referred as

Which of the following is not an adventitious sound?

What coexistent cardiac disease do you usually find in a patient with aortic stenosis from rheumatic valvular disease?

A 52-year-old woman is referred for shortness of breath. Her clinical examination shows a 2/6 diastolic murmur along the LSB and a wide pulse pressure. The patient has no signs of heart failure but has a third heart sound and a soft systolic murmur of MR. In patients with a barely audible diastolic murmur and heart failure, what sign is suggestive that severe AR is the cause of heart failure?

Where can a gallbladder pain refer to?

Which of these can be the source of the patient’s medical history?

Melena or melaena is the sign of

What is the typical splitting pattern of S2 heart sound in a patient with aortic valve stenosis?

A technique of examination of internal organs via the stethoscope is referred as

The odor of acetone from the patients mouth suggests which diagnosis

Which of the following disorders causes platypnea?

At which level of BMI is a person considered overweight?

Which of these does NOT belong to the 7 symptom attributes

A 65-year-old man with a previous history of an anterior MI comes for follow-up. On examination, he has a systolic murmur heard best at the apex and radiating to the axilla. Transient external compression of both arms with blood pressure cuffs 20 mm Hg over peak systolic pressure increases the murmur. Select answer.

Which of these is the correct order?

The biggest artery in the neck is:

The occipital artery originates from:

A man is stabbed and arrives at the emergency room within 30 minutes. You notice that the trachea is deviated away from the side of the chest with the puncture. The most likely lung finding on physical examination of the traumatized side is which of the following?

Select the characteristic JVP finding for tricuspid regurgitation.

Rebound tenderness is one of the following:

A 76-year-old woman presents with new-onset syncope. She has also noticed early fatigue on exertion for the past year. On examination, there is a systolic ejection murmur at the right sternal border that radiates to the carotids. Your clinical diagnosis is

Clubbing of the fingers is associated with which of the following?

A 25-year-old woman is found to have a midsystolic murmur on routine evaluation. The murmur does not radiate but it does increase with standing. She otherwise feels well and the rest of the examination is normal. Select answer.

Which term describes the probability that a person with the disease has a positive test result

Laboratory information belongs to

A 16-year-old high school student presents with sudden onset of sharp right-sided chest pain associated with shortness of breath. He denies any history of trauma. On physical examination, the patient is afebrile with a respiratory rate of 28/min. His blood pressure is 100/70 mm Hg and his heart rate is 120/min. Neck examination reveals no tracheal deviation. On lung auscultation, the patient has decreased fremitus, hyperresonance, and diminished breath sounds over the right posterior hemothorax. Which of the following is the most likely diagnosis?

Nocturia is one of the following

In case of ascites the percussion reveals one of the following:

Which of the following is a normal physical finding of the lungs:

During auscultation of the posterior lung fields, the following lobe can be auscultated in the infrascapular region

The lobe that cannot be auscultated from the posterior lung fields:

Hematochezia is one of the following:

Which finding suggests prehypertension

In patients with an area of consolidated lung you can expect to find which change to breath sounds?

Pallor, cyanosis, jaundice, rashes, bruises are possible findings during examination of:

A 23-year-old has a mid-diastolic rumble and sharp early diagnostic sound. What is the likely explanation?

Tall stature finding during physical examination could be a sign of

Caput meduse is one of the following:

The facial artery originates from:

Which of these is NOT part of the past history?

A 60-year-old man presents to your office with an 80-pack-year history of cigarette smoking. He complains of some dyspnea on exertion. He has an asthenic body fremitus and pursed-lip breathing. He has an increased anteroposterior thickness of the thorax. Lung examination reveals decreased fremitus, hyperresonance on percussion, and diminished breath sounds. Which of the following is the most likely diagnosis?

What is the “gold standard” in evaluation of patient with acute limb ischemia?

The following information is recorded in the health history: “Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea.”

A 15-year-old high-school student presents to your office for a sports physical. He is 1.6 meters and weighs 70 kg. His BMI falls into which category?

A 24-year-old man is referred to cardiology after an episode of syncope while playing basketball. He has no recollection of the event, but he was told that he collapsed while running. He awakened lying on the ground and suffered multiple contusions as a result of the fall. He has always been an active individual by recently has developed some chest pain with exertion that has caused him to restrict his activity. His father died at age 44 while rock climbing. He believes his father’s cause of death was sudden cardiac death and recalls being told his father had an enlarged heart. On examination, the patient has a III/VI mid-systolic crescendo-decrescendo murmur. His electrocardiogram shows evidence of left ventricular hypertrophy. You suspect hypertrophic cardiomyopathy as the cause of the patient’s heart disease. Which of the following maneuvers would be expected to cause an increase in the loudness of the murmur?

