Clinical 1

Question 0

What is the Snellen test ? 3

Answer 0

1) test of visual acuity
2) pt stands 20 feet from chart of letters with one eye covered at a time
3) pt reads chart to smallest letter visible

Question 1

What’s tonometry? 3

Answer 1

1) measures intra ocular pressure
2) when pressure is applied to the inner cornea if intra ocular pressure increases indicates glaucoma
3) advise not to squint,cough, or hold breath during procedure.

Question 2

What is Myopia? 2

Answer 2

1) nearsightedness

2) light rays refract at a point in front of the retina

Question 3

What’s hyperopia? 2

Answer 3

1) Farsightedness

2) the light rays refract behind the retina

Question 4

What is presbyopia? 1

Answer 4

Impaired vision acuity caused by aging

Question 5

What’s stigmatism? 1

Answer 5

1) uneven curvature of the cornea causing blurring

Question 6

What’s conjunctivitis? 4

Answer 6

1) pinkeye
2) caused by virus, bacteria, allergies
3) apply warm moist compress
4) give topical antibiotics, hydrocortisone ophthalmic ointment

Question 7

What’s a sty? 2

Answer 7

1) staphylococcal organisms

2) apply warm compresses, antibiotics, incision & drainage

Question 8

What’s Retinopathy of prematurity (Rop)? 3

Answer 8

1) retina detachment
2) high concentrations of oxygen cause blindness
3) sometimes occurs when O2 concentration are greater than 40% for 48 to 72 hrs

Question 9

What’s a detached retina? 3

Answer 9

1) flashes of light, floaters
2) a feeling of curtain coming up or down hallmark symptom
3) surgery to reattach retina choroid gas or air bubble to apply pressure to retina

Question 10

What’s cataracts? 5

Answer 10

1) objects appear distorted or blurred
2) decreased color perception
3) intracapsular extraction- removal of entire lense & capsule; easier for Drs , but puts pt at risk for retina detachment
4) extra capsular extraction- cut anterior capsule to expose opaque lense material, most common procedure
5) hemorrhage indicated by sudden sharp pain

Question 11

What’s Glaucoma? 5

Answer 11

1) artificial lights appear to have rainbows or halos around them,
2) decreased peripheral vision
3) close angle- sudden onset emergency
4) avoid mydriatics ( atropine)
5) open angle- (primary glaucoma) humor flow blockage

Question 12

What’s otitis media? 5

Answer 12

1) ear tugging (child)
2) red bulging tympanic membrane
3) children more susceptible because short Eustachian tube
4) bx, antihistamine
5) myringotomy: tympanic membrane incision to relieve pressure & fluid

Question 13

What’s Ménière’s disease? 5

Answer 13

1) vertigo
2) feeling of fullness in the ear
3) nystagmus (jerking ness of the eyes)
4) compazine, antivertigo meds ( antivertigo, Valium, raglan, Titan)
5) low sodium diet and diuretics

Question 14

What’s trigeminal neuralgia (tic doulourex)? 4

Answer 14

1) V cranial nerve disorder
2) facial pain
3) alcohol injection to nerve ( destroy nerve)
4) avoid extreme temperatures

Question 15

What’s Bell’s palsy? 4

Answer 15

1) VII cranial nerve
2) assist with electrical stimulation
3) teach exercises for facial muscles ( blow and suck from straw)
4) recover in 3-5 weeks

Question 16

What’s acoustic neuroma? 3

Answer 16

1) deafness
2) grimacing of facial muscles
3) bening tumor of the eight cranial nerve

Question 17

What’s Guillain-barre syndrom? 3

Answer 17

1) paresthesia motor looses usually beginning in lower extremities then extended up ward to trunk, upper extremities
2) demyelination occurs & alters nerve conduction
3) mech ventilation, elevate head of bed, suctioning

Question 18

What’s Huntington’s disease? 3

Answer 18

1) depression, temper outbursts
2) person in constant motion by end of disease progression
3) Librium, haldol, Thorazine.

Question 19

What’s hyperglycemia? 4

Answer 19

1) blood sugar 300-800mg/dl
2) hypotension, tachycardia,
3) skin warm & dry
4) fruity odor to breath

Question 20

What’s hypoglycemia? 6

Answer 20

1) Bs <50-60
2) confusion, tremors, blurry vision, coma, seizures
3) hypotension, tachycardia
4) skin cool and diaphoretic
5) skim milk is ideal, dextrose 50% IV if unconscious, glucagon 1 mg IM,sq.
6) follow with carbohydrates

Question 21

What’s phenylketonuria? 3

Answer 21

1) high blood phenylalanine that leads to retardation
2) lofenalac substitutes for infant milk
3) low protein diet for children ( no meat, dairy, eggs)

Question 22

What’s Gout? 4

Answer 22

1) high Utica acid that lead to joint deterioration
2) low purine diet
3) kidney stones
4) inborn error of purine metabolism

Question 23

What’s Celiac disease? 3

Answer 23

1) inborn error of wheat and rye metabolism
2) intestinal malabsorption that leads to malnutrition, diarrhea and failure to thrive
3) gluten free diet; no wheat, oats, rye, barely

Question 24

What’s Renal failure and protein malabsorption? 2

Answer 24

1) increased protein & albumin losses in urine that leads to protein deficiency
2) high calorie, low protein as allowed by kidney function

Question 25

What’s hepatobiliary disease? 2

Answer 25

1) decreased bile leads to fat malabsorption

2) low fat, high protein diet, vitamins

Question 26

What’s Cystic fibrosis ? 2

Answer 26

1) absence of pancreatic enzymes leads to malabsorption of fat & fat soluble vit
2) weight loss, infection & lung disease lead to increase need for calories & protein

Question 27

What’s Hiatal hernia? 2

Answer 27

1) Heart burn, regurgitation

2) the esophagus passes becomes enlarged part of the upper stomach comes up into the lower portion of the thorax

Question 28

What’s Pyloric stenosis ? 5

Answer 28

1) projectile vomiting in infants
2) infant always hungry and irritable
3) palpable olive shape tumor in epigastrium
4) infants don’t show symptoms until the second to fourth week after birth
5) most seen in male white

Question 29

What’s gastritis? 3

Answer 29

1) n&v and possible blood
2) Npo slowly progressing to bland diet
3) antacid to relieve pain

Question 30

What’s Chronic duodenal ulcer? 2

Answer 30

1) pain 2-3 hrs PC; night often during sleep

2) foods relieve pain

Question 31

What’s Chronic gastric ulcer? 3

Answer 31

1) 1/2 to 1 hr PC or when fasting
2) pain relieved by vomiting
3) foods don’t relief pain

Question 32

What’s Chron’s disease ? 3

Answer 32

1) fatty stool with occasional rectal bleeding
2) R colon & Ileum
3) high protein, high calorie,low fat, & low fiber.

Question 33

What’s Ulcerative colitis ? 4

Answer 33

1) absent fatty stools
2) common rectal bleeding, pus, mucus in stool
3) high protein & calories, low fat & fiber
4) increase fluids & electrolytes

Question 34

What’s Appendicitis ? 4

Answer 34

1) peri umbilical pain shifts to right lower quadrant at McBurney’s point
2) low grade fever
3) ice bag to abd to alleviate pain; no heating pads, enemas, or laxatives
4) fowlers to alleviate abd pain

Question 35

What’s peritonitis? 2

Answer 35

1) causes; ruptured appendix, ectopic pregnancies, perforated ulcer.
2) gastