University of lahore past papers THE UNIVERSITY OF LAHORE-ISLAMABAD CAMPUS


Subject: Physical Assessment

Session:                 Pharm-D

Total Marks:  15

Date: 12/12/12

Time Allowed:  30min



Roll No.

A 50year old physician arrives at his office in the morning and is seized with crushing substernal chest pain accompanied bydiaphoresis. A sublingual nitroglycerin tablet does not relieve
his symptoms so he asks his nurse to drive him to the ER. Shepulls into the ER ramp entrance when her boss suddenly gasps and arrests. He is dead on arrival. The most likely cause of his
death is:

a. cardiogenic shock
b. ventricular arrhythmia
c. myocardial rupture
d. heart block
e. papillary muscle rupture

A 38-year-old landscape designer presents to the clinic to be evaluated for a cough. His vital

signs show a temperature of 103ºF, a pulse of 120, and a blood pressure of 88/55. His

respiratory rate is 28. He appears to have labored breathing. All of these indicators are signs of

(A) Pain from the cough

(B) Anxiety about the visit

(C) Respiratory distress

You notice that your patient’s submental lymph nodes are enlarged. You would then assess


(A) Supraclavicular area

(B)Infraclavicular area

(C) Area proximal to the enlarged node

(D) Area distal to the enlarged node

An 18-year-old college student presents to the clinic with the complaint that

her heart is “racing.” You obtain blood for thyroid studies and diagnose her

with Graves’ disease (hyperthyroidism). On physical examination of her eyes,

what would you expect to see?

(A) Recession

(B) Protrusion

(C) Clouding of the cornea

(D)Ciliary injection

Which of the following is the best technique for assessing the supraclavicular lymph nodes?

(A) Place the patient in a supine position and ask him to hold his breath while you palpate

(B) Place the patient in Trendelenburg position and illuminate the nodes with a bright light

(C) Standing behind the patient, palpate deeply behind the clavicles as he takes a deepbreath

(D) Palpate lightly below the clavicles with the patient in a sitting position

A 48-year-old unemployed man comes into the urgent care clinic complaining of increased

swelling in his lower extremities. He states that he has had swelling for a number of months but

that the swelling worsened last night. He complains of no ulcers or pain in the legs. His medical

history reveals a past diagnosis of “liver problems.” He isn’t sure what the exact diagnosis was.

He states he used to drink a case of beer a night but he has recently cut back to a six-pack. He

has smoked one pack of cigarettes a day for over 30 years and denies any IV drug use. On

exam, you note that both legs are swollen, with no skin thickening or ulcerations. Pressing your

thumb against his tibia reveals soft edema. Auscultation of his lungs reveals no crackles. His

heart sounds are regular, with no murmurs, rubs, or gallops. His abdomen reveals a small liver

but no discernable fluid wave. What diagnosis of peripheral causes of edema is most likely the

cause of his problem?

(A) Pitting edema

(B) Chronic venous insufficiency

(C) Lymphedema

Which of the following statements regarding myocardial infarction is false?
a. the diagnosis of acute non transmural myocardial infarction cannot reliably be made on the basis of a single ECG
b. uncommon causes of myocardial infarction include cocaine,arteritis, and emboli
c. most transmural myocardial infarcts result from plaque rupture and consequent complete thrombotic occlusion of a coronary artery
d. infarct extension can reliably be detected using ECG and history together

A 16-year-old sophomore presents to the clinic for a sports physical; she is accompanied by

her mother. She is involved in gymnastics and has been since age 5. In addition to training for

the gymnastics team, she runs 10 miles per day. She is proud of her athleticism and states that

she is still too fat and wants to lose more weight. You note that her BMI is 15. She denies

eating excessively or making herself vomit. The patient’s mother states she barely eats. This

patient is at risk for which medical problem?

(A) Obesity

(B) Bulimia

(C) Anorexia nervosa

(D) Not at risk; normal adolescence

A 20-year-old college junior presents to the clinic for a physical; he is going to be a camp

counselor for the summer. He is healthy and exercises regularly. His BMI is 22. You take his

blood pressure and obtain a value of 160/100. Which of the following is the most likely reason for

the unexpected blood pressure measurement?

(A) The width of the inflatable bladder of the cuff was 40% of the upper arm circumference

(B) The length of the inflatable bladder was 50% of the upper arm circumference

(C) The aneroid sphygmomanometer was calibrated just prior to measuring this patient’s

blood pressure

(D) The patient had sat for 15 minutes prior to the measurement of his blood pressure

A 58-year-old college professor presents to your clinic to establish care. In taking vital signs,

you feel the patient’s radial pulse. The pulse pressure is diminished, and the pulse feels weak

and small. The upstroke feels a little slow, and the peak is prolonged. You immediately suspect

that this patient may have which of the following diagnoses?

(A) Hypertrophic cardiomyopathy

(B) Premature atrial contractions

(C) Severe aortic stenosis

(D) Constrictive pericarditis

QNo.2)Enlist the Causes of Odema ?

b)Write down Examination Sequence of Arterial pulse Examination?

Q.No 3) Write down Examination sequences of Lymph nodes?

b)Write down Examination sequences of JVP?

Prepared by :

Dr. Haseeb Sattar

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