Assignment: The cause of constipation

Assignment: The cause of constipation

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Question 6. Question : A 42-year-old florist comes to your office, complaining of chronic constipation for the last six months. She has had no nausea, vomiting, or diarrhea, and no abdominal pain or cramping. She denies any recent illnesses or injuries. She denies any changes to her diet or exercise program. She is on no new medications. During the review of systems (ROS), you note that she has felt fatigued, had some weight gain, has irregular periods, and has cold intolerance. Her past medical history is significant for one vaginal delivery and two cesarean sections. She is married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her mother has type 2 diabetes and her father has coronary artery disease. There is no family history of cancers. On examination, she appears her stated age. Her vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her cardiac, lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is negative. Her deep tendon reflexes are delayed in response to a blow with the hammer, especially the Achilles tendons.

What is the best choice for the cause of her constipation?

Large bowel obstruction

Irritable bowel syndrome

Rectal cancer

Hypothyroidism

Question 7. Question : A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked two packs per day since the age of sixteen, but is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning symptoms for the peripheral vascular system?

Intermittent claudication

Chest pressure with exertion

Shortness of breath

Knee pain

Question 8. Question : You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which of the following locations would the patient’s pain make you concerned for this disease process?

Thigh

Knee

Calf

Ankle

Question 9. Question : A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?

Femoral pulse, popliteal pulse

Dorsalis pedis pulse, posterior tibial pulse

Carotid pulse

Radial pulse, brachial pulse

Question 10. Question : Cody is a teenager with a history of leukemia and an enlarged spleen. Today he presents with fairly significant left upper quadrant (LUQ) pain. On examination of this area, a rough grating noise is heard. What is this sound?

It is a splenic rub.

It is a variant of bowel noise.

It represents borborygmi.

It is a vascular noise.

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