Thyroid and Neck Disorders
90 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the likely diagnosis of a patient with severe pain in the right upper quadrant, associated with nausea and non-bilious emesis, but no fever, weight loss, malaise, or ill contacts?

  • Acute appendicitis
  • Cholecystitis
  • Cholelithiasis (correct)
  • Gallstone pancreatitis

    • What is the likely cause of a 5-year-old girl's fever and severe abdominal pain, which worsens with hip extension?

  • Inflamed obturator internus muscle
  • Acute appendicitis (correct)
  • Irritation of the psoas major muscle
  • Quadratus lumborum muscle strain

    • What is the most likely explanation for a 65-year-old woman's constant, severe abdominal pain and decreased urine output?

  • Bladder cancer with urinary retention (correct)
  • Diverticulitis with bladder dyskinesis
  • Kidney stones with bilateral hydronephrosis
  • Peptic ulcer disease with anemia

    • A 44-year-old man comes to the emergency department with abdominal pain and nausea. What is the most likely diagnosis?

    <p>Cholelithiasis</p> Signup and view all the answers

    What is the likely cause of a patient's severe right upper quadrant pain, nausea, and vomiting?

    <p>Choledocholithiasis</p> Signup and view all the answers

    A patient is diagnosed with acute appendicitis. What muscle is most likely to be irritated?

    <p>Psoas major muscle</p> Signup and view all the answers

    What is the most likely finding on imaging of a patient with bladder cancer and urinary retention?

    <p>Bilateral hydronephrosis</p> Signup and view all the answers

    What is the most likely cause of a patient's abdominal pain, nausea, and vomiting, with a normal abdominal exam?

    <p>Acute gastroenteritis</p> Signup and view all the answers

    What is the most likely diagnosis of a patient with severe abdominal pain, nausea, and vomiting, with a history of smoking?

    <p>Bladder cancer</p> Signup and view all the answers

    What is the most probable diagnosis of a midline swelling in the anterior neck that moves on swallowing and protrusion of the tongue?

    <p>Thyroglossal Cyst</p> Signup and view all the answers

    A diffusely enlarged thyroid that is tender to touch is likely a sign of which condition?

    <p>Hashimoto's thyroiditis</p> Signup and view all the answers

    A 16-year-old girl presents with a diffuse swelling in her neck that is not associated with a bruit on auscultation. What is the most likely diagnosis?

    <p>Simple goitre</p> Signup and view all the answers

    What is the most likely diagnosis of a fluctuant swelling on the lateral neck that is asymptomatic and recently enlarged following an upper respiratory tract infection?

    <p>Scrofula</p> Signup and view all the answers

    What is the most likely diagnosis of a neck swelling in a child that is associated with pain and severe fever?

    <p>Lymphadenitis</p> Signup and view all the answers

    A patient presents with a swelling in the front of the neck that is enlarging over time. What is the most likely diagnosis?

    <p>Non-toxic multinodular goiter</p> Signup and view all the answers

    A patient presents with a midline swelling in the anterior neck that is mobile and fluctuant. What is the most likely diagnosis?

    <p>Thyroglossal Cyst</p> Signup and view all the answers

    What is the most likely diagnosis of a neck swelling that is associated with irritability and stress?

    <p>Hyperthyroidism</p> Signup and view all the answers

    A patient presents with a diffusely enlarged thyroid that is not tender to touch. What is the most likely diagnosis?

    <p>Simple goitre</p> Signup and view all the answers

    What is the characteristic of herpes simplex keratitis?

    <p>Corneal hyposthesia</p> Signup and view all the answers

    What is the immediate action to be taken for a patient with a full thickness corneal laceration?

    <p>Put a clear eye shield on the eye</p> Signup and view all the answers

    What is the type of gland affected in chalazion?

    <p>Meibomian gland</p> Signup and view all the answers

    What is the best treatment for deep leucoma?

    <p>Penetrating keratoplasty</p> Signup and view all the answers

    Where do blood vessels in a trachomatous pannus lie?

    <p>Between Bowman's membrane &amp; Epithelium</p> Signup and view all the answers

    What type of cells are characteristic in vernal catarrh?

    <p>Eosinophils</p> Signup and view all the answers

    Which muscle is paralyzed in Horner's syndrome, leading to ptosis?

