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2016 4. Clin Med Reviewer NeuroSpine Abdomen Pages 1 734 5576 90 P44.00
2016 4. Clin Med Reviewer NeuroSpine Abdomen Pages 1 734 5576 90 P44.00
1
By
Medical
Students
For
Medical
Students
2014
“This
is
not
intended
to
be
your
reviewer.
Your
best
reviewer
is
of
Barbara
Bates,
your
best
handout
is
your
ear,
and
your
best
teacher
is
yourself”
2
CLINICAL
NEUROLOGY
by
Dra
Rosales
3
HEAD,
EYES,
EARS,
NOSE,
THROAT
by
Dra
Solis
8
EXTREMITIES
by
Dr
Paulino
34
CHEST
and
LUNGS,
BREAST
by
Dra
Lee
56
CARDIOLOGY
by
Dra
Deduyo
65
ABDOMEN
by
Dra
Cortez
76
Please
be
guided
that
answers
are
coming
from
medical
students;
do
not
rely.
AKO
NA
MISMO
NAGSASABING
MALI
MALI
UNG
IBANG
MGA
SAGOT
DITO
KASI
AYAW
MAKINIG
NG
IBA
NA
NAG
EENCODE
SABING
WAG
PALITAN
UNG
SAGOT.
-‐
N
3
NEUROLOGY
1. Gait
ataxia
and
hypotonia
will
be
seen
in
a
patient
with
a
lesion
in
the
a. Rostral
vermis
b.Posterior
lobe
c.Caudal
vermis
d.All
e.
A
and
C
2. Manifestation
of
vermian
lesion
a. Dysarthria
b.
Scanning
speech
c.
Nystagmus
d.All
e.A
and
c
3. Manifestation
of
cerebellar
dysfunction
a. Hypotonia
b.
Decomposition
of
movement
c.
Mild
aesthenia
d.All
e.
A
and
C
4. Test
for
arm
dystaxia
a. Wrist
tapping
test
b.
Arm
pulling
test
c.
Thigh
patting
test
d.All
e.A
and
C
5. True
in
a
patient
with
cerebellar
hemisphere
infarct
in
the
right
a. Nystagmus
b.
Limb
ataxia
C.
Dysmetria
L
d.
All
e.
A
and
B
6. Superficial
sensation
routinely
examined
a. Romberg
b.
Asteriognosis
c.
Joint
position
d.
Pain
e.
C
and
D
7. Manifestation
of
polyneuropathy
a. Symetrical
distal
weakness
b.
Areflexia
c.
Preferential
sensory
loss
in
proximal
limb
d.
A
and
B
e.
All
8. From
medial
to
lateral
(CTLS)
segmented
arrangement
of
fibers
in
the
spinal
cord
is
seen
in
the
a. Fascicular
cuneatus/
gracilis
b.
Lateral
cortico
spinal
c.
Spinothalamic
d.
All
e.
B
and
C
9. TRUE
during
testing
of
sensory
function,
a. Usually
done
with
patient’s
eyes
closed
b. Should
compare
cornified
vs.
Non
cornified
areas
c. Should
examine
symmetrical
dermatomal
area
d. All
e. A
and
C
10. Pins
and
needles
sensation
a. Dysaesthesia
b.
Paresthesia
c.
Alodynia
e.
Analgesia
11. Biceps
reflex
is
subserved
a. C2
–
c3
b.C4-‐c5
c.
C5-‐c6
d.
C7-‐c8
12. Variations
of
babinski
a. Snout
reflex
c.
Hoffman’s
d.
Chaddock’s
e.All
b. B
and
C
13. Examination
of
motor
function
a. Look
for
involuntary
movements
c. Inspect
muscle
size
b. Look
for
coordinated
performance
of
d. all
motor
acts
14. TRUE
of
spastic
gate:
a. Narrow
base
of
support
b. Foot
plantar
flexed
and
everted
c. Leg
externally
rotated
at
the
hip
d. All
e. A
and
C
15. Upper
motor
neuron
paralysis:
a. Muscles
affected
in
groups
e. A
and
C
b. Rigidity
c. Babinski
d. All
4
5
A. MATCHING
TYPE:
1. A
stoke
patient
can
open
his
eyes,
moans
and
flexes
on
painful
stimulation
has
a
Glasgow
coma
scale
of:
A. 3/15
B. 6/15
C. 10/15
D. 12/15
2. The
main
objective
of
doing
deep
tendon
reflex
is
to:
A. Differentiate
whether
the
lesion
is
UMN
or
LMN
B. Differentiate
whether
the
lesion
is
brain
stem
or
spinal
cord
C. Differentiate
whether
the
lesion
is
anterior
horn
cell
or
peripheral
nerve
D. All
of
the
above
3. Babinski
is
not
seen
in:
A. Frontal
lobe
tumor
B. Brainstem
stroke
C. Spinal
cord
D. Diabetic
compression
neuropathy
4. A
high
stepped,
slapping
gate
is
usually
secondary
to:
A. Parkinson’s
disease
B. Posterior
column
C. UMN
Lesion
D. Gait
apraxia
lesion
5. Paralysis
of
upward
gaze
is
usually
secondary
to:
A. Optic
nerve
lesion
B. Optic
chiasm
lesion
C. Pineal
lesion
D. Pituitary
Lesion
6. Not
a
feature
of
metabolic
encephalopathy
A. Pupils
are
equal
and
reactive
C. Common
occurrence
of
movement
abnormality
B. Severe
mental
status
alteration
D. Presence
of
lateralizing
sign
7. Fatigue
with
exercise
is
usually
seen
in:
A. Neuropathy
B. Myopathy
C. Neuromuscular
function
disorder
D. UMN
lesion
8. A
unilateral,
dilated,
non
–
reactive
pupil
in
a
comatose
pate
will
indicate:
A. Metabolic
encephalopathy
C. Pontine
hemorrhage
B. Temporal
bone
herniation
D. Drug
overdose
9. A
patient
complaining
of
weakness
that
he
can
only
move
his
extremities
against
gravity
is
graded
as:
A. 1/5
B. 2/5
C. 3/5
D. 4/5
10. Mental
status
examination
is
a
test
for
the
integrity
of:
A. Cerebral
cortex
B. Cerebellum
C. Brainstem
D. Cranial
nerves
11. An
optic
chiasm
lesion
would
cause:
A. Failure
of
B. Paralysis
of
upward
C. Bitemporal
Hemianopsia
D. All
of
the
above
convergence
gaze
12. Lesion
in
the
cavernous
sinus
would
involve
the
following
cranial
nerves,
except:
A. CN
III
B. CN
IV
C. CN
V
D. CN
VI
13. Weakness
of
knee
extension
is
caused
by
a
lesion
of:
A. Femoral
nerve
B. Peroneal
nerve
C. Sciatic
Nerve
D. Popliteal
nerve
14. Features
of
upper
motor
neuron,
except:
A. Spastic
B. (+)
Babinski
C. Atrophy
D. None
of
the
above
15. Foot
drop
is
secondary
to
a
lesion
in
the:
A. Femoral
nerve
B. Peroneal
nerve
C. Lateral
cutaneous
D.
nerve
16. The
first
cranial
nerve
to
be
affected
by
increased
intracranial
pressure
is:
A. CN
III
B. CN
IV
C. CN
VI
D. CN
VI
17. Signs
of
peripheral
nerve
lesion,
except:
A. Atrophy
B. Fasciculations
C. Spasticity
D. Hyporeflexia
18. Neurologic
examination
in
a
comatose
patient
includes
the
following,
except:
A. Fundoscopy
B. Pupillary
light
reflex
C. Mental
status
D. Cerebellar
examination
examination
19. Signs
and
symptoms
of
myopathy
includes
the
following,
except:
A. Proximal
weakness
B. Atrophy
C. Hyperreflexia
D. None
of
the
above
20. The
most
reliable
sign
of
UMN
lesion:
A. Hyperreflexia
B. Atrophy
and
fasciculation
C. (+)
Babinski
D. Spasticity
21. Presence
of
cheery
red
spots
seen
in
the
retina
by
fundoscopy
is
seen
in:
A. Tay
Sach’s
disease
C. Inreacrania
hemorrhage
6
HEENT
1.
Unilateral
headache
that
can
be
localized
behind
the
eyes
–
CLUSTER
2.
Enlarged
blind
spot
occurs
in
a
condition
affecting
the
optic
nerve
3.
Rhinoscopy
(ndi
dapat
tamaan)
–
NASAL
SEPTUM
4.
polyps
–
MEDIAL
MEATUS
5.
Family
history
–
MIGRAINE
6.
Hyperthyroidism
–
GRAVE’S
DISEASE
7.
button
like
–CHANCRE
IN
SYPHILIS
8.
maplike
–GEOGRAPHICAL
9.
caused
by
deficiency
in
riboflavin
and
niacin
–
SMOOTH
TONGUE
10.
ear
pull
(adults)
–
UP
&
BACK
11.
unilateral
painless
–
RETINAL
WALL
12.
examining
the
oropharynx
use
a
tongue
depressor
–
DISTAL
HALF
OF
TONGUE
13.
white
optic
disc
and
tiny
vessel
are
absent
–
OPTIC
ATROPHY
14.
fissured
tongue
–
APPEARED
WITH
INCREASING
AGE
15.
nutritional
deficiency
(cold
sore)
–
ANGULAR
CHEILITIS
16.
caused
by
trauma
–
SUBCONJUNCTIVAL
HEMORRHAGE
17.
tonsilar
LN
pulsation
a.
carotid
artery
b.
ext.
Jugular
Vein
c.
lymph
adenopathy
d.
bruit
18.
convergence
test
–
ADDITIONAL:
• Otitis
Externa
–
pale,
moist
,
narrow
• Retracted
eardrum
• Soft
nodule
in
the
thyroid
gland
–
GRAVE’s
• Behind
the
eye
–
Cluster
• Riboflavin
def.
and
chemotx.
–
smooth
• Exposure
to
sumlight
–
lip
carcinoma
• Factor
to
carcinoma
–
Actinic
Cheilitis
• Worsen
in
noisy
environmanet
–
sensorineural
hearing
loss(SNHL)
• Presbyopic
–
better
seen
further
away
Central
loss
• Button
like
infection
–
Angular
cheilitis
• Ill
fitting
dentures
• Fissure
tongue
–
increasing
age
• Sign
of
lip
canar?
–
Actinic
cheilitis
9
1.
Hold
target
at
the
midline
and
at
eye
level
gradually
moving
the
target
toward
the
bridge
of
the
nose.
a.
Lid
lag
b.
Convergence
c.
Accommodation
d.
Confrontation
2.
For
the
test
above
a.
This
is
normally
maintained
at
a
distance
of
2-‐3
inches
from
the
nasal
bridge
of
the
nose
b.
Watch
for
the
appearance
of
white
sclera
between
the
iris
and
the
upper
lid.
c.
Usually
a
person
sees
both
sets
of
fingers
at
the
same
time.
d.
There
is
pupillary
constriction
in
the
opposite
eye
3.
There
is
poor
convergence
in
a.
Hypothyroidism
b.
Hypertension
c.
Hyperthyroidism
d.
Diabetes
mellitus
4.
Absent
red
reflex
suggest
a.
Normal
eye
b.
Artificial
eye
c.
Papilledema
d.
Hyperthyroidism
5.
External
auditory
canal
is
often
swollen
,
narrowed
moist,
pale
and
tender.
It
may
be
reddened.
This
is
a.
Chronic
otitis
externa
b.
Acute
otitis
externa
c.
Acute
purulent
otitis
media
d.
acute
otitis
media
6.
This
is
not
a
special
eye
technique
for
eye
examination
a.
Nasolacrimal
duct
obstruction
b.
Inspection
of
the
upper
palpebral
conjunctiva
c.
For
assessing
protruding
eyes
d.
Extraocular
muscle
test
7.
Inspection
of
the
nasal
cavity
through
the
anterior
naris
us
usually
limited
to
the
following:
a.
Vestibule
b.
Superior
turbinates
c.
Sphenoid
sinus
d.
Frontal
sinus
8.
Spinning
sensation
is
accompanied
by
nystagmus
and
ataxia
a.
Vertigo
b.
Dizziness
c.
Tinnitus
d.
Disequilibrium
9.
Retracted
tympanic
membrane
a.
More
conical
b.
Seen
on
Acute
suppurative
otitis
media
c.
Loss
of
bony
landmarks
d.
Accentuated
bony
landmarks
10.
Local
cause
of
nosebleeding
10
a.
Flying
b.
Hypertension
c.
Nose
Picking
d.
Leukemia
e.
English
11.
Deacrease
facial
mobility
and
characteristic
stare
(Parkinson’s
disease)
12.
Head
is
elongated
with
bony
prominence
of
the
forehead,
nose
and
lower
jaw
(Acromegaly)
13.
swelling
usually
appears
first
in
the
eyes
and
in
the
morning
(Nephrotic
syndrome)
14.
hair
is
dry,
coarse
and
sparse
with
periorbital
edema.
Lateral
eyebrows
thin
(Myxedema)
15.
Red
cheeks,
hirsutism
and
“moonface”
(Cushing’s
syndrome)
16.
May
accompany
lipid
disorders
(Xanthelasma)
17.
Tearing
is
prominent.
Nasolacrimal
duct
obstruction
is
also
noted
(Dacryocyctitis)
18.
Usually
points
inside
the
lid
rather
that
the
lid
margin
(Chalazion)
19.
A
painful,
tender
red
infection
in
a
gland
at
the
margin
of
the
eyelids
(Sty)
20.
Drooping
of
eyelids
(Ptosis)
Q:
Unilateral
headache
that
can
be
localized
behind
the
eye
A.
Cluster
Q:
Enlarge
Blind
spot
occurs
in
a
condition
affecting
optic
nerve
A:
Q:
Rhinoscopy
(hindi
dapat
tamaan)
A:
Nasal
septum
Q:
Polyps
A:
Medial
Meatus
Q:
Family
History
A:
Migraine
Q:
Hyperthyroidism
A:
Grave’s
disease
Q:
Button
like
A:
Chancre
syphilis
Q:
Map-‐like
A:
Geographical
Q:
Caused
by
a
deficiency
in
riboflavin
and
Niacin
A:
smooth
Tongue
Q:
Ear
pull
(adult)
A:
Up
and
back
Q:
Unilateral,
painless
A:
Retinal
Wall
Q:
Examining
oropharynx,
use
tongue
depressor:
A:
Distal
half
of
tongue
11
• Ptosis
-‐
cause
myasthenia
gravis,
damage
to
the
oculomotor
nerve
(CN
III),
damage
to
the
sympathetic
nerve
supply
(
Horner's
syndrome)
• Ectropion -‐ the margin of the lower lid is turned outward, exposing the palpebral conjunctiva
• Inflammation of the Lacrimal Sac (Dacryocystitis) -‐ swelling between the lower eyelid and the nose
• Horner's
Syndrome-‐
small
affected
pupil,
reacts
briskly
to
light
and
near
effort,
ptosis
present,
loss
of
sweating
on
forehead,
heterochromia
• Argyll-‐Robertson pupils -‐ small, irregular pupils that accomodate but do not react to light indicate CNS syphilis
• Normal arterial wall is transparent; Normal light reflex is narrow
• Silver
wiring
-‐
occasionally
a
portion
of
a
narrowed
artery
develops
such
as
an
opaque
wall
that
has
no
blood
is
visible
within
it.
• Microaneurysms
-‐
tiny,
round
red
spots
seen
commonly
but
not
exclusively
in
and
around
the
macular
area;
minute
dilatations
of
very
small
retinal
vessels,
but
the
vascular
connections
are
too
small
to
be
seen
opthalmoscopically
• Neovascularizations
-‐
formation
of
new
blood
vessels;
more
numerous,
more
tortuous,
and
narrower
than
other
blood
vessels
in
the
area
and
form
disorderly
looking
red
arcades
• Hypertensive
Retinopathy
-‐
marked
arteriolar
venous
crossing
changes
are
seen,
copper
wiring
of
the
arterioles
is
present.
Cotton
wool
spot
is
seen
just
superior
to
the
disc.
• Proliferative
Retinopathy
(
Neovascularization)
-‐
new
preretinal
vessels
arising
on
the
disc
extening
across
the
disc
margins.
Visual
acuity
is
still
normal,
but
risk
for
visual
loss
is
high
• Keloid
-‐
a
firm,
nodular,
hypertrophic
mass
of
scar
tissue
(binding)
extending
beyond
the
area
of
injury
• Tophi -‐ deposit of uric acid crystals characteristic of chronic tophaceous gout
• Cutaneous
cyst/
Sebaceous
cyst
-‐
a
dome
shaped
lump
in
the
dermis
forms
a
benign
closed
firm
sac
attached
to
the
dermis
• Rheumatoid
Nodules
-‐
small
lump
on
the
helix/antihelix
and
additional
nodules
elsewhere
on
the
hands
along
the
surface
of
the
ulna
distal
to
the
elbow
12
• Acute
Otitis
Media
with
Purulent
Effusion
-‐
caused
by
bacterial
infection
earache,
fever
and
hearing
loss.
Hearing
loss
is
of
the
conductive
type
• Sensorineural loss -‐ weber's test: sound lateralizes to good ear
• Angular
Cheilitis
-‐
softening
of
the
skin
at
the
angles
of
the
mouth,
fissuring
• Chancre of Syphilis -‐ appear on the lip, firm button-‐like lesion
• Large
Normal
Tonsils
-‐
normal
tonsils
may
be
enlarged;
protrude
medially
beyond
the
pillars
and
even
to
the
midline
• Diptheria -‐ dull red, gray exudate (pseudomembrane) is present on the uvula, pharynx and tongue
• Koplik's spots -‐ early sign of measles, small white specks that resembles grains of salt
• Acute Necrotizing Ulcerative Gingivitis -‐ ulcers develop in the interdental papilla
• Hutchinson's teeth -‐ sides of these teeth show normal contours; sides, shaping of the teeth are unaffected
• Smooth
tongue
(Atrophic
Glossitis)
-‐
lost
its
papillae,
deficiency
in
riboflavin,
niacin,
folic
acid,
Vit.
B12,
pyridoxine,
iron
• Apthous
ulcer
(Canker
sores)
-‐
painful,
round/oval
ulcer
that
is
white/yellowish
gray
and
surrounded
by
a
halo
of
reddened
mucosa
1. Enlarged
skull
may
signify:
Hydrocephalus
or
Paget’s
disease
of
Bone
2. 20/200
vision
meaning:
at
20
ft.,
the
patient
can
read
print
that
a
person
with
normal
vision
could
read
at
200
feet.
