ChatGBT IA final

B) cirrhosis

A 49-year-old male complains that his legs are swollen towards the end of the day. He also says that he is tired in the evenings. He says that he eats a balanced diet and exercises occasionally. He does not smoke nor does he drink alcohol in excess. His stool is normal in consistency and color. On examination, his vital signs are normal. His urine is normal in color. His sclera is slightly icteric. There is no hepatosplenomegaly nor is there any ascites. Based on the available information, which is the most likely diagnosis? A) stone in the common bile duct B) cirrhosis C) carcinoma of the head of the pancreas D) viral hepatitis

1)fever 5)recent unexplained weight loss

A 65-year-old female complains of a painful swollen left leg and foot for the past three days. Which are TWO possible red flags for this patient? 1)fever 2)jaundice 3)fatigue 4)cough 5)recent unexplained weight loss

D) congestive heart failure

A 75-year-old man develops swelling of both legs. This is worse in the evenings. He says that some nights he wakes up because of a tight sensation across his chest, which disappears once he gets up and goes to the bathroom to pee. His vital signs are in the normal range. There are no cardiac murmurs or abdominal bruits. There is no hepatosplenomegaly nor ascites. His sclera is non-icteric and his mucous membranes are pink. Which is the most likely diagnosis? A) renal failure B) chronic bronchitis C) emphyema D) congestive heart failure

C) congestive heart failure

A positive hepatojugular reflex is more likely to be seen in which condition? A) cirrhosis B) chronic venous insufficiency C) congestive heart failure D) myxedema

D) champagne bottle legs

Chronic venous insufficiency is likely to be accompanied by which physical finding? A) shifting dullness B) flaky paint dermatitis C) frothy urine D) champagne bottle legs

A) shifting dullness

Cirrhosis is likely to be accompanied by which physical finding? A) shifting dullness B) flaky paint dermatitis C) champagne bottle legs D) frothy urine

A) cirrhosis

Gynecomastia is more likely to be seen in which condition? A) cirrhosis B) kwashiorkor C) chronic venous insufficiency D) nephritic syndrome

B) polycystic ovarian syndrome

Hirsutism is more likely to be seen in which condition? A) kwashiorkor B) polycystic ovarian syndrome C) nephritic syndrome D) chronic venous insufficiency

D) alcoholic cirrhosis

His Complete Blood Count is within normal limits. His bilirubin is 1.8 mg.dL [0.201.3]. His Alkaline Phosphatase is 145 U;L[20-125]. AST is 56 U/L [2-35]; ALT is 120 U/L [2-40] and his GGT is 145 U/L [<45]. His serum electrolytes, BUN and creatinine are within the normal range. His total serum proteins are 4.8 g/dL [6-8.5] with a reversed albumin/globulin ratio. His urinalysis is normal and so is his Hep B and C serology. What is the most likley diagnosis? A) non-alcoholic fatty liver disease B) multiple myeloma C) hepatocellular carcinoma D) alcoholic cirrhosis

A) malar rash

If you suspect Systemic Lupus Erythematosus in a young adult with multiple small joint pains, which might be present in the physical examination? A) malar rash B) purple nodules C) silvery plaques at the back of the elbow D) vesicles and pustules along a dermatome

D) Pemphigus

Nickolsky's sign is seen in which condition? A) Psoriasis B) Measles C) Hansen's disease D) Pemphigus

D) lymphedema of the leg

Stemmer's sign is more likely to be present in which disease? A) deep vein thrombosis B) premenstrual edema C) idiopathic edema D) lymphedema of the leg

A) kwashiorkor

The edema in which condition is caused by decreased oncotic pressure? A) kwashiorkor B) beriberi C) deep vein thrombosis D) congestive heart failure

B) Asymmetry

What does the A in the ABCDE screen for melanoma represent? A) Amorphic B) Asymmetry C) Anastomosis D) Atrophic

D) Border

What does the B in the ABCDE screen for melanoma represent? A) Bulge B) Black C) Brown D) Border

C) Color change

What does the C in the ABCDE screen for melanoma represent? A) Cirrhosis B) Cutaneous C) Color change D) Cartilaginous

