PACKRAT EXAM QUESTIONS BANK
History & Physical/Hematology A 55-year-old non-smoking male presents with a hemoglobin of 18.5 g/dl and a hematocrit of 56%. Which of the following physical examination findings is the most likely to be noted with this patient?
- Splenomegaly
- Cheilosis
- Purpura
- Decreased vibratory sense - ✔✔Explanations
(c) A. Patients with polycythemia vera present with elevated hemoglobin and hematocrit. On physical examination plethora, engorged retinal veins, and splenomegaly are common.(u) B. Cheilosis is noted in iron deficiency anemia.(u) C. Purpura is typically noted in bleeding disorders.(u) D. Decreased vibratory sense is noted in vitamin B12 deficiency.
History & Physical/Obstetrics/Gynecology On examination of a pregnant patient the physician assistant notes a bluish or purplish discoloration of the vagina and cervix. This is called Answers
- Hegar's sign.
- McDonald's sign. 1 / 4
- Cullen's sign
- Chadwick's sign - ✔✔Explanations
(u) A. Hegar's sign is the softening of the cervix that often occurs with pregnancy.(u) B. McDonald's sign is when the uterus becomes flexible at the uterocervical junction at 7-8 weeks.(u) C. Cullen's sign is a purplish discoloration periumbilical and noted in pancreatitis.(c) D. Chadwick's sign is a bluish or purplish discoloration of the vagina and cervix.
History & Physical/Orthopedics/Rheumatology Abduction of the shoulder against resistance helps localize pain in which of the following muscles of the shoulder girdle?Answers
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis - ✔✔Explanations
(c) A. Abduction against resistance tests the supraspinatus.(u) B. Lateral rotation against resistance tests the infraspinatus and teres minor.(u) C. See B for explanation.(u) D. Medial rotation against resistance tests the subscapularis.
History & Physical/Pulmonology 2 / 4
A 45 year-old male presents with sudden onset of pleuritic chest pain, productive cough and fever for 1 day. He relates having symptoms of a "cold" for the past week that suddenly became worse yesterday. Which of the following findings will most likely be seen on physical examination of this patient?Answers
- spoken "ee" heard as "ay"
- hyperresonant percussion note
- wheezes over the involved area
- vesicular breath sounds over involved area - ✔✔Explanations
(c) A. This patient most likely has a bacterial pneumonia with consolidation, which would produce egophony, where a spoken "ee" is heard as "ay." (u) B. Consolidation from bacterial pneumonia causes findings of dullness to percussion, late inspiratory crackles and bronchial breath sounds over the involved area.(u) C. See explanation B.(u) D. See explanation B.
History & Physical/ENT/Ophthalmology A 4 year-old child presents with a rapid onset of high fever and extremely sore throat. Which of the following findings are suggestive of the diagnosis of epiglottitis?Answers
- Croupy cough and drooling
- Thick gray, adherent exudate
- Beefy red uvula, palatal petechiae, white exudate 3 / 4
- Inflammation and medial protrusion of one tonsil - ✔✔Explanations
(c) A. A croupy cough with drooling in a patient who appears very ill is consistent with epiglottitis. Examining the throat is contraindicated, unless the airway can be maintained.(u) B. Thick gray adherent exudate is suggestive of diphtheria.(u) C. Beefy red uvula, palatal petechiae, and white exudate are findings suggestive of streptococcal pharyngitis.(u) D. Inflammation with medial protrusion of the tonsil is suggestive of a peritonsillar abscess.
Which of the following is a common physical examination finding in early intestinal obstruction?
- high fever.
- profuse flatulence.
- rebound tenderness
- hyperactive, high-pitched bowel sounds - ✔✔(u) A. Fever and rebound tenderness occur only
if a perforation has occurred.(u) B. Profuse flatulence is not noted in early intestinal obstruction.(u) C. See A for explanation.(c) D. Abdominal distention and high-pitched, hyperactive bowel sounds are common in early intestinal obstruction.
History & Physical/Endocrinology A 26-year-old obese female complains of a 3-4 month history of discrete erythematous plaques on the pretibial areas of her legs. The lesions have increased in size, become darker, and are
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