Which of the following is the proper sequence for examination of the lungs?

What muscles make you smile?

The echocardiogram of a 22-year-old woman reveals mitral valve prolapse. Which of the following is the most common physical finding in this condition?

Sternocleidomastoid muscle is inserted on:

Which of the following is true regarding vocal resonance?

Which one is not a part of the four strap muscles?

Crescendo-decrescendo systolic ejection murmur following ejection click. Radiates to carotids. Pulses are weak, compared to heart sounds

Which of the following does not cause a holosystolic murmur?

The components of the health history include all of the following components except which one?

An elderly patient presents with a diastolic murmur that gets louder during inspiration. Which of the following are the most likely?

Lateral compartment for surgical anatomy of LN (for Thyroid) is

A 22-year-old woman with no past medical history is found to have a systolic ejection murmur on routine physical examination. She has no symptoms and feels well. The murmur is heard along the right and left sternal borders and it decreases after rapid squatting. What could be the underlying disease?

The following information is recorded in the health history: “The patient has had abdominal pain for 1 week. The pain lasts for 30 minutes and comes and goes. The severity is 7 to 9 on a scale of 1 to 10. It is accompanied by nausea and vomiting. It is located in the mid-epigastrium.”

A 38-year-old landscape designer presents to the clinic to be evaluated for cough. His vital signs show a temperature of 103ᴼF, a pulse of 120, and a blood pressure of 88/55. His respiratory rate is 28. He appears to have laboured breathing. All of the indicators are signs of

Which of the following is true regarding the auscultation of breath sounds?

Where can be palpated pulses on the hand? Choose the right one

Symptoms of acute arterial occlusion are all except:

A 45-year-old woman is referred for a murmur. Which finding on a physical examination would be suggestive of a diagnosis of hypertrophic obstructive cardiomyopathy?

A 25-year-old woman is referred for a murmur. Transthoracic echocardiography demonstrates mitral valve prolapse. Which of the following is true about the click accompanying mitral valve prolapse?

Name the earliest sign in case of acute extremity ischemia caused by thromboembolism?

A 63-year-old woman develops exertional angina and has had two episodes of syncope. Examination shows a systolic ejection fraction murmur with radiation to the carotids and a soft S2. Which of the following is the most likely diagnosis?

Immediate high-pitched diastolic murmur. Wide pulse pressure when chronic. Can present with bounding pulses and head bobbing

Which one are different types of selective neck dissection based on nodal levels removed?

In the usual preparation for general surgery, the patient may be:

Rovsing sign is one of the following:

When expiratory sounds last longer than inspiratory ones, it is:

A 17-year-old girl develops exertional dyspnea, but has no cough, sputum, or wheezing symptoms. On examination, she has a fixed splitting of her second heart sound and a 3/6 systolic ejection murmur heard best over the left sternal border. An echocardiogram confirms the condition. Which of the following is the best physiologic explanation for her condition?

A 79-year-old woman presents for her annual check-up examination. She has a history of hypertension. She is not a smoker, does not drink alcohol. Vital signs are: BP 140/85 mmHg, HR – 70 beats/min, RR – 16, T – 36.5 C. Precordium examination is remarkable for midsystolic murmur, radiating into the carotid arteries, The murmur is loudest with the patient sitting up and leaning forward and in full expiration. S2 is normal in intensity. Which of the following is the most likely diagnosis?

Which from the following are associated with upper motor neuron lesions?

Which of the following can be the cause of the increased JVP?

What is the origin of S4 sound?

An 18-year-old presents with bilateral leg weakness that has progressed over the last week. He noticed some numbness and tingling of the toes and feet that has been now progresses to his thigh. He has no bladder or bowel incontinence. He denies weight loss, night sweats and fever, use of tobacco, alcohol, or illicit drugs and takes no medications. Past medical history is unremarkable except for an upper respiratory tract infection two weeks ago. On physical examination, the vital signs are normal. On neurological examination there is bilateral symmetric weakness and deficit to pinprick and vibration of the lower extremities. Deep tendon reflexes in the lower extremities are graded 0. Which one from the following is the most likely diagnosis?

Which of the following is correct about neurological disorders?

Examiner’s hand is placed on the patient’s right anterior thigh and the patient is asked to raise his/her right leg against the examiner’s hand.

71 year old male during his office visit complains about pain in his legs during rest and very soon upon any physical activity. He smokes 1 package per day. On inspection legs look pale, there is obvious hair loss on the anterior surface of the tibias. In order to screen the peripheral artery disease there is necessary to conduct

Which one from the following cannot be heard with the bell of the stethoscope?

