Physical Examination and Health Assessment 9th Edition Test Bank

Correct Answer: B

Rationale: Based on the description provided, the skin lesions are most consistent with seborrheic keratosis. Seborrheic keratoses are common non-cancerous (benign) growths of the skin that often appear as brown, black, or light tan growths with a waxy, stuck-on appearance. They can vary in color and may be round or oval, with a well-defined border. Seborrheic keratoses are typically asymptomatic and can be found on various parts of the body including the face, arms, and legs. The dry, hard scale covering the lesion is typical for seborrheic keratoses.

Correct Answer: B

Rationale: The clinical presentation described in the question is consistent with Candida vaginitis, also known as vaginal yeast infection. Candida vaginitis typically presents with a thick, white, curdy discharge that can be visualized on examination. The low pH of 1 is characteristic of Candida infection. The negative KOH whiff test and absence of an unusual smell help differentiate Candida vaginitis from other types of vaginitis.

Correct Answer: C

Rationale: Epistaxis, also known as a nosebleed, should be considered in a patient complaining of coughing up blood along with a history of smoking. Epistaxis can sometimes lead to blood trickling down the throat and being coughed up. It is important to consider this differential diagnosis, especially in patients with risk factors such as smoking. Intestinal bleeding (choice A) has a different presentation and cause compared to epistaxis. Hematoma of the nasal septum (choice B) is unlikely to cause coughing up blood. Bruising of the tongue (choice D) is also less likely to be the cause of hemoptysis in this case.

Correct Answer: B

Rationale: Paraphimosis is a condition where the foreskin is retracted behind the glans penis and cannot be returned to its original position. This can lead to swelling and constriction of the penis, causing pain and potential damage to the tissue due to decreased blood flow. Phimosis (Choice A) refers to a tight prepuce that cannot be retracted over the glans penis. Balanitis (Choice C) is inflammation of the glans penis, often associated with poor hygiene or infections. Balanoposthitis (Choice D) refers to inflammation of both the glans penis and the foreskin.

Correct Answer: D

Rationale: The patient in this scenario presents with symptoms suggestive of an anorectal disorder. The presence of an irregular, firm mass on the posterior side of the rectum, along with frank blood seen on the glove after a digital rectal examination, raises suspicion for an underlying anorectal cancer. Anorectal cancer can present with symptoms such as rectal bleeding, changes in bowel habits, palpable masses, and weight loss. In this case, the findings of an irregular mass and rectal bleeding are concerning for a malignant process such as anorectal cancer. Further evaluation with imaging studies and biopsy would be warranted for confirmation and to guide appropriate management.