CC Exam No. 1 Intro Packet/Lectures pr 2

Question 1

breathing characterized by unpredictable irregularity; breaths may be shallow or deep and stop for short periods;

Answer 1

Biot’s respiration, sometimes also called ataxic respiration

Question 2

type of breathing most commonly seen in CHF patients

Answer 2

orthopnea; upright respiration

Question 3

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.

Answer 3

Paroxysmal nocturnal dyspnea

Question 4

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.

Answer 4

platypnea

Question 5

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”

Answer 5

trepopnea

Question 6

what is the treatment for bradycardic infant?

Answer 6

give O2 - never atropine as you would with adults

Question 7

what are the 9 places to feel a pulse?

Answer 7

temporal, carotid, brachial, radial, femoral, popliteal, dorsalis pedis, thumb, posterior tibialis

Question 8

how should the carotids be palpated?

Answer 8

one at a time, at or below the level of thyroid cartilage

Question 9

what should you do before you palpate the carotids?

Answer 9

listen for bruits; if present avoid palpation

Question 10

a naturally occurring variation in heart rate that occurs during a breathing cycle - what is this called and how is this treated?

Answer 10

sinus arrhythmia - no treatment

Question 11

when conducting CPR which pulse should be checked on an adult? on a child?

Answer 11

carotid; brachial

Question 12

what is the pulse like in both early and late shock?

Answer 12

early shock increases c/o and the pulse is bounding; late shock involves falling c/o and diminished pulse

Question 13

femoral pulse should be stronger or less strong than radial? why/why not? indications?

Answer 13

stronger; if reversed coarctation of the aorta is indicated

Question 14

what is the 5th vital sign?

Answer 14

pain

Question 15

what are the two classifications of pain?

Answer 15

neurophysiologic and temporal

Question 16

what are the subdivisions of neurophysiological pain?

Answer 16

nociceptive (somatic and visceral) and non-nociceptive (neuropathic and psychogenic)

Question 17

is a renal stone/colic a somatic pain?

Answer 17

no b/c it is not relieved upon rest

Question 18

what is the referred pain of pancreatic cancer?

Answer 18

mid back pain; but also remember that back pain may also be sign of AAA

Question 19

visceral pain poorly localized or well?

Answer 19

poor; somatic is well

Question 20

which type of pain typically has referral sites?

Answer 20

visceral

Question 21

what are your 3 cause of SBO’s divided by demographics?

Answer 21

HAM - hernia (kids); adhesions (adults); malignancy (geriatric)

Question 22

a lack of bowel signs is an indication of what?

Answer 22

obstruction

Question 23

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.

Answer 23

Kehr’s sign

Question 24

what are the three ways in which cancer spreads?

Answer 24

blood supply (including lymph); adjacent tissue; accidental implantation during surgery

Question 25

the other name for Trigeminal Neuralgia

Answer 25

tic Douloureux (a type of neuropathic pain)

Question 26

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.

Answer 26

Tic Douloureux

Question 27

An essential feature of trigeminal neuralgia is what?

Answer 27

that objective signs of sensory loss cannot be demonstrated on examination.

Question 28

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.

Answer 28

(Lhermitte's sign)

Question 29

what is the primary treatment for multiple sclerosis?

Answer 29

Tegretol (carbamazepine)

Question 30

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.

Answer 30

Chvostek sign

Question 31

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.

Answer 31

Trousseau sign of latent tetany

Question 32

what does paraneoplastic syndrome do to calcium levels?

Answer 32

increase them - hypercalcemia; Basically: Low Ca++-->Increased Na+ entry (action potentials)--->increased muscle contraction, often to the point of severe cramping or tetany.

Question 33

nerve pain due to damage caused by the varicella zoster virus.

Answer 33

Postherpetic neuralgia

Question 34

treatment for Postherpetic neuralgia

Answer 34

Amitriptyline (Tricyclic antidepressants)

Question 35

what would an anti cholinergic drug do to the bowel sounds? Does this differ from a sympathomimetic drug?

Answer 35

Anti cholinergic decreases bowel sounds. Sympathomimetic increases bowel sounds

Question 36

What are the two drugs that we use to treat dystonia?

Answer 36

Benadryl (diphenhydramine) and cogentin

Question 37

What is the oldest drug that can treat viral syndrome?

Answer 37

Amantadine

Question 38

What should be part of any differential with female patients who syncopizes?

Answer 38

Pregnancy

Question 39

What does it mean to have an afferent pupillary defect?

Answer 39

The pupil is not responding to light.

Question 40

What is the treatment for temporal arteritis?

Answer 40

High dose corticosteroids.

Question 41

What are the five differentials for HA?

Answer 41

Meningitis, any cranial bleed, tumor, temporal arteritis, or glaucoma.

Question 42

what are the three side effects of ACEi?

Answer 42

Angioedema, hyperkalemia, cough.

Question 43

What does the key word phrase "board like abdomen" indicate? In term of a diagnosis?

Answer 43

Perforated viscous.

Question 44

Acute diverticulitis is another way of calling what disease process?

Answer 44

Left sided appendicitis.

Question 45

What is the position that you will find pts with acute pancreatitisin?

Answer 45

Fetal position.

Question 46

what is the treatment for sinus tachycardia?

Answer 46

treat the underlying cause!

Question 47

true or false: you can treat sinus tach with beta blocker.

Answer 47

FALSE!!

Question 48

what are the four ddx for dizziness?

Answer 48

BPV, meniere's disease,labyrinthitis, and acoustic neuroma

Question 49

what is the triad for meniere's disease?

Answer 49

recurrent vertigo, fluctuating sensorineural hearing loss, and tinnitus.

Question 50

what is the main cause of labyrinthitis?

Answer 50

URI

Question 51

what is a cause of dizziness that is a form of unilateral vestibular dysfunction.

Answer 51

labyrinthitis

Question 52

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?

Answer 52

doppler to look for PE - if visible treat with hep right away!!

Question 53

what is the lab test you should run before you send a patient for CT with contrast? why?

Answer 53

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)

Question 54

in pregnancy, when there is a suspicion of PE what is the next best test to do in place of CT and doppler?

Answer 54

V/Q lung scan (no ventilation - just check perfusion)

Question 55

test ordered to help rule out the presence of a thrombus.

Answer 55

d dimer

Question 56

three causes of respiratory alkalosis?

Answer 56

hyperventilation,aspiration OD, and PE!!

Question 57

a medical condition consisting of asthma, aspirin sensitivity, and nasal/ethmoidal polyposis.

Answer 57

sampter's triad