B) Diameter

What does the D in the ABCDE screen for melanoma represent? A) Dimorphic B) Diameter C) Dangerous D) Dermatoblastic

A) Evolving

What does the E in the ABCDE screen for melanoma represent? A) Evolving B) Elevation C) Elongated D) Ebola

B) Red hair

What does the R in the MMRISK screen for skin cancer mean? A) Round B) Red hair C) Risky D) Raised

B) polyarthritis

What else might be present in a child with this rash following a sore through three weeks ago? A) conjunctivitis B) polyarthritis C) dysuria D) dysphagia

D) calcium concentration

What factor is unrelated to the pathogenesis of edema? A) hydrostatic pressure B) oncotic pressure C) vascular permeability D) calcium concentration

B) refer to a dermatologist

What is the appropriate management of a patient with this skin lesion? A) refer to an oncologist B) refer to a dermatologist C) suggest the use of hydrogen peroxide D) recommend coal tar application

B) Malassezia furfur

What is the cause of this rash? A) Epidermophyton flococum B) Malassezia furfur C) Mycobacterium leprae D) Sporothrix schenkii

D) molluscum contagiosum

What is the diagnosis in a patient with these lesions? A) acanthosis nigricans B) erythema multiforme C) pityriasis alba D) molluscum contagiosum

B) pemphigus

What is the diagnosis with the dermatological term bulla? A) acne vulgaris B) pemphigus C) molluscum contagiosum D) scabies E) syphilitic gumma

D) scabies

What is the diagnosis with the dermatological term burrows? A) acne vulgaris B) pemphigus C) molluscum contagiosum D) scabies E) syphilitic gumma

E) molluscum contagiosum

What is the diagnosis with the dermatological term central umbilication? A) pemphigus B) scabies C) acne vulgaris D) syphilitic gumma E) molluscum contagiosum

C) acne vulgaris

What is the diagnosis with the dermatological term comedones? A) molluscum contagiosum B) pemphigus C) acne vulgaris D) syphilitic gumma E) scabies

A) syphilitic gumma

What is the diagnosis with the dermatological term ulcer? A) syphilitic gumma B) acne vulgaris C) molluscum contagiosum D) pemphigus E) scabies

D) Trichophyton rubrum

What is the most likely cause of a red, itching annular rash on the trunk of a child? A) Streptococcus pyogenes B) Malasezzie furfur C) Sarcoptes scaebii D) Trichophyton rubrum

D) decreased oncotic pressure

What is the most likely cause of the peripheral edema in this 49-year-old man with swollen legs? A) increased hydrostatic pressure B) increased vascular permeability C) lymphatic obstruction D) decreased oncotic pressure

A) silent myocardial infarction

What is the most likely cause of this condition in the swollen legs in this patient? A) silent myocardial infarction B) hypertension C) congenital heart disease D) valvular heart disease

A) impetigo

What is the most likely diagnosis in a child with these lesions on the face? A) impetigo B) herpes labialis C) chickenpox D) contact dermatitis

C) leprosy

What is the most likely diagnosis in a patient with numerous annular lesions with anesthetic centers on the trunk? A) pityriasis rosea B) pinta C) leprosy D) tinea corporis

C) Gottron's palules

What is the name of these raised lesions seen in a patient with fatigue and heliotrope eyelids? A) Gumma B) Silvery plaques C) Gottron's palules D) Bullae

C) actinic keratosis

What is the precursor of this lesion called? A) acanthosis nigricans B) erythema nodosum C) actinic keratosis D) seborrheic dermatitis

A) pre-eclampsia

What is the significance of the presence of proteinurina in a pregnant nulliparous female? A) pre-eclampsia B) portal hypertension C) pyelonephritis D) iron deficiency anemia

A) increased hydrostatic pressure

What is the underlying mechanism for the leg swelling in this patient? A) increased hydrostatic pressure B) increased vascular permeability C) lymphatic obstruction D) decreased oncotic pressure

1)Cellulitis 4)Deep Vein Thrombosis

Which TWO conditions are the most likely differential diagnoses in this patient? 1)Cellulitis 2)Myxedema 3)Chronic bronchitis 4)Deep Vein Thrombosis 5)Lymphedema

