AHA Exam 3 Flashcards
With female rectal exam a lax sphincter may indicate what?
neurologic deficit
With female rectal exam absent sphincter tone may indicate what?
improper repair of 3rd degree perineal laceration after childbirth or trauma
Extremely tight sphincter in female rectal exam may indicate what?
anxiety, scarring, or spasticity from fissures, lesions, or inflammation
How do you get a child to relax sphincter muscles with rectal exam?
Pant like a puppy
What should a normal prostate feel like?
firm, smooth, and slightly movable, nontender
What does cancer of the prostate feel like?
stony hard nodularity
Lack of anal wink in a child indicates what?
lower spinal cord lesion or chronic abuse
What type of hernia is most common in young men?
Indirect (inguinal canal, can pass into scrotum, may be bilateral)
What type of hernia is most common in men greater than 40?
Direct (palpated medial to external canal)
What is the most common hernia for women
Femoral (near femoral vessels)
What is paraphimosis?
inability to replace foreskin
What is hypospadius?
urethral meatus on ventral surface
What male GU condition includes yellow green discharge and pain or burning with urination?
Gonococcal urethritis
NGU is most often related to what condition?
Chlamydia
What is a hydrocele?
accumulation of fluid in the tunica vaginalis. Does transilluminate
What is a spermatocele?
swelling of the epididymis; transilluminates
What is a varicocele?
engorged veins in the spermatic cord
Orchitis is associated with what condition?
Mumps
What are the causes for epididymitis?
UTI or STI
Is a testicular tumor tendor?
No
Kleinfelter syndrome is what type of chromosome disorder?
XXY
Acute bacterial prostatitis usually includes what symptoms?
fever, perineal pain, back pain, frequency, hurts when they sit
Benign prostatic hypertrophy is common after what age?
50
Molluscum contagiosum has what type of appearance?
viral flesh colored papules
What condition causes deviation of the penis?
Peyronie disease
Penile cancer typically occurs in what type of male?
Uncircumsized
What condition is described as a ‘bag of worms”
Vericocele
Epididymitis is most often associated with what?
STDs
Testicular cancer appears in what age of men?
young
Chronic pelvic prostatitis lasts for how long?
3-6 months: frequent UTIs
How do you detect asymptomatic inflammatory prostatitis?
WBC in prostatic secretions with or without pain
Name for injury to nails from picking at them
tic deformity
nail lifts from nail bed; inflammation and thickening of nail
oncholysis
hangnail with infection
paronychia
Nail infected with tinea fungus
tinea unguium
splitting of nails related to iron deficiency anemia
kollonychia
lines across nails that often occur with major illness
Beau lines
appearance of nails with poor protein intake
white banding
condition that may cause pitting of the nails as well as lesions on skin
psoriasis
Term that means all over
diffuse
term that means distinct or by itself
discrete
term that means lesions run together
confluent
AST/ALT ratio <1 indicates what?
liver damage or hepatitis
AST/ALT ratio >1 indicates what?
alcoholic liver disease
What test is more specific to ETOH?
GGT
ALT more specific to what?
liver damage
AST reflective of what?
skeletal muscle and alcohol intake
ALP and ALT elevation specific to what condition
cholecystitis
Total cholesterol should be what?
<200
LDL is ideally less than what?
<130
HDL should be what in men?
> 40
HDL should be what in women?
> 50
Triglycerides should be what?
<150
With prerenal failure, what happens to labs?
BUN elevates significantly, creatinine more slowly, BUN/Cr ration >20; Urine osmo >400 and urine Na <20 confirms dehydration
What happens to labs with intra renal failure?
BUN rises gradually, creatinine rises rapidly, BUN/Cr ratio <20; Urine osmo <400 and Na >30
What happens to labs with post renal failure?
BUN and Creatinine both increase
What 5 things indicate a quality X-ray?
Inspiration 9-10 ribs; Rotation: vertebral process between the clavicles; Penetration: vertebral processes visible to the aortic notch; entire lung field is visible; clavicle is over the 3rd rib
What condition on x-ray has flattened diaphrams, increased retrosternal space, and fewer markings
COPD: appears black because of hyperinflation of lungs
What condition on xray has batwing markings, Kerly B lines, enlarged cardiac sillhouette?
CHF
What 5 things are included in a pediatric assessment?
For infants <2 months, include prenatal and birth history; feeding patterns; stooling pattern; activity/ sleep/ Milestones
At what age should an infant be able to keep his head aligned with his body?
4 months
If delayed head lag, what is the possible link?
autism
What is the Moro reflex?
full body extension
When does the Moro reflex disappear?
2 months
When does the stepping reflex disappear?
2 months
When does the rooting reflex disappear?
4 months
When does the fencing reflex disappear?
5-7 months
When does the palmar grasp disappear?
5-6 months
When does the plantar grasp disappear?
9-12 months
At what age should a child be able to say their name, say several words, point to requests, and use a spoon?
