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Physical Diagnosis > 15.8.2013(history) > Flashcards

15.8.2013(history) Flashcards

0
Q

Best predictor of future depression

A

Sleep disturbance

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1
Q

Early awakening with inability to go to sleep

A

Depression

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2
Q

Rx of restless leg syndrome

A 
Gabapentin
Carbamazepine
Clonazepam
Dopamine receptor agonists
Opioids
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3
Q

Causes of restless leg syndrome

A 
Iron deficiency
Polyneuropathy
Diabetes
Pregnancy
Rheumatoid arthritis
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4
Q

Akathesia

A

Inner sense of restlessness with intense desire to move not referable to legs

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5
Q

__________ is associated with development of REM behaviour disorder

A

PTSD

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6
Q

A high percentage of REM behaviour disorder patients have

A

Parkinsonism
Multi-system atrophy
Dementia(lewy body)

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7
Q

Symptoms of parasomnias in predisposed persons can be precipitated by

A

Sleep deprivation

Vigorous physical activity

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8
Q

Narcoleptic tetrad

A

Day time sleepiness
Cataplexy
Sleep paralysis
Hypnagogic hallucination

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9
Q

_______ % of narcoleptics experience all 4 symptoms

A

15-20%

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10
Q

Family history in narcolepsy?

A

1/3rd have family history

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11
Q

Age of onset of murmurs

A

Before 5: congenital heart disease
5-15: rheumatic heart disease
15-30: mitral valve prolapse
After 30- idiopathic hypertrophic sub-aortic stenosis,bicuspid aortic valve

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12
Q

Vaccines given to adults

A 
Pneumococci
Meningococci
Tetanus
Rabies
Rubella
Hepatitis A or B
RhoGam
Influenza
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13
Q

Symptoms of PTSD

A 
Intrusive recollections(flashbacks)
Nightmares
Avoidance of reminders
Psychic numbing
Anhedonia
Autonomic hyper arousal
Hypervigilance
Insomnia
Enhanced startle reaction
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14
Q

History that is a must in women?

A

LMP

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15
Q

Important past history in a suspected ectopic pregnancy case

A

PID

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16
Q

Blue velvet lung

A

Angio thrombotic hypertension in injectable drug users

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17
Q

Ratio of omega 6 to omega 3 fatty acids

A

Less than 5:1

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18
Q

Rich source of omega 3 fatty acids

A

Fish

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19
Q

Acute acoustic trauma causing cochlear hydrops may manifest as

A

Tinnitus

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20
Q

Diet rich in omega 6 fatty acids

A 
Canola oil
Safflower oil
Corn oil
Cottonseed oil
Soybean oil
Peanut oil
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21
Q

Adverse effects of trans fat

A

High LDL cholesterol
Impaired glucose tolerance
Low birth weights
Decreased visual acuity by transmission through breast milk

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22
Q

Chinese restaurant syndrome

A

MSG(mono sodium glutamate)

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23
Q

Briquet syndrome

A

25 different symptoms in 9 or 10 symptom groups

24
Components of general appearance
``` Development Nutrition Apparent state of consciousness Apparent age Sex Posture or position in bed Comfort Attitude toward examination Degree of illness(acute or chronic) Movements Habitus Body proportions ```
25
Psoas sign
``` Hip externally rotated and knee flexed Appendicitis Diverticulitis Regional ileitis Psoas hematoma Psoas abscess ```
26
Position of Perinephric abscess patient
Bends towards the side of lesion
27
Orthopnea signifies left sided congestive cardiac failure _____ % of time
95
28
Relief of breathlessness in left sided heart failure
When rt sided heart failure supervenes
29
Causes of Orthopnea other than lt heart failure
``` Pulmonic stenosis Increased abdominal contents Pulmonary Orthopnea(b/l apical lung disease) ```
30
Why PND pts go near window?
Cold air to face relieves Dyspnea
31
Platypnea is accompanied by
Orthodeoxia
32
Platypnea in a cirrhosis pt is a signal for
Liver transplant
33
Causes of Platypnea
``` Recurrent pulmonary emboli Necrotising pneumonia with pneumatocele formation B/L staphylococcal pneumonia Pleural effusion TB PFO ```
34
Trepopnea in pulmonary disease,side?
Good side down Exceptions: Pleuritis Infants
35
Causes of Trepopnea
Atrial myxoma | RCC or HCC growing into rt atrium(lt Trepopnea)
36
US:LS ratio in achondroplasic dwarfs
More than 1
37
Body Habitus abnormalities in Marfan syndrome
US:LS ratio is low | Arm span is more than height
38
Skeletal abnormality in achondroplasic dwarfs
Humeri and femora are shorter
39
First signs of Marfan syndrome in children
Skeletal changes
40
Normal waist/hip ratio
0.7 Pear : less than 0.7 Apple: more than 0.85
41
HIV associated lipodystrophy
``` Emaciated cheeks,arms,thighs,buttocks with prominent superficial veins Buffalo hump Neck circumference expands by 5 to 10cm Breast hypertrophy Central truncal obesity ```
42
The bladder of riva rocci cuff should encircle atleast _______ % of arm circumference
80
43
What to do if the mercury column is bouncy in sphygmomanometer
Tighten the knurled nut at top of column
44
BP auscultation is done with
Bell of steth
45
What to do if korotkoff sounds are very faint?
Make the pt raise his arm with the cuff in situ and close and open his fists a few times..slowly inflate the cuff and ask the patient to lower his arm
46
Can diastolic pressure be measured by palpation?
Yes..Palpate the brachial artery for korotkoff sounds
47
Effect of smoking on blood pressure
Increases systolic pressure by 20mm in 4 min
48
Drugs that increase blood pressure
``` NSAID anti migrane drugs Anti incontinence drugs Oral contraceptives Cold remedies Cyclosporine Tricyclics ```
49
Who is at high risk of side effects of hypertension? | Dippers or nondippers
Non dippers(no nocturnal fall in BP)
50
Why identifying pre-hypertensives is important?
There is no threshold blood pressure level for CVS morbidity
51
How are hypertensives classified by JNC criteria?
According to higher component of either systolic or diastolic
52
Components of blood pressure
Average Variability(increased CVS morbidity) Diurnal variation
53
Health risks of increasing blood pressure begins at
115/75 mm Hg
54
How many blood pressure measurements should be made before classifying according to JNC?
Two or more seated measurements in two or more visits
55
Stage 3 of hypertension according to ESC
More than or equal to 180/110
56
Isolated systolic hypertension
Systolic pressure more than or equal to 140 | Diastolic pressure less than 90
57
Isolated systolic hypertension in young
High systolic pressure in brachial arteries alone

Physical Diagnosis (6 decks)

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