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In the vast majority of cases of delayed puberty, the problem is:

Slow Maturation

A 6-year-old female is showing growth of pubic hair. All other physical characteristics appear normal.
The correct diagnosis would be:

incomplete precocious puberty

A 7-year-old male presents to his physician because of breast enlargement. A CT scan reveals adrenal hyperplasia. What is the most likely diagnosis?

Heterosexual precocious puberty

An I8-year-old female is diagnosed with dysmenorrhea. Which of the following symptoms will she most likely experience?

Painful menses

A 20-year-old female presents with pelvic and back pain severe enough to miss work. She reports that the pain occurs with the onset of menses. Physical examination fails to find pelvic pathology. The most likely cause of her condition is:

elevated prostaglandins

A 20-year-old female presents with irregular and heavy bleeding, passage of large clots, and anemia.
She is most likely experiencing:


By definition, dysfunctional uterine bleeding is abnormal uterine bleeding resulting from:

disturbances in menses

A 25-year-old female presents with amenorrhea and hirsutism. She is diagnosed with polycystic ovarian syndrome. Lab testing will most likely reveal:


A 30-year-old female with newly diagnosed polycystic ovarian syndrome is being counseled by her OB-GYN. The physician indicates that this condition often results in:


A 23-year-old sexually active female presents with white copious discharge and itch. She is diagnosed with yeast vaginitis caused by overgrowth of which microorganism?

Candida albicans

The descent of the bladder and the anterior vaginal wall into the vaginal canal is called a:


During a routine pelvic exam, a 34-year-old female is found to have an ovarian cyst containing skin, hair, cartilage, and bone. This cyst is classified as a(n):

dermoid cyst

A 40-year-old female presents with cramping and excessive vaginal bleeding. Ultrasound reveals beni~ uterine tumors in the smooth muscle cells of the myometrium. These tumors are commonly called:


A 35 y/o female is dx with endometriosis. Suppressing which of the following would be the most appropriate medical tx for this dz?


A 21 y/o female is infected with HPV following unprotected sexual ic with a male she recently met. She is now at higher risk of developing which of the following cancers?

Cervical Ca

A 38-year-old female was recently diagnosed with cancer. She learns that her mother almost miscarried while pregnant with her and was given diethylstilbestrol (DES) to prevent it. Which of the following cancers does she most likely have?


The most commonly occurring cancer of the female reproductive tract is

Endometrial Ca

A 35-year-old female is diagnosed with ovarian cancer. CT scan reveals that the cancer is limited to the ovaries. It would be classified as stage:


An 18-year-old male presents with urethral itching and burning and increased frequency and urgency with urination. He reports recently having unprotected sex with a new partner. What is the most likely cause of his symptoms?

Neisseria gonorrhea

A 30-year-old male presents with penile tenderness and discharge. Physical examination reveals that his foreskin cannot be retracted back over the glans penis. He is suffering from:


An 18-year-old male presents complaining of difficulty having sexual intercourse. He reports that his penis curves during erection. This condition is referred to as:

Peyronie dz

________ is inflammation of the glans penis.


Cryptorchidism can be defined as:

problems with testicular descent

A 21-year-old male presents with inflammation of the testes. He has a high fever and edema and redn of the testes. Which organism is the most likely the cause of his symptoms?


The risk of testicular cancer is greater for men with a history of:


An important risk factor in the development of benign prostatic hypertrophy (BPH) is:

increased age

A middle-aged male speaks to his physician about benign prostatic hypertrophy. He reveals that his father was recently diagnosed with this condition, and he wants to know if he could have it. The physician tells him that a common complaint from men with mild to moderate benign prostatic hypertrophy is:

decrease urinary stream

Symptoms of prostatitis are similar to symptoms of:


Prostate cancer:

is the leading type of ca in men in the US

A 40 y/o male is concerned about the possibility of developing prostate ca. He reports that his father died of prostate ca, and he wants to take all preventative measures. He is told to consume a diet low in:


A 35-year-old nonpregnant female presents complaining of breast discharge. This condition is most likely caused by:

hormonal imbalance

Which of the following signs is usually the first clinical manifestation of breast cancer?

A painless lump

Gynecomastia is:

overdevelopment of breast tissue in males

A 35-year-old female presents with infertility and gradual blindness. She reports that she has otherwise been healthy. History reveals that she was promiscuous and had unprotected sexual intercourse several times when she was younger. Which oft he following sexually transmitted infection does she most likely) have?