3)Complete Blood Count 4)Ultrasound venography

Which TWO tests might be helpful in establishing the above chosen diagnoses? 1)B type Natriuretic Peptide 2)Urinalysis 3)Complete Blood Count 4)Ultrasound venography 5)Comprehensive Metabolic Panel

C) Myxedema

Which cause of edema is associated with fatigue and Woltman's sign? A) Obstructive Sleep Apnea B) Graves' disease C) Myxedema D) Cushing's disease

D) cirrhosis

Which cause of edema is related to high aldosterone levels? A) idiopathic edema B) nephrotic syndrome C) lymphedema D) cirrhosis

C) pityriasis rosea

Which condition is associated with a herald patch? A) urticaria B) pityriasis versicolor C) pityriasis rosea D) sarcoidosis

D) erythema multiforme

Which condition should be referred urgently to the hospital? A) erythema migrans B) erythema nodosum C) erythema infectiosum D) erythema multiforme

B) portal hypertension

Which contributes to the development of edema in cirrhosis? A) decreased Vitamin K production B) portal hypertension C) decrease estrogen production D) excess Growth Hormone

D) calcinosis cutis

Which cutaneous lesion is more likely to be present in a patient with dysphagia and sclerodactyly? A) splinter hemorrhages B) pitted nails C) enlarged nerves D) calcinosis cutis

B) Koplik spots

Which dermatological findings are caused by a single-stranded negative-sense RNA virus? A) Honey-colored crusts B) Koplik spots C) Eyrthema migrans D) Erythema nodosum

A) deep vein thrombosis

Which disease causes edema due to increased hydrostatic pressure? A) deep vein thrombosis B) bacterial sepsis C) cellulitis D) angioedema

B) Scabies

Which disease is cased by an ectoparasite? A) Kaposi sarcoma B) Scabies C) Erythema infectiosum D) Syphilis

A) chronic renal failure

Which edema-causing disease is associated with a BUN/Creatinine ratio greater than 25:1? A) chronic renal failure B) obstructive sleep apnea C) chronic bronchitis D) complex regional pain syndrome

D) premenstrual edema

Which edema-causing disease is most likely to be responsible for weight gain and mood swings? A) lipedema B) edema of pregnancy C) lymphedema D) premenstrual edema

A) pathological Q wave on an electrocardiogram

Which finding would support the hypothesis in the question above? A) pathological Q wave on an electrocardiogram B) boot-shaped heart on chest x-ray C) valve damage on an echocardiogram D) R wave greater than 12 mm in the aVL lead

D) purple nodules in the oral cavity and on the trunk

Which findings might suggest the diagnosis of Kaposi sarcoma? A) red, oozing rash on the cheeks and under the neck B) vesicles in dermatomal pattern across one side of the chest C) raised lesions over the dorsal aspects of the knuckles and fingers D) purple nodules in the oral cavity and on the trunk

B) hypercoagulability

Which is a causative factor in the development of deep vein thrombosis? A) excessive mobilization B) hypercoagulability C) lymphatic obstruction D) vascular malformation

D) acute renal failure

Which is a cause of a decrease in creatinine clearance? A) kwashiorkor B) nephrotic syndrome C) cirrhosis D) acute renal failure

A) deep vein thrombosis

Which is a cause of a painful swollen leg? A) deep vein thrombosis B) kwashiorkor C) premenstrual edema D) congestive heart failure

A) wet beriberi

Which is a cause of bilateral pitting ankle edema and shortness of breath? A) wet beriberi B) myxedema C) lipedema D) cellulitis

C) Milroy's disease

Which is a congenital cause of lymphedema? A) Achalasia B) Hirschsprung's disease C) Milroy's disease D) Meckel's diverticulum

C) café au lait spots

Which is a cutaneous marker for neurofibromatosis? A) acanthosis nigricans B) erythema nodosum C) café au lait spots D) actinic keratosis

D) ascites

Which is a feature in kwashiorkor? A) proteinuria B) angular cheilitis C) Casal's necklace D) ascites

A) proteinuria

Which is a red flag in a pregnant female with edema of the legs? A) proteinuria B) koilonychia C) low back pain D) hemorrhoids

