CC Exam No. 1 Intro Packet/Lectures pr 2 Flashcards
breathing characterized by unpredictable irregularity; breaths may be shallow or deep and stop for short periods;
Biot’s respiration, sometimes also called ataxic respiration
type of breathing most commonly seen in CHF patients
orthopnea; upright respiration
Type of breathing associated with patients waking in the middle of the night, opening the window to catch some fresh air and then going back to sleep; It is also common in patients with left ventricular heart failure.
Paroxysmal nocturnal dyspnea
refers to shortness of breath (dyspnea) that is relieved when lying down, and worsens when sitting or standing up. It is the opposite of orthopnea.
platypnea
twisted respiration characterized by the patient’s inability to lie supine or prone and by preference to left lateral decubitus position; “down with good lung”
trepopnea
what is the treatment for bradycardic infant?
give O2 - never atropine as you would with adults
what are the 9 places to feel a pulse?
temporal, carotid, brachial, radial, femoral, popliteal, dorsalis pedis, thumb, posterior tibialis
how should the carotids be palpated?
one at a time, at or below the level of thyroid cartilage
what should you do before you palpate the carotids?
listen for bruits; if present avoid palpation
a naturally occurring variation in heart rate that occurs during a breathing cycle - what is this called and how is this treated?
sinus arrhythmia - no treatment
when conducting CPR which pulse should be checked on an adult? on a child?
carotid; brachial
what is the pulse like in both early and late shock?
early shock increases c/o and the pulse is bounding; late shock involves falling c/o and diminished pulse
femoral pulse should be stronger or less strong than radial? why/why not? indications?
stronger; if reversed coarctation of the aorta is indicated
what is the 5th vital sign?
pain
what are the two classifications of pain?
neurophysiologic and temporal
what are the subdivisions of neurophysiological pain?
nociceptive (somatic and visceral) and non-nociceptive (neuropathic and psychogenic)
is a renal stone/colic a somatic pain?
no b/c it is not relieved upon rest
what is the referred pain of pancreatic cancer?
mid back pain; but also remember that back pain may also be sign of AAA
visceral pain poorly localized or well?
poor; somatic is well
which type of pain typically has referral sites?
visceral
what are your 3 cause of SBO’s divided by demographics?
HAM - hernia (kids); adhesions (adults); malignancy (geriatric)
a lack of bowel signs is an indication of what?
obstruction
the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. when this sign presents in the inferior angle of scapula, it is considered a classical symptom of a ruptured spleen.
Kehr’s sign
what are the three ways in which cancer spreads?
blood supply (including lymph); adjacent tissue; accidental implantation during surgery
the other name for Trigeminal Neuralgia
tic Douloureux (a type of neuropathic pain)
characterized by excruciating paroxysms of pain in the lips, gums, cheek, or chin and, very rarely, in the distribution of the ophthalmic division of the fifth nerve. The pain seldom lasts more than a few seconds or a minute or two but may be so intense that the patient winces.
Tic Douloureux
An essential feature of trigeminal neuralgia is what?
that objective signs of sensory loss cannot be demonstrated on examination.
In pts with MS, flexion of the neck sometimes leads to an electric shock like sensation that radiates down the back and into the legs.
(Lhermitte’s sign)
what is the primary treatment for multiple sclerosis?
Tegretol (carbamazepine)
One of the signs of tetany seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped at the angle of the jaw (i.e. masseter muscle), the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of hypocalcemia (i.e. from hypoparathyroidism, pseudohypoparathyroidism, hypovitaminosis D) with resultant hyperexcitability of nerves.
Chvostek sign
To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. This will occlude the brachial artery. In the absence of blood flow, the patient’s hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal joints flex, the DIP and PIP joints extend, and the fingers adduct.
Trousseau sign of latent tetany
what does paraneoplastic syndrome do to calcium levels?
increase them - hypercalcemia; Basically: Low Ca++–>Increased Na+ entry (action potentials)—>increased muscle contraction, often to the point of severe cramping or tetany.
nerve pain due to damage caused by the varicella zoster virus.
Postherpetic neuralgia
treatment for Postherpetic neuralgia
Amitriptyline (Tricyclic antidepressants)
what would an anti cholinergic drug do to the bowel sounds? Does this differ from a sympathomimetic drug?
Anti cholinergic decreases bowel sounds. Sympathomimetic increases bowel sounds
What are the two drugs that we use to treat dystonia?
Benadryl (diphenhydramine) and cogentin
What is the oldest drug that can treat viral syndrome?
Amantadine
What should be part of any differential with female patients who syncopizes?
Pregnancy
What does it mean to have an afferent pupillary defect?
The pupil is not responding to light.
What is the treatment for temporal arteritis?
High dose corticosteroids.
What are the five differentials for HA?
Meningitis, any cranial bleed, tumor, temporal arteritis, or glaucoma.
what are the three side effects of ACEi?
Angioedema, hyperkalemia, cough.
What does the key word phrase “board like abdomen” indicate? In term of a diagnosis?
Perforated viscous.
Acute diverticulitis is another way of calling what disease process?
Left sided appendicitis.
What is the position that you will find pts with acute pancreatitisin?
Fetal position.
what is the treatment for sinus tachycardia?
treat the underlying cause!
true or false: you can treat sinus tach with beta blocker.
FALSE!!
what are the four ddx for dizziness?
BPV, meniere’s disease,labyrinthitis, and acoustic neuroma
what is the triad for meniere’s disease?
recurrent vertigo, fluctuating sensorineural hearing loss, and tinnitus.
what is the main cause of labyrinthitis?
URI
what is a cause of dizziness that is a form of unilateral vestibular dysfunction.
labyrinthitis
what is the alternative test for PE for those pts allergic to the die used in pulmonary angio and for pregnant women who can’t take a CT?
doppler to look for PE - if visible treat with hep right away!!
what is the lab test you should run before you send a patient for CT with contrast? why?
BUN b/c you want to make sure the pt’s clearance is okay (b/c they need to properly get rid of the dye)
in pregnancy, when there is a suspicion of PE what is the next best test to do in place of CT and doppler?
V/Q lung scan (no ventilation - just check perfusion)
test ordered to help rule out the presence of a thrombus.
d dimer
three causes of respiratory alkalosis?
hyperventilation,aspiration OD, and PE!!
a medical condition consisting of asthma, aspirin sensitivity, and nasal/ethmoidal polyposis.
sampter’s triad