3. Absence
of
a
red
reflex:
Cataract
(opacity
of
lens),
detached
retina,
retinoblastoma
4. Light
rays
from
a
distance
focus
on
the
anterior
of
retina:
Myopia
Light
rays
from
a
distance
focus
on
the
posterior
of
retina:
Hyperopia
5. Loss
of
venous
pulsation
in
pathologic
conditions
like
head
trauma,
meningitis,
or
mass
lesions
may
be
an
early
sign
of:
Elevated
ICP
6. Canal
is
swollen,
narrowed,
moist,
pale,
tender,
reddened:
Acute
Otitis
externa
7. Unilateral
Conductive
hearing
loss:
Sound
is
heard
in
the
Impaired
ear
8. Unilateral
Sensorineural
Hearing
loss:
Sound
is
heard
in
the
good
ear
9. Conductive
hearing
loss:
BC
>
AC
10. Mucosa
is
reddened
and
swollen:
Viral
rhinitis
11. Mucosa
is
pale,
bluish,
or
red:
Allergic
rhinitis
12. Submental
Lymph
node
(maytanong
bout
sa
Submental
LN)
13. Basic
landmark
for
palpating
Thyroid
gland:
Thyroid
cartilage
and
Cricoid
cartilage??
14. Nausea,
Vomiting:
Migraine/Subarachnoid
15. Sudden
movements
of
the
head
may
be
associated
with:
Brain
tumor
16. Spinning
sensation:
Vertigo
17. Left
Homonymous
Hemianopsia:
Right
Optic
Radiation
18. Damage
to
Oculomotor
nerve:
Ptosis
19. Eye
no
longer
drains
satisfactorily:
Ectropion
13
15
c.
Mouth
breathing
d.
Allergic
rhinitis
8.
A
hole
in
nasal
septum
is
commonly
caused
by
a.
Syphilis
b.
Tuberculosis
c.
Cocaine
abuse
d.
Repeated
trauma
in
picking
off
crusts
9.
Headache
presents
on
aakening
a.
Migraine
b.
Brain
tumor
headache
c.
Meningitis
d.
Subarachnoid
hemorrhage
10.
Sudden
unilateral
painless
visual
loss
a.
Acute
glaucoma
b.
Corneal
ulcer
c.
Uveitis
d.
Retinal
vein
occlusion
Test
II:
Match
the
abnormalities
of
the
lips
with
description
below
a.
Angular
cheilitis
b.
Cold
sore
c.
Chancre
of
syphilis
d.
Carcinoma
of
the
lips
e.
Angioedema
B
11.
Produce
recurrent
and
painful
eruptions
of
the
lips
and
surrounding
skin
A
12.
Maybe
due
to
ill-‐fitting
dentures
C
13.
Highly
infectious,
firm,
button-‐like
lesion
that
ulcerates
and
may
become
crusted
D
14.
Fair
skin
and
prolonged
exposure
to
the
sun
are
common
risks
factors
A
15.
It
may
be
due
to
nutritional
deficiency
Test
III:
Match
the
pattern
of
hearing
loss
with
description
below
a.
Conductive
hearing
loss
b.
Sensorineural
hearing
loss
A
16.
One
cause
is
otitis
media
B
17.
In
weber
test,
sound
lateralizes
to
good
ear
17
HEENT
a.
Conductive
hearing
loss
b.
Sensorineural
hearing
loss
1. Voice
may
be
loud
because
the
patient
has
trouble
hearing
his
or
her
own
voice
B
2. Age
of
onset
is
most
often
in
childhood
and
young
adulthood,
up
to
age
40
A
3. Otitis
media
A
4. Sound
lateral
to
good
ear
in
Weber
test
B
5. AC>BC,
Rinne
test
B
6. Basic
landmark
–
cricoid
cartilage
7. Lesion
in
the
posterior
2/3
of
the
scalp
and
nasopharynx
–
subscapular
8. Retrosternal
goiter
–
venous
engorgement
9. Examination
of
the
lymphnode
–
palpation
10. Ophalmoscopic
examination
a.
The
view
is
limited
to
posterior
structure
b.
Pheripheral
structures
can
be
evaluated
in
the
absence
of
mydriatic
drops
c.
(+)3
or
(+)4
diopters
will
allow
you
to
see
the
anterior
structures
clearly
d.
Red-‐orange
reflex
is
normally
not
visualize
first
11. A
(-‐)
lens
is
used
in
a.
Hyperopic
eyes
b.
Aphakic
eyes
c.
Myopic
eye
d.
Astigmatism
12. Firm,
button-‐like
lesion
–
chancre
of
syphilis
13. Risk
factors
are
fair
skin,
and
prolonged
exposure
to
sun
–
carcinoma
of
the
lip
14. Nutritional
insufficiency
–
angular
cheilitis
15. Ill-‐fitting
dentures
–
angular
cheilitis
16. Painful
vesicular
lesions
in
angle
of
the
mouth
–
herpes
simplex/cold
sore
17. Unilateral,
painless
visual
loss
a.
Acute
glaucoma
b.
uveitis
c.
retinal
vein
occlusion
d.
all
of
the
above
18. Headache
upon
waking
up
–
migraine
19. Nasal
flaring
associated
to
a.
Respiratory
distress
b.
Chronic
nasal
obstruction
c.
Mouth
breathing
19
d.
Allergic
rhinitis
20. Hole
in
the
basal
septum
most
common
in
a.
Syphilis
b.
Tuberculosis
c.
Cocaine
abuse
d.
Repeated
trauma
in
picking
off
crusts
20
Test
III:
Match
the
pattern
of
hearing
loss
with
description
below
a.
Conductive
hearing
loss
b.
Sensorineural
hearing
loss
A
16.
One
cause
is
otitis
media
B
17.
In
weber
test,
sound
lateralizes
to
good
ear
B
18.
In
Rinne
test,
normal
pattern
prevails
A
19.
Voice
maybe
loud
because
hearing
is
difficult
A
20.
Usual
ageof
onset
childhood
and
adulthood,
up
to
age
40
23
HEENT
a.
Conductive
hearing
loss
b.
Sensorineural
hearing
loss
1. Voice
may
be
loud
because
the
patient
has
trouble
hearing
his
or
her
own
voice
B
2. Age
of
onset
is
most
often
in
childhood
and
young
adulthood,
up
to
age
40
A
3. Otitis
media
A
4. Sound
lateral
to
good
ear
in
Weber
test
B
5. AC>BC,
Rinne
test
B
6. Basic
landmark
–
cricoid
cartilage
7. Lesion
in
the
posterior
2/3
of
the
scalp
and
nasopharynx
–
subscapular
8. Retrosternal
goiter
–
venous
engorgement
9. Examination
of
the
lymphnode
–
palpation
10. Ophalmoscopic
examination
a.
The
view
is
limited
to
posterior
structure
b.
Pheripheral
structures
can
be
evaluated
in
the
absence
of
mydriatic
drops
c.
(+)3
or
(+)4
diopters
will
allow
you
to
see
the
anterior
structures
clearly
d.
Red-‐orange
reflex
is
normally
not
visualize
first
11. A
(-‐)
lens
is
used
in
a.
Hyperopic
eyes
b.
Aphakic
eyes
c.
Myopic
eye
d.
Astigmatism
12. Firm,
button-‐like
lesion
–
chancre
of
syphilis
13. Risk
factors
are
fair
skin,
and
prolonged
exposure
to
sun
–
carcinoma
of
the
lip
14. Nutritional
insufficiency
–
angular
cheilitis
15. Ill-‐fitting
dentures
–
angular
cheilitis
16. Painful
vesicular
lesions
in
angle
of
the
mouth
–
herpes
simplex/cold
sore
17. Unilateral,
painless
visual
loss
a.
Acute
glaucoma
b.
uveitis
c.
retinal
vein
occlusion
d.
all
of
the
above
18. Headache
upon
waking
up
–
migraine
19. Nasal
flaring
associated
to
a.
Respiratory
distress
b.
Chronic
nasal
obstruction
c.
Mouth
breathing
24
d.
Allergic
rhinitis
20. Hole
in
the
basal
septum
most
common
in
a.
Syphilis
b.
Tuberculosis
c.
Cocaine
abuse
d.
Repeated
trauma
in
picking
off
crusts
25
16.
An
enlarged
blind
spot
occurs
in
condition
affecting
optic
nerve
such
as:
a.
Optic
atrophy
c.
Glaucoma
b.
Cataract
d.
Papilledema
17.
Contraindication
for
mydriatic
drops
a.
Coma
c.
Arcus
senillis
b.
Cataract
d.
pterygium
18.
The
Tug
test
is
painful
in:
a.
Otitis
media
c.
chronic
otitis
externa
b.
Acute
otitis
externa
d.
purulent
otitis
media
19.
Unilateral
sensory
neural
loss
a.
Sound
is
heard
at
the
good
ear
b.
Sound
is
heard
in
the
impaired
ear
c.
Due
to
impact
cerumen
d.
due
to
eardrum
perforation
20.
The
nasal
mucosa
is
pale,
bluis
or
red.
This
suggests:
a.
Viral
rhinitis
c.
allergic
rhinitis
b.
Acute
sinusitis
d.
normal
mucosa
21.
A
triangular
thickening
of
the
bulbar
conjunctiva:
a.
pterygium
22.
Characteristic
of
Optic
atrophy
a.
Visible
optic
vessel
c.
absent
optic
vessel
b.
tiny
optic
vessel
d.
no
vessel
pulsation
23.
Normal
retinal
artery
a.
Arterial
wall
transplant
c.
Narrow
light
reflex
b.
narrow
column
of
blood
vessel
d.
focal
narrowing
24.
Fullness
and
popping
sound
in
the
ear
with
mild
conductive
hearing
loss
and
ear
pain
a.
Acute
otitis
media
c.
with
effusion
b.
Chronic
otitis
externa
25.
Bulging
eardrum
a.
Hearing
loss
is
sensorineural
c.
accentuated
b.
Obscured
d.
changes
in
atmospheric
pressure
26.
The
patient
complains
of
earache
and
hearing
loss.
The
eardrum
are
reddened.
Losses
its
landmark
and
buldges
laterally
towards
the
examiners
eye
a.
Acute
otitis
media
with
purulent
effusion
b.
Chronic
otitis
externa
c.
Chronic
otitis
media
d.
Acute
otitis
externa
27.
The
skin
of
the
ear
canal
is
often
thickened,
red
and
itchy:
Chronic
otitis
externa
28.
Button
like
lesion:
Chancre
syphilis
29.
Benign
condition
that
may
follow
antibiotic
therapy:
a.
Geographic
tongue
c.
smooth
tongue
b.
Fissured
tongue
d.
hairy
tongue
30.
Deficiency
in
riboflavin,
niacin,
folicacid,
B12
and
pyrodoxin
a.
Atrophic
c.
Hairy
b.
Fissured
d.
Geographic
31.
Basic
landmark
of
the
thyroid
a.
Thyroid
cartilage
c.
Trachea
b.
Cricoid
cartilage
d.
Isthmus
32.
Furosemide
–
medication
that
affect
the
hearing
33.
Nose
picking
for
local
cause
of
epistaxis
34.
Rhinitis
medicamentosa
–
excessive
use
of
decongestant
35.
Cause
of
excessive
tearing
36.
Absence
of
red
reflex
37.
Bilateral/unilateral
exopthalmus
27
1. Vision
of
20/200
means
that
a. at
20
ft,
the
patient
can
read
print
that
a
person
with
normal
vision
could
read
at
200
ft
b. at
200
ft,
the
patient
can
read
print
that
a
person
with
normal
vision
could
read
at
20
ft.
c. the
larger
the
first
number,
the
worse
the
vision
d. normal
vision
2. An
image
from
the
upper
nasal
visual
field
strikes
the
a. Upper
temporal
area
c. Lower
temporal
area
b. Lower
nasal
area
d. Upper
nasal
area
3.
Sees
better
when
the
card
is
farther
away
a. Nearsightednesss
c. Presbyopia
b. Myopia
d. hyperopia
4.
Absence
of
red
reflex
indicates
a. Artificial
eye
c.
b. Opacity
of
lens
d.
5.
An
enlarged
blind
spot
occurs
in
a. Grave’s
c. Optic
neuritis
b. Retroorbital
tumor
d. Diabetic
neuropathy
6.
Headache
from
errors
of
refraction
include
a. nearsightedness
c. astigmatism
b. farsightedness
d. myopia
7. Testing
near
reaction
is
used
in
diagnosis
of
a. Argyll
Robertson
pupil
c. Oculomotor
nerve
paralysis
b. Anisocoria
d. Horner’s
syndrome
8.
Fixed
defects
(scotoma)
are
seen
in
a. Retina
c. Lens
b. Cornea
d. Pupil
9.
Excessive
tearing
from
increased
production
is
due
to
a. Corneal
irritation
c. Entropion
b. Extropion
d. Nasolacrimal
duct
obstruction
10.
Most
important
attribute
of
headache
a. Severity
c. Quality
b. Chronological
pattern
d. location
11. Hyperthyroidism
a. Intolerance
to
cold
c. Involuntary
weight
loss
b. Preference
for
warm
clothing
d. Decreased
sweating
12. The
tug
test
is
painful
in
a. Otitis
media
c. Chronic
otitis
externa
b. Acute
otitis
externa
d. Purulent
otitis
media
13.
Bilateral,
painless
change
in
refractory
may
be
due
to
a. Chemical
exposure
c. Steroids
b. Radiation
exposure
d. Diabetes
14.
Family
history
may
be
positive
is
a. Tension
c. Migraine
b. Cluster
d. Medication
obveruse
15.
The
eardrum
itself
is
scarred,
no
landmarks
visible,
often
closes
in
healing
processs
a. Tympanosclerosis
c. Otosclerosis
b. Perforation
of
eardrum
d. Serous
effusion
Retinal
Arteries
and
Arteriovenous
Crossing
C
16.
Arteries
may
show
focal
or
generalized
narrowing
a.
Copper
wore
B
17.
Opaque
wall
and
no
blood
visible
b.
Silver
wire
29
A
18.
Arteries
close
to
the
disc
become
full
and
somewhat
torturous
c.
Retinal
Arteries
in
Hypertension
C
19.
Arterial
wall
is
invisible
A-‐V
crossing
is
visible
d.
Normal
Retinal
Artery
C
20.
Light
reflex
is
narrow
about
one-‐fourth
the
diameter
of
blood
column
Pupillary
Abnormalities
D
21.
pupils
that
accommodate
but
do
not
react
to
light
a.
Anisocoria
C
22.
dialted
pupil
is
fixed
to
light
and
near
effort
b.
Adie’s
pupil
B
23.
slow
accommodation
causes
blurred
vision
c.
Oculomotor
nerve
paralysis
B
24.pupil
is
large
regular,
usually
unilateral
d.
Argyll
Robertson
pupil
A
25.causes
include
blunt
trauma
to
the
eyes,
open-‐angle
glaucoma
Diplopia
A
26.
Images
are
side
by
side
a.
Horizontal
diplopia
A
27.
Caused
by
palsy
of
CN
III
or
IV
b.
Vertical
diplopia
D
28.
Diplopia
in
one
eye
with
the
other
closed
c.
Both
B
29.
Images
are
on
top
of
each
other
d.
None
A
30.
One
kind
of
this
diplopia
is
physiologic
30
Hearing
Loss
A
31.
Abnormality
is
usually
visible
except
in
the
otosclerosis
a.
Conductive
hearing
loss
B
32.
In
Weber
test,
room
noise
not
appreciated
b.
Sensorinueral
hearing
loss
B
33.
Voice
is
loud
because
hearing
is
difficult
c.
Both
C
34.
To
estimate
hearing,
test
one
ear
at
a
time
d.
None
B
35.
In
Rinne
test,
the
normal
pattern
prevails
Eardrum
D
36.
Pink,
grayish,
intact
a.
Serous
Effusion
C
37.
Caused
by
acute
purulent
infection
of
the
middle
ear
b.
Perforated
Eardrum
B
38.
Eardrum
itself
is
scarred,
no
landmarks
are
visible
c.
Acute
Otits
Media
with
Purulent
Effusiion
A
39.
Amber
fluidbehind
the
eardrum
is
characteristic.
d.
Normal
Eardrum
Air
bubbles
can
be
seen
with
the
amber
fluid
C
40.
Eardrum
is
bulging
and
redden,
most
landmarks
are
obscured
Clinical
Findings
D
41.
Diptheria
a.
Benign
midline
lump
F
42.
Apthous
ulcer
b.
Nasal
sputum
G
43.
Epulis
c.
Poor
convergence
E
44.
Fever
blister
d.
Pseudomembrane
J
45.
Microaneurysm
e.
Cold
sore
H
46.
Sentinel
node
f.
Canker
sore
B
47.
Transilumination
g.
Pregnancy
tumor
I
48.
Hyperthyroidism
h.
Thoracic
malignancy
K
49.
Hypothyroidism
i.
(+)
lidlag
A
50.
Torus
palatus
j.
Diabetes
k.
None
of
the
above
1. Major
attributes
to
headache
a. Location
b. Quality
c. Chronologic
pattern
d. Hindi
kya
AOTA
to?
Kasi
tama
lahat
2. Headache
is
episodic
and
tends
to
peak
after
several
hours.
a. Migraine
b. Cluster
c. Brain
tumor
d. Meningitis
3. Nausea
and
vomiting
is
common
in
(MIGRAINE
ang
sagot,
wala
s
choices.
Lahat
ng
choices
walang
assoc.
nausea
and
vomiting)
a. Meningitis
b. Tension
c. Brain
tumor
d. Rebound
31
4. Cough,
sneezing,
changing
position
of
the
head
can
increase
the
pain
from:
a. Tension
headache
–
sustained
muscle
tension
b. Migraine
–
noise
and
bright
lights
c. Brain
tumor
(and
sinusitis)
d. Cluster
–
alcohol
5. Aging
vision
–
PRESBYOPIA
6. Bilateral
painful
eye
a. Chronic
radiation
exposure
b. Cholinergic
medication
–
bilateral,
painless
c. Central
retinal
artery
occlusion
–
unilateral,
painless
d. Corneal
ulcer-‐
unilateral,
painful
7. Horizontal
diplopia
a. Weakness
or
paralysis
of
EOM
b. Lesion
of
CN
III
or
IV
c. Lesion
of
CN
III
or
VI
d. Corneal
problems
8. Conductive
hearing
loss
a. Have
particular
trouble
understanding
speech
–
sensorineural
b. Noisy
environment
makes
hearing
worse
–
sensorineural
c. Problem
in
inner
ear
–
sensorineural
d. Noisy
environment
may
help
9. Perception
that
the
patient
or
the
environment
is
spinning\
a. Tinnitus
–
perceived
sound
without
external
stimulus
b. Vertigo
c. Dizziness
d. Meniere’s
disease
–
tinnitus
+
hearing
loss
+
vertigo
10. Perceived
sound
without
external
stimulus
–
TINNITUS
11. Sensation
of
spinning
–
VERTIGO
(hindi
kaya
dizziness
to?)
