What is the most likely cause of his gynecomastia? You feel no discrete masses and her axillae are normal. She does admit to 6 months of fatigue but no weight loss, weight gain, fever, or night sweats. What would you do next? Examining her left arm, you see a scabbed-over superficial laceration over her left hand. The aorta should be 3 cm or less. Then you carry out each maneuver of the examination. Facilitation can be posture, actions, or words that encourage the patient to say more. Which of the following is considered an instrumental activity of daily living? The pain is new, located in the wrists and fingers bilaterally, with some subjective fever.
Most of these patients will have tenderness over one or both of the temporal arteries, and some have diminished temporal pulses as well. This would be worsened by motion of the chest wall. A Breast cancer B Lymphadenopathy of infectious origin C Hidradenitis suppurativa Ans: A Chapter: 10 Page and Header: 402, Techniques of Examination Feedback: Metastatic lymph nodes tend to be hard, nontender, and fixed, often to the rib cage. Ans: C Chapter: 20 Page and Header: 906, The Health History Feedback: This is part of the Rapid Screen for Dietary Intake. A Five to seven days following her menses B Midcycle C Immediately prior to menses D During her menses Ans: A Chapter: 10 Page and Header: 392, The Health History Feedback: The breast examination should be conducted during the time with the least estrogen stimulation of the breast tissue.
Her first child arrived when she was 26 and her second at age 28. Palpation of her left axilla and breast is unremarkable. He has reported falling twice at home to his son and has telephoned late at night because of insomnia. Her father is in good health. On examination you see a mildly obese female who is breathing comfortably.
He is agreeable to taking a drug test. One critical Medical textbook used by colleges across the country is Bates' Guide to Physical Examination and History Taking by Bickley. The patient denies tobacco, alcohol, or drug use. This happened once before, about a year ago, according to your detailed office notes. You can buy as many ebooks and etextbooks as you need all in one order, once your payment is completed you will be taken to the order page where you will be given access to download all of your items all at once or one by one, you are free to come back and re download your items as many times as you need. The pain is associated with nausea and vomiting and occurs 1 to 2 hours after eating greasy foods.
This policy has been established to stop fraudulent returns along with non-refundable licensing fees and charges that are incurred from each sale. The remainder of her heart, lung, abdominal, and pelvic examinations are unremarkable. A Lateral B Subscapular C Pectoral D Central Ans: D Chapter: 10 Page and Header: 389, Anatomy and Physiology Feedback: The central nodes at the apex of the axilla are most commonly involved in breast cancer. Ans: C Chapter: 02 Page and Header: 27, Assessment and Plan: The Process of Clinical Reasoning Feedback: In cholecystitis, the pain, which originates from the gallbladder, is located in the right upper quadrant. A Breast tissue B Fibrocystic disease C Breast cancer D Lymph node Ans: A Chapter: 10 Page and Header: 389, Anatomy and Physiology Feedback: Approximately one third of adult men will have palpable breast tissue under the areola. The provider should acknowledge that he was late and apologize for this, no matter the reason for being late. Remember, the patient is the focus of the visit, so it would be appropriate to allow him to control who is in the room with him and inappropriate to address his wife first.
A 23-year-old computer programmer comes to your office for an annual examination. Her mother died of a stroke. Your clinical reasoning skills are important for sorting through all of the data to arrive at the most likely conclusion. Her mother died of a heart attack and her father died of a stroke. Recently he has injured his back and you are thinking he would benefit from physical therapy, three times a week, for an hour per session. She states she is so upset because her mother died in her 50s of breast cancer. The patient denies a rash; she also denies recent travel or camping activities.
Likewise, physicians from Ghana should not ask about signs or symptoms of multiple sclerosis, as it is found almost exclusively in northern latitudes. Ans: A Chapter: 03 Page and Header: 60, Learning About the Patient: The Sequence of the Interview Feedback: Even in situations involving people very familiar with each other, it is important to respect individual privacy. Medication, particularly use of more than three, is associated with falls. A Breast cancer B Imbalance of hormones of puberty C Drug use Ans: B Chapter: 10 Page and Header: 402, Techniques of Examination Feedback: Approximately one third of teenage boys develop gynecomastia during puberty. On examination you find a middle-aged woman appearing older than her stated age. Revised and expanded chapter on the skin, hair, and nails includes new dermatology photographs and provides the framework for assessing common lesions and abnormalities.
Inspection of her left breast reveals a flattened nipple deviating toward the lateral side. The mastectomy site should be carefully examined for local recurrence as well. She has a family history significant for rheumatoid arthritis. In this scenario, the patient can neither speak nor move well. On examination you see a mildly overweight teenager with enlarged breast tissue that is slightly tender on both sides. She is interested in knowing what her risk of developing breast cancer would be if she were positive for the gene. Ans: C Chapter: 10 Page and Header: 402, Techniques of Examination Feedback: Although self-examination has not been shown to reduce mortality and is not recommended by all groups making screening recommendations, many choose to teach women a systematic method in which to examine their breasts.
She does not have a history of eczema or allergies. She denies using tobacco or illegal drugs and drinks three to four beers a week. The heart attack reduced the ability of her heart to handle her volume status and subsequently produced the many features of congestive heart failure. Many elderly do not have regular eye examinations and are not screened for glaucoma. Although a breast mass is not palpated, in this case a fixed lymph node is palpated. Her breast and axilla examinations are unremarkable. You go on to do more examination, laboratory work, and diagnostic tests, only to find that there is no sign of the disease you thought would correlate with the finding.
Although depression may be present, we have no indications of it in this scenario. She has a raised tone of voice and states that she has been waiting for the past hour and has to get back to work. Which of the following is most appropriate? She denies any tobacco, alcohol, or drug use. He has recently noticed changes in his penis, testicles, and pubic hair pattern. Her aunt died of ovarian cancer and her father died of colon cancer. The shortness of breath occurs with exertion and improves with rest.