Physician Assistant History and Physical Examination 3

Question 1

Which cranial nerve is tested when you ask a patient to shrug their shoulders against resistance?

Accepted Answer

CN XI

Answer

CN XI (spinal accessory nerve) innervates the sternocleidomastoid and trapezius, tested by shoulder shrug and head turning against resistance.

Question 2

A 40-year-old presents with painless lymphadenopathy in the right supraclavicular region. What is this finding classically called and what does it suggest?

Accepted Answer

Virchow's node — suggests right-sided thoracic or cervical malignancy

Answer

The right supraclavicular node (Virchow's on the right side) drains the thorax, lungs, and esophagus and its enlargement suggests right-sided thoracic or mediastinal malignancy.

Question 3

During a musculoskeletal exam, a patient has pain with passive range of motion of a joint. This finding most suggests:

Accepted Answer

Pathology within the joint itself

Answer

Pain with passive range of motion implicates the joint capsule or intra-articular structures, as the examiner — not the patient's muscles — is generating the movement.

Question 4

Which of the following best describes the CAGE questionnaire used in clinical history-taking?

Accepted Answer

A 4-item tool screening for alcohol use disorder

Answer

CAGE screens for alcohol use disorder using four yes/no questions: Cut down, Annoyed, Guilty, Eye-opener.

Question 5

A patient's apical pulse is palpated at the 6th intercostal space, anterior axillary line. This displacement suggests:

Accepted Answer

Left ventricular hypertrophy or dilation

Answer

The point of maximal impulse (PMI) displaced laterally and inferiorly from the 5th ICS, MCL suggests left ventricular enlargement.

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Physician Assistant History and Physical Examination 3