12. Fever,
pharyngeal
exudates,
anterior
lymphadenopathy,
no
cough
a. Viral
pharyngitis
b. Strep
pharyngitis
c. Diphtheria
d. Infectious
mononucleosis
13. Hyperthyroidism
a. Cold
intolerance
–
hypo
b. Preference
of
warm
clothing
–
hypo
c. Weight
loss
d. Decrease
sweating
–
hypo
nd
14. Leading
cause
of
blindness
in
African
American
and
2
leading
cause
of
blindness
overall
a. Cataract
b. Glaucoma
c. Macular
degeneration
d. Retinal
detachment
32
15. 20/40
corrected
is
a. Patient
can
read
line
40
with
glasses
b. Patient
can
read
the
line
without
glasses
c. Vision
is
normal
d. Presbyopia
16. An
enlarged
blind
spot
occurs
in
conditions
effecting
the
optic
nerve
such
as:
(glaucoma,
optic
neuritis,
papilledema)
a. Optic
atrophy
b. Cataract
c. Glaucoma
d. Papilledema
17. Contraindications
for
mydriatic
drops
(head
injury,
coma,
suspicion
of
narrow
angle
glaucoma)
a. Coma
b. Cataract
c. Arcus
senilis
d. Pterygium
18. Tug
test
is
painful
in
a. Otitis
media
b. Acute
otitis
externa
c. Chronic
otitis
externa
d. Purulent
otitis
media
19. Unilateral
sensorineural
loss
a. Sound
is
heard
in
good
ear
b. Sound
is
heard
in
impaired
ear
–
unilateral
conductive
c. Impacted
cerumen
d. Eardrum
perforation
20. The
nasal
mucosa
is
pale,
bluish,
or
red
a. Viral
rhinitis
b. Acute
sinusitis
c. Allergic
rhinitis
d. Normal
mucosa
21. Triangular
thickening
of
bulbar
conjunctiva
–
PTERYGIUM
22. Characteristic
of
optic
atrophy
a. Visible
optic
vessel
b. Tiny
optic
vessel
c. Absent
optic
vessel
d. No
vascular
pulsation
23. Normal
retinal
artery
a. Arterial
wall
is
transparent
b. Narrow
column
of
blood
vessel
–
HPN
c. Narrow
light
reflex
d. Focal
narrowing
–
HPN
24. Fullness
and
popping
sound
in
the
ear
with
mild
conductive
hearing
loss
and
ear
pain
–
SEROUS
EFFUSION
25. Bulging
eardrum
(Parang
wala
tamang
sagot.
Dapat
acute
otitis
media
with
purulent
effusion)
a. Hearing
loss
is
sensorineural
–
conductive
33
b. Obscured
c. Accentuated
d. Changes
in
atmospheric
pressure
–
serous
effusion
26. The
patient
complains
of
earache
and
hearing
loss.
The
eardrums
are
reddened,
loses
its
landmark,
and
bulges
lateral
towards
examiner’s
eye.
a. acute
otitis
media
with
purulent
effusion
b. chronic
otitis
media
externa
c. chronic
otitis
media
d. acute
otitis
externa
27. skin
of
the
ear
canal
is
often
thickened,
red
and
itchy
–
CHRONIC
OTITIS
EXTERNA
28. Button
like
lesion
–
CHANCRE
IN
SYPHILLIS
29. Benign
condition
that
may
follow
antibiotic
therapy
a. Geographic
tongue
–
dorsum
shows
scattered
smooth
areas
denuded
of
papillae
b. Fissured
tongue
–
increasing
age
c. Smooth
tongue
/
atrophic
glossitis
–
deficiency
of
riboflavin,
niacin,
folic
acid,
vitB12,
pyridoxine,
iron
or
treatment
with
chemotherapy
d. Hairy
tongue
–
HIV,
AIDS
30. Deficiency
of
riboflavin,
niacin,
folic
acid,
B12,
pyridoxine
a. Atrophic
glossitis
b. Fissured
c. Hairy
d. Geographic
31. Basic
landmark
of
thyroid
cartilage
a. Thyroid
cartilage
b. Cricoid
cartilage
c. Trachea
d. Isthmus
34
EXTREMITIES
d.
all
8. Palmar
erythema
except
a.portal
HPN
b.aplastic
anemia
c.
pregnancy
d.valvular
heart
dse
9. Wrist
ROM
Ans.
Flexion,
extension,
abduction,
adduction
10. True
regarding
neck
ROM
a.flexion
and
extensionat
the
skull
and
C1
–
C3-‐C7
b.rotation
at
c1
and
c2
–
ATLANTO-‐AXIAL
c.a&b
d.
none
11. Visual
examination
from
behind..
landmarks
except
a.spinous
process
of
T1
-‐
PALPATION
b.iliac
crest
C.POSTERIOR
SUPERIOR
ILIAC
SPINE
d.
dimple
of
venus
12. Test
for
Lumbar
lordosis
ANS.
THOMAS
TEST
13. Examination
of
motor
function
a.look
for
tremor
b.look
for
coordinated
movement
c.muscle
size
d.all
14. Pronated
hand
dropped
from
wrist
a. Carpal
tunnel
syndrome
b. Ulnar
nerve
palsy
c. Median
nerve
palsy
(MEDIAN
=
RADIAL)
d. None
15. Lateral
deviation
from
midline
ANS.
GENU
VALGUM
16. Rheumatoid
arthritis
A.MIP
&POP
INVOLVEMENT
36
B.HAYGARTH’S
NODES
c.Bouchard’s
nodes
-‐
OA
d.all
e.a&b
17. Unequal
shoulder
length
A.SCOLIOSIS
B.SPRENGEL’S
DEFORMITY
c.a&b
d.none
18. Unequal
leg
length
except
Ans.
Kyphosis
19. Long
narrow
nails
except
a.hypopotuitarism
b.eunochoidism
c.
cretinism
-‐
SQUARE
d.none
20. Lordosis
except
Ans.
A.
…convexity
NOTE:
Kindly
Recheck
all
the
answers!
God
bless!
37
A. Matching
type
E
1.
Drumstick
fingers
A.
Passive
hyperextension
C
2.
Spider
fingers
B.
Radial
nerve
injury
3.
Subungal
haemorrhage
C.
Arachnodactyly
A
4.
Graenlen's
test
D.
Ulnar
nerve
injury
H
5.
Lesague's
test
E.
Clubbing
E
6.
Hypertrophic
osteoarthropathy
F.
SBE
G
7.
Trendelenburg's
sign
G.
Hip
dislocation
8.
Tinel'
sign
H.
Straight
leg
test
K
9.
Infrapatellar
bursitis
I.
Carpal
tunnel
syndrome
10.
Genu
recurvatum
J.
Housemaid's
knee
M
11.
Acromegaly
K.
Clergyman's
knee
F
12.
Azure
half-‐moon
L.
Small
patella
D
13.
Hypothenar
M.
Square
&
round
nail
plate
-‐-‐-‐-‐-‐
N.
-‐-‐-‐-‐-‐
-‐-‐-‐-‐-‐
O.
-‐-‐-‐-‐-‐
P.
-‐-‐-‐-‐-‐
B.
MULTIPLE
CHOICE
16.
Thumb
in
Filipino
is:
A.
Hinlalaki
C.
Hinlalato
B.
Palasingsingan
D.
None
17.
Hinlalato
is:
A.
Thumb
C.
Middle
finger
B.
Index
finger
D.
None
18.
Severe
carpal
tunnel
syndrome
is
managed
by:
A.
NSAIDs
C.
Complete
rest
of
the
wrist
B.
Physical
therapy
D.
Surgical
decompression
19.
Not
a
malposture
of
the
hand:
A.
Claw
hand
C.
Wrist
drop
B.
Ape
hand
D.
Polydactyly
20.
Most
common
hypothesis
of
clubbing:
A.
Unknown
mechanism
C.
Parrot
beak
nails
B.
Hypoxia
D.
(?)
21.
Lateral
bending
of
the
spine:
A.
Atlanto-‐axial
joint
C.
Atlanto-‐occipital
B.
Midcervical
vertebra
D.
C3-‐C7
22.
Eggshell
nails:
A.
Vitamin
A
deficiency
C.
Thyrotoxicosis
B.
Hypochromic
anemia
D.
Bronchiectasis
38
35.
When
doing
the
lumbar
puncture,
iliac
crest
is
at:
A.
4th
lumbar
vertebrae
C.
T12-‐
L1
B.
L1-‐L2
D.
S4
36.
Extreme
dorsiflexion
of
the
foot
A.
Ruptured
Achilles
tendon
C.
Soleus
tear
B.
Fracture
of
the
tibial
shaft
D.
Fracture
of
the
fibular
shaft
37.
Pressure
diverticulum
of
the
synovial
sac
protruding
thru
the
joint
capsule
of
the
knee
A.
Baker's
cyst
C.
Pyarthrosis
B.
Popliteal
abscess
D.
Prepatellar
bursitis
38.
Swelling
in
the
popliteal
fossa
A.
Baker's
cyst
C.
Prepatellar
bursitis
B.
Popliteal
abscess
D.
Infrapatellar
bursitis
39.
Which
of
the
following
is
the
most
common
cause
of
painful
swelling
in
young
males?
A.
Paget's
disease
B.
Ankylosing
spondylitis
C.
Pott's
disease
D.
Osteoporosi
40
UPPER
EXT
1.
Hands
(ROM
–
ABDUCTION,
ADDUCTION,
EXTENSION,
FLEXION)
Condition
impaired
ROM
=
FAT
1. Fibrosis
of
palmar
fascia
(DUPUYTREN’S
CONTRACTURE)
2. Arthritis
3. Tenosynovitis
(inflammation
of
tendon
sheaths)
Size
hands
LONG
ACROMEGALY
AFTER
EPIPHYSIS
CLOSE
(ADULT)
EXCESSIVE
PRODUCTION
GH
NOT
SYMMETRICAL
GIGANTISM
BEFORE
EPIPHYSIS
CLOSE
(CHILD)
PROPORTIONATE
AND
SYMMETRIC
ND
NOTE:
BOTH
ARE
2
TO
TUMOR
+
BY
AN
EXCESS
OF
SOMATOTROPHIC
HORMONE
FROM
EOSINOPHILIC
ADENOMA
OF
ANTERIOR
PIT
GLAND
LOND
AND
SLENDER
HANDS
*SPIDER
FINGERS
SMALL,
THICK
HANDS
CRETINISM
(CHILD)
DWARF
PX
MYXEDEMA
(OLD)
ABSOLUTE
DEF
OF
TH
HANDS
SHORT,
THICK,
FAT
RADIUS
MAY
BE
SHORTENED
MONGOLISM
CHROMOSOMAL
ABN
HANDS
SHORT,
THICK,
THUMB
DIVERGES
FROM
NEARER
THE
WRIST
THAN
NORMAL
LITTLE
FINGER
IS
CURVED
(RADIAL
WARD)
MALPOSTURE
(ABNORMALITY
IN
POSTURE)
=
CAW
CLAW
HAND
BUSMA
BRACHIAL
PLEXUS
ULNAR
NERVE
INJURIES
SYRINGOMYELIN
MUSCULAR
ATROPHIES
ACUTE
POLIOMYELITIS
APE
HAND
PAS
PROGRESSIVE
MUSCULAR
ATROPHY
AMYOTROPHIC
LATERAL
SCLEROSIS
SYRINGOMYELIN
WRIST
DROP
RPP
RADIAL
NERVE
INJURIES
POLIOMYELITIS
POISONING
(LEAD,
ARSENIC,
ALCOHOL)
2.
PALM
ABNORMALITIES
CAROTENODERMA
HEPATIC
DISEASE
MYXEDEME
THENAR
ATROPHY
MEDIAN
NERVE
HYPOTHENAR
ATROPHY
ULNAR
NERVE
HANSEN’S
THICK
AND
CORD
LIKE
41
HYPOTHENAR
=
FLAT
AND
ATROPHIED
+NUMBNESS
PALMAR
ERYTHEMA
LLV
LIVER
CIRRHOSIS
LATE
STAGE
PREGNANCY
VULVAR
HEART
DISEASE
3.
FINGERS
MALFORMATION
POLYDACTYL
(SUPERNUMENARY
FINGER)
LAURENCE
–
BIEDL
SYNDROME
ASSOCIATED
WITH:
1. JUVENILE
OBESITY
2. RETINAL
DEGENERATION
3. GENITAL
HYPOPLASIA
4. MENTAL
RETARDATION
SYNDACTYL
(WEBBED
FINGERS)
CONGENITAL/HEREDITARY
HEBERDEN’S
NODES
(OSTEOARTHRITIS)
OSTEOARTHRITIS
PAINLESS
–
DIJ
HARD
OLD
WOMEN
MEN
(DUE
TO
TRAUMA,
SINGLE
JOINT)
HAYGARTHS
NODES
(RHEUMATOID
ARTHRITIS)
INFLAMMATORY
MIDDLE
AND
PROXIMAL
FUSIFORM
PAINFUL
JOINT
CAPSULE
THICKENED
5.
DIGITS
INFECTION
PARONYCHIA
SWOLLEN
REDDENED
PAINFUL
FELON
ABSCESS
TERMINAL
PULP
ND
2
BACTERIAL
INFECTION
ONSET
SWELL
AND
DULL
PAIN
6.
FINGERNAILS
MALFORMATION
ONYCHORREXIS
MALNUTRITION
-‐ BRITTLE
NAIL
PLATE
IRON
DEFICIENCY
-‐ BORDER
FRAYED
AND
TORN
THYROTOXICOSIS
CALCIUM
DEFICIENCY
CLUBBING
W/O
PERIOSTOSIS
TB
-‐ CONVEX
COPD
ND
-‐ 2
HYPOXIA
BROCHIECTASIS
-‐ PARROT-‐HIPPOCRATIC-‐SERPENT-‐DRUMSTICK
ABSENCE
OF
NAILS
ICHTHYOSIS
-‐ CONGENITAL
TRAUMA
BITTEN
NAILS
PERSONALITY
DISORDER
-‐ IRREGULAR
NEUROLOGIC
-‐ SHORT
NAILS
SQUARE
AND
ROUND
CAS
ACROMGELY
42
CRETINISM
LONG
AND
NARROW
HEM
HYPOPITIUTARISM
EUNOCHOIDISM
MARFAN’S
SYNDROME
SPOON
HIS
-‐ CONCAVE
HYPOCHROMIC
ANEMIA
-‐ KOILONYCHOSIS
IRON
DEFICIENCY
RARE:
RLS
-‐ RHEUMATIC
-‐ LICHEN
PLANUS
-‐ SYPHILIS
EGGSHELL
VIT
A
DEFICIENCY
-‐ CONCAVE
ND
ONYCHAUXIS
2
TO
FUNAL
INFECTION
-‐ HYPERTHOPHY
WASHER
WOMEN
-‐ NAILS
ON
TOP
OF
ANOTHER
-‐ IRREGULAR
DISCOLORED
-‐ UNKNOWN
CAUSE
RED
HAFT
MOON
CARDIAC
LANULA
RED
AZURE
BLUE
HAFT
MOON
WILSON
LANULA
BLUE
ND
ONYCHOLYSIS
2
TO
FUNAL
INFECTION
AND
TRAUMA
-‐
SEPRATION
OF
NAIL
FROM
NAILBED
+FOUL
ODOR
-‐ THYROTOXICOSIS
-‐ ECZEMA
-‐ PSORIASIS
-‐ MYENTERIC
DISEASE
SUB
UNGCAL
HEMORRHAGE
BACTERIAL
ENDOCARDITIS
-‐ SPLINTER
HEMMORAGE
TRICHINOSIS
-‐ LINEAR
RED
-‐ EMBOLIC
BEUS’S
LINE
ACUTE
SEVERE
ILLNESS
-‐
TRANSVERSE
DEPRESSION
7.
WRIST
–
ROM
DORSIFLEX,
PALMARFLEXION,
ULNAR
AND
RADIAL
DEVIATION
CONDITIONS
A.CHRONIC
ARTHRITIS
–
PAINFUL
AND
FUSIFORM
ENLARGMENT
B.
NON-‐SUPPURATIVE
TENOSYNOVITIS
–
PAINFUL
SWELLING
ANATOMIC
SNUFFBOX
-‐
(SAUSAGE
LIKE
SWELLING)
-‐
TENDON
SHEATHS
(EXTERNAL
POLLICIS
BREVIS
AND
ABDUCTOR
POLLICIS
LONGUS)
-‐
+CREPITUS
-‐
DUE
TRAUMA
AND
INFLAMMATION
(GOUT
AND
GONOCCOCAL)
C.
CARPAL
TUNNER
SYNDROME
-‐
COMPRESSION,
NEUROPATHY
MEDIAN
NERVE
-‐
(+)
TPN
(TINGLING,
PAIN,
NUMBNESS)
-‐
FLEXOR
CARPI
RADIALIS
AND
FLEXOR
CARPI
ULNARIS
-‐
PHYSICAL
SIGN
ATROPHY
HYPERSTHESIAS
PROGESSIVE
WEAKNESS
AND
AWKWARDNESS
NOTE:
43
1. TINEL’S
SIGN
–
TINGLING
PALMARIS
LONGUS
2. PHALEN
SIGN
–
HYPEREXTENSION
BOTH
HANDS
FOR
3
MINS
(PRAYER
SIGN)
8.
FOREARM
-‐
MOST
SUSCEPTIBLE
FRACTURE
-‐
VOLAR
MASS
FORM
BY
FLEXORS
-‐
SMITH’S
FRACTURE
9.