A 19-year-old female presents with genital warts. Which of the following would cause this condition?


A 25-year-old sexually active female presents with pain during intercourse, dysuria, and spotting. She is diagnosed with trichomoniasis, which is a:


An example of a parasitic sexually transmitted infection that is transmitted through close skin-to-skin contact is:


The incidence of fractures of the pelvis is highest in:

elderly adults

A 65-year-old Hispanic female is admitted to the hospital with a pathologic, compound, oblique fracture of the femur. Which of the following statements best describes this type of fracture?

The fracture line is diagonal to the shaft of the bone

A 70-year-old female with osteoporosis fractures her leg at a location of preexisting abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the fracture?

Pathologic fracture

A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This fracture is referred to as a ________ fracture.


Transchondral fractures are most prevalent in:


A 35-year-old female suffers a broken clavicle following a motor vehicle accident. X-ray reveals that i bone surfaces in the joint partially lost contact with each other. This condition is called:


A 12-year-old female hurts her ankle while playing basketball. Tests reveal that she tore a ligament. TJ condition is known as a:


A 36-year-old male complains of pain and weakness in the elbow. He reports that he is a warehouse worker and lifts boxes daily. MRI reveals inflammation of the tendon where it attaches to bone. This condition is called:


After the Boston Marathon, seven runners were admitted to local hospitals with suspected myoglobinuria (rhabdomyolysis). What is the most likely cause of myoglobinuria in these athletes?

Excessive muscular atrophy

Which of the following hospital patients is at the highest risk for developing myoglobinuria (rhabdomyolysis )?

Admitted to the hospital for hip surgery and has had problems with anesthesia in the past

A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. This condition is caused by an increase in bone:


A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:

decreased estrogen levels

A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for:

bone fractures

An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with osteomalacia caused by:

inadequate bone mineralization

A 56-year-old male was admitted to the hospital with a diagnosis of osteomalacia. History reveals that he takes anticonvulsants, underwent small bowel resection 3 years earlier, and suffers from chronic pancreatitis. What is the common link between these three factors and the development of osteomalacia?

Vit D deficiency

Although ______ is similar to osteomalacia, it occurs in growing bones of children.


A 35-year-old female presents with impaired motor function, gradual deafness, and visual disturbances. Physical examination reveals asymmetric shape of skull and displaced teeth. X-ray reveals thickened and disorganized bones caused by abnormal and excessive bone remodeling. This condition is referred to as:

Paget Dz

The cause of Paget disease is:

unknown at present

A 70-year-old male presents wlback pain, fever, & weight loss. He reports he had a recent respiratory infection from which he thought he recovered. Tests revealed increased WBC count, & a diagnosis of endogenous osteomyelitis was made. The organisms causing this condition entered the bone through:

blood capillaries

Noninflammatory joint disease is differentiated from inflammatory joint disease by all of the following factors except:

the presence of pain

A 54-year-old female was recently diagnosed with degenerative joint disease. This condition causes:

degeneration and loss of articular cartilage

A 54-year-old male was recently diagnosed with osteoarthritis. Which of the following symptoms is he most likely experiencing?

Joint pain

Researchers have now determined that rheumatoid arthritis:

is an autoimmune dz

A 34-year-old female was recently diagnosed with rheumatoid arthritis. Physical examination revealed that inflammation started in the:

synovial membrane

A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity.
She was diagnosed with ankylosing spondylitis. Which of the following joints would be most affected?

Vertebral and sacroiliac

A 29-year-old male was recently diagnosed with ankylosing spondylitis. He is interested in obtaining more information about his disease. Patient teaching would include all of the following statements except:

the more common s/s of early dz include restricted joint movement and increased pain after physical activity

Which of the following .Qeople is at highest risk for the development of gout?

Men age 40 to 50

A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. The symptoms he experienced are caused by the crystallization of __ within the synovial fluid.

uric acid

A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. He is at risk for developing:

renal dz

A 51-year-old male experienced severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?


The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:

tophaceous gout

A 32-year-old male was injured in a motor vehicle accident and confined to bed for 3 weeks. During this time, the size and strength of muscle fibers decreased, a condition referred to as:

disuse atrophy

Fibromyalgia is a chronic musculoskeletal disorder characterized by:

diffuse pain, fatigue, and point tenderness

A 32-year-old female presents to her physician asking for something to ease her pain. She was previously diagnosed with fibromyalgia. Her pain is most likely caused by:

alterations in pain tolerance

Myotonia is characterized by:

prolonged depolarization of muscle cell membranes

The pattern of bone destruction indicative of an aggressive malignant tumor is known as a:

permeative pattern

A 13-year-old female is admitted to the hospital for evaluation and treatment of an osteosarcoma in her left distal femur. Which statement best describes osteosarcoma?