    <p>Muller's muscle</p> Signup and view all the answers

    What is the treatment for severe congenital ptosis with no levator function?

    <p>Fascia lata sling operation</p> Signup and view all the answers

    Where is Fleischer ring found?

    <p>Keratoconus</p> Signup and view all the answers

    What is the most likely diagnosis for the patient experiencing constant abdominal pain that radiates to the back and flanks?

    <p>Pancreatitis</p> Signup and view all the answers

    What is the significance of the patient's family history of pancreatitis in his father and paternal uncle?

    <p>It increases the patient's risk of pancreatitis</p> Signup and view all the answers

    What is the most likely cause of the patient's abdominal distension?

    <p>Pancreatitis</p> Signup and view all the answers

    What is the significance of the patient's abdominal examination findings?

    <p>They indicate pancreatitis</p> Signup and view all the answers

    What is the most specific laboratory result for diagnosing pancreatitis?

    <p>Serum lipase &gt; 3 times the upper limit of normal</p> Signup and view all the answers

    What is the most likely diagnosis for the 22-year-old man with right lower quadrant abdominal pain?

    <p>Appendicitis</p> Signup and view all the answers

    What is the most likely cause of the 22-year-old man's rebound tenderness?

    <p>Inflammation of the appendix</p> Signup and view all the answers

    What is the most likely cause of the 26-year-old man's generalized fatigue?

    <p>Inflammatory bowel disease</p> Signup and view all the answers

    What is the significance of the 26-year-old man's family history of colon cancer?

    <p>It increases his risk of colon cancer</p> Signup and view all the answers

    What is the most likely cause of a patient's symptoms with a cloudy ascitic fluid, SAAG < 1.1, and triglyceride count > 200 mg/dL?

    <p>Intra Abdominal lymphoma</p> Signup and view all the answers

    What is the next step in management for a 75-year-old man with hematochezia and hemodynamic instability?

    <p>NG tube, proctosigmoidoscopy, and a tagged RBC scan with or without mesentery angiography</p> Signup and view all the answers

    What is the most likely test performed by a gastroenterologist to confirm a patient's ulcerative colitis flare-up?

    <p>Colonoscopy</p> Signup and view all the answers

    What is the rationale for using lactulose in a patient with hepatic encephalopathy?

    <p>To reduce ammonia levels in the gut</p> Signup and view all the answers

    What is the most likely diagnosis for a patient with ascites, spider angiomas, and icteric sclerae?

    <p>Chronic liver disease</p> Signup and view all the answers

    What is the most likely cause of a patient's altered mental status and flapping tremors?

    <p>Hepatic encephalopathy</p> Signup and view all the answers

    What is the significance of a SAAG < 1.1 in a patient with ascites?

    <p>It indicates a non-portal hypertensive cause of ascites</p> Signup and view all the answers

    What is the most likely finding on laboratory investigation in a patient with chronic liver disease?

    <p>Elevated liver enzymes and bilirubin</p> Signup and view all the answers

    What is the next step in management for a patient with hepatic encephalopathy?

    <p>Lactulose administration</p> Signup and view all the answers

    What is the most appropriate initial management for a patient with a 10% pneumothorax on the right?

    <p>Needle decompression</p> Signup and view all the answers

    What is the next step in management for a 62-year-old man presenting with mild breathlessness on exertion, occasional right-sided chest pain, and sweats?

    <p>Pleural ultrasound and diagnostic aspiration</p> Signup and view all the answers

    What is the most appropriate therapy for a 70-year-old man with a history of heavy smoking and COPD, who reports cough, chills, pleuritic chest pain, and low-grade fever?

    <p>Gram-negative cocci antibiotics</p> Signup and view all the answers

    What is the most likely diagnosis for a patient with a small dense infiltrate in the right lower lobe?

    <p>Pneumonia</p> Signup and view all the answers

    What is the most appropriate management for a patient with a pneumothorax and underlying COPD?

    <p>Needle decompression and chest tube insertion</p> Signup and view all the answers

    What is the most likely cause of a patient's symptoms with a large pneumothorax?

    <p>Underlying lung disease</p> Signup and view all the answers

    What is the most appropriate next step in management for a patient with a recurrent pneumothorax?