ELBOW
-‐
SWELLING
MORE
COMMON
EXTENSOR
SURFACE
-‐
RHEUMATOID
NODULE
–
FOUND
OLECRANON
BURSAE
AND
ULNAR
REGION
NOTE:
HUMERO-‐ULNAR
=
EXTENSION
AND
FLEXION
HUMERO-‐RADIAL
=
PRONATION
AND
SUPINATION
CUBITUS
VALGUS
=
OUTWARD
(ANGLE
LESS
THAN
170)
CUBITUS
VARUS
=
INWARD
OLECRANON
BURSITIS
=
STUDENT
MINER’S
ND
ARTHRITIS
ELBOW
=
TENNIS
2
TENDONITIS
10.
SHOULDER
WINGED
SCAPULA
-‐ SPRENGELS
SCAPULA
-‐ PARALYSIS
LONG
THORACIC
NERVE
-‐ CONGENITAL
-‐ SOMETIMES
ASSOCIATED
WITH
SHORT
WEBBLED
NECK
11.
SPINE
NODDING
AND
LIFTING
=
ATLANTO-‐OCCIPITAL
FLEXION
AND
EXTENSION
=
C3
AND
C7
LATERAL
BENDING
=
MIDCERVICAL
ROTATION
=
ATLANTO-‐AXIAL
(C1-‐C2)
CONDITIONS:
PANCOAST
-‐
SUPERIOR
PULMO
SULCUS
SYNDROME
-‐
TUMOR
PULMO
APEX,
UPPER
MEDIASTINUM
AND
SUPERIOR
THORACIC
APERTURE
+NECK
PAIN
PARESIS
OR
ATROPHY
OF
ARM
MUSCLE
MAY
OCCUR
HORNER
UNI
MIOSIS,
PTOSIS
OF
EYELIDS
-‐SWEAT
TUMOR
LUNG
APEX
OR
NECK
CERVICAL
SPONDYLOSIS
DEGENERATION
OF
NUCLEUS
PULPOSUS
CERVICAL
OSTEOARTHRITIS
WHISPLASH
RUPTURE
OF
LIGAMENTUM
NUCHAE
SUDDEN
FORCEFUL
HYPEREXTENSION
OF
NECK
WITH
HYPERFLEX
RECOIL
POST
TRAUMA
HYPERREFLEXION
OF
NECK
–
C5
PARTIAL
DISLOCATION
FROM
HYPEREXT
–
UNABLE
TO
NOD
FRACTURE
ATLAS
–
SEVER
OCCIPITAL
HEADACHE
44
THORACOLUMBAR
CONDITIONS
1. WHIPLASH
CERVICAL
–
GRADUAL
NUMBNESS
AND
TINGLING
SENSATION
THAT
GOES
DOWN
TO
THE
HAND
2. KYPHOSIS
–
FORWARD
DEFORMITY
OF
THORACIC
(HUNCHBACK)
3. SMOOTH
CURVE
4. ANGULAR
CURVE
-‐
+GIBBUS
5. LORDOSIS
–
POSTERIOR
CONCAVITY
OF
LUMBAR
SPINE,
DEEP
FURROW,
POT
BELLY
6. SCOLIOSIS
–
FEMALE
WALK
SEXY,
CONGENITAL,
PARALYSIS
BACK
OR
ABDOMINAL
MUSCLE
LOWER
EXT
1.
HIP
JOINT
AND
THIGH
TEST
FOR
HIP
LESAQUE’S
TEST
STRAIGHT
LEG
RAISING
SCIATIC
NERVE
TEST
THE
RANGE
OF
HIP
FLEXION
PATRICS
LATERAL
ROTATION
OF
THE
HIP
GRAELEN’S
PASSIVE
HYPEREXTENSION
ACTIVE
HYPEREXTENSION
ONLY
TEST
IN
PRONE
2.
KNEE
CONDITIONS
GENU
VARUM
BOW
LEG
LEGS
DEVIATE
TOWARD
MIDLINE
1. RICKETS
2. OSTEITIS
DEORMANS
3. COWBOY
AND
JOCKEY
GENU
VALGUM
KNOCKED
KNEE
LATERAL
DEVIATION
OUTWARD
GENU
RECURVATUM
KNEES
FIXED
IN
HYPEREXTENSION
WITH
LITTLE
ABILITY
TO
FLEX
ABSENSE
PATELLA
1.
Which
of
the
following
disease
manifest
a
big
hand,
big
bones
and
muscles?
a.
Gigantism
b.
Acromegaly
c.
Polydactyl
d.
Marfan
syndrome
2.
What
is
the
action
of
axiohumeral
muscle
group?
a.
Internal
rotation
of
shoulder
b.
External
rotation
of
shoulder
c.
Shrug
shoulder
at
the
back
d.
All
of
the
above
3.
What
is
the
action
of
axioscapular
muscles?
(same
choices)
4.
This
disease
is
cause
of
adenoma
in
pituitary
gland
related
to
hypothyroidism?
a.
Cretinism
b.
Ehler
danlos
syndrome
c.
mongolism
5.
The
following
are
changes
seen
in
carpal
tunnel
syndrome?
a.
Thenar
atrophy
b.
Hypothenar
atrophy
c.
Ape
hand
d.
All
of
the
above
6.
Which
of
the
following
has
a
smooth
curve
of
spine?
a.
Cancer
b.
Infectious
spondylitis
c.
Ankylosis
spondylitis
d.
Pott’s
disease
45
7.
Which
of
the
following
has
an
angular
curve
of
spine?
a.
Ostetitis
deformans
b.
Ankylosis
spondylitis
c.
Senile
osteoporosis
d.
Infectious
spondylitis
8.
Manifestation
of
Achilles
tendon
damage
.
Positive
simmond
test
.
Body
weight
is
applied
to
base
of
the
foot
because
of
plantar
flexion
.
Because
of
hyper
extension
and
dorsiflexion
.
A
and
b
only
9.
This
is
associated
with
eunochoidism
a.
Eggshell
nail
b.
Spoon
nails
c.
Long
narrow
nails
d.
Square
and
round
nails
10.
Sub
ungal
haemorrhage
is
the
cause
of
the
following
disease
except?
a.
Cardiac
disease
b.
SBE
c.
Trichinosis
d.
None
of
the
above
11.
This
line
is
associated
with
acute
severe
illnesses
–
Beau’s
Line
This
is
associated
with
renal
disease
something?haha!
forgot
exact
na
sakit
a.
Red
half
moon
b.
Blue
half
moon
c.
Onychauxis
d.
None
of
the
above
12.
Test
for
lateral
rotation
a.
Graenlen
b.
Stretching
of
legs
upward
c.
Patrick
d.
Owen
Test
for
hip
flexion
(same
choices)
13.
Type
3
pitting
edema
is?
a.
2mm
b.
4mm
c.
6mm
d.
8mm
14.
This
is
a
congenital
disease
associated
with
damage
to
long
thoracic
nerve?
–
Winged
scapula
15.
Location
of
tumor
in
pancoast
syndrome
a.
Apex
b.
Mediastinum
c.
Base
d.
A
and
b
e.
All
of
the
above
16.
Responsible
for
movement
of
neck
from
left
to
right
a.
C3-‐c7
b.
Atlanto
occipital
c.
Axial
d.
Midcervical
vertebrae
17.
Scoliosis
can
be?
a.
Paralysis
of
back
muscle
b.
Congenital
c.
1
leg
is
paralyzed
d.
A
and
b
e.
All
of
the
above
18.
Genu
recurvatum
a.
Fixed
hyperextension
b.
Fixed
flexed
c.
Congenital
d.
A
and
c
19.
Morrant
baker
cyst
is
associated
with?
–
Popliteal
artery
syndrome
20.
Genu
Valgum?
a.
Lateral
deviation
of
leg
b.
Bow
leg
c.
Cause
of
rickets
d.
.
?
21.
Genu
Varus
a.
Can
be
cause
of
occupational
b.
Paget’s
disease
c.
Can
be
cause
by
rickets
d.
All
of
the
above
22.
Associated
with
Marfan
Syndrome
a.
Long
slender
nails
b.
Arachnodactyl
c.
Claw
hand
d.
A
and
b
e.
All
of
the
above
23.
Cause
of
claw
hand
a.
Brachial
plexus
injury
b.
Syringomyelia
c.
Muscle
dystrophy
d.
All
of
the
above
24.
Nodes
found
in
DIP
is
associated
with?
a.
Osteoarthirits
b.
Systemic
rheumatic
arthritis
c.
Gout
arthritis
d.
Infectious
arthritis
25.
Combing
of
hair
is
associated
with?
a.
Internal
rotation
and
abduction
b.
External
rotation
and
abduction
c.
Internal
rotation
and
adduction
d.
External
rotation
and
adduction
26.
Movement
of
the
right
arm?
46
a.
Counter
clockwise
on
pronation
and
clockwise
on
supination
b.
Counterclockwise
on
supination
and
clockwise
on
pronation
c.
Both
are
correct
d.
None
of
the
above
27.
What
should
you
assess
when
looking
at
the
spine
sideward?
a.
Height
of
shoulder
b.
Curvature
c.
Location
of
ASIS
d.
All
of
the
above
28.
What
should
you
assess
if
you
are
looking
at
the
back
of
patient?
a.
Height
of
shoulder
b.
Dimples?
c.
ASIS
d.
All
of
the
above
30.
If
a
person
cannot
raise
greater
than
10
degrees
in
elbow
joint?
a.
Dislocation
b.
Fracture
c.
Damage
of
supraspinatus
tendon
d.
All
of
the
above
31.
Heloma
Durum
is?
a.
Hard
corn
b.
Callus
c.
Soft
corn
d.
Stiffened
toe
32.
If
there
will
be
a
fracture
in
humerus,
what
should
you
check?
a.
Brachial
artery
b.
Radial
artery
c.
Brachioradial
artery
d.
?
Medicine
Extremities
1. Dorsiflexion
–
Soleus
Tear
2. Housemaid’s
–
anterior
knee
cyst
3. To
test
range
of
hip
flexion,
nerve
irritation
and
lumbar
herniation
–
straight
leg
test
4. Test
done
to
detect
excessive
lumbar
convexity
/
lordosis
–
Hugh
Owen
Thomas
sign
5. Yellow
discoloration
in
palms
imparted
to
the
skin
by
carotene
–
carotenemia
6. Inspection
of
vertebral
column
viewed
laterally
–
AOTA,
cervical,
thoracic
,
lumbar
curve
7. True
about
lordosis
except:
-‐
posterior
convexity
of
lumbar
sign
Posterior
concavity
of
lumbar
sign
Deep
furrow
between
paraspinous
muscle
Pot
belly
8. Test
for
hip
dislocation
–
trendelenberg’s
sign
9. What
is
the
joint
that
allows
free
movement
like
knee
and
shoulder
joint
–
fibrous
Synovial
Cartilaginous
10. SITS
muscle
of
rotator
cuff
muscle
except:
-‐
supraspinatus
Infraspinatus
Teres
minor
Subscapularis
Muscle
None
11. ROM
of
ELBOW
–
extension
,
pronation
flexion,
supination
47
12. Drop
arm
definition
(bates)
-‐
if
patient
cannot
hold
arm
fully
abducted
at
shoulder
level,
possible
rotator
cuff
tear.
13. This
can
be
seen
in
osteoarthritis
-‐
heberdens
14. Bouchards
-‐
rheumatoid
arthritis
Asymmetric
deformitiesof
the
hands
and
wrists
All
15. Range
of
motion
for
the
wrist:
flexion,
extension,
abduction,
adduction
16. Hypertrophy
of
nailplates
caused
by
chronic
fungal
infection
–
onychauxis
17. Long
narrow
nail
plates
except:
cretinism
18. Pronated
wrist
drop
–
radial
nerve
palsy
19. Rotation
of
neck
–
rotation
at
c1
and
c2
20. Difference
in
shoulder
length
is
due
to
:
scoliosis
Sprengels
shoulder
A
and
b
NONE
21. View
person
from
spine
is
for
:
cervical
convexity
Thoracic
convexity
Lumbar
convexity
None
22. Matching
type:
hugh
owen
23. Stretch
sciatic
muscle
–
straight
leg
raising
24. Lateral
rotation
grip
–
patricks
test
25. Passive
hyperextension
–
graelens
test
26. Eversion
–
talipes
valgus
27. Dorsiflexion,
defect
on
neural
arch
–
talipes
calcaneus
28. Genu
varum
occur
in
–
rickettes
Pagets
Both
29. Length
of
lower
extremities
–
from
ASIS
to
medial
malleolus
30. Thumping
of
posterior
spine
–
volar
surface
of
wrist
31. Spoon
nail
–
iron
deficiency
32. Test
for
acromioclavicular
joint
–
cross
over
test
33. Bowleg
–
genu
varum
34. Bitten
nails
common
to
personality
disorder
35. Knocked
knee
–
genu
valgum
36. Onychauxis
–
chronic
fungal
infection
37. Subungal
hemorrhage
–
splinter
hemorrhage
linear
red
hemorrhage
in
nailbed
38. Square
and
round
nail
plates
–
cretinism
Unequal
Leg
Length
can
be
seen
-‐
Scoliosis,
Hip
Fracture,
Poliomyelitis
except:
Kyphosis
48
EXTREMITIES
1. Lumbar
concavity:
false
regarding
lordosis(dapat
lumbar
concavity)
2. Soleus
tear:
extreme
dorsiflexion
3. Flexion
and
extension
occur
primarily
between
the
skull
and
C1,
the
atlas;
rotation
at
C1-‐C2;
both
4. Sits
muscles:
supraspinatus,infraspinatus,teres
minor
and
subscapularis
5. In
osteoarthritis,
Heberden’s
nodes
at
DIP
joints,
Bouchard’s
nodes
at
the
PIP
joint.
In
rheumatoid
arthritis,
symmetric
deformity
in
the
PIP,MCP
and
wrist
joints
with
ulnar
deviation.