Osteogenic, most often develops in the bone marrow

A 60-year-old male presents with swelling and pain in the knee. CT reveals a cartilage-forming tumor. His diagnosis would be:


Myeloma is a cancer that originates in which bone marrow cell?

Plasma cell

A malignant tumor of skeletal muscle tissue origin is called:


A 2-month-old female was diagnosed with developmental dysplasia of the hip. If left untreated, she may develop hip:


A 9-month-old male was diagnosed with osteogenesis imperfecta following recurrent fractures and findings of osteopenia. This disease is caused by:

a genetic defect

A 9-month-old male was diagnosed with osteogenesis imperfecta following recurrent fractures and findings of osteopenia. This disease is caused by errors in the synthesis of:


Children with osteogenesis imperfecta suffer from frequent:

bone fractures

A I-year-old female was diagnosed with osteogenesis imperfecta. Which of the following could be a life-threatening complication in this patient?

Aortic aneurysm

A 6-year-old male presents with fever, pain, swelling, and warmth. Tests reveal osteomyelitis and development of an involucrum. Treatment should include:

surgical debridement and abx

Polyarthritis is a type of juvenile arthritis in which:

more than three joints are affected

A 5-year-old female was diagnosed with juvenile rheumatoid arthritis. The treatment option for this disease is:


Incidence of Legg-Calve-Perthes disease peaks at age:


Legg-Calve-Perthes disease affects which of the following joints?


Osgood-Schlatter disease causes inflammation of the:

patellar tendon

Structural scoliosis with no known cause, termed ________ scoliosis, accounts for at least 65% of the cases.


A 3-year-old male presents with developmental delay. Testing reveals that the child has muscular dystrophy. This disease causes:

degeneration of skeletal muscle fibers

Which protein is present in normal muscle cells and absent in muscle cells affected by Duchenne muscular dystrophy?


Duchenne muscular dystrophy has a(n) __ inheritance pattern.

X-linked recessive

Seventy-five percent of individuals with Duchenne muscular dystrophy will die before age:


A 22-year-old female has a brother with Duchenne muscular dystrophy and wants to know if her children will inherit it. A fairly accurate test to identify female carriers of the disease is measurement of serum levels of:

creatine kinase

A 13-year-old female presents with pain at night, cough, and dyspnea. Testing reveals a malignant bone tumor. The most likely type of tumor is:


There is a link between osteosarcoma and:


A 16-year-old male was recently diagnosed with osteosarcoma. The tumor is most likely present in the __ of long bones.


Ewing sarcoma originates from:

the bone marrow

A major predictor of prognosis for Ewing sarcoma is:

presence of metastasis

Dermal appendages include all of the following structures except:

dermal papilla

A 12-year-old female notices her hair and skin feel more oily than normal. Her physician explains that during puberty her sebaceous glands enlarge and are stimulated by:


Of the sweat glands, the______ glands are most abundant in the axilla and genital areas.


Keratinocytes are found in which layer of the skin?


Which cells are involved in initiating immune responses in the skin?

Langerhans cells

More heat may be conserved by the body if blood is shunted away from the arteriovenous anastomoses in the:


A 70-year-old male nursing home resident developed a dermal pressure ulcer. This condition is most often caused by:

unrelieved pressure

A 25-year-old paralyzed male develops a dermal pressure ulcer. The first indication of this ulcer was:


To promote efficient wound healing, dressings applied to a dermal pressure ulcer should be:

flat and moist

Individuals of _______ descent are more prone to developing keloids


A 23-year-old male received a knife wound in a fight. His scar was sharply elevated, irregularly shaped, and progressively enlarging. This condition is caused by excessive amounts of _____ in the corneum during connective tissue repair.


A 23-year-old male opiate abuser develops pruritus. An increase in which of the following is associated with pruritus?


