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

How would you categorize this?

Correct Answer: C

Rationale: This categorization is based on the blood pressure readings. Stage 1 hypertension is defined as having a systolic blood pressure between 130-139 mmHg or a diastolic blood pressure between 80-89 mmHg. The blood pressure falls within this range, indicating mild hypertension. It is important to monitor and manage blood pressure to prevent complications associated with hypertension.

Question 3 of 5

A man's wife is upset because when she hugs him with her hands on his left shoulder blade, "it feels creepy." This came on gradually after a recent severe left-sided rotator cuff tear. How long does it usually take to develop muscular atrophy with increased prominence of the scapular spine following a rotator cuff tear?

Correct Answer: D

Rationale: Following a severe rotator cuff tear, it typically takes around 2-3 months for muscular atrophy to develop with increased prominence of the scapular spine. This is due to disuse of the affected shoulder muscles leading to muscle wasting and changes in the bony structures around the shoulder blade. Over time, the lack of muscle activity causes the shoulder blade to become more prominent and noticeable, which can result in altered sensations during activities like hugging. The gradual onset of these changes aligns with the timeline provided in the question, where the wife started to feel discomfort in her husband's left shoulder blade after the recent severe rotator cuff tear.

Question 4 of 5

You are growing fatigued of performing a maneuver on examination because you have never found a positive and are usually pressed for time. How should you next approach this maneuver?

Correct Answer: A

Rationale: It is important to adjust your approach based on the clinical context and your suspicion for a certain condition. If you have never found a positive result with a particular maneuver and you are usually pressed for time during examinations, it may be more beneficial to reserve that maneuver for situations where you have a higher suspicion for a correlating condition. This allows you to use your time and resources more effectively, targeting specific tests based on the clinical scenario to increase the chances of identifying any relevant issues. By using the test selectively, you can improve the diagnostic yield without compromising the overall assessment.

Question 5 of 5

An elderly woman with dementia is brought in by her daughter for a "rectal mass." On examination you notice a moist pink mass protruding from the anus, which is nontender. It is soft and does not have any associated bleeding. Which of the following is most likely?

Correct Answer: A

Rationale: Rectal prolapse occurs when the rectum protrudes through the anus. It typically appears as a moist, pink mass that protrudes outside the body. The prolapse is usually painless and can be seen and felt by the patient or the examiner. It is commonly seen in elderly individuals, especially women, and those with conditions like chronic constipation, pelvic floor weakness, or dementia. On the other hand, external hemorrhoids are swollen veins located around the anus, usually painful and may cause bleeding. Perianal fistula is an abnormal tunnel-like connection between the skin near the anus and the rectum, which can cause pain and discharge. Prolapsed internal hemorrhoids are internal hemorrhoids that have descended outside the anal canal and may require manual reduction. Given the symptoms described in the scenario - a moist pink mass protruding from the anus that is nontender and soft without bleeding - the most likely diagnosis is rectal prol

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