6. Wrist
movement:
flex,extend,
abduct,
adduct
7. Wrist
drop:
radial
nerve
8. Unequal
shoulder
heights
seen
in
scoliosis;:
Sprengel’s
deformity
of
the
scapula(from
the
attachment
of
an
extra
bone
or
band
between
the
upper
scapula
and
C7);
in
“winging”
of
the
scapula
(from
loss
of
innervations
of
the
serratus
anterior
muscle
by
the
long
thoracic
nerve);
and
in
contralateral
weakness
of
the
trapezius
9. Anterior
knee
cyst:
prepatellar(housemaid’s
knee)
and
infrapatellar(clergyman’s
knee)
10. Genu
varum:
legs
deviate
towards
the
midline
11. Long
narrow
nails:
all
except
cretinism(included:
Marfan’s,
eunochoidism,
hypopituitarism)
12. Palmar
erythema:
except
hemolytic
anemia(included:
pregnancy,
portal
HPN,
vulvar
heart
dse)
13. Motion
of
elbow:
supination,
pronation,
flexion,
extension
14. Thomas
sign:
test
for
lumbar
lordosis
15. Lesaque’s
test
16. Synovial:
freely
movable(knee,
shoulder)
17. Scoliosis,
kyphosis,
hip
fracture
18. You
may
wish
to
percuss
the
spine
for
tenderness
by
thumping,
but
not
too
roughly
with
your
fist
19. Patrick’s
test
20. Dorsiflexion:
either
ankle
motion
or
talipes
calcaneus
21. Housemaid’s:
anterior
knee
cyst
22. To
test
range
of
hip
flexion,
nerve
irritation,
and
lumbar
herniation:
straight
leg
test
23. Test
done
to
detect
excessive
lumbar
convexity/lordosis:
Hugh
owen
Thomas
sign
24. Yellow
discoloration
in
palms
imparted
to
the
skin
by
carotene:
carotenemia
25. Inspection
of
vertebral
column
viewed
laterally:
49
AOTA,
cervical,
thoracic,
lumbar
curve
26. True
about
lordosis
except:
posterior
convexity
of
lumbar
sign,
post
concavity
of
lumbar
sign,
deep
furrow
between
paraspinous
muscle,
pot
belly
27. Test
for
hip
dislocation:
trendelenberg’s
sign
28. What
is
the
joint
that
allows
free
movt
like
knee
and
shoulder
joint:
fibrous,
synovial,
cartilaginous
29. SITS
muscle
of
the
rotator
cuff
muscle:
supraspinatus,
infraspinatus,
teres
minor,
none
30. ROM
of
elbow:
extension,
pronation,
flexion,
supination
31. Drop
arm
definition(BATES)
32. This
can
be
seen
in
osteoarthritis:
heberden’s,
bouchard’s,
asymmetric
deformities
of
the
hands
and
wrists,
all
33. Range
of
motion
of
the
wrist:
flexion,
extension,
abduction,
adduction
34. Hypertrophy
of
the
nail
plates
caused
by
fungal
infection:
onychauxis
35. Pronated
wrist
drop:
radial
nerve
palsy
36. Rotation
of
the
neck:
rotation
at
c1
and
c2
37. Difference
in
shoulder
length
is
due
to:
scoliosis,
sprengel’s
shoulder,
a
and
b,
none
38. Long
narrow
nail
plates
except:
Cretinism
39. View
person
for
spine
is
for:
cervical
convexity,
thoracic
convexity,
lumbar
convexity,
none
40. Matching
type:
hugh
owen
41. Stretch
sciatic
nerve:
straight
leg
raising
42. Lateral
roattion
grip:
Patrick’s
test
43. Passive
hyperextension:
graenlen’s
test
44. Eversion:
talipes
valgus
45. Dorsiflexion,
defect
on
neural
arch:
talipes
calcaneus
46. Genu
varum
occurs
in:
rickettes,
paget’s,
both
47. Length
of
the
lower
extremities:
from
ASIS
to
medial
malleolus
48. Thumping
of
posterior
spine:
volar
surface
of
wrist
49. Spoon
nail:
iron
deficiency
50. Test
for
acromioclavicular
joint:
cross
over
test
50
51. Bowleg:
genu
varum
52. Bitten
nails
common
to:
personality
disorder
53. Knocked
knee:
genu
valgum
54. Onychauxis:
chronic
fungal
infection
55. Subungal
hemorrhage:
splinter
hemorrhage
linear
red
hemorrhage
56. Square
and
round
nailplates:
cretinism
57. Dorsiflexion:
either
ankle
motion
or
talipes
calcaneus
58. Test
done
to
detect
excessive
lumbar
convexity/lordosis:
hugh
owen
Thomas
sign
59. True
about
lordosis
except:
posterior
convexity
of
lumbar
sign
60. Test
for
hip
dislocation:
trendelenberg’s
sign
61. Joint
that
allows
free
movement
like
knee
and
shoulder
joint:
synovial
joint
62. ROM
of
elbow:
extension,
pronation,
flexion,
supnation
63. Rotaion
of
neck:
rotation
at
c1
and
c2
64. Difference
in
shoulder
length:
scloiosis,
sprengel’s
shoulder
65. Lateral
rotation:
patrick’s
test
66. Passive
hyperextension:
graenlen’s
test
67. Eversion:
talipes
valgus
68. Stretch
sciatic
nerve:
straight
leg
test
51
1. One
of
the
following
regarding
examination
of
spine
is
incorrect
a. From
the
side
inspect
the
spinal
profile
b. From
behind
inspect
lateral
curves
c. Percuss
the
spine
with
a
neurological
hammer
d. Inspect
and
palpate
paravertebral
muscles
2. Conditions
that
impair
range
of
motion
of
fingers
and
wrist
are:
a. Arthritis
b. Tenosynovitis
c. Fibrous
in
the
palmar
fascia
d. AOTA
e. A
&
B
3. All
of
the
following
are
associated
with
Marfan’s
syndrome
Except:
a. Thumb
sign
b. Hyperextensible
joints
c. Hypertrophic
osteoarthropathy
d. Elongated
long
bones
4. The
following
statements
about
carpal
tunnel
syndrome
are
correct
Except:
a. There
is
atrophy
of
the
radial
half
of
thenar
eminence
b. Pain
especially
at
night
is
experience
c. Weakness
and
loss
of
finer
movements
is
not
common
on
this
disease
d. Trauma
from
excessive
flexion
of
the
wrist
is
common
cause
5. Which
of
the
following
statements
is
associated
with
clawhand:
a. Claw
is
formed
by
hyperextension
of
the
interphalangeal
joint
b. The
condition
maybe
secondary
to
Rheumatoid
arthritis
c. Brachial
plexus
injury
is
one
of
the
possible
cause
d. AOTA
6. Ruptured
Achilles
tendon
is
manifested
by:
a. pain
at
the
heel
b. inability
to
plantar
flex
the
foot
c. inability
to
dorsiflex
the
foot
d. shortening
of
the
tendon
7. Pain
on
elevation
of
the
arm
60-‐120
degrees
is
due
to:
a. Chronic
tendinitis
b. Partial
rupture
of
of
supraspinatous
tendon
c. Dislocation
d. Complete
fracture
8. One
of
the
following
is
a
cause
of
kyphosis
in
post
menopausal
a. Osteoporosis
b. Faulty
posture
c. Osteitis
deformans
d. Ankylosing
spondylitis
9. Gibbus
deformity
maybe
secondary
to:
a. Pagets
dse
b. Hypercalcemia
c. Metastatic
carcinoma
d. Cervical
spondylosis
10. Internal
rotation
of
the
shoulder
joint
is
tested
by:
a. Raising
both
arms
to
a
vertical
position
52
b. Putting
both
hands
behind
the
small
___
of
the
back
c. Putting
both
hands
behind
the
neck
d. NOTA
st
11. Among
the
tests
of
the
hip
joint
the
most
gentle
test
that
should
be
done
1
is:
a. Anvil
test
b. Active
hyperextension
c. Graenlen’s
test
d. Rotation
of
the
thigh
12. Deviation
of
the
legs
toward
the
midline
,
leads
to
condition
called:
a. Genu
valgum
b. Bowlegs
c. Knock
knee
d. Genu
recurvatum
13. Popliteal
artery
entrapment
syndrome
maybe
secondary
to:
a. Prepatellar
bursitis
b. Popliteal
abscess
c. Clergyman’s
knee
d. NOTA
14. The
landmarks
of
the
shoulder
joint
are:
a. Coracoid
process,
medial
epicondyle
and
greater
tuberosity
b. Acromion,
coracoid
process,
greater
tuberosity
of
humerus
c. Greater
tuberosity,
lateral
epicondyle,
clavicle
d. NOTA
15. Excessive
transverse
growth
of
the
nail
plate
causing
the
lateral
edge
to
lacerate
a. Onychauxis
b. Onychocryptosis
c. Ram’s
horn
nail
d. onychogryphosis
53
1. Rheumatoid
Arthritis
Answer Key
2. Acromegaly
3. Mongolism
C
A
4. Palmar
Erythema
P
5. Phalen’s
Sign/
Tinel’s
Sign
J
M
6. Trendelenberg
test/
Anvil
test
H
B
7. Lesaque’s
sign
I
8. Hugh
Owen
Thomas
Sign
D
L
9. Patrick’s
test
E
10. Winged
Scapula
N
Q
11. Talipes
Equinus
G
12. Talipes
Varus
K
13. Eggshell
nails
14. Carotenoderma
15. Thumb
sign/
Wrist
Sign
A. Pituitary
tumor
B. Straight
Leg
Raising
C. PIPJ
D. Lateral
Rotation
of
hip
E. Toe
wear
of
shoes
F. Short
fat
hand
G. Yellow
vegetables
H. Hip
dislocation
I. Flexure
contracture
of
hip
joint
J. Liver
Cirrhosis
K. Arachnodactyly
L. Sprengels
deformity
Median
Nerve
M. Median
nerve
N. Lateral
wear
of
shoes
O. Active
hyperextension
P. Little
finger
is
curved
Q. Vitamin
A
deficiency
54
1. Rheumatoid
Arrthritis/
Haygarth’s
Node
Answer Key
2. Acromicria
B
3. Mongolism
E
A
4. Palmar
Erythema
L
I
5. Tinel’s
Sign
J
6. Simmond’s
test
G
F
7. Lesaques
sign
C
8. Hugh
Owen
Thomas
test
K
H
9. Graenlen’s
test
N
10. Azure
Half
moon
D
O
11. Whiplash
Injusry
P
12. Nodding
and
lifting
the
head
13. Fracture
of
humeral
back
14. Winged
scapula
15. Olecranon
Bursitis
A. Little
finger
is
curved
B. PIPJ
C. Passive
hyperextension
shoulder
pain
small
hand
D. Flexion
contracture,
hip
joint
E. Straight
leg
raising
F. Ruptured
ligamentum
nuchae
G. Median
nerve
H. Achilles
tendon
I. Hepatolenticular
regeneration
J. Cirrhosis
K. Short
thick
hands
L. Atlanto
occipital
joint
M. Paralysis
long
thoracic
nerve
N. Miner’s
elbow
O. Atlanto
axial
joint
55
EXTREMITIES
1.
Popliteal
artery
entrapment
syndrome
maybe
due
to:
A.Housemaid’s
cyst
B.
Infrapatellar
cyst
C.
Popliteal
abcess
D.
Large
Baker’s
cyst
2.
Splinter
hemorrhage
in
nailbeds
is
suggestive
of:
A..SubAcute
bacterial
endocarditis
B.
Anemia
C.
Hepatolenticular
degeneration
D.
Iron
deficiency
3.
Congenital
small
patella
A.Genu
Varum
B.
Genu
Recurvatum
C.
Genu
Valgus
D.
Degenerative
osteoarthritis
4.
The
thumb
is
held
in
extension
by
its
inability
to
flex
A.Ape
hand
B.Claw
hand
C.Wrist
drop
D.
Benediction
Hand
5.
In
performing
the
ROM
of
the
spine
the
examiner
should
assist
the
elderly
patient
by
A.Holding
one
hand
of
the
patient
B.Asking
him
to
be
careful
C.Asking
him
to
hold
Hand
Rails
D.Stabilizing
the
pelvis
by
holding
the
pelvis
of
the
patient
while
patient
performs
ROM
6.
Lesion
of
the
Ulnar
Nerve
leads
to:
A.Wrist
drop
B.
Claw
hand
C.
Hypothenar
atrophy
D.
Palmar
Erythema
7.
As
the
examiner
positions
himself
behind
the
patient,
he
does
the
ff:
A.Inspect
for
lateral
curves
B.
Locate
the
dimples
of
venus
C.
Take
note
of
the
height
of
shoulders
and
iliac
crest
D.Inspect
cervical,
thoracic
and
lumbar
curves
8.
When
looking
for
rheumatic
nodules
the
most
likely
area
to
look
is:
A.Medial
Epicondyle
B.
Extensor
surface
near
olecranon
process
C.Knee
Joint
D.
Lateral
Epicondyle
9.
The
paravertebral
muscles
are
evaluated
by:
A.Inspection
for
fasiculations
B.
Ascultation
for
crepitus
C.
Palpate
for
tenderness
and
spasm
D.All
are
correct
10.
Motions
of
the
forearm:
A.Pronation
&
Supination
B.
Flexion
&
Extension
C.
Both
D.
Neither
11.
The
popular
theory
as
to
the
cause
of
clubbing
of
the
finger
is/are:
A.Floating
nail
B.-‐20
degress
angulation
of
the
nail
C.hypozia
D.
All
12.
Haygarth’s
Node
except
A.Distal
Interphalangeal
joint
B.
Rheumatoid
arthritis
C.Prodromal
Interphalengeal
joint
D.
Metacarphophalengeal
gout
13.
A
casue
of
kyphosis
in
young
males
due
to
painful
disease
of
the
spine
is
A.Paget’s
Disease
B.
Osteoporosis
C.
Faulty
posture
D.Ankylosis
spondylitis
14.
Legs
are
outwardly
deviated:
A.Genu
recurvatum
B.
Genu
varus
C.
Genu
valgum
D.
Osteoarthritis
Knee
15.
Nodding
and
lifting
the
head
involves:
A.Midcervical
Vertebra
B.
C3-‐C7
C.
Atlantooccipital
joint
D.
Atlantoaxial
joint
16.
Conditions
that
impair
range
of
motion
of
the
hands
and
wrists
because
of
scarring
A.Arthritis
B.Dupuytren’s
Contracture
C.
Tendenitis
D.
ALL
17.
Carpal
Tunnel
Syndrome:
st nd rd th
A.Numbers
if
the
Small
&
Ring
fingers
B.
Numbness
of
the
1 ,
2
,3
&
4
fingers
C.
Wrist
drop
D.ALL
18.
Ruptures
ligamentum
nuchae
A.C5
fracture
B.
Cervical
Spondylosis
C.
C1
fracture
D.
whiplash
cervical
injury
19.
A
line
drawn
across
the
iliac
spine
approximates
the
nd th th st
A.2
lumbar
vertebra
B.4
lumbar
vertebra
C.7
thoracic
vertebra
D.1
lumbar
Vertebra
20.
Absence
of
plantar
flexion
A.Tibial
Fracture
B.Ruptured
tendon
od
Achilles
C.
Ruptured
Baker’s
cyst
D.
Soleus
tear
56
CHEST,
LUNGS,
BOOBS
Medicine
I
nd
Midterms
2
Semester
(February,
2013)
1. Acute
onset
but
chronic
progressive.
-‐ SMOKING
2. Which
is
likely
the
mechanism
of
cough
among
patients
with
heart
failure?
-‐ DECREASED
LUNG
COMPLIANCE
3. Which
is
likely
the
mechanism
of
cough
among
patients
with
heart
failure?
a. Pressure
in
the
airway
b. Decreased
lung
compliance
c. Inflammation
of
the
airway
d. Thermal
change
4. 50
y.o.
patient
male
with
>
5
months
cough.
He
cough
when
he
lays
down
wearing
tight
clothes.
It
is
productive
with
watery
whitish
sputum.
a. Congestive
heart
failure
b. Gastroesophageal
regurgitation
c. Bronchiectasis
d. Intestinal
fibrosis
5. 45
year
old
male
has
cough
for
3
months
now
and
claims
to
clear
his
throat
every
morning
a. Smoking
b. Post
Nasal
Drip
8. A
62
years
old
female
was
found
unconscious
and
at
the
ER
she
was
noted
with
very
fast
and
deep
breathing
with
fruity
breath.
Her
pattern
of
breathing
is:
a. Biot’s
respiration
b. Tachypnea
c. Kassmaul’s
respiration
d. Hyperpnea
9. 17
yo
female
consulted
at
the
ER
because
of
high
grade
fever
w/o
other
symptoms.
She
is
observed
w/
abnormal
respiration.
Her
abnormal
respiration
expected
to
be:
a. Tachypnea
b. Platypnea
c. Hyperpnea
d. Kussmaul’s
10.
An
IV
drug
user
presents
to
ER
due
to
hemoptysis
and
DOB
but
denies
any
fever
and
cough.
What
is
the
most
common
cause
of
hemoptysis?
a. PTB
b. Lung
Abscess
c. Pneumonia
d. Vasculitis
12. Kussmaul’s
respiration
is
heard
among
patient
with:
a. Meningitis
b. Ascites
c. CVD
d. Renal
failure
13. 38
y/o
female,
rushed
to
ER
because
of
severe
retrosternal
pain,
relieved
by
nitroglycerine;
pain
occurs
when
cold
substance
ingested.
a. Angina
b. Trachitis
c. Esophagitis
d. Esophageal
spasm
14. Acute
onset
of
Difficulty
of
Breathing
precipitated
by
valsalva
maneuver
a. Pulmonary
edema
b. Rupture
of
aortic
aneurism
57
c. Pneumothorax
d. Pulmonary
emboli
15. Most
common
cause
of
hemoptysis
-‐ Bronchiectasis
16. Patient
with
heart
failure
-‐ Orthopnea
17. Dry
cough
and
unilateral
effusion
-‐ Trepopnea
18. Pneumococoniosis
is
due
to
exposure
to:
a. Silica
b. Coal
c. Asbestos
d. Silver
19. Bagasse
-‐ Sugar
cane
20. Primary
malignancy
-‐ Silica
21. Psittacosis
-‐ Parrot
22. Lagging
of
one
side
of
the
chest
is
best
identified
by:
-‐ Palpation
24. Where
is
the
landmark
for
the
posterior
rib?
a. C7
b. T1
c. Superior
scapular
line
d. Inferior
scapular
line
26. Referenced
used
in
identifying
posterior
ribs
a. C7
b. T1
c. Superior
scapular
line
d. Inferior
scapular
line
27. Tactile
fremitus
is
usually
decreased
with:
a. Atelactasis
b. Emphysema
c. Bronchitis
d. Pneumonia
29. Stridor
-‐ Epiglottis
31. Normal
breath
sound
heard
in
intrascapular
area
a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal
33. Sounds
of
secreations
produce
on
bronchi?
a. Stridor
b. Rhonchi
c. Rales
d. Wheezes
34. Bilateral
hyperresonance
a. Tension
pneumothorax
b. Pneumomediastinum
c. Chronic
bronchitis
d. Emphysema
58
35. Findings
on
the
exam
of
the
anterior
chest
would
mostly
involved
which
of
the
following:
a. Upper
lobe
b. Middle
lobe
c. Lower
lobe
d. A
&
B
36. Shorter
I:E
ratio
a. Metabolic
acidosis
b. Bronchitis
c. Pleurisy
d. Fever
37. Describe
the
type
of
breathing
for
patient
with
heart
failure:
a. Cheyne-‐stokes
b. Biot
c. Kusmail
d. Apneustic
38. Fremitus
is
decreased
a. Pneumonia
b. Obesity
c. Pleural
effusion
d. Atelectasis
40. Early
inspiratory
crackles
is
heard
at:
a. Interstitial
lung
disease
b. Pneumonia
c. CHF
d. Chronic
bronchitis
41. Breast
extends
from?
nd th
-‐ 2
to
6
ICS
42. Most
frequently
palpable
lymph
node
in
Breast
Ca:
-‐ Central
Lymph
Node
43. Mastitis
-‐ Lactation
44. Dividing
into
quadrants
is
toL
a. Clinical
finding
b. Staging
46. Seen
in
acute
onset
and
chronic
progressive
DOB:
a. Bronchiectasis
b. Asthma
c. Pneumonia
d. Anemia
47. Orange
peel
in
breast
cancer:
a. Protrusion
of
mass
b. Lymphatic
abscess
c. Venous
abscess
d. Increased
blood
flow
Q:
Mediastinal
mass
cough,
described
as
signs
of
respiratory
distress,
except:
Q:
Diaphragmatic
excursion
except:
a. Atelectasis
b. Pneumonia
c. Pneumothorax
d. Pleural
effusion
Q:
A
35
y/o
consulted
for
fear
of
breast
cancer.
Her
sister
died
of
breast
cancer
at
23
y/o.
What
is
the
risk?
59
a. >40
b. 2.1-‐4
c. 1.1-‐2
d. None
Q:
Suggestive
of
barky
cough
Q:
Brassy
cough
A:
Emphysema
Q:
Brassy
A:
Trachea
Q:
Barky
A:
Glottis
Q:
Pink
puffer
A:
Emphysema
Q:
Mastitis
A:
Lactation
Q:
Man
can’t
keep
up
with
friend
at
same
age
A:
Grade
2
Q:
Occupational
asthma
common
among
workers
exposed
to
which
of
the
following
dust:
a. Asbestos
b. Coal
c. Cotton
dust
d. Silicon
Q:
Pneumocosis
A:
Coal
Q:
Heart
Failure
A:
Orthopnea
Q:
Apex
above
clavicle
A:
2-‐4cm
Q:
COPD
A:
10x
Q:
Lung
cancer
in
women
A:
13x
Q:
Basilan
A:
Paragoniasis
Q:
Rusty
color
of
sputum
A:
S.
pneumonia
Q:
Pursed
lip
A:
Emphysema
60
Q:
Crescendo=decrescendo
with
apnea
A:
Cheyne
strokes
Q:
Afferent
limb
A:
IX
Q:
Decreased
or
low
fremitus
A:
Thick
chest
wall
Q:
Soft
and
low
A:
Vesicular
Q:
Early
inspiratory
crackles
A:
Chronic
bronchitis
Q:
Most
common
palpable
lymph
node
of
breast
cancer
A:
Central
Node
Q:
High
(4x)
breast
density
A:
Highest
to
relative
risk
for
breast
cancer
Q:
Modifiable
risk
for
breast
cancer
A:
Obesity
Q:
Chronic
cough
A:
2
months
Q:
Cough
complication
A:
Pneumothorax
Q:
IE
ration
is
decreased
in
fever
A:
Chronic
bronchitis
Q:
Chest
pain
associated
with
chest
tenderness
pathology
of
A:
Chest
wall
Q:
Pursed
lip
breathing
is
manifested
by
patients
with:
a. Bronchiectasis
b. Asthma
c. Emphysema
d. Pneumonia
Q:
Pink
puffer
also
known
as
a. Asthma
b. Emphysema
c. Chronic
bronchitis
Q:
Below
are
hereditary
diseases
except
a. HPN
b. Leprosy
c. Heart
Disease
d. DM
61
BREAST
1. Intraductal
Papilloma
>
SPONTANEOUS
UNILATERAL
BLODDY
DISHARGE
FROM
ONE/TWO
WARANTS
FURTHER
EVALUATION
2. 1.1–
2.0
>
OBESITY,
LATE
AGE
ETC.