18 months
At what age should a baby be able to transfer objects hand to hand, roll over prone to supine, sit unsupported, and babble and repeat vowels?
6 months
At what age should a child be able to roll over supine to prone, pull objects to mouth, and respond to human voice?
4 months
At what age should a child walk with or without support, experience separation anxiety, use gestures, copy sounds and actions, and follow simple instructions?
12 months
At what age should a child be able to pretend play, tell stories, sing songs, hop on 1 foot and catch a ball?
4 years
At what age should a child be able to follow objects especially faces, hold head up when prone, and turn toward sounds?
2 months
At what age should a child have a pincer grasp, crawl and cruise, stand with help, play patty cake or peek a boo, and say Momma, dada, and bye bye
9 months
At what age should a child be able to copy shapes, dress and undress, identify body parts, and use complete sentences?
3 years
At what age should a child be able to copy a line, run, be self centered, use 2-4 word sentences, parallel play, and be ready for toilet training
2 years
How long should a head circumference be measured in an infant?
Each visit up to 2 years
When can you start checking a blood pressure on a child?
3 years
When should anemia be assessed in peds?
assess risk at 4 months and 2 years, check at 12 months, and assess risk in adolescent females
When should lead levels be checked in peds?
Assess risk at 6-9 months, check lead levels at 1 year unless low risk, assess and check at 2 years if high risk
When should you screen for autism?
9, 18, and 24 months
What are screening risks for autism?
premature, family history, developmental delays)
What types of tests are available to assess for autism?
M-CHAT or ages and stages
When should hearing be checked?
newborn, at each visit
How often should objective hearing tests be performed on children?
4, 5, 6, 8, and 10 years
How do you check vision in a newborn and at 2 weeks?
corneal light reflex and red reflex
How often should an objective vision screen be done in peds?
3, 4, 5, 6, 8, 10, 12, 15, 17
When can you start supplementing nutrition with formula in an infant?
4-6 months
When can whole milk be introduced to children?
1 year
At what age should children switch to low fat milk?
2 years
When can fluoride supplement be started on children?
6 months
When can you wean from bottle to cup in children?
1 year
When can a child first visit the dentist?
1 year
When do dental assessments have to be done?
4-5 years and 9th grade
How long should an infant not be exposed to direct sun?
6 months
How long should an infant sleep on their back?
6 months
Tanner stage breast: enlarges, areola and papilla form secondary contour
Stage 4
Tanner stage breast: breast buds
Stage 2
Tanner stage breast: small mounds beyond areola
Stage 3
Tanner female pubic area: course curly hair spreads
Stage 3
Tanner female pubic area: downy straight hair on labia majora
Stage 2
Tanner female pubic area: hair involves medial thighs
Stage 5
Tanner female pubic area: hair covers pubis
Stage 4
Tanner boys: penis and scrotum increase to adult size, hair to interior thighs
Stage 5
Tanner boys: scrotum enlarges, slightly reddens, straight downy hair
Stage 2
Tanner boys: penis increases in length and circumference, hair covers pubis
Stage 4
Tanner boys: scrotum continues to enlarge, penis lengthens, hair becomes course and curly
Stage 3
Name for external representation via choice of clothing and/or mannerisms
gender expression
Name for assigned gender based on physical attributes
sex at birth
Female sex at birth living as male
transman
personal sense on one’s own sexuality
gender identification
sexual attraction (to male, female, both, or neither)
sexual orientation
social and cultural expectations for behavior
gender norms
What sexual orientation should have 3 swabs done to check for STD’s?
men having sex with men
What sexual orientation is at highest risk for STI’s?
Bisexual women
What type of patient should be offered a PreP?
men with male HIV positive partner
What type of patient should have a prostate evaluation and mammogram?
Trans gender men over 50
A chest xray shows a fissure and appears gray and fuzzy on one side
Pneumonia
A chest xray shows costovertebral angle blunted on one side. Difficult to see diaphragm
Pleural effusion
A chest xray shows diaphragms flattened. Lungs mostly black on film; barrel chest
emphysema
How does cardiomegaly appear on xray?
heart fills more than 50% of the chest
What happens to WBC count with a bacterial infection?
Neutrophils will increase and lymphocytes will decrease
What happens to WBC count with a viral infection?
neutrophyls or segs will decrease and lymphocytes will increase
What happens to the white blood cell after an infection resolves?
monocytes increase
What happens to WBC count with an acute infection?
bands increase
high amylase, normal lipase indicate what condition?
early pancreatitis
On chest xray, a thin black line just under the right diaphragm indicates what condition?
Free air in the abdomen
On chest xray, linear densities indicate what condition?
pneumonia
On xray, flattened diaphragms indicate what condition?
COPD
Which hilem is higher on chest xray?
left
Which diaphragm is higher on chest xray?
right
Left shift on CBC indicates what?
bacterial infection
High TSH indicates what?
hypothyroid
High AST, high GGT indicates what?
alcoholism
ALT is much higher than AST
hepatitis
