Jarvis Physical Examination and Health Assessment Practice Questions

Questions 28

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Jarvis Physical Examination and Health Assessment Practice Questions Questions

Question 1 of 5

An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in braids. On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation. There are no hair shafts visible. Based on this description, what is your most likely diagnosis?

Correct Answer: A

Rationale: The description provided, which includes a clearly demarcated, round patch of hair loss without visible scaling or inflammation and absence of hair shafts, is characteristic of alopecia areata. Alopecia areata is an autoimmune condition that causes hair loss in round or oval patches on the scalp or other parts of the body. It is not associated with pulling or twisting of hair (trichotillomania), fungal infection (tinea capitis), or hair loss due to constant pulling force (traction alopecia). In alopecia areata, the affected area usually appears smooth and without visible signs of irritation. Treatment options for alopecia areata may include corticosteroid injections, topical immunotherapy, or minoxidil.

Question 2 of 5

Ray works a physical job and notes pain when he attempts to lift his arm over his head. When you move the shoulder passively, he has full range of motion without pain and there is no gross swelling or tenderness. What type of joint disease does this most likely represent?

Correct Answer: B

Rationale: The scenario described suggests that Ray experiences pain only when actively lifting his arm over his head, which indicates the issue is likely originating from structures outside of the joint itself. When the shoulder is moved passively (moved by an external force), there is full range of motion without pain, suggesting that the limitation and pain occur due to muscles, tendons, or ligaments surrounding the joint rather than within the joint itself. In this case, the joint disease is likely to be extra-articular, involving structures such as muscles or tendons rather than being articular in nature.

Question 3 of 5

Sudden, painful unilateral loss of vision may be caused by which of the following conditions?

Correct Answer: B

Rationale: A sudden, painful unilateral loss of vision is a medical emergency that may be caused by central retinal artery occlusion. This condition occurs when the main artery supplying blood to the retina becomes blocked, leading to a sudden and severe reduction in blood flow to the eye. The lack of blood flow can cause irreversible damage to the retina, resulting in a significant loss of vision. Patients with central retinal artery occlusion typically present with sudden, painless, and severe vision loss in one eye. Immediate medical attention is crucial to try to restore blood flow and minimize potential permanent vision loss in these cases. Vitreous hemorrhage, macular degeneration, and optic neuritis do not typically present with sudden, painful unilateral loss of vision as seen in central retinal artery occlusion.

Question 4 of 5

Mr. Q. is a 45-year-old salesman who comes to your office for evaluation of fatigue. He has come to the office many times in the past with a variety of injuries, and you suspect that he has a problem with alcohol. Which one of the following questions will be most helpful in diagnosing this problem?

Correct Answer: B

Rationale: Asking Mr. Q. when his last drink was is an open-ended question that can provide valuable information regarding his alcohol consumption patterns. This question allows Mr. Q. to disclose whether he has been drinking recently and can help determine the frequency and quantity of his alcohol consumption. It avoids leading or judgmental language, which can help build rapport and facilitate a more honest conversation about his alcohol use. By knowing when his last drink was, you can better assess the potential impact of alcohol on his current symptoms of fatigue and further explore any potential issues related to alcohol abuse.

Question 5 of 5

A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis?

Correct Answer: A

Rationale: The description provided fits the criteria for tension-type headache. Tension-type headaches are typically described as a mild to moderate, dull, band-like pressure or tightness around the head. They can last from minutes to days and are often triggered by stress, anxiety, poor posture, or prolonged computer use. The absence of symptoms like photophobia and nausea, along with the response to over-the-counter medication, further support the diagnosis of tension-type headache in this case. Other headache types such as migraines or cluster headaches usually present with additional symptoms like nausea, photophobia, or tearing of the eye, which are not mentioned in this scenario. Analgesic rebound headaches typically occur in individuals who overuse pain medications, leading to worsening headaches when the medication wears off, but this patient's history does not suggest such misuse.

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