3. Surface
of
Areola
>
SMALL,
ROUNDED
ELEVATION
FORMED
BY
SEBACCEOUS
GLANDS
,
SWEAT
GLANDS
&
ACCESSORY
AREOLAR
GLANDS
4. Tail
of
Spence
>
EXTENDS
ACROSS
THE
ANTERIOR
AXILLARY
FOLD
5. Female
Breast
ND TH
>
CLAVICLE,
2
RIB
DOWN
TO
THE
6
RIB
AND
FROM
THE
STERNUM
ACROSS
TO
THE
MIDAXILLARY
LINE
Recall
–
Clinical
Medicine
“Chest
and
Lungs”
(Dec.
17,
2012)
1.
During
cough,
the
speed
of
airflow
in
the
airway
is
as
fast
as
the
speed
of:
a.
Light
c.
Airplane
b.
Sound
d.
Lightning
2.
What
is
etiology
of
cough
in
pleural
effusion?
a.
Inflammation
c.
Decrease
pulmonary
compliance
b.
Mechanical
irritation
d.
Chemical/thermal
3.
18
y.o.
female
with
acute
onset
of
cough
associated
with
runny
nose,
sore
eyes,
and
chest
discomfort.
What
condition?
a.
Pneumonia
c.
Mycoplasm
pneumonia
b.
Acute
bronchitis
d.
Tracheobronchitis
4.
Chronic
cough,
sputum
purulent,
often
copious
and
foul-‐smelling
a.
Bronchiectasis
c.
Obstructive
pneumonia
b.
Chronic
bronchitis
d.
PTB
5.
Cause
of
brassy
cough
a.
Glottis
c.
Bronchiole
b.
Trachea
d.
Lung
parenchyma
6.
Patient
with
which
of
the
following
lung
problem
would
present
with
sudden
onset
of
difficulty
of
breathing
preceded
by
pleuritic
chest
pain?
a.
Pulmonary
edema
c.
Pulmonary
emboli
b.
Pneumothorax
d.
Pulmonary
hemorrhage
7.
Sudden
onset
of
difficulty
of
breathing
precipitated
by
exposure
to
grass
pollen
a.
Asthma
c.
Pneumonia
b.
COPD
d.
Hypersensitive
Pneumonitis
8.
Alpha
I
antitrypsin
increase
risk:
a.
Asthma
c.
Chronic
bronchitis
b.
Cystic
fibrosis
d.
Emphysema
9.
49
y.o.
DB,
he
has
DOB
for
3
years.
Lately,
he
can’t
keep
up
with
his
friends
of
the
same
age.
What
is
the
grade
or
American
Thoracic
Dyspnea
Scale?
a.
Grade
1
c.
Grade
3
b.
Grade
2
d.
Grade
4
62
10.
Considered
as
the
most
common
cause
of
hemoptysis?
a.
Pneumonia
c.
Bronchiectasis
(not
sure)
b.
PTB
d.
Lung
CA
11.
Lung
parenchyma,
common
cause
of
hemoptysis?
a.
Bronchiectasis
c.
Bronchogenic
CA
(not
sure)
b.
Good
pasteur’s
syndrome
d.
Cystic
fibrosis
12.
Squeezing
retrosternal
pain
felt
after
ingestion
of
cold
liquid
and
relieved
by
nitroglycerin
is
felt
in?
a.
Heart
c.
Chest
Wall
b.
GIT
d.
13.
40
y.o.
female
with
rheumatoid
arthritis
of
more
than
15
years
now
and
taking
methotrexate.
Started
to
have
cough
and
difficulty
of
breathing
2
years
ago.
What
respiratory
disease
is
the
most
likely
the
cause?
a.
Non-‐cardiogenic
pulmonary
edema
c.
Pulmonary
vasculitis
b.
Pulmonary
emboli
d.
Interstitial
infiltrative
disease
14.
Which
of
the
following
occupational
inorganic
substances
will
cause
pneumoconiosis?
a.
Bagasse
c.
Coal
b.
Asbestos
d.
Silica
15.
Exposure
to
which
of
the
following
dusts
increases
the
risk
of
lung
cancer?
a.
Bagasse
c.
Coal
b.
Tin
oxide
d.
Silica
16.
Cigarette
smoking
increases
risk
of
COPD
mortality
by:
a.
2.3x
c.
10x
b.
4x
d.
13x
17.
Smoking
increases
lung
cancer
mortality
in
men
by:
a.
4x
c.
20x
b.
6x
d.
23x
18.
Alcoholics
have
higher
risk
of
getting
pneumonia
and
they
are
more
prone
to
develop:
a.
Aspiration
pneumonia
c.
Pneumonia
due
to
tularemia
b.
Psittacosis
d.
Pneumocystic
pneumonia
19.To
decrease
tension
pneumothorax
where
will
you
insert
the
big
bore
needle:
nd th
a.
2
ICS
MCL
(Mid
Clavicular
Line)
c.
6
ICS
AAL
(Anterior
Axillary
Line)
th th
b.
4
ICS
MAL
(Mid
Axillary
Line)
d.
8
ICS
MAL
20.
Which
of
the
following
vertebrae
has
the
most
prominent
spinous
process
a.
C6
c.
T1
b.
C7
d.
21.
Needle
insertion
of
thoracocentesis
nd th
a.
2
ICS
c.
6
ICS
th th
b.
4
ICS
d.
8
ICS
22.
The
apex
of
the
lungs
is
extended
above
the
inner
1/3
of
the
clavicle
by
as
much
as:
a.
1-‐3cm
c.
3-‐5cm
b.
2-‐4cm
d.
4-‐6cm
23.
Diaphragmatic
excursion
from
resting
to
full
inspiration
is
at:
a.
1-‐3cm
c.
5-‐6cm
63
b.
3-‐5cm
d.
6-‐7cm
24.
Bifurcation
of
trachea
at:
nd
a.
Manubrium
c.
2
ICS
rd
b.
Sternal
Angle
d.
3
Rib
25.
Pursed
lip
breathing
a.
Emphysema
c.
Asthma
b.
d.
26.
Blue
bloater
a.
Chronic
bronchitis
c.
Bronchiectasis
b.
Emphysema
d.
27.
Ribs
angle
is
usually
more
horizontal
compared
to
normal
individual
if
patient
have
which
of
the
following
problem:
a.
Pneumonia
c.
Pneumothorax
b.
COPD
d.
Mild
Asthma
28.
Normal
angle
of
the
rib:
a.
35
degrees
c.
45
degrees
b.
40
degrees
d.
50
degrees
29.
Narrowing
of
ICS
may
cause
shift
to
the
chest
to
the
one
side:
a.
Massive
effusion
c.
Disc
atelectasis
b.
Severe
pneumonia
d.
Obstruction
of
main
bronchus
30.
Unilateral
widening
and
even
bulging
of
ICS
is
suggestive
of:
a.
Massive
effusion
c.
Large
lung
mass
b.
Severe
pneumonia
d.
Pneumothorax
31.
IE
ratio
in
emphysematous
patient:
a.
1:2
c.
1:4
b.
1:3
(not
sure)
d.
1:5
32.
Which
among
the
following
abnormal
respiratory
rhythm
is
seen
in
the
lesion
of
the
PONS?
a.
Cheyne
stroke
c.
Kussmaul
b.
Biot’s
d.
Apneustic
33.
Diabetic
Ketoacidosis:
a.
Cheyne
stroke
c.
Kussmaul
b.
Biot’s
d.
Apneustic
34.
Type
of
respiration
associated
with
morphine
overdose:
a.
Cheyne
stroke
c.
Kussmaul
b.
Biot’s
d.
Apneustic
35.
Clubbing
of
fingers
are
seen
in
this
pathologic,
except:
a.
Bronchiectasis
c.
Mesothelioma
(not
sure)
b.
COPD
d.
Pulmonary
fibrosis
36.
37.
Which
of
the
following
breath
sounds
have
intermediate
pitch
and
loudness?
a.
Tracheal
c.
Broncho-‐vesicular
b.
Bronchial
d.
Vesicular
64
38.
Which
of
the
following
breath
sounds
has
loud
and
high
pitched
sound?
a.
Tracheal
c.
Broncho-‐vesicular
b.
Bronchial
d.
Vesicular
39.
40.
Mid
inspiratory
&
expiratory
crackles
usually
heard
in
patients
with:
a.
Bronchiectasis
41.
Normally
breast
tissue
extend
from
the
sternum
to:
a.
AAL
c.
PAL
b.
MAL
d.
Between
AAL
&
MAL
42.
Rounded
elevations
seen
in
the
areola
is
caused
by
the
following
except:
a.
Sebacceous
glands
c.
Accessory
glands
b.
Sweat
glands
d.
Fat
globule
43.
Fibroadenoma
of
the
breast
is
a
common
cause
of
breast
mass
among
female
aging:
a.
15-‐20
y.o.
c.
50-‐65
y.o.
b.
25-‐50
y.o.
d.
>65
y.o.
44.
40
y.o.
nullipara,
married,
no
family
history
of
breast
CA,
what
is
the
risk
factor?
a.
>4
c.
1.1-‐2.0
(not
sure)
b.
1-‐4
d.
45.
Which
of
the
following
can
decrease
the
risk
of
breast
CA?
a.
Use
of
contraceptive
c.
Breast
feeding
b.
Late
pregnancy
d.
Post
menopausal
46.
MRI
of
the
breast
is
recommended
for
the
following
except:
a.
Older
woman
c.
High
risk
group
b.
Newly
diagnosed
breast
CA
d.
Women
with
dense
breast
47.
Galactorrhea
may
be
seen
in
patient
with
a.
Herpes
zoster
c.
Ovarian
CA
b.
Pituitary
adenoma
d.
48.
Benign
condition
of
breast
may
cause
bloody
breast
discharge
a.
Adenofibrosarcoma
c.
Fibroadenoma
b.
Intraductal
papilloma
d.
Neurosarcoma
49.
Breast
malignancy
is
most
likely
to
have
if
breast
tumor
is
about:
a.
2cm
c.
4cm
b.
3cm
d.
5cm
(not
sure)
50.
Breast
malignancy
is
highly
considered
if
the
patient
have
a.
Smooth
border
c.
Palpable
mass
b.
Wall
delineated
d.
Immobile
65
CARDIOLOGY
Areas
of
Auscultation
nd
a. 2
ICS
LSB
nd
b. 2
ICS
RSB
c. Erb’s
Point
th
d. 4
ICS
LSB
th
e. 5
ICS
LMCL
nd
36.
Pulmonary
Stenosis
–
2
ICS
LSB
th
37.
Mitral
Stenosis
–
5
ICS
LMCL
nd
38.
Opening
Snap
–
2
ICS
LSB
th
39.
Mitral
valve
prolapse
–
5
ICS
LMCL
nd
40.
PDA
–
2
ICS
LSB
nd
41.
Aortic
stenosis
–
2
ICS
RSB
th
42.
S3
&
S4
–
5
ICS
LMCL
th
43.
Mitral
regurgitation
–
5
ICS
LMCL
nd
44.
Splitting
of
S2
–
2
ICS
LSB
th
45.
Tricuspid
regurgitation
–
4
ICS
LSB
Clinical
Medicine:
CVS
exam
1
to
5
choices:
a.
concentric
d.
RVH
b.
eccentric
e.
LVH
c.
LV
dilatation
1.
Not
palpable
in
PE
2.
Forceful
apical
beat
but
not
displaced
3.
Markedly
displaced
at
the
left
axillary
line,
hardly
palpable
th th
4.
Displaced
to
axillary
line
5
or
6
ICS
anterior
axillary
line
5.
Palpable
parasternally
but
retract
in
systole
6
to
20
choices:
nd th
a.
2
Left
ICS
d.
4
ICS
PS
nd th
b.
2
Right
ICS
e.
5
ICS
MCL
c.
Erb’s
point
D
6.
Pulmonic
stenosis
C
7.
VSD
D
8.
ASD
A
9.
PDA
10.
11.
Aortic
valve
regurgitation
E
12.
Mitral
valve
regurgitation
D
13.
Mitral
prolapse
B
14.
Aortic
stenosis
E
15.
Mitral
stenosis
E
16.
Loud
S1
A
17.
Opening
snap
66
A
18.
Loud
P2
D
19.
Hypertrophic
cardiomyopathy
E
20.
LV
hypertrophy
Multiple
choice
ito
na
super
haba,
eto
yung
summary
21.
Mitral
stenosis
–
diastolic
rumbling
22.
Aortic
stenosis
–
transmitted
to
the
carotid
23.
Aortic
regurgitation
–
Diastolic
rumbling
murmur
24.
VSD
–
pansystolic
25
to
30
choices:
a.
Caravallo’s
sign
d.
Gallavardin’s
b.
Kussmauls
e.
Austin-‐Flint
c.
(+)
Hepatojugular
f.
Machinery-‐like
D
25.
Aortic
stenosis
A
26.
Tricuspid
regurgitation
F
27.
PDA
E
28.
Chronic
aortic
regurgitation
C
29.
CHF
B
30.
Constrictive
pericarditis
31
to
35
choices:
a.
Loud
P2
d.
Opening
snap
b.
Loud
A2
e.
Ejection
Click
c.
Non-‐ejection
sound
D
31.
Mitral
stenosis
C
32.
Mitral
valve
prolapse
33.
Constrictive
pericarditis
A
34.
Pulmonary
hypertension
B
35.
Chronic
uncontrolled
hypertension
36
to
40
choices:
a.
Paradoxical
b.
Wide
c.
Loud
d.
Negative
hepatojugular
reflex
36.
Mitral
stenosis
37.
Hypertensive
urgency
38.
Pulmonary
hypertension
A
39.
Severe
aortic
stenosis
40.
Pulmonary
hypertension
67
41
to
45
choices:
a.
Pulsus
parvus
et
tardus
b.
Corrigan
pulse
c.
Pulsus
bisferiens
d.
Hepatojugular
e.
Neck
vein
distention
at
60˚
D
41.
Normal
PE
finding
E
42.
Pulmonary
edema
A
43.
Aortic
stenosis
C
44.
Combined
aortic
regurgitation
and
aortic
stenosis
45.
Chronic
aortic
regurgitation
46
to
50
choices:
a.
Ejection
systolic
murmur
best
heard
at
b.
Persistent
splitting
c.
Diastolic
murmur
d.
Rumbling
e.
Blowing
46.
A
47.
Aortic
stenosis
D
48.
Mitral
stenosis
49.Aortic
regurgitation
50.
Pulmonic
stenosis
CVS
A.Concentric
B.
RVH
C.
Kussmaul
Sign
D.
+Hepatojugular
Reflex
E.
LV
Dilatation
68
1.
52
year
old
female
known
to
be
diabetic
and
hypertensive
patient
admitted
because
of
severe
dyspnea
(Orthopnea),
cardiomegaly
and
bilateral
basal
crackles.
Neck
vein
is
visible
and
become
more
distended
upon
application
of
pressure
in
the
liver
2.
27
year
old
male
complained
of
fever,
dyspnea
and
chest
pain
aggravated
by
breathing.
Apical
beat
is
markedly
displaced
to
midaxillary
region
with
distant
heart
sound.
The
patient
is
diagnosed
with
viral
cardiomyopathy.
3.
42
year
old
male
who
was
not
aware
that
he
was
hypertensive,
when
seen
in
OPD
his
BP
was
180/110
on
sitting
position.
Apex
beat
at
5th
ICS
LAAL
with
apical
beat
to
be
sustained
and
foreceful.
4.
36
year
old
female
school
teacher
with
history
of
frequent
sore
throat
was
admitted
because
of
pedal
edema,
esay
fatigability
and
DOE.
+Parasternal
retraction
during
systole
and
an
apical
diastolic
rumbling
murmur
5.
65
years
old
male
known
CAD
patient
status
post
bypass
graft
surgery
10
years
ago
is
now
suffering
from
fatigue,
dyspnea,
orthopnea,
edema
and
pulmonary
edema.
Apical
beat
is
hardly
palpable
at
6th
ICS.
Axillary
region
faintly
audible
heart
sounds
and
adynamic
precordium
*****
A.
Loud
S1
B.
Soft
S1
C.
Loud
A2
D.
Loud
P2
1.
Chronic
regurgitation
2.
Hypertensive
Urgency
with
BP
220/120
3.
Rheumatic
Mitral
Stenosis
4.
Pulmonary
edema
in
a
patient
with
CHF
5.
Chronic
mitral
regurgitation
*****
A.
Physiologic
Splitting
S2
B.
Persistent
Splitting
S2
C.
Paradoxical
Spilitting
S2
D.
Wide
Splitting
S2
1.
ASD
2.
Pulmonic
Stenosis
3.
Aortic
Stenosis
4.
Complete
RBBB
5.
LBBB
****
69
A.
Right
mitral
stenosis
B.
Right
aortic
with
mitral
regurgitation
C.
Congenital
bicuspid
aortic
stenosis
D.
Congenital
pulmonic
stenosis
E.
Right
aortic
regurgitation
1.
36
year
old
male
admitted
because
or
bilateral
pedal
edema
and
orthopnea.
P.E
revealed
a
hyperdynamic
apical
pulse
seen
adn
palpable
at
6th
ICS
LMA
region
and
a
diastolic
blowing
murmur
at
the
ERBS
point
transmitted
to
the
apex
2.
A
42
year
old
GRO
was
admitted
because
of
easy
fatigability
pedal
edema
orthopnea
and
PND
which
started
around
6
months
PTC
becoming
progressive.
P.E
revealed
diastolic
thrill
and
murmur
with
Loud
S1
and
opening
snap
3.
42
year
old
male
admitted
because
of
chest
pain
and
episode
of
syncope.
P.E
revealed
+ejection
systolic
murmur
at
2nd
ICS
RSB
transmitted
to
the
neck
4.