    <p>Thoracotomy with blebectomy</p> Signup and view all the answers

    Which of the following is the preferred imaging technique for diagnosing acute pulmonary embolism?

    <p>CT angiography</p> Signup and view all the answers

    A 27-year-old pregnant woman presents with sudden-onset right-sided chest pain and shortness of breath. What is the most appropriate next step in diagnosis?

    <p>Ventilation/perfusion scan</p> Signup and view all the answers

    What is the differential diagnosis for a patient suspected of having pulmonary embolism?

    <p>All of the above</p> Signup and view all the answers

    What is the most common symptom of pulmonary embolism?

    <p>Shortness of breath</p> Signup and view all the answers

    Which of the following is a complication of pulmonary embolism?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment of choice for acute pulmonary embolism?

    <p>Anticoagulation therapy</p> Signup and view all the answers

    Which of the following is a contraindication for fibrinolytic therapy in pulmonary embolism?

    <p>All of the above</p> Signup and view all the answers

    What is the most appropriate next step in management for the 14-year-old girl with recurrent episodes of shortness of breath and nonproductive cough?

    <p>Inhaled budesonide-formoterol as needed</p> Signup and view all the answers

    What is the most appropriate initial pharmacotherapy for the 28-year-old man with newly diagnosed asthma?

    <p>Low-dose steroid inhaler</p> Signup and view all the answers

    What is the most likely diagnosis for the 55-year-old male with a history of IV drug use presenting with fever, chills, and chest pain?

    <p>Endocarditis</p> Signup and view all the answers

    What is the most appropriate next step in management for the 14-year-old girl who is brought to the physician with acute onset of dyspnea and wheezing?

    <p>Albuterol inhaler</p> Signup and view all the answers

    What is a common feature of empyema?

    <p>Staphylococcus aureus, Streptococcus, and gram-negative bacilli are common causes</p> Signup and view all the answers

    What is the most likely diagnosis for the patient with a normal FEV1 and no abnormalities on cardiopulmonary examination and x-ray of the chest?

    <p>Gastroesophageal reflux disease</p> Signup and view all the answers

    What is the most appropriate first step in treatment for the 28-year-old man with newly diagnosed asthma and symptoms once or twice a week?

    <p>Short-acting beta-2 agonist inhaler</p> Signup and view all the answers

    What is the most likely cause of bilateral interstitial infiltrates in a 68-year-old man with atrial fibrillation and hypertension?

    <p>Amiodarone</p> Signup and view all the answers

    What is the most likely diagnosis for the 14-year-old girl with recurrent episodes of shortness of breath and nonproductive cough, which have resolved spontaneously with rest?

    <p>Asthma</p> Signup and view all the answers

    What is the diagnosis of a 25-year-old woman with cough, unintentional weight loss, and an 8-cm cavity in the right upper lobe on chest x-ray?

    <p>Tuberculosis</p> Signup and view all the answers

    What is the most likely diagnosis of a patient with pleural fluid pH 6.95 and gram-negative rods on Gram stain?

    <p>Empyema</p> Signup and view all the answers

    What is the most common cause of empyema?

    <p>Staphylococcus aureus and Streptococcus</p> Signup and view all the answers

    What is the next step in management of a patient with empyema?

    <p>Drainage with a chest tube</p> Signup and view all the answers

    What is the significance of a low pH in pleural fluid?

    <p>Suggests an exudative effusion</p> Signup and view all the answers

    What is the most likely diagnosis for a 55-year-old sandblaster presenting with cough, fatigue, and pleuritic chest pain?

    <p>Silicosis</p> Signup and view all the answers

    What is the most likely etiology of a 35-year-old HIV-positive man’s presentation with sudden onset of right-sided chest pain and shortness of breath?

    <p>Pneumothorax</p> Signup and view all the answers

    What is the first step in managing a patient with pneumothorax?

    <p>Administer oxygen therapy</p> Signup and view all the answers

    What is the indication for fibrinolytic therapy in a patient with pulmonary embolism?

    <p>All of the above</p> Signup and view all the answers

    What is the most common occupational lung disease caused by inhaling silica particles?

    <p>Silicosis</p> Signup and view all the answers

    What is the most likely complication of HIV-related respiratory disease?