A 19-year-old female developed a circular, demarcated, and salmon-pink lesion. Two weeks later she developed more lesions over the trunk and upper part of the extremities. This disorder is caused by a:


A 12-year-old female visits her physician to obtain acne medication for recurrent acne vulgaris. This condition is an inflammatory disorder of the:

pilosebaceous follicle

A 42-year-old female presents with raised red lesions with a brownish scale. She was diagnosed with discoid lupus erythematosus. This disorder is caused by:


In discoid lupus erythematosus, skin lesions are often accompanied by:

vasospasm in the extremities

A 45-year-old male presents with a chronic blister-forming disease of the skin and oral mucous membranes. This condition is referred to as:


A 9-year-old male presents with severe erythematous bullous lesions. Which of the following is the most likely diagnosis?

Steven-Johnson syndrome

A 50-year-old male recently underwent a liver transplant and is taking immunosuppressive drugs. He now has pain and vesicular eruptions on the face and trunk. He reports that he had chickenpox as a child. Which of the following is the most likely diagnosis?

Herpes Zoster

Tinea corporis (ringworm) is a __ infection of the skin.


A 20-year-old female presents with vaginal itch and thin-walled pustular lesions. She is diagnosed with candidiasis. This condition is caused by a(n):


A 30-year-old female has a history of frequent candidiasis. The region most likely affected is the:

mucous membranes

Candidiasis is likely to be exacerbated by:

systemic abx

A 10-year-old male is given penicillin for an infection. He has an allergic reaction, during which he develops urticarial lesions. These lesions are mediated by the release of:


Scleroderma involves___________of the skin


A 52-year-old female is diagnosed with scleroderma. Which complication results in skin ulcers to the fingers and nail shedding?

Raynauds phenomenon

What is the prognosis for patients with scleroderma?

There is no cure, and many individuals with scleroderma die within 5 yrs

A 13-year-old female is concerned about several pigmented skin lesions on her body. Her physician tells her that these lesions must be monitored because of their ability to transform into malignant melanoma. These lesions are referred to as:


Which of the following malignant skin lesions is the most serious?

malignant melanoma

A 40-year-old female is diagnosed with skin cancer. Her physician explains that the most important risk factor for skin cancer is:

amount of direct sun exposure at a young age

A 27-year-old male AIDS patient developed Kaposi sarcoma. Which of the following is the most likely risk factor associated with his disease?


A 29-year-old female is burned through all her dermis with only a few epidermal appendages intact. This burn is classified as:

deep partial-thickness

Which of the following burns is the most painful?

Superficial partial thickness

A 10-year-old male is playing with matches and gets burned. His burn develops large water-filled blisters immediately after the injury. This burn is classified as:

Superficial partial thickness

In burn injury patients, the Rule of NiSignificant decrease in systemic vascular resistance nes and the Lund and Browder chart are used to estimate:

total body surface area burned

A 30-year-old male fire fighter is badly burned and is admitted to the emergency department. Which of the following would be expected in the first 24 hours?

Significant decrease in systemic vascular resistance

Hypovolemia in the early stages of burn shock is directly related to:

increased capillary permeability and evaporative water loss

A 28-year-old male is admitted to the burn unit 2 hours after receiving second- and third-degree burns over 50% of his body surface in an industrial explosion. Abnormal vital signs include low blood pressure and tachycardia. Lab results show a high hematocrit. Urine output is low, and he is developing generalized edema. These clinical manifestations of the systemic response to the burn injury can be attributed to:

loss of capillary seal

Increased blood viscosity in the first 24 hours of burn shock predisposes the patient to:

blood clotting

A 36-year-old male is experiencing frontotemporal hair recession. He is diagnosed with male pattern baldness, a form of:


A 15 y/o female complains of hair growth on her face and body. This condition is referred to as:


A 4-month-old male is brought to his physician for severe itching and skin lesions. He is diagnosed with atopic dermatitis. Which of the following would be elevated in this patient?


A 4-month-old female is diagnosed with atopic dermatitis. Which of the following most likely led to this diagnosis?

Dry, itchy skin

A 2-month-old female develops diaper dermatitis. This condition is frequently accompanied by a secondary infection with:

Candida albicans

Acne vulgaris involves inflammation of the:

sebaceous glands

A 14-year-old female presents with severe acne. Which ofthe following promotes acne development


Bullous impetigo is caused by a strain of _____ that produces an exfoliative toxin that disrupts cellular adhesion.

Staph aureus

A lO-year-old female presents with vesicles consistent with vesicular impetigo. Which of the following causes this condition?

Streptococcus pyogens

A 3-year-old male develops tinea capitis after playing with the family dog. This infection is caused by a:


A 5-year-old male is diagnosed with tinea corporis following development of lesions on the nonhairy parts of his face, trunk, and limbs. A common source of this condition is:

young kittens

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