30
year
old
female
presents
a
persistent
spilitting
of
S2
with
expiratory
splitting
of
S2
at
the
2nd
ICS
LCB
ejection
systolic
murmur
at
the
same
time
5.
42
year
old
male
known
RHD
patient
was
admitted
because
of
severe
dyspnea,
jaundice,
ascites,
hepatomegaly,
P.E
revealed
apical
beat
markedly
displaced
at
the
6th
ICS
left
midaxillary
region
with
apical
lift,
apical
diastolic
blowing
murmur
transmitted
from
the
axilla
and
posterior
scapula
Significant
Clinical
Findings
1. Important
physical
examination
finding
in
CHF
–
(+)
hepatojugular
reflux
2. Systolic
ejection
murmur
of
chronic
severe
aortic
regurgitation
is
accompanied
by
which
sound
–
Austin-‐Flint
murmur
3. Mid-‐diastolic
murmur
heard
over
the
pulmmonic
area
is
ASD
is
accompanied
by
which
sound
–
Persistent
splitting
of
S2
4. Increased
loudness
of
holosystolic
murmur
of
tricuspid
regurgitation
upon
inspiration
–
Caravallo’s
sign
5. Heard
in
aortic
stenosis
–
Paradoxical
splitting
of
S2
Cardiomyopathies
th
6. Apex
beat
is
displaced
at
the
6
ICS
LAAL,
(+)
para
sterna
heave,
(+)
lift
–
Eccentric
7. 40
year
old
female,
with
apical
beat
that
retracts
during
systole
–
Right
Ventricle
Hypertrophy
8. Hardly
palpable
–
Left
ventricle
dilatation
th
9. 40
year
old
female
with
chronic
hypertension
complained
of
chest
pain,
PE
revealed
apex
beat
at
the
5
ICS
LMCL
with
a
(+)
apical
lift
–
Concentric
10. A
52
year
old,
Male,
chronic
hypertensive
and
DM2
complained
of
chest
pain
and
SOB
(DOB?),
PE
revealed
(+)
th
murmur
of
AR
and
MR,
apex
beat
is
displaced
at
5
ICS
left
anteroaxillary
line
with
(+)
lift.
–
Eccentric
Abnormal
Sounds
11. Pulmonary
Hypertension
–
loud
P2
12. Mitral
stenosis
–
Loud
S1
13. Atrial
Fibrillation
–
Soft
S1
14. BP
220/120
–
loud
S1
15. Pulmonic
stenosis
–Paradoxical
splitting
of
S2
16. Sinus
Tachycardia
–
loud
S1
17. Chronic
aortic
regurgitation
–
Loud
A2
18. LBBB
–
Paradoxical
splitting
of
S2
19. Severe
aortic
stenosis
–
Loud
A1
20. Normal
PE
findings
–
splitting
of
S2
upon
inspiration
70
Abnormal
Pulses
21. Chronic
aortic
regurgitation
and
aortic
Stenosis-‐
Pulsus
Bisfierens
22. Aortic
regurgitation
–
Corrigan’s
pulse
23. Constructive
pericarditis
–
Pulsus
Paradoxus
24. Severe
aortic
Stenosis
–
Pulsus
parvus
et
tardus
25. CHF
–
pulsus
alterans
Cases
26. Diastolic
blowing
murmur
–
aortic
regurgitation
th
27. 4
ICS
parasternal
line
–
Tricuspid
regugitation
28. Ejection
systolic
murmur
transmitted
to
carotid
–
aortic
stenosis
29. Ejection
systolic
murmur
loud
on
expiration
–
pulmonic
stenosis
30. Holosystolic
murmur
displaced
to
left
axilla,
diminished
S1
–
Mitral
regurgitation
1. Important
physical
examination
finding
in
CHF
+
Hepatojugular
reflux
2. Mid
diastolic
murmur
heard
over
the
pulmonic
area
in
ASD
is
accompanied
by
what
sound?
Persistent
splitting
of
S2
3. Loudness
of
holosystolic
murmur
of
tricuspid
regurgitation
upon
inspiration
Caravallo’s
Sign
th
4. Apex
beat
is
displaced
at
the
6
ICS
LAAL,
faint
heart
sound,
(+)
parasternal
heave,
(+)
lift.
Eccentric
Hypertrophy
5. 40
year
old
female,
with
apical
beat
that
retracts
during
systole
RVH
th
6. SOB,
apex
at
6
ICS
left
midaxillary
line..faint
heart
sound,
alcoholic
and
elicit
drug
use
Eccentric
th
7. 40
year
old
with
chronic
hypertension
complained
of
chest
pain.
PE
revealed
apex
beat
@
5
ICS
LMCL
with
a
(+)
apical
lift.
Concentric
8. A
52
year
old
Male,
chronic
hypertension
&
DM2
complained
of
chest
pain
and
SOB.
PE
revealed
(+)
murmur
of
th
AR
&
MR.
Apex
beat
is
displaced
@
5
ICS
left
anteroaxillary
line
with
(+)
lift.
Eccentric
9. Pulmonary
hypertension
Loud
P2
10. Atrial
fibrillation
Soft
S1
11. BP
220/120
Loud
S1
12. RBBB
persistent
13. Sinus
Tachycardia
Loud
S1
14. Chronic
Aortic
Regurgitation
Soft
S1
15. LBBB
Paradoxical
splitting
of
S2
16. Severe
Aortic
Stenosis
Paradoxical
splitting
of
S2
71
17. Normal
PE
findings
Split
S2
on
inspiration
18. Chronic
aortic
regurgitation
and
aortic
stenosis
Pulsus
bisfiriens
19. Severe
aortic
stenosis
20. CHF
Pulsus
Alterans
21. A
27
year
old
female,
worried
about
ECG
finding
of
RBBB.
Auscultation
revealed
presence
of
ejection
systolic
murmur
which
became
louder
during
forceful
expiration.
Pulmonic
stenosis
22. 65
year
old
patient
with
DM,
HPN,
has
a
holosystolic
murmur
displaced
to
the
left
axilla,
has
a
diminished
S1
Mitral
regurgitation
23. Machinery-‐like
murmur
PDA
24. Greater
BP
in
the
upper
extremities
compared
to
the
lower
extremities
Coarctation
of
Aorta
25. Characteristics
peripheral
pulse
in
CHF
Pulsus
Alterans
26. DM
hypertensive
64
year
old
experienced
pain
in
right
calf
muscle
on
walking
for
20
mins
and
relived
by
rest
Intermittent
Claudication
27. PDA
nd
2
Left
ICS
28. Aortic
Stenosis
nd
2
Right
ICS
29. S3
&
S4
th
5
ICS
LMCL
30. Mitral
Regurgitation
31. Fixed
splitting
of
S2
ASD
32. Holosystolic
murmur
at
the
left
parasternal
area
are
transmitted
to
the
right
sternal
border
VSD
33. Sail
Sound
Ebstein’s
anomaly
34. BP
elevated
in
the
upper
extremities
markedly
lower
in
the
lower
extremities
Coarctation
of
Aorta
35. Machinery-‐like
murmur
PDA
36. Pulmonary
Stenosis
nd
2
Left
ICS
72
Clinical
Medicine
:
CARDIOVASCULAR
SYSTEM
EXAM
For
1
to
5,
choices
are:
a.
concentric
d.
RVH
b.
eccentric
e.
LVH
c.
LV
dilataion
1. Not
palpable
in
PE
C
2. Forceful
apical
beat
but
not
displaced.
A
3. Markedly
displaced
at
the
left
axillary
line,
hardly
palpable.
C
4. Displaced
to
axillary
line
5th
or
6th
ICS
anterior
axillary.
B
5. Palpable
parasternally
but
retract
in
systole.
D
For
6
to
20,
choices
are:
a.
2nd
LEFT
ICS
d.
4th
ICS
PS
b.
2nd
RIGHT
ICS
e.
5th
ICS
MCL
c.
Erb's
point
6. Pulmonic
Stenosis
A
7. VSD
C
8.
9.
10.
11. Aortic
valve
regurgitation
A
or
D
12. Mitral
valve
regurgitation
E
13. Mitral
Prolapse
E
14. Aortic
stenosis
B
15. Mitral
stenosis
E
16. Loud
S1
E
17. Opening
snap
A
18. Loud
P2
A
19. Hypertrophic
Cardiomyopathy
D
20. LV
Hypertrophy
E
multiple
choice
ito
na
super
haba,
eto
yung
summary:
21. Mitral
stenosis
-‐
diastolic
rumbling
22. Aortic
stenosis
-‐
transmitted
to
the
carotid
23. Aortic
Regurgitation
-‐
diastolic
rumbling
murmur
24. VSD
-‐
pansystolic
For
25
to
30,
choices
are:
a.
Caravallo's
d.
Gallavardin's
b.
Kussmaul's
e.
Austin-‐Flint
c.
+
hepatojugular
f.
Machinery-‐like
25. aortic
stenosis
D
26. tricuspid
regurgitation
A
27. PDA
F
28. chronic
aortic
regurgitation
E
73
29. CHF
C
30. constrictive
pericarditis
B
For
36
to
40,
choices
are:
a.
Paradoxical
b.
Wide
c.
Loud
d.
Negative
hepatojugular
reflex
36. Mitral
stenosis
C
(Loud
S2)
37. Hypertensive
urgency
38. Pulmonary
hypertension
C
(Loud
S2)
39. Severe
aortic
stenosis
A
(Paradoxical
splitting
of
S2)
40. Pulmonary
hypertension
C
(Loud
S2)
For
41
to
45,
choices
are
:
a.
Pulsus
parvus
et
tardus
d.
negative
hepatojugular
b.
Corrigan's
pulse
e.
neck
vein
distention
at
60
degrees
c.
pulsus
bisferiens
41. normal
PE
finding
D
42. Pulmonary
edema
E
43. Aortic
stenosis
A
44. Combined
aortic
regurgitation
and
aortic
stenosis
C
45. Chronic
aortic
regurgitation
B
For
46
to
50,
choices
are:
a.
ejection
systolic
murmur
best
heard
at
b.
persistent
splitting
c.
diastolic
murmur
d.
rumbling
e.
blowing
46. Mitral
regurgitation
D
47. Aortic
stenosis
A
48. Mitral
stenosis
C
49. Aortic
stenosis
E
50. Pulmonic
stenosis
B
74
1. The
anterior
portion
of
the
heart
a. LV
b. RV
c. Aorta
d. Pulmonary
Artery
2. The
diameter
of
the
apical
beat
a. 1.5cm
b. 2.5cm
c. 2.0cm
d. .5cm
3. Patient
with
COPD
has
palpable
pulse
at
the
epigastric
and
subxiphoid
region
a. Abdominal
aorta
b. RVH
c. LVD
d. Biventral
hypertrophy
4. Mitral
stenosis
a.
loud
s1
5. CAR
b.
soft
s1
6. Atrial
fibrillation
c.
loud
s2
7. MSD
d.
ejection
8.
a.
deep
inspiration
9.
b.
forceful
expiration
10. MVP
c.
leaning
forward
d
.LL
decubitous
11. Einsteins
Anomaly
a.
Caravalla’s
12. Chronic
Tricuspid
Regurgitation
b.
Galavardin’s
13. Aortic
Stenosis
c.
Snail
sound
14. Chronic
Severe
Aortic
Regurgitatin
d.
Paradox
pulse
nd
15. Opening
snap
at
rheumatic
mitral
stenosis
a.
2
LICS
nd
16. Pulmonic
regurgitation
b.
2
RICS
17. VSD
c.
Parasternal
18. MVP
d.
Erb’s
19. Congenital
Pulmonic
Stenosis
e.
Apex
20. Position
of
the
apical
beat
during
physical
exam
a. upright,
leaning
forward
b. supine
c. LLD
75
21. Normal
location
of
the
apical
beat
a. Strong
and
forceful
th
b. Always
at
5
ICP,
L
MCL
c. Gentle
tap
d. Strong
during
inspiration
22. Concentric
LV
a.
Persistent
S2
23. Ischemic
Dilated
Cardiomyopathy
b.
Paradox
S2
24. Chronic
Severe
Aortic
Stenosis
c.
Physiologic
S2
25. ASD
d.
26. Normal
1. Ventricular
Septal
Defect
>
HEARD
@
APEX
2. Very
loud
S1
>
BEST
HEARD
ON
APEX
3. Opening
Snap
>
BEST
HEARD
ON
PULMONIC
AREA
4. Apical
mid-‐diastolic
rumbling
murmur
>
BEST
HEARD
ON
APEX
5. Chronic
Aortic
Regurgitation
>
ERBS
POINT
6. Acute
Severe
Mitral
Regurgitation
w/
s3
Gallop
RD
>
3
LICS
7. Right–Bundle
Branch
Block
>
PERSISTENT
/
WIDE
S2
SPLITTING
8. Left–Bundle
Branch
Block
>
PARADOXICAL
S2
SPLITTING
9. Non-‐Systolic
Click
>
(MVP)
ERB’S
POINT
10. Less
Prolapse:
SQUAT
;
More
Prolapse:
STAND
11. Ejection
Systolic
Murmur
(HEARD
LOUDEST
@
BASE)
12. Atrial
Septal
defect
ND
>
2
LICS
13. Concentric
L-‐ventricular
Hypertrophy
th
>
5
ICS
LAAL
14. Restrictive
Hypertrophy
Cardiomyopathy
>
STANDING
–SQUATTING
POSISTION
15. Kussmaul
Sign
>
CAUSE
BY
INABILITY
OF
THE
(R)
HEART
TO
ACCOMODATE
INCREASE
VENOUSE
RETURN
16. Loud/accentuated
S1
>
HYPERTENSION
17. Physiologic
Splitting
>
2-‐3
(L)
ICS
18. Paradoxical
Splitting
of
S2
>
(L)
BUNDLE
BRANCHING
BLOCK
76
ABDOMEN
36-‐40:
Draw
and
label
the
4
quadrants
of
the
abdomen
and
its
landmarks:
40-‐50:
Draw
and
label
the
nine
regions
of
the
abdomen
and
its
landmarks:
Abdomen
–
Finals
Samplex
1. A
palpable
left
flank
mass
is
probably
the
left
kidney
if:
a. You’re
palpating
fingers
can
probe
deep
to
the
medial
and
lateral
borders
(splenomegaly
to)
b. Preservation
of
normal
tympany
in
LUQ
c. A
notch
is
palpated
on
medial
border
(splenomegaly
din)
d. Edge
of
mass
extend
beyond
the
midline
2. An
extremely
tight
sphincter
tone
on
rectal
examination
is
due
to:
a. Neuropathy
(seen
in
lax
sphincter
to)
c.
Cerebrovascular
disease
b. Spinal
cord
lesion
d.
Anxiety
3. A
35
y/o
male
complains
of
sudden
severe
epigastric
pain
radiating
to
the
back,
duration
noted
after
a
heavy
meal.
If
this
is
acute
abdominal
pain,
the
following
statement
is/are
correct
a. Always
mandate
surgical
intervention
c.
Can
be
manage
medially
b. Duration
of
pain
is
less
than
2
days
d.
Consider
if
the
pain
is
severe
4. A
21
y/o
male
with
acute
leukemia
have
a
palpable
splenic
notch.
The
traube’s
percussion
will
be:
a. Hyperresonant
c.
Resonant
b. Dull
d.
Tympanic
5. A
60
y/o
diabetic
had
stroke
1
month
ago
with
right
sided
hemiparesis
and
dysarthria..for
sensation
of
food
won’t
go
down
and
just
stay
on
the
mouth
and
repeatedly
attempts
to
swallow.
This
type
of
dysphagia
is:
a. Oropharyngeal
c.
Esophageal
dysphagia
b. Esophageal
web
6. In
patient
complaining
of
burning
sensation
that
begins
inferiorly
and
radiates
up
to
the
entire
retrosternal
area
to
the
neck
should
avoid
the
following
except:
a. NSAIDs
c.
Meperidine
e.
Citrus
food
b. Coffee
d.
Beta
blockers
______________________________________________________________________________________
Abnormal
contour
–
xymphoid
to
symphisis
pubis
Portal
HPN:Except
-‐
SMJ
nodule
Puddle
sign
–
flicking
sound
becomes
louder,
as
the
stet
goes
farther
Hypoactive
bowel
–
Ruber
test
Abdominal
paradox
–
chest
in,
abdomen
expand
upon
inspiration
Ovarian
cyst
and
ascites
–
hypokalemia,
furosemide,
abdominal
distention
Difference
of
voluntary
form
involuntary
rigidity
–
Inspire
with
wide
open
mouth
Carnette’s
sign
–
Abdominal
vs
Intramural
tendencies
Normal
liver
span
–
4-‐8
cm
Midsternal,
6-‐12
RMCL
Normal
size
of
aorta
–
3
cm
To
palpate
liver:except
–
Castell
technique
(splenomegaly)
th
Kidney
punch
–
12
rib,
costovertebral
angle
Methods
to
assess
Appx:
except
–
Boa’s
sign
77
Sim’s
position
–
Left
knee
flex,
side
of
the
table
Rectal
exam
in
women
–
mass,
tenderness,
nodules,
lateral
wall,
uterus
Acute
prostatitis
–
Boddy
and
tender
Grade
3
–
3-‐4
cm
protrusion
Murphy’s
sign
–
Inspiratory
arrest
Using
Ulnar
surface
of
the
pt
hand
at
midline
–
fluid
wave
_____________________________________________________________________________________
Alcoholic
portal
hpn
massive
ascites
except:
a. shifting
dullness
c.
everted
umbilicus
b. fluid
wave
d.
Typhanitic
Nixon
–
lateral
decubitus
To
confirm
secondary
hpn
a. Epigastric
c.
R/L
iliac
e.
All
b. R/L
upper
q
d.
A
and
B
Obese
pt
a. light
palpate
c.
Reinforced
palpate
b. deep
palpate
d.