    <p>Pneumocystis jirovecii pneumonia</p> Signup and view all the answers

    What is the goal of management in a patient with pneumothorax?

    <p>Prevent recurrence</p> Signup and view all the answers

    What is the most likely diagnosis based on an x-ray of the chest showing hyperinflation and hypertranslucency of the lower lobes of both lungs?

    <p>Emphysema</p> Signup and view all the answers

    Which antihypertensive medication is responsible for a dry cough in a 48-year-old woman?

    <p>Lisinopril</p> Signup and view all the answers

    What is the most likely diagnosis based on a productive cough with blood-tinged sputum, lethargy, night sweats, and decreased appetite in a 56-year-old man who recently returned from India?

    <p>Tuberculosis</p> Signup and view all the answers

    What is the most appropriate next step in the evaluation of a 45-year-old male with asthma whose symptoms have worsened despite medication?

    <p>Exercise physiology testing</p> Signup and view all the answers

    What is the most likely occupation-related lung disease in a 45-year-old textile worker with episodic cough and wheezing?

    <p>Byssinosis</p> Signup and view all the answers

    What is the most appropriate initial management for a patient with a 10% pneumothorax on the right?

    <p>Observation</p> Signup and view all the answers

    What is the most likely diagnosis in a patient with chronic cough, fever, and weight loss, and a history of HIV infection?

    <p>Pneumocystis pneumonia</p> Signup and view all the answers

    What is the most appropriate therapy for a 70-year-old man with a history of heavy smoking and COPD, who reports cough, chills, pleuritic chest pain, and low-grade fever?

    <p>Antibiotics and bronchodilators</p> Signup and view all the answers

    What is the most likely diagnosis in a patient with a small dense infiltrate in the right lower lobe?

    <p>Pneumonia</p> Signup and view all the answers

    What is the next step in management for a 62-year-old man presenting with mild breathlessness on exertion, occasional right-sided chest pain, and sweats?

    <p>Chest x-ray</p> Signup and view all the answers

    Study Notes

    Thyroid and Neck Swellings

    • A 15-year-old girl presents with a discrete mobile fluctuant midline swelling of the anterior neck at the level of the hyoid bone, moving on swallowing and protrusion of the tongue. The probable diagnosis is a thyroglossal cyst.
    • A 45-year-old woman presents with an enlarging mass in the front of her neck, feeling well with no changes in her health. The most likely diagnosis is Hashimoto's thyroiditis.

    Eye Conditions

    • Herpes simplex keratitis is characterized by corneal hyposthesia.
    • A 40-year-old male had a trauma to his right eye while hammering a metallic nail. Immediate action is to put a clear eye shield on the eye.
    • Chalazion is a chronic inflammatory granuloma of the Meibomian gland.
    • Deep leucoma is best treated by penetrating keratoplasty.
    • Blood vessels in a trachomatous pannus lie between Bowman's membrane and epithelium.
    • In vernal catarrh, the characteristic cells are eosinophils.
    • Ptosis in Horner's syndrome is due to paralysis of Muller's muscle.
    • Severe congenital ptosis with no levator function can be treated by fascia lata sling operation.
    • Fleischer ring is found in keratoconus.

    Abdominal Conditions

    • A patient presents with a swelling in the neck, pain, and fever. The most likely diagnosis is a cervical lymphoepithelial cyst.
    • A 5-year-old girl is brought to the emergency department because of fever and severe abdominal pain. Acute appendicitis is diagnosed, and the inflamed structure associated with these symptoms is most likely in contact with the psoas major muscle.
    • A 65-year-old woman is admitted to the hospital for constant, severe abdominal pain that has worsened over the prior week. The most likely diagnosis is bladder cancer, and bilateral hydronephrosis is likely to be detected upon imaging.
    • A 44-year-old man comes to the emergency department with abdominal pain and nausea for the past 24 hours. The pain started a few hours after dinner, and the most specific laboratory result in diagnosing this patient's condition is serum lipase > 3 times the upper limit of normal.
    • A 22-year-old man develops marked right lower quadrant abdominal pain over the past day. The pain experienced by this patient is predominantly the result of prostaglandin and bradykinin.

