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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
Q

Components of general appearance

A 
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
Q

Psoas sign

A 
Hip externally rotated and knee flexed
Appendicitis
Diverticulitis
Regional ileitis
Psoas hematoma
Psoas abscess
26
Q

Position of Perinephric abscess patient

A

Bends towards the side of lesion

27
Q

Orthopnea signifies left sided congestive cardiac failure _____ % of time

A

95

28
Q

Relief of breathlessness in left sided heart failure

A

When rt sided heart failure supervenes

29
Q

Causes of Orthopnea other than lt heart failure

A 
Pulmonic stenosis
Increased abdominal contents
Pulmonary Orthopnea(b/l apical lung disease)
30
Q

Why PND pts go near window?

A

Cold air to face relieves Dyspnea

31
Q

Platypnea is accompanied by

A

Orthodeoxia

32
Q

Platypnea in a cirrhosis pt is a signal for

A

Liver transplant

33
Q

Causes of Platypnea

A 
Recurrent pulmonary emboli
Necrotising pneumonia with pneumatocele formation
B/L staphylococcal pneumonia 
Pleural effusion
TB
PFO
34
Q

Trepopnea in pulmonary disease,side?

A

Good side down
Exceptions:
Pleuritis
Infants

35
Q

Causes of Trepopnea

A

Atrial myxoma

RCC or HCC growing into rt atrium(lt Trepopnea)

36
Q

US:LS ratio in achondroplasic dwarfs

A

More than 1

37
Q

Body Habitus abnormalities in Marfan syndrome

A

US:LS ratio is low

Arm span is more than height

38
Q

Skeletal abnormality in achondroplasic dwarfs

A

Humeri and femora are shorter

39
Q

First signs of Marfan syndrome in children

A

Skeletal changes

40
Q

Normal waist/hip ratio

A

0.7
Pear : less than 0.7
Apple: more than 0.85

41
Q

HIV associated lipodystrophy

A 
Emaciated cheeks,arms,thighs,buttocks with prominent superficial veins
Buffalo hump
Neck circumference expands by 5 to 10cm
Breast hypertrophy
Central truncal obesity
42
Q

The bladder of riva rocci cuff should encircle atleast _______ % of arm circumference

A

80

43
Q

What to do if the mercury column is bouncy in sphygmomanometer

A

Tighten the knurled nut at top of column

44
Q

BP auscultation is done with

A

Bell of steth

45
Q

What to do if korotkoff sounds are very faint?

A

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
Q

Can diastolic pressure be measured by palpation?

A

Yes..Palpate the brachial artery for korotkoff sounds

47
Q

Effect of smoking on blood pressure

A

Increases systolic pressure by 20mm in 4 min

48
Q

Drugs that increase blood pressure

A 
NSAID
anti migrane drugs
Anti incontinence drugs
Oral contraceptives 
Cold remedies
Cyclosporine
Tricyclics
49
Q

Who is at high risk of side effects of hypertension?

Dippers or nondippers

A

Non dippers(no nocturnal fall in BP)

50
Q

Why identifying pre-hypertensives is important?

A

There is no threshold blood pressure level for CVS morbidity

51
Q

How are hypertensives classified by JNC criteria?

A

According to higher component of either systolic or diastolic

52
Q

Components of blood pressure

A

Average
Variability(increased CVS morbidity)
Diurnal variation

53
Q

Health risks of increasing blood pressure begins at

A

115/75 mm Hg

54
Q

How many blood pressure measurements should be made before classifying according to JNC?

A

Two or more seated measurements in two or more visits

55
Q

Stage 3 of hypertension according to ESC

A

More than or equal to 180/110

56
Q

Isolated systolic hypertension

A

Systolic pressure more than or equal to 140

Diastolic pressure less than 90

57
Q

Isolated systolic hypertension in young

A

High systolic pressure in brachial arteries alone

Physical Diagnosis (6 decks)

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