Question 1

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

Accepted Answer

The symptoms described are consistent with the Cushingoid effect, which is a side effect of prolonged steroid use. It is characterized by facial swelling and weight gain due to the steroid's effect on regulating salt and water balance in the body. Angioedema is a localized swelling due to an allergic reaction, parotitis is inflammation of the parotid gland, and myxedema is a term used to describe skin and tissue changes due to severe hypothyroidism. These conditions are not related to prolonged steroid use.

Question 2

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 are all classic signs of hyperthyroidism. Enlargement of the thyroid gland is also commonly seen in hyperthyroidism. Hypothyroidism would present with the opposite symptoms (feeling cold, fatigue, weight gain). Thyroid cancer may present with an enlarged thyroid gland, but would not typically cause the other symptoms mentioned.

Question 3

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

The symptoms described (burning,epigastric pain, regurgitation of food when lying flat) are classic symptoms of gastroesophageal reflux disease (GERD), which occurs due to the backward flow of stomach acid into the esophagus. Neuromuscular disorders, esophageal cancer, and achalasia may also cause similar symptoms, but they are less common than GERD.

Question 4

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

The most common cause of constantly itchy scalp in a child is Pediculosis, which is an infestation of head lice. Seborrheic dermatitis and psoriasis are also possible causes, but lice infestation is more common in school-aged children. Basal cell carcinoma is a rare type of skin cancer and is not associated with an itchy scalp.

Question 5

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

Accepted Answer

Numbness of the cheek is a symptom related to the sensory function of the trigeminal nerve (cranial nerve V). Therefore, testing the trigeminal nerve is necessary to evaluate the patient's complaint.

Question 6

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

Accepted Answer

Calcium phosphate stones can form in the ducts of the salivary glands, causing a disorder known as sialoadenitis. Temporomandibular joint syndrome, trigeminal neuralgia, and mumps are unrelated conditions.

Question 7

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

Accepted Answer

The use of alcohol and tobacco are significant risk factors for diseases of the head, face, and neck, including oral, pharyngeal, and laryngeal cancers. Past dental work, history of tension headaches, and use of aspirin may be relevant to the patient's overall health history but are not specifically related to the risk of diseases in the head, face, and neck.

Question 8

A 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 presentation of extremely tight, shiny skin over the hands and face, lack of nasolabial folds and facial expression is a classic presentation of scleroderma, an autoimmune condition that causes thickening and hardening of the skin and connective tissues. Bell's palsy refers to facial paralysis, trigeminal neuralgia is a painful condition affecting the trigeminal nerve, and hypothyroid myxedema presents with puffiness and swelling of the face and hands due to accumulation of mucopolysaccharides.

Question 9

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

Accepted Answer

A solitary cold nodule on RAI uptake on a thyroid scan is suspicious for thyroid cancer. In a thyroid scan, a low uptake of radioactive iodine indicates that the thyroid tissue is not functioning normally. A solitary cold nodule refers to an area on the thyroid scan where there is no uptake of radioactive iodine, which can indicate a non-functioning or cancerous nodule. Therefore, option D, thyroid cancer, is the best choice.

Question 10

Inflammation of the parotid gland can cause which of the following conditions?

Accepted Answer

Inflammation of the parotid gland can cause mumps, which is a viral infection that leads to fever, headache, and swollen salivary glands, including the parotid gland. Trigeminal neuralgia, bruxism, and temporomandibular joint syndrome are not directly related to parotid gland inflammation.

Question 11

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

Accepted Answer

The symptoms described are classic signs of temporomandibular joint (TMJ) syndrome, including pain with chewing, earache, and teeth grinding. Trigeminal neuralgia typically presents with sudden, severe facial pain, while facial nerve palsy results in weakness or paralysis of the facial muscles. Angina refers to chest pain or discomfort that occurs when the heart muscle does not receive enough blood flow.

Question 12

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

The symptoms described suggest facial nerve (cranial nerve VII) dysfunction, which can cause weakness or paralysis of the muscles of facial expression, including the inability to close the eye on one side. Testing cranial nerve VII would help to confirm this diagnosis.

Question 13

Your patient presents to the ER 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

The increasing facial swelling, redness, and swelling of the lips and eyes suggest an allergic reaction, specifically angioedema, which can occur as a result of a bee sting. Parotitis, sinusitis, and sialoadenitis do not typically cause these signs and symptoms.

Question 14

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

The presentation of left-sided unilateral facial droop and inability to close the left eye is consistent with Bell's palsy, which is a type of facial paralysis that is typically caused by a viral infection, such as Lyme disease in this case. Trigeminal neuralgia is characterized by facial pain and not facial droop. Temporomandibular joint syndrome primarily affects the jaw and does not involve facial droop. Multiple sclerosis can cause facial droop, but it is typically bilateral and not unilateral.

Question 15

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

Accepted Answer

Cervical lymphadenopathy, or enlarged lymph nodes in the neck, is a common symptom of Epstein-Barr viral infection.

Question 16

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 with oral sex. Hemolytic Streptococcus can cause pharyngitis but not through sexual transmission. Epstein-Barr virus and Cytomegalovirus can cause cervical lymphadenopathy, but not through sexual transmission.

Question 17

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 18

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 point towards cellulitis, which is a bacterial infection of the skin and subcutaneous tissue that can occur after a break in the skin such as the cut from shaving. The warmth, erythema, and swelling are characteristic of cellulitis, as is the exudate. Folliculitis is limited to the hair follicle and would not typically cause this much swelling or exudate. Suppurative parotitis and sialadenitis involve infection of the salivary glands and would present with localized pain and swelling in that area, which is not mentioned in the scenario.

Question 19

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

Accepted Answer

Squamous cell carcinoma is a type of cancer commonly associated with chronic abuse of alcohol and tobacco. It can present with lymphadenopathy of the head and neck. Alcohol and tobacco use have also been associated with an increased risk of other cancers, including thyroid cancer, but squamous cell carcinoma is the most strongly associated with these risk factors. Lymphoma and leukemia are not as strongly associated with alcohol and tobacco use.

Question 20

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

Accepted Answer

The presenting signs of weight loss, fever, fatigue, cervical and mediastinal lymphadenopathy are often seen in lymphoma, a type of cancer that affects the lymphatic system. Hypothyroidism may cause weight gain and fatigue, but not the other symptoms listed. Scleroderma is a connective tissue disorder that can cause skin tightening and other symptoms, but not the ones listed. Esophageal cancer can present with weight loss and difficulty swallowing, but typically not with fever, fatigue, and lymphadenopathy.

Quiz 4: Head,face,and Neck