D) small translucent papules with a central depression on the face

Which is the best description of the lesions seen in molluscum contagiosum? A) pigmented asymmetrical lesion on the trunk 1.5 cm in diameter B) well demarcated, silvery plaques at the back of the elbows C) warty cauliflower-like lesions on the hands D) small translucent papules with a central depression on the face

C) advise him to stop drinking alcohol

Which is the best management plan for this 49-year-old man with swollen legs? A) consult with a herpetologist B) refer him to the hospital C) advise him to stop drinking alcohol D) recommend milk thistle

A) B-type natriuretic peptide

Which is the best test to confirm the most likely diagnosis in this 75-year-old with swollen legs? A) B-type natriuretic peptide B) serum amylase C) chest radiograph D) comprehensive metabolic panel

D) increased vascular permeability

Which is the cause of the edema seen in cellulitis? A) decreased oncotic pressure B) blocked lymphatic drainage C) increased hydrostatic pressure D) increased vascular permeability

D) Vitiligo

Which is the diagnosis in the patient? A) Pityriasis versicolor B) Hansen's disease C) Impetigo D) Vitiligo

C) cirrhosis of the liver

Which is the most likely cause of bilateral pitting ankle edema, icterus, ascites and gynecomastia? A) carcinoma of the head of the pancreas B) stone in the common bile duct C) cirrhosis of the liver D) viral hepatitis

C) melanoma

Which is the most likely diagnosis in an 63-yearold college administrator with a non-itching, raised, brown-colored lesion that is 8 mm in diameter? A) pityriasis alba B) benign nevus C) melanoma D) impetigo

C) squamous cell carcinoma

Which is the most likely diagnosis of a chronic, non-healing lesion on the lower lip of a farmer? A) impetigo B) herpes labialis C) squamous cell carcinoma D) pemphigus

A) sodium retention

Which is the underlying mechanism of the edema associated with some non-steroidal anti-inflammatory drugs like naproxen? A) sodium retention B) decrease serum albumin C) blocks ADH secretion D) decrease aldosterone production

B) increased vascular permeability

Which is the underlying pathophysiology of the edema seen in wet beriberi? A) decrease lymphatic drainage B) increased vascular permeability C) increased hydrostatic pressure D) decreased oncotic pressure

A) steroids

Which medication could cause edema due to increase sodium retention? A) steroids B) acetaminophen C) anticholinergics D) beta blockers

E) Malassezia furfur

Which of the following causative agents is displayed in the image? A) Paramyxovirus B) Solar radiation C) Parvo B19 D) Sarcoptes scabeii E) Malassezia furfur

B) Solar radiation

Which of the following causative agents is displayed in the image? A) Paramyxovirus B) Solar radiation C) Sarcoptes scabeii D) Malassezia furfur E) Parvo B19

B) Sarcoptes scabeii

Which of the following causative agents is displayed in the image? A) Parvo B19 B) Sarcoptes scabeii C) Malassezia furfur D) Paramyxovirus E) Solar radiation

D) Paramyxovirus

Which of the following causative agents is displayed in the image? A) Parvo B19 B) Solar radiation C) Malassezia furfur D) Paramyxovirus E) Sarcoptes scabeii

C) Parvo B19

Which of the following causative agents is displayed in the image? A) Solar radiation B) Paramyxovirus C) Parvo B19 D) Malassezia furfur E) Sarcoptes scabeii

E) sscaly plaques

Which of the following dermatological descriptions is displayed in the image? A) honey colored crusts B) vesiculopustules in a dermatome C) hyperpigmented D) hypopigmented E) scaly plaques

B) hypopigmented

Which of the following dermatological descriptions is displayed in the image? A) hyperpigmented B) hypopigmented C) scaly plaques D) honey colored crusts E) vesiculopustules in a dermatome

D) honey colored crusts

Which of the following dermatological descriptions is displayed in the image? A) hypopigmented B) vesiculopustules in a dermatome C) hyperpigmented D) honey colored crusts E) scaly plaques

C) vesiculopustules in a dermatome

Which of the following dermatological descriptions is displayed in the image? A) scaly plaques B) honey colored crusts C) vesiculopustules in a dermatome D) hypopigmented E) hyperpigmented

