Question 1

A patient with a positive Lyme titer presents with left-sided unilateral facial droop and inability to close the left eye. This is most likely due to:

Accepted Answer

Bell's palsy is a condition often associated with Lyme disease, characterized by sudden, unilateral facial weakness or paralysis due to inflammation of the facial nerve. In areas where Lyme disease is common, it can be a cause of facial palsy.

Question 2

Your patient presents to the emergency room due to a bee sting on the cheek. As you are examining the patient, you note increasing facial swelling and redness, as well as swelling of the lips and eyes. This condition is due to:

Accepted Answer

Angioedema is the correct answer because it is characterized by the rapid swelling of the deeper layers of the skin, often affecting the face, lips, and around the eyes, which matches the symptoms described in the scenario. This condition can be triggered by an allergic reaction, such as a bee sting.

Question 3

A goiter is most commonly associated with:

Accepted Answer

Goiters can be associated with hypothyroidism, hyperthyroidism, or even normal thyroid function (euthyroidism), depending on the underlying cause.

Question 4

Which of the following is a sexually transmitted infection that can cause pharyngitis and cervical lymphadenopathy with oral sex?

Accepted Answer

Chlamydia trachomatis can cause pharyngitis and cervical lymphadenopathy when transmitted through oral sex, highlighting its role as a sexually transmitted infection that can affect areas beyond the genital region.

Question 5

A solitary cold nodule on radioactive iodine (RAI) uptake on a thyroid scan is suspicious for:

Accepted Answer

A solitary cold nodule on a radioactive iodine uptake scan indicates an area within the thyroid gland that is not taking up iodine as expected. This can be suspicious for thyroid cancer, as cancerous cells may not absorb iodine in the same way as normal thyroid tissue.

Question 6

Calcium phosphate stones can develop within the salivary gland ducts. This can occur in the disorder called:

Accepted Answer

Sialadenitis is an infection or inflammation of the salivary glands that can lead to the development of calcium phosphate stones within the salivary gland ducts.

Question 7

A 6-year-old patient complains of a constantly itchy scalp that developed after returning home from school today. The most common cause for this condition in a child is:

Accepted Answer

Pediculosis, or head lice infestation, is the most common cause of an itchy scalp in children, especially those attending school where close contact facilitates the spread of lice.

Question 8

On physical examination, your 55-year-old female patient has an enlarged thyroid gland. She complains of feeling hot all the time, nervousness, palpitations, tremor, and recent weight loss of 10 pounds over the past 3 weeks. These signs and symptoms are commonly due to:

Accepted Answer

The symptoms described (feeling hot, nervousness, palpitations, tremor, weight loss) along with an enlarged thyroid gland are classic signs of hyperthyroidism, where the thyroid gland is overactive and produces too much thyroid hormone.

Question 9

Weight loss, fever, fatigue, and cervical and mediastinal lymphadenopathy are often the presenting signs of:

Accepted Answer

Lymphoma often presents with symptoms such as weight loss, fever, fatigue, and lymphadenopathy (including cervical and mediastinal regions), which are not typical of the other conditions listed.

Question 10

Which of the cranial nerves should be tested when a patient presents with right-sided facial droop and inability to close the right eye?

Accepted Answer

Cranial nerve VII, also known as the facial nerve, is responsible for facial expressions, including the ability to close the eyes. Right-sided facial droop and inability to close the right eye indicate a dysfunction of this nerve.

Question 11

One of the most common signs of Epstein-Barr viral infection (infectious mononucleosis) is:

Accepted Answer

Cervical lymphadenopathy is a common sign of Epstein-Barr viral infection (infectious mononucleosis), characterized by the swelling of lymph nodes in the neck.

Question 12

A patient complains of pain with chewing, earache, and grinding her teeth when asleep. These are symptoms of:

Accepted Answer

The symptoms described are characteristic of Temporomandibular Joint Syndrome (TMJ), which includes pain with chewing, earaches, and teeth grinding (bruxism) during sleep.

Question 13

When obtaining a health history focusing on the patient's head, face, and neck, which of the following is particularly important with regard to risk of disease?

Accepted Answer

The use of alcohol and tobacco is particularly important when obtaining a health history focusing on the patient's head, face, and neck because both substances are significant risk factors for oral, head, and neck cancers.

Question 14

A patient with systemic lupus erythematosus has been taking a prolonged course of steroids. She complains that her face appears swollen and she has experienced a 10-pound weight gain. This is often referred to as:

Accepted Answer

The Cushingoid effect is a side effect of prolonged corticosteroid use, characterized by weight gain and fat redistribution leading to a "moon face" appearance, which the patient describes.

Question 15

Which of the cranial nerves should be tested if the patient complains of numbness of the cheek?

Accepted Answer

Cranial nerve V, also known as the trigeminal nerve, is responsible for sensation in the face, including the cheek area, as well as motor functions for biting and chewing.

Question 16

Chronic abuse of alcohol and tobacco are associated with __________________, which can present with lymphadenopathy of the head and neck.

Accepted Answer

Chronic abuse of alcohol and tobacco significantly increases the risk of developing squamous cell carcinoma, especially in the head and neck region. This type of cancer can indeed present with lymphadenopathy in those areas.

Question 17

A patient complains of burning, epigastric pain, and regurgitation of food when lying flat. It is important to recognize that these symptoms are common in:

Accepted Answer

These symptoms are characteristic of gastroesophageal reflux disease (GERD), where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing symptoms like burning epigastric pain and regurgitation of food, especially when lying flat.

Question 18

A 40-year-old female patient presents with extremely tight, shiny skin over the hands and face. There is also a lack of nasolabial folds and blank facial expression. This is a common sign of:

Accepted Answer

The symptoms described, such as extremely tight, shiny skin over the hands and face, lack of nasolabial folds, and a blank facial expression, are characteristic of scleroderma. Scleroderma is a group of autoimmune diseases that cause the skin and connective tissues to harden and tighten.

Question 19

With the influx of immigrants to the United States and/or parent refusal of immunizations for their children, paramyxovirus (mumps) can still be seen in the clinical setting. Mumps can cause which of the following conditions?

Accepted Answer

Mumps is known to cause parotitis, which is the inflammation of the parotid glands, a common symptom of the mumps virus.

Question 20

Your patient accidentally cut his cheek while shaving 3 days ago. Today, the region is warm, erythematous, swollen, and has the appearance of an orange peel. There is a serous exudate coming from the wound. This is most likely due to:

Accepted Answer

The symptoms described, including warmth, erythema, swelling, and a serous exudate, along with the "orange peel" appearance (peau d'orange), are indicative of cellulitis. Cellulitis is a common, potentially serious bacterial skin infection. The affected skin appears swollen and red and is typically painful and warm to the touch.

Quiz 4: Head, Face, and Neck