    Other Conditions

    • A 26-year-old man comes to the physician because of a 6-month history of increasing generalized fatigue, inability to work out, lower abdominal pain, and occasionally bloody diarrhea. The most likely cause of this patient's symptoms is chylous ascites.
    • A 75-year-old man develops hematochezia and presents with hemodynamic instability. The most appropriate next step in management is NG tube, mesentery angiography, and colonoscopy.
    • A 28-year-old man presents to his gastroenterologist with a two-week history of abdominal pain, bloody diarrhea, and urgency to have a bowel movement. The most likely diagnosis is a flare-up of ulcerative colitis.
    • L, a patient with chronic liver disease, presents with altered mental status and flapping tremors. The rationale for using lactulose in this patient is to treat hepatic encephalopathy.

    Pneumothorax

    • A 10% pneumothorax on the right can cause diminished breath sounds, hyperresonance, and decreased tactile fremitus in the right lung field.
    • The most appropriate initial management for a 10% pneumothorax is needle decompression.

    Management of Chest Pain

    • For a 62-year-old man with a three-day history of mild breathlessness on exertion, occasional right-sided chest pain, and sweats, the next step in management is pleural ultrasound and diagnostic aspiration.
    • For a 70-year-old man with a history of heavy smoking and COPD, the most appropriate therapy is antibiotics, such as for gram-negative cocci.

    Differential Diagnosis of PE

    • PE should be considered in the differential diagnosis of patients suspected of having cardiac ischemia, heart failure, COPD exacerbation, pneumothorax, pneumonia, sepsis, acute chest syndrome, and acute anxiety with hyperventilation.
    • The preferred imaging technique for diagnosing acute PE is CT angiography.

    Chest Pain in Pregnancy

    • For a 27-year-old woman who is 7 months pregnant with sudden-onset right-sided chest pain and shortness of breath, the most appropriate next step in diagnosis is CT angiography or ventilation/perfusion scan.

    Empyema

    • Empyema is typically caused by Staphylococcus aureus, Streptococcus, and gram-negative bacilli.
    • Gross purulence is diagnostic of empyema, and the absence of frank pus rules out infection.

    COPD and Pulmonary Fibrosis

    • A 68-year-old man with a worsening nonproductive cough and progressive shortness of breath may have bilateral interstitial infiltrates due to medication, such as amiodarone.
    • A 55-year-old man with a history of IV drug use and fever, chills, and chest pain may have a grade II/VI systolic murmur and petechial skin lesions due to endocarditis.

    Asthma

    • For a 25-year-old woman with a 4-month history of cough and unintentional weight loss, the most appropriate next step in management is to start treatment with oral medications.
    • For a 14-year-old girl with recurrent episodes of shortness of breath and nonproductive cough, the most appropriate initial pharmacotherapy is an albuterol inhaler.
    • For a 28-year-old man with asthma, the most appropriate first step in treatment is a short-acting beta-2 agonist inhaler or a low-dose steroid inhaler.

    Other Respiratory Conditions

    • A 35-year-old HIV-positive man with right-sided chest pain and shortness of breath may have a pneumothorax due to Pneumocystis jiroveci pneumonia.
    • A 55-year-old man with a history of sandblasting and cough, fatigue, and pleuritic chest pain may have silicosis.
    • A 48-year-old woman with a dry cough that has not improved despite taking cough linctus and antibiotics may have a medication-related side effect, such as from ACE inhibitors.

    Infections

    • A 56-year-old man with a productive cough with blood-tinged sputum, lethargy, night sweats, and decreased appetite after returning from India may have tuberculosis.
    • A 45-year-old male with episodic cough and wheezing that responded initially to inhaled bronchodilators and inhaled corticosteroids may have occupational asthma.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Q Bank MSQs PDF

    Description

    This quiz consists of solved questions related to thyroid and neck disorders, including symptoms and diagnosis. It's a useful resource for medical students and professionals.

    More Like This

    CHAPTER 11 Head and Neck
    134 questions

    CHAPTER 11 Head and Neck

    BeneficentSagacity avatar
    BeneficentSagacity
    Thyroid Disorders
    3 questions

    Thyroid Disorders

    IntegratedAntigorite84 avatar
    IntegratedAntigorite84
    Thyroid Disorders: Hyperthyroidism
    8 questions

    Thyroid Disorders: Hyperthyroidism

    PoeticNickel avatar
    PoeticNickel
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser