Question 1. You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of a patient with hypothyroidism?
Moist and smooth
Moist and rough
Dry and smooth
Dry and rough
Question 2. Question : You are assessing a patient with joint pain and are trying to decide whether it is inflammatory or noninflammatory in nature. Which one of the following symptoms is consistent with an inflammatory process?
Tenderness
Cool temperature
Ecchymosis
Nodules
Question 3. Question : A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis?
Actinic keratosis
Seborrheic keratosis
Basal cell carcinoma
Squamous cell carcinoma
Question 4. Question : A 28-year-old graduate student comes to your clinic for evaluation of pain “all over.” With further questioning, she is able to relate that the pain is worse in the neck, shoulders, hands, low back, and knees. She denies swelling in her joints. She states that the pain is worse in the morning. There is no limitation in her range of motion. On physical examination, she has several points on the muscles of the neck, shoulders, and back that are tender to palpation. Muscle strength and range of motion are normal. Which one of the following is likely the cause of her pain?
Rheumatoid arthritis
Osteoarthritis
Fibromyalgia
Polymyalgia rheumatica
Question 5. Question : Heberden’s nodes are commonly found in which one of the following diseases?
Rheumatoid arthritis
Degenerative joint disease
Psoriatic arthritis
Septic arthritis
Question 6. Question : A new patient is complaining of severe pruritus that is worse at night. Several family members also have the same symptoms. Upon examination, areas of excoriated papules are noted on some of the interdigital webs of both hands and on the axillae. This finding is most consistent with:
Contact dermatitis
Impetigo
Larva migrans
Scabies
Question 7. Question : An obese 55-year-old woman went through menarche at age 16 and menopause 2 years ago. She is concerned because an aunt had severe osteoporosis. Which one of the following is a risk factor for osteoporosis?
Obesity
Late menopause
Having an aunt with osteoporosis
Delayed menarche
Question 8. Question : Ms. Whiting is a 68-year-old female who comes in for her usual follow-up visit. You notice a few flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else. She doesn’t mention them. They are tender when you examine them. What should you do?
Conclude that these are lesions she has had for a long time.
Wait for her to mention them before asking further questions.
Ask how she acquired them.
Conduct the visit as usual for the patient.
Question 9. Question : A 58-year-old man comes to your office complaining of bilateral back pain that now awakens him at night. This has been steadily increasing for the past 2 months. Which one of the following is the most reassuring in this patient with back pain?
: Age over 50
Pain at night
Pain lasting more than 1 month or not responding to therapy
Pain that is bilateral
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