A 33-year-old woman presents for routine check-up. She has no complaints and denies previous medical problems. Precordium auscultation shows the patient has an accentuated S1, a grade 2 lowpitched mid-to-late diastolic murmur that is best heard at the apex. Immediately preceding the murmur is a loud extra sound. Which of the following is the most likely diagnosis?

A 21-year-old college student presents with a left-sided chest pain and shortness of breath with exertion that started when he felt ma… and did not go to his family doctor. Pain is worsened with inspiration and felt also in the left shoulder. He is a nonsmoker and does not …. Safe sexual contact. His family history is not remarkable. On physical examination, he looks ill, his temperature is 38.8ᴼC any his respiration rate is ….., pulse is ….. beats/min, BP – 100/70 mm Hg. Chest palpitation reveals tenderness on the left lower side of the chest with guarding, on auscultation in ….. Peripheral edema is not found. Which of the following is the most likely diagnosis?

Which of the following maneuvers of examining the shoulder is pain provocation test for rotator cuff disorder?

16 years old male presents to the hospital with abdominal pain, which he describes as generalized the previous day, but localized in the lower right quadrant at the moment. He also complains about nausea and anorexia. Examining the patient you palpate his left lower quadrant and he admits that pain is worse when you remove your hand in comparison with when you press on the area. What is the name on the list?

A 3-year-old boy is brought into your office by his parents after 4 days of abdominal pain. His parents state that it appeared their son had some pain in his abdomen, and they assumed he had a simple "stomach virus" with some associated vomiting and malaise. They decided to bring him to the office because he was not completely better. They noted he felt “warm" during the past few days and had not been eating much. According to the parents, the pain seems to be improved today but he is still not himself. On examination, the temperature is 38 C and the pulse is 105 beats per minute. The boy appears ill but is not lethargic or in any distress. Abdominal examination reveals tenderness in the right lower quarters with deep palpation. The abdomen is otherwise soft, and there is no guarding or rebound tenderness. You suspect the patient has appendicitis. All except which of the following may be positive physical examination sings in acute appendicitis?

A 50-year-old construction worker presents with a slow-growing eroded papule on his lower lip. He has a history of leukoplakia and was a heavy smoker. He has a small, tender supraclavicular node. Which of the following is the most likely diagnosis?

A 45-year-old obese man presents to the emergency department in the middle of the night screaming and holding his foot. He tells you that he think he has an acute blood vessel blockage in his left toe. He wakes up the entire emergency department observation unit with his screams. His past history is significant for essential hypertension, for which he has been treated with a thiazides diuretic for the past 5 years. He categorically relates to you that he has never had the symptoms that he is experiencing now, and his further adds that instead of all these questions he would prefer if you just got on with treatment. On examination, the patient's temperature is 39.1 C and his blood pressure is 170/110 mm hg. He has an inflamed tender, swallow left great toe at the MTP joint. There is extensive swelling and erythema of the left foot, and his whole foot is tender. No other joints are swallow. No other abnormalities are found on physical examination. What is the most likely diagnosis?

Which of the following do require mental health screening?

A 61-year-old man comes to your office complaining of a popping sensation in his left ear for nearly two weeks. He also complains of impaired hearing recently another physician treated him for an acute otitis media with antibiotics. Physical examination reveals a normal right ear canal and tympanic membrane. The left tympanic membrane is gray retracted and immobile. Which of the following is the most likely diagnosis?

A 34-year-old firefighter presents to the emergency room complaining of the sudden onset of severe right-sided flank pain that radiates to the right groin and genitalia. He is unable to lie still on the stretcher. He denies any history of trauma. He denies any dysuria, frequency, nocturia, or fever Examination of the genitalia is normal. Abdominal and rectal examinations are normal. There is positive right costovertebral angle (CVA) tenderness. Urinalysis reversals blood. Which of the following is the most likely diagnosis?

A) Strangulated hernia b) Acute prostatitis c) Pyelonephritis d) Renal calculi e) Testicular torsion

A 22-year-old man is brought to the emergency department 8 hours after twisting his right knee while playing in a soccer match. At the time of injury, he felt a sharp pain on the inner part of his right knee. He has been unable to straighten his knee fully and had to be carried off the field by his team mates. On examination, there is a moderate joint effusion, tenderness at the medial joint line, and limitations of the last 20 degrees of extension by a springy resistance. There is sharp anteromedial knee pain when passive extension is forced. Lackman test is negative. What is the most likely diagnosis in this patient?

Which of the following is correct about jugular venous pressure?

Which of the following is correct about Musculo-skeletal disease?

Louder, clearer voice sounds during auscultation of the lungs are called

By the following description grade the heart murmur: quiet, heard immediately after placing the stethoscope on the chest

Which continuous breath sounds are relatively high pitched with a hissing or shrill quality?

