Jarvis Physical Examination and Health Assessment Practice Questions

Correct Answer: B

Rationale: Relief of the pain with bending at the waist is a key hallmark of spinal stenosis. This position helps relieve the pressure on the nerves in the spinal canal, which is often the root cause of the leg symptoms experienced by the patient. The symptoms described by Mr. Edwards, such as cramps in the calves after walking a certain distance, followed by relief with rest and recurrence upon walking again, are highly suggestive of spinal stenosis. This condition involves narrowing of the spinal canal, leading to compression of the nerves and resulting in symptoms like leg cramps, weakness, and difficulty walking, especially with prolonged activity. The relief of symptoms when bending forward (e.g., leaning on a shopping cart while walking) is a characteristic feature of neurogenic claudication associated with spinal stenosis.

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.

Correct Answer: B

Rationale: The clinical presentation described involves a patient with pericarditis. Pericarditis is inflammation of the pericardium, the sac surrounding the heart, which can lead to characteristic findings such as a scratching noise heard on auscultation, leaning forward relieving pain, and normal lung examination findings. The presence of pericarditis can also lead to a pericardial friction rub, which is often described as a scratching or grating sound heard best at the lower left sternal border.

Correct Answer: A

Rationale: Intermittent claudication is a common symptom of peripheral vascular disease. It is characterized by muscle pain or cramping in the legs, usually in the calves, thighs, or buttocks, that occurs during physical activity such as walking and is relieved by rest. This symptom is due to inadequate blood flow to the muscles during exercise. It is important to assess for intermittent claudication in patients with risk factors such as smoking, diabetes, and hypertension, as it may indicate underlying peripheral arterial disease. The other symptoms listed (chest pressure with exertion, shortness of breath, knee pain) are not typically associated with peripheral vascular disease.

Correct Answer: C

Rationale: The presence of an irregular, asymmetric, hard nodule on the posterior surface of the prostate detected during digital rectal examination raises suspicion for prostate cancer. Prostate cancer commonly presents with nodules or indurations on the prostate gland during physical examination. Other findings, such as no inflammation, masses, or fissures in the anus and normal examinations of the scrotum and penis, further support the likelihood of prostate cancer as the most probable diagnosis in this case. Additional laboratory results, including prostate-specific antigen (PSA) levels, can help confirm the diagnosis. Both benign prostatic hyperplasia (BPH) and prostatitis typically present with different symptoms than those described in the scenario, making prostate cancer the most likely disorder based on the provided information. Anorectal cancer is less likely given the absence of findings indicating involvement of the anus or rectum in this case.