Ballotment
ABDOMEN
1. Abdominal
contour
→
Xyphoid
to
symphysis
pubis
2. Portal
Hypertension
→
Except:
SMJ
nodule
3. Puddle
Sign
→
Flicking
sound
becomes
louder,
as
the
stet
goes
farther
4. Hypoactive
bowel
→
Hypokalemia,
Furosemide,
Abdominal
distention
5. Ovarian
cyst
and
ascites
→
Ruler
Test
6. Differentiate
voluntary
to
involuntary
rigidity
→
Inspire
with
wide
open
mouth
7. Garnett’s
Sign
→
Abdominal
versus
intramural
tenderness
8. Normal
liver
span
→
4-‐8
cm
Midsternal;
6-‐12
RMCL
9. Normal
size
of
the
aorta
→
3cm
10. To
palpate
liver
→
Except:
Castell’s
technique
(for
splenomegaly)
th
11. Kidney
punch
→
12
rib,
costovertebral
angle
12. Method
to
assess
AP
(Appendicitis)
→
Except:
Boa’s
Sign
13. Sim’s
Position
→
Left
knee
flexed
side
of
the
table
14. Rectal
exam
in
women
→
Mass,
tenderness,
nodules,
lateral
wall,
uterus
15. Acute
prostatitis
→
Boggy
and
tender
16. Grade
3
→
3-‐4cm
protrusion
17. Murphy’s
sign
→
Inspiratory
arrest
18. Using
ulnar
surface
of
patient
hand
in
the
midline
→
Fluid
wave
78
ABDOMEN
1. In
doing
fluid
wave,
the
ulnar
surface
of
the
patient’s
hand
is
pressed
into
the
midline
of
the
abdomen
to
a. Prevent
movement
of
intestines
b. Direct
the
movement
of
the
wave
to
the
opposite
side
c. Block
the
movement
of
the
mesenteric
fat
d. Clearly
visualize
the
fluid
wave
2. A
60
yo
CHF
for
which
he
was
maintained
on
Furosemide
developed
hypokalemia.
He
has
abdominal
distention
without
abdominal
pain.
The
auscultatory
findings
will
be
a. Succusion
splash
b. Hyperactive
bowel
sounds
c. Hypoactive
bowel
sounds
d. Normal
bowel
sounds
3. A
smoker
with
emphysema
was
noted
to
have
palpable
liver
3
finger
breaths
below
the
right
subcostal
margin.
The
expected
liver
span
is
a. 4-‐8
cm
midsternal
b. 6-‐12
MCL
c. 8-‐14cm
anterior
axillary
line
d. All
4. All
but
one
are
expected
findings
in
a
46
yo
male
alcoholic
with
portal
hypertension
(All
are
expected
findings
in
a
46
yo
male
alcoholic
with
portal
hypertension
EXCEPT)
a. Globular
abdomen
with
everted
umbilicus
b. Sister
Mary
Joseph
nodules
c. Spider
angioma
d. Obliterated
Traube’s
space
e. (+)
Castells’s
sign
percussion
5. A
19
yo
male
have
severe
attacks
of
bronchial
asthma
was
noted
to
have
abdominal
paradox.
The
abdominal
respiratory
motion
is
a. Abdomen
contract
with
expiration
b. Rocking
motion
of
chest
and
abdomen
c. Abdomen
expands
while
chest
is
pulled
inward
d. All
6. To
differentiate
ascites
from
large
ovarian
cyst,
you
must
do
a. Ballotment
palpation
b. Deep
palpation
c. Shifting
dullness
d. Fluid
wave
e. Ruler
Test
79
7. Carnett’s
sign
will
differentiate
(please
double
check
na
lang
po
yung
correct
answer,
thanks!)
a. Intraabdominal
mass
from
intramural
mass
b. Rebound
tenderness
from
direct
tenderness
c. Intraabdominal
tenderness
from
abdominal
tenderness
d. Subcutaneous
crepitus
from
cutaneous
hyperthesia
8. A
45
yo
female
complaining
of
RUQ
pain
was
diagnosed
to
have
acute
cholecystitis.
A
positive
Murphy’s
sign
is
a. Tenderness
on
RUQ
b. Inspiratory
arrest
c. (+)
fist
tenderness
on
percussion
of
right
subcostal
margin
d. Exaggerated
pain
on
gentle
lifting
of
a
fold
of
skin
on
RUQ
9. In
a
22
yo
male
with
RLQ
pain
suspected
to
have
acute
appendicitis,
the
ff
are
positive
abdominal
signs,
EXCEPT
a. Markle’s
b. Blumberg’s
c. Aaron’s
d. Boa’s
e. Obturator
10. Positive
puddle’s
sign
is
a. Distinct
tap
on
your
palpating
hand
b. The
sound
becomes
louder
while
the
stethoscope
moves
away
from
the
flicking
spot
c. Dullness
shift
to
the
dependent
side
while
tympanitic
shift
to
the
top
d. A
visible
movement
as
a
tap
was
done
on
the
other
side
of
the
puddle
11. In
doing
the
kidney
punch,
a
direct
percussion
with
the
fist
should
be
applied
to
a. Subcostal
margin
b. Flank
th
c. 12
rib
and
vertebral
angle
d. ASIS
12. A
66
yo
male
with
enlarged
prostate
Grade
III
on
rectal
examination,
have
this
amount
of
protrusion
a. 1-‐2
cm
b. >2-‐3
cm
c. >3-‐4
cm
d. >4
cm
13. A
30
yo
male
complaining
of
dysuria
and
fever
with
pyuria
on
urinalysis.
The
expected
rectal
examination
findings
if
this
is
acute
bacterial
prostatitis
is/are
a. Sulcus
is
obliterated
b. >1
cm
protrusion
c. Nodular
d. Boggy
and
tender
e. All
80
14. The
ff
statements
is/are
true
with
regards
to
significance
of
rectal
examination
in
female
EXCEPT
a. Cervix
may
be
palpable
through
anterior
wallt
b. Uterus
is
never
palpable
on
rectal
examination
c. Tenderness
of
peritoneal
inflammation
can
be
appreciated
d. Nodularity
of
peritoneal
metastasis
can
be
felt
15. Sequence
of
abdominal
examination
ANS.
Inspection,
Auscultation,
Palpation,
Percussion,
Special
Examination
16. Reference
used
in
determining
abdominal
contour
is
an
imaginary
line
drawn
from
a. Breast
to
umbilicus
b. Clavicle
to
the
symphysis
pubis
c. Rib
margin
to
umbilicus
d. Xiphoid
or
rib
margin
to
the
pubis
17. To
differentiate
between
abdominal
rigidity
amd
voluntary
muscle
guarding,
examiner
should
do
this
while
doing
palpation
a. Distract
the
patient
by
conversation
b. Ask
the
patient
to
breathe
with
mouth
wide
open
and
feel
relaxation
of
abdomen
during
expiration
c. Ask
patient
to
raise
his
head
from
supine
position
d. All
e. A
and
B
only
18. Technique
to
palpate
a
large
organ
is
freely
movable
as
mass
obscured
by
ascites
a. Capture
technique
b. Deep
palpation
c. Reinforced
palpation
d. Ballotment
19. Sim’s
position
of
patient
in
rectal
examination
a. Bent
over
the
examining
table
b. Lateral
position
lying
on
the
left
side
with
right
hip
and
knee
flexed
with
buttocks
close
to
edge
of
table
c. Knee-‐chest
position
d. Lithotomy
position
20. An
enlarged
prostate
gland
on
rectal
examination
has
the
following
findings
EXCEPT
a. Firm,
rubbery
consistency
b. Obliteration
of
sulcus
c. >1cm
protrusion
into
the
rectum
d. Lateral
lobes
are
palpable
81
Abdomen
A.MATCHING
TYPE
Questions
1-‐10
matching
type
1.fluid wave-‐ NO VISIBLE WAVE! hindi umaalon ang abdomen accdg to macy
4. Boa's Sign
6. Castell
7. Psoas
8. Puddle
9. Rovsing
86
12.
77
y/o
male,
smoker,
developed
dysphagia
that
progressed
to
include
liquids.
What
type
of
disorder?
A. Transfer
B. Oropharyngeal
C. Motility
D. Esophageal (accdg sa pinakamamahal kong scholar na si larizza, eto daw po sagot)
14. How much urine volume is excreted by a person who is oliguric? <500mL
16. 17,male, excreting blood per orem, differentiate hematemesis from hemoptysis?
C. Do NGT
Ans. Accdg again kay Lare, B sinagot nya PERO, di sya sure kasi mukhang ok din ung D.
P.S Roi, ikaw na sumagot, nakalimutan ko tanungin si Macy at Ana tungkol dito
17. Patient passing out tarry, black, foul smelling stool,. Where is the bleeding?
A. Upper GIT
B. Lower GIT
C. Obscure
D. A and B
E. All
Sabi ni Macy E daw, sabi ni Roi E din daw, sabi ko,mkinig sa higher center ^_^
18. Patient with heartburn, you should inquire if patient is taking all but one in the history taking:
A. Coffee
B. KCl tablets
C. Theophylline
D. Omeprazole
87
19.
25
year
old
male
with
dysuria
what
should
you
inquire
about?
A. Urethral Discharge
B. Sexual practices
C. Renal calculi
D. A and C
E. All
20. 72 yr old with dribbling, distended bladder upon PE, What kind of incontinence?
21. Looking for secondary cause of HPN, where to look for bruit?
22. sound produced upon auscultation, due to large air and fluid production. Can be detected by unaided ear
24. Paradoxical breathing: Rocking motion (sorry nakalimutan na yung ibang choices)
25. In portal HPN, direction of flow of upper abdominal veins? Drains upward
26. Patient with history of redness in the urine. Differentiate hematuria and pigmenturia
B. Foamy urine
88
ABDOMEN
1.
A
patient
with
ascites
&
obliterated
Traube’s
space
have
a
prominent
abdominal
superficial
veins.
The
expected
direction
of
blood
flow
on
this
vessel
will
be
a.
upward
on
upper
abdominal
veins
c.
lateral
at
middle
abdominal
veins
b.
downward
on
lower
abdominal
veins
d.
all
over
2.
Normally,
the
abdominal
respiratory
motion
is/are
a.
rocking
motion
of
chest
&
abdomen
d.
all
b.
abdomen
expand
with
inspiration
e.
b&c
c.
abdomen
contract
with
expiration
3.
In
umbilical
hernias,
if
the
contents
is
incarcerated
&
blood
supply
is
interrupted,
it
is
called
a.
reducible
c.
irreducible
b.
incarcerated
d.
strangulated
4.
A
smoker
with
COPD
on
abdominal
exam
has
a
palpable
liver
3
finger
breathe
below
the
right
subcostal
margin
is
expected
to
have
a
liver
span
of
a.
4-‐6
cm
on
midsternal
c.
8-‐13cm
on
anterior
axillary
line
e.
a
&
b
only
b.
6-‐12
cm
on
MCL
d.
all
5.
A
21
y/o
male
with
acute
leukemia
have
a
palpable
splenic
notch.
The
Traube’s
space
percussion
will
be
a.
dull
c.
resonant
b.
tympanitic
d.
hyperresonant
6.
To
assess
liver
tenderness
in
a
patient
with
a
liver
abscess
when
the
liver
is
not
palpable,
you
should
do
a.
deep
palpation
on
RUQ
c.
reinforced
palpation
b.
capture
technique
d.
fist
percussion
of
right
subcostal
margin
7.
In
patient
with
gastric
outlet
obstruction,
the
sound
produced
by
large
collection
of
air
and
fluid
from
stomach,
detected
by
unaided
ear
is
a.
venous
hum
c.
succussion
splash
b.
borborygmi
d.
tinkling
bowel
sounds
8.
During
abdominal
examination
of
patient
with
generalized
abdominal
pain,
you
ask
patient
to
stand
on
his
toes
&
suddenly
drop
his
heels
on
the
floor.
You
are
eliciting
a.
Blumberg
sign
c.
Psoas
sign
b.
Rovsing’s
sign
d.
Markle’s
sign
9.
A
hypertensive
78
y/o
male
is
being
evaluated
for
abdominal
aortic
aneurysm.
If
this
is
present,
the
expected
findings
will
be:
a.
width
of
aorta
is
>3cm
b.
direction
of
aortic
pulsation
is
directly
on
the
palpating
fingers
c.
lateral
pulsation
of
aorta
is
noted
d.
all
e.
a
&
b
only
10.
An
80y/o
male,
developed
anuria
&
complaining
of
hypogastric
pain.
Rectal
examination
revealed
grade
4
prostate
enlargement.
The
expected
abdominal
finding/s
is/are
a.
palpable
mass
on
hypogastric
area
d.
all
b.
dullness
on
percussion
of
hypogastric
area
e.
a
&
b
c.
symmetrically
globular
abdomen
89
11.
Normal
prostate
gland
on
rectal
examination
has
the
following
findings,
except
a.
firm
and
rubbery
in
consistency
c.
nontender
and
movable
b.
prominent
median
sulcus
d.
5cm
diameter
with
>1cm
protrusion
12.
On
rectal
examination
the
examining
finger
can
palpate
a
distance
of
a.
2-‐4
cm
b.
4-‐6
cm
c.
6-‐10
cm
d.
8-‐12cm
13.
On
PE
of
the
abdomen,
auscultation
is
done
before
doing
palpation
because:
a.
it
will
prevent
ticklishness
of
the
patient
b.
palpation
alters
frequency
of
bowel
sounds
c.
more
convenient
for
the
examiner
d.
it
is
more
preferred
by
the
patient
14.
Reference
used
in
determining
the
abdominal
contour
is
an
imaginary
line
drawn
from:
a.
rib
margin
to
the
umbilicus
c.
xiphoid
to
rib
margin
to
the
symphysis
pubis
b.
breast
to
the
umbilicus
d.
clavicle
to
the
symphysis
pubis
15.
All
but
one
are
use
to
overcome
ticklishness
of
the
patient
on
palpation
of
the
abdomen,
EXCEPT
a.
ask
patient
to
perform
self-‐palpation
b.
talk
to
the
patient
c.
place
your
hands
over
patients
finger
and
after
sometime
drift
slowly
your
fingers
onto
the
abdomen
d.
use
diaphragm
of
stethoscope
as
palpating
instrument
90
ABDOMEN
1.
PARIETAL
PAIN
-‐
More
intense
and
more
precisely
located
-‐
Aggravated
by
movement
or
coughing
2.
ACUTE
ABDOMINAL
PAIN
-‐
<24
hours
-‐
Not
always
mandate
surgery
-‐
CAN
be
manage
medically
3.
APLEY’S
RULE
-‐
The
farther
from
the
navel/umbilicus,
the
more
likely
it
will
be
organic
in
origin
(only
answer)
-‐
Other
choices:
-‐
Touch
me
not
warning
-‐
Organic
disease
when
patient
closes/opens
his
eyes
4.
OROPHARYNGEAL
DYSPHAGIA
-‐
Food
won’t
go
down
-‐
Repeatedly
attempts
to
swallow
5.
ACHALASIA
-‐
All
are
related
to
disease:
-‐
With
weight
loss
6.
All
are
associated
with
HEARTBURN
-‐
Coffee,
alcohol,
NSAIDS,
nitrates,
theophylline
-‐
EXCEPT:
-‐
Colchicine
7.
HEMATOCHEZIA
-‐
Bright
red
blood
in
rectum
-‐
Lower
GI
bleeding
-‐
Massive
upper
GI
bleeding
(>1L)
8.
OCCULT
GI
BLEEDING
-‐
Chronic
anemia
-‐
No
change
in
color
-‐
(+)
Guiac’s
test
9.
BLEEDING
OF
OBSCURE
ORIGIN
-‐
All
of
the
above
10.
PEPTIC
ULCER
-‐
Upper
GI
bleeding
or
massive
bleeding
11.
AMOEBIC
COLITIS
-‐
Small
painful
stool
(tenesmus)
12.
ALLERGY
IN
CRABS
AND
OYSTERS
-‐
Vibrio
species,
salmonella,
hepatitis
A
13.
All
are
part
of
ROME
2
CRITERIA
except:
-‐
Lumpy
or
hard
stool
-‐
Sensation
of
incomplete
evacuation
-‐
bowel
action
per
week
14.
CONSTIPATION
IN
ELDERLY
-‐
Decrease
food
intake
-‐
Weak
abdominal
and
pelvic
muscles
-‐
Slow
colonic
transit
15.
HESITANCY
-‐
Delay
between
attempting
to
initiate
urination
and
actual
flow
of
urine
16.
CAUSE
OF
PYURIA
-‐
All
of
the
above
17.
OLIGURIA
-‐
<500ml/24hrs
18.
POLYURIA
-‐
Increase
osmotic
load
-‐
Increase
intake
of
fluid
-‐
ADH
deficiency
19.
HEMATURIA
-‐
(+)
RBC
sedimentation
20.
OVERFLOW
INCONTINENCE
-‐
A
continuous
dripping
or
dribbling
incontinence
21.
NIXON’S
TECHNIQUE
-‐
Percussion
is
initiated
at
lower
level
of
lung
resonance
22.
REINFORCEMENT
-‐
Deep
palpation
is
difficult,
obesity
and
deep
seated
pathology
23.
LIVER
SPAN
-‐
Accurate
liver
size
24.
SIM’S
POSITION
-‐
Patient
lies
on
one
side
with
arms
behind
the
back
and
the
upper
thigh
flexed,
use
in
vaginal
exam
MATCHING
TYPE
25.
Ascites
and
obesity
-‐
Inspection
of
umbilicus
26.
Ascites
and
ovarian
cyst
-‐
Ruler
test
27.
Intramural
and
intraabdominal
-‐
Patient
raises
his
head
while
in
supine
position
28.
Abdominal
tenderness
(muscle
strain)
-‐
Carnet’s
sign
29.
Splenomegaly
and
hepatomegaly
-‐
Traube’s
space
30.
PORTAL
HYPERTENSION
-‐
Globular
abdomen
(everted)
-‐
Alcoholic;
liver
cirrhosis
-‐
(+)
engorge
abdominal
veins
radiating
from
umbilicus
31.
JAUNDICE
-‐
Can
only
be
differentiated
from
carotenemia
in
the
color
of
palm
32.
CULLEN’S
SIGN
-‐
Acute
hemorrhagic
pancreatitis
33.
RESPIRATORY
PARADOX
-‐
Rocking
motion
of
chest
and
abdomen
34.
ABDOMINAL
HERNIA
-‐
Strangulated
35.
SUCCESSION
SPLASH
-‐
Large
collection
of
air
and
fluid
from
stomach
and
intestine
36.
JAR
TENDERNESS
Personal
note:
Please,
wag
kayo
umasa
dito,
maipasa
niyo
man
ang
clinmed
I,
babagsak
parin
kayo
sa
board
exam
pag
to
lang
aralin
niyo.
Kung
kasing
tamad
kayo
tulad
ko,
makinig
ka
nalang
ng
mabuti
sa
prof,
3
hours
of
lecture
of
your
24
hrs
is
not
so
hard
to
give.
-‐
N