Conditions and Treatments - NCLEX-PN

Exercise intolerance is a typical clinical finding in pediatric patients with aortic stenosis. This condition may present with any of the other symptoms but mania, excessive sweating, and epigastric pain are not directly associated with aortic insufficiency in this population.

Polymyositis is characterized by symmetric proximal muscle weakness in the upper and lower extremities, often without the presence of distal muscle weakness. The first sign is often weakness in the thighs while walking, the inability to rise from a seated position without assistance, or the inability to raise the arms above the head.

Dermatomyositis generally includes a characteristic periorbital rash. Weakness is expressed in the neck, arms, and legs. Guillain-Barre syndrome is an ascending paralysis: symptoms start in the hands and feet, then spread proximally as it progresses. Muscular weakness in myasthenia gravis is often especially expressed in muscles of the face and head, especially those that control eye and eyelid movement, facial expression, chewing, swallowing, and speaking.

A rhabdomyoma is a benign tumors of striated muscle. 90% of adult rhabdomyomas present as round masses in the neck.

Paget's disease of bone is a condition characterized by high bone turnover due to accelerated osteoclast and osteoblast activity. This results in increased calcification of bones, especially prominent in the skull, pelvis, femur, and tibia.

Osteogenesis imperfecta is an issue with collagen formation that causes fragile bones and multiple fractures. Multiple myeloma is a malignancy of plasma calls, and giant cell tumors are rare tumors that generally originate from the epiphysis of long bones (with no effect on bone deposition).

The most common time for miscarriage to occur is during the first trimester, between 8 and 12 weeks. This may even occur before an individual is aware that they are pregnant. Chromosomal abnormalities are identified in approximately 50% of first trimester miscarriages, while later miscarriages may be more likely in individuals with uterine malformations or cervical incompetence.

Paget's disease of the bone generally presents in after the age of 55, and is very rare in younger individuals. The prevalence in individuals over 55 is as high as 3%.

Osteoid osteoma is a benign, bone-forming tumor characterized by a small area of neoplastic growth surrounded by an area of mature, reactive bone.

Fibrosarcoma, osteosarcoma, and Ewing's sarcoma are all malignancies.

Osteosarcoma is the most common primary malignancy of bone, excluding hematopoietic malignancies, making up approximately 20% of all primary bone cancers.

Fibrosarcoma and Ewing's sarcoma are relatively rare conditions, and osteoid osteomas are is non-malignant.

Roughly 75% of osteosarcomas occur in the distal femur or around the knee. The next most common site is the upper arm. Spinal or pelvic involvement are rare.

Migraine headaches are commonly treated at first by over the counter (OTC) medications such as NSAIDS and acetaminophen. Other treatment options include triptans, antidepressants such as amitriptyline, and anti-hypertensives (beta blockers and calcium channel blockers).

The majority of cases of osteosarcoma are in children and adolescents between the age of 10 and 25. It's the most common type of bone cancer in children and young adults, and the third most common cancer in teens.

Dystonia is a condition of sustained muscle contractions causing abnormal posture, twisting, restricted movement, and pain. Torticollis is a form of dystonia specific to the muscles of the neck. Ballismus is a condition of rapid, violent involuntary motions. Geniospasm is specific to the mentalis muscle, causing involuntary movements of the jaw.

Petasites hybridus (butterbur) is a flowering plant of the family asteraceae. It has been shown in studies to reduce the frequency of migraine headaches by as much as 68%. None of the other herbs listed have any significant medicinal benefit in migraine headaches.

The correct answer is bulimia nervosa.

Bulimia nervosa is an eating disorder in which a patient classically consumes large amounts of food (binge eating) and then induces vomiting (purge behavior) to expel the food prior to absorption in the gastrointestinal tract. As such, the patient restricts their ability to gain weight. Patients with bulimia nervosa are frequently successful, high-achieving individuals under a great deal of stress, and often may be adolescent athletes, as patients in this population frequently have specific weight cutoffs that they must achieve for their respective sports/activities. Some signs of bulimia nervosa, as exhibited by this patient, are thin, brittle hair, a hypovolemic appearance (due to frequent vomiting), excoriations on the knuckles (from self-inducing vomiting with their hands), yellow discoloration of the teeth (from the acidity of vomitus), and swelling of the parotid glands (colloquially known as "chipmunk cheeks") as a response to the frequent vomiting. Patients with bulimia may also use other methods to purge themselves of food and drinks including diuretic use, and/or laxative use.

A key distinction between bulimia nervosa and anorexia nervosa is that in bulimia the patient exhibits a form of purge behavior following binge eating, whereas in anorexia, classically, the patient simply restricts eating rather than binging and purging.

Hypothyroidism is not a correct answer choice because while this patient is exhibiting lethargy, weakness, and brittle hair, given the constellation of her other symptoms and exam findings, it is less consistent with her presentation than bulimia nervosa. If these symptoms persisted following treatment for bulimia, then hypothyroidism could be considered as a concurrent finding.

Exogenous use of testosterone would not account for the symptoms seen in this patient.

Marfan's syndrome would also not account for the symptoms seen in this patient.

This is a normal finding, the QRS should have a duration between 0.6-0.12 seconds.

aVF is the main lead that points to the base of the heart (inferiorly). ST segment elevations in this lead help localize the area of infarction and can help identify the coronary artery involved. The precordial leads (V1-V6) do not point towards the base of the heart. Lead I is considered a lateral lead.

Helicobacter pylori is present in the stomach of 60% of individuals with gastric cancer. Cancer in these cases may be caused by chronic inflammation at the site of infection, resulting in metaplasia.

Staphylococcus aureus, Salmonella enterica, and Escherichia coli are all common causes of gastroenteritis but are not associated with malignancy.

Smoking, obesity, and high blood pressure are among the most common risk factors for development of renal cell carcinoma. Other risk factors include genetic susceptibility, diuretic use, and male gender. Alcohol consumption has not been associated with increased rates of renal cell cancer.

Renal cell carcinoma can cause hypercalcemia, due to secretion of PTHrP (parathyroid hormone-related protein).

SIADH and Lambert-Eaton myasthenic syndrome are both associated with small-cell lung cancer, while polymyositis is associated with non-Hodgkin lymphoma.