Title: Usmle Step 1 MCQ’s # 32
Subject: Behavioral Science
Q NO 32: An 85-year-old man presents with complaints of pain in his left chest on inspiration. Physical examination reveals bilateral bruises on his upper arms. X-ray films of his chest show three broken ribs on the left side. The most likely explanation for this constellation of findings is
A. alcoholic incoordination
B. elder abuse
C. falling in the bathtub
D. phase III Alzheimer’s disease
E. physical sequela of pseudodementia
Explanation:
The correct answer is B. The bilateral bruises on the upper arms suggest that he has been tightly grabbed. The left-sided rib fractures would support the possibility that he was struck forcefully by someone who is right-handed (as most people are).
Alcoholic incoordination (choice A) characteristically results in bruises on the lateral surface of the body as the person stumbles into door frames, or on the shins at” coffee table” height.
Falling in the bathtub (choice C) is likely to produce bruises localized to one side of the body.
There are no characteristic physical signs of trauma associated with either Alzheimer’s disease (choice D) or pseudodementia (choice E)
Source: http://www.usmleworldwide.com/blog/?p=670
Subject: Behavioral Science
Q NO 32: An 85-year-old man presents with complaints of pain in his left chest on inspiration. Physical examination reveals bilateral bruises on his upper arms. X-ray films of his chest show three broken ribs on the left side. The most likely explanation for this constellation of findings is
A. alcoholic incoordination
B. elder abuse
C. falling in the bathtub
D. phase III Alzheimer’s disease
E. physical sequela of pseudodementia
Explanation:
The correct answer is B. The bilateral bruises on the upper arms suggest that he has been tightly grabbed. The left-sided rib fractures would support the possibility that he was struck forcefully by someone who is right-handed (as most people are).
Alcoholic incoordination (choice A) characteristically results in bruises on the lateral surface of the body as the person stumbles into door frames, or on the shins at” coffee table” height.
Falling in the bathtub (choice C) is likely to produce bruises localized to one side of the body.
There are no characteristic physical signs of trauma associated with either Alzheimer’s disease (choice D) or pseudodementia (choice E)
Source: http://www.usmleworldwide.com/blog/?p=670
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