B) hyperpigmented

Which of the following dermatological descriptions is displayed in the image? A) vesiculopustules in a dermatome B) hypopigmented C) hyperpigmented D) honey colored crusts E) scaly plaques

B) Psoriasis

Which of the following diagnoses is displayed in the image? A) Impetigo B) Psoriasis C) Vitiligo D) Melanoma E) Herpes zoster

A) Herpes zoster

Which of the following skin diseases is characterized by vesicles and pustules? A) Herpes zoster B) Psoriasis C) Scabies D) Eczema

A) Borrelia burgdorferi

Which organism is associated with this non-pruritic lesion? A) Borrelia burgdorferi B) Mycobacterium leprae C) HPV type 16 D) Trichophyton rubrum

A) puffy eyelids

Which physical finding is likely to be seen in renal disease? A) puffy eyelids B) gynecomastia C) jaundice D) buffalo hump

C) palpable swelling due to increase fluid in the interstitial space

Which statement best describes edema clinically? A) excess fluid in the extravascular compartment B) excess fluid in the intravascular compartment C) palpable swelling due to increase fluid in the interstitial space D) excess fluid in the intracellular compartment

B) It can cause osteopenia

Which statement regarding Complex Regional Pain Syndrome is correct? A) it is due to lymphatic obstruction B) It can cause osteopenia C) It always follows trivial injury D) It is more common in males

A) the intravascular oncotic pressure is negative 25 mm Hg at the arterial end

Which statement regarding Starling's forces is true? A) the intravascular oncotic pressure is negative 25 mm Hg at the arterial end B) the intravascular hydrostatic pressure is 80 mm Hg + at the arterial end C) the net capillary pressure at the arterial end is 35 mm Hg + D) the tissue hydrostatic pressure is positive 10 mm Hg at the venous end

A) it may be associated with varicose veins and obesity

Which statement regarding chronic venous insufficiency is true? A) it may be associated with varicose veins and obesity B) the brownish discolored skin is due to lipofuscin C) it often leads to right-sided heart failure D) there is often a wine glass appearance of the legs

A) it may be associated with a positive Stemmer's sign

Which statement regarding lymphedema is true? A) it may be associated with a positive Stemmer's sign b) it usually affects all four limbs C) it always follows radical mastectomies D) It could follow an infection with Neisseria

A) it is more common in males as in females

Which statement regarding obstructive sleep apnea is true? A) it is more common in males as in females B) it is associated with lower airway collapse C) it is due to excitation of the medullary centers D) it is accompanied by somnolence at night

D) it is only evident when more than 2.5 liters of fluid has accumulated

Which statement regarding the impact of edema is correct? A) it is an uncommon event in the general population B) more than 44 million people in the US suffer from edema C) it is generally not associated with serious underlying disease D) it is only evident when more than 2.5 liters of fluid has accumulated

A) papule

Which term best describes a raised lesion that measures 8 mm in diameter? A) papule B) macule C) nodule D) plaque

A) comedone

Which term is used to describe these lesions on the forehead and face of this teenager? A) comedone B) plaque C) ulcer D) bulla

A) silvery plaques

Which terms best described the lesions seen in psoriasis? A) silvery plaques B) lichenification C) vesiculopustular D) wheals

A) greater than 3.5 grams of proteinuria in a 24 hour-period

Which test result in a patient with bilateral pitting edema is conclusive of nephrotic syndrome? A) greater than 3.5 grams of proteinuria in a 24 hour-period B) there is an increase in serum cholesterol C) the albumin/globulin level is reversed D) the serum albumin level is less than 2.1 g/dl

D) Comprehensive Metabolic Panel

Which tests would be helpful in establishing the diagnosis and possibly its cause of swollen legs in a 49-year-old man? A) Hep B and C serology B) Complete Blood Count C) Thyroid Function Tests D) Comprehensive Metabolic Panel

C) myxedema

Which type of edema is related to a decrease in thyroxine? A) lipedema B) lymphedema C) myxedema D) angioedema

A) red, raised and itching

Which words best describes these ilesions? A) red, raised and itching b) honey-colored crusting lesions C) vesiculopustular rash D) red itching oozing rash