29-year-old male comes to the office with complains of almost persistent increased BP, ACE inhibitors do not work and worsen his condition. You should think

A 27-year-old woman comes to your office for assessment of symptoms including weakness, visual loss, bladder incontinence sharp, shooting pain in the lower back, clumsiness when walking, and sensory loss. These symptoms have occurred during three episodes (different combinations of symptoms each time) approximately 3 months apart and each episode lasted approximately 3 days. The first episode consisted of weakness, bladder incontinence, and sharp shooting pains in the lower back (in both hip girdles). The second episode consists of visual loss, clumsiness when walking, and sensory loss. The third episode (last week) consisted of sharp shooting pains in the lower back and sensory loss (bilateral) in the upper extremities. Given this information, what is the most likely diagnosis in this patient?

Left ventricle hypertrophy is related to which of the following findings?

Which of the following cannot be heard with the bell of the stethoscope?

30 year old male presents with a sudden shaking chill with a rapid rise in temperature up to 40.5deg C. Within a few hours agonizing left pleuritic pain and cough with rust coloured sputum appeared. On examination the man looks acutely ill with rapid shallow respiration. The presumptive diagnosis in this case is left sided pneumonia. Physical examination on day 2 of the illness would probably show all of the following over the left chest EXCEPT?

Affection of the cerebellar may produce any of the following except

Skin cancer is definitively diagnosed by

Patient has hematemesis. This means

A 30-year-old woman presents for routine check-up. She has no complaints and denies previous medical problems. On heart examination, the patient has a loud S1. She has a grade 2 low-pitched mid-to-late diastolic murmur that is best heard at the apex. Immediately preceding the murmur is a loud extra sound. Which of the following is the most likely diagnosis?

Which of the following is correct about common symptoms of nervous system disorders?

To percuss the lower edge of the liver span, where should you start the percussion?

A 15-year-old boy visits the doctor for evaluation of hearing loss. He has had multiple middle ear infections and his hearing is diminished in the right ear. You place a vibrating tuning fork on the top of his head. What is the name of the test and what do you suspect to identify

Which of the following statement is correct about fatigue?

Presyncope may be resulted from the following except

A vibrating sensation on palpation perceived when examining a precordium is called

The proximal weakness of shoulder/hip girdle can be resulted from the following except:

A 30-year-old man presents complaining of facial pain and nasal congestion with a yellow nasal discharge after an upper respiratory tract infection 10 days ago. Physical examination reveals a temperature of 38.2ᴼC. The patient has maxillary sinus tenderness with palpation, and the nasal mucosa are pale with some yellowish drainage. Clouding of the maxillary sinus is seen with transillumination. Which of the following is the most likely diagnosis?

On the musculoskeletal examination of the 17 year old female chest reveals: sternum is displaced anteriorly, AP diameter is increased, the costal cartilages adjacent to the protruding sternum are depressed. The described shape of the thorax is common for

Intrahepatic jaundice does not arise from

Odynophagia can be resulted from the following causes, except:

Causes of central cyanosis do not include

A 60-year-old, mildly obese woman presents complaining of bilateral medial right knee pain that occurs with prolonged sitting or climbing stairs but seems to be worse with other activity and at the end of the day. The patient denies morning … reveals no deformity, but there are small effusions. Some mild pain and crepitus are produced with palpation of the medi… following is the most likely diagnosis?

Which of the following is correct about relation of auscultatory findings to the chest wall?

Which of the following is correct about timing of Murmurs?

Actions of hyoid muscles is:

When doing a respiratory assessment to a patient, which of the following is the most appropriate technique?

An abnormal respiration cycle begins with slow, shallow respirations that become slower, followed by periods of apnea (20 seconds – usually caused by heart failure, opioid overdose, renal failure, meningitis, and severe headache

Which one from the following can be the cause of the increased JVP?

All from the following are true about data in patient’s history, except:

The 17-year-old active female patient presents with the gradual onset of bilateral knee, ankle, and wrist pain more then a year prior to visit. She enjoyed outdoor activities such as hiking, walking, and rollerblading, and danced on a competitive team. Her medical history included anxiety and depression, sleep disturbances, and scoliosis treated with braces and physical therapy. Her anxiety and depression were treated with psychotropic medications and counseling. Her family history was significant for fibromyalgia in a second-order relative, diabetes and one sibling on the autism spectrum. She has a good interpersonal relation with family. She enjoyed learning and had no learning disabilities. Some social anxieties were reported, though she denied being bullied. Pain distribution was not anatomically plausible. She could not note any particular aggravating/easing factor. NSAID medication did not help. What type of pain does the patient have?

42 Year old male present with right flank pain, which he describes as severe and burning. He is restless and cannot stay in bed in one position for a long time. His pain is