CD1201 Bates Head & Neck

Posterior cervical

Brittanie presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles along the anterior edge of the trapezius. What group of nodes is this? A) Submandibular B) Tonsillar C) Occipital D) Posterior cervical

Aneurysm of the thoracic aorta

If a patient has a tracheal tug what does this indicate?

D

A 19-year old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been. Which of the following physical examination descriptions is most consistent with meningitis? A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full range of motion B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with paraspinous muscle spasm and limited range of motion to the right C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck tender to palpation, unable to perform range of motion D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck supple with full range of motion

Tension

A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis? A) Tension B) Migraine C) Cluster D) Analgesic rebound

Cushing's syndrome

A 30-year old females comes to you with concerns of increased hair growth on her face and chest. You note that she also has red rosy cheeks and rounded face. What is the most likely clinical diagnosis? A) Myxedema B) Bell's Palsy C) Cushing's syndrome D) Parkinson's disease

Migraine

A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over-the-counter analgesic and this results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache? A) Tension B) Migraine C) Cluster D) Analgesic rebound

Benign positional vertigo

A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You elicit the information that the dizziness is a spinning sensation of sudden onset, worse with head position changes. The episodes last a few seconds and then go away, and they are accompanied by intense nausea. She has vomited one time. She denies tinnitus. You perform a physical examination of the head and neck and note that the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely diagnosis? A) Benign positional vertigo B) Vestibular neuronitis C) Ménière's disease D) Acoustic neuroma

Parkinson's disease

A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not on any medications and does not take herbs or supplements. She has no chronic medical conditions. She does not smoke or drink alcohol. She walks into the examination room with slow movements and shuffling steps. She has decreased facial mobility and a blunt expression, without any changes in hair distribution on her face. Based on this description, what is the most likely reason for the patient's symptoms? A) Cushing's syndrome B) Bell's Palsy C) Myxedema D) Parkinson's disease

Hematemesis (consider if the blood is coming from nose or if they vomited blood. coughed up blood = hemoptysis)

A patient complains of epistaxis. Which other cause should be considered? A) Intracranial hemorrhage B) Hematemesis C) Intestinal hemorrhage D) Hematoma of the nasal septum

Obesity/Diabetes

Chronic bilaterally enlarged parotid glands may be associated with A) Mumps B) Neoplasm C) Obesity/Diabetes D) Cirrhosis

lung pathology

Patient has 1 finger width between the lateral border of the trachea and the SCM on the right side but a 2 finger width on the left side. This indicates _______ _________

Lymph node

You feel a small mass that you think is a lymph node. It is mobile in both the up-and-down and side-to-side directions. Which of the following is most likely? A) Cancer B) Lymph node C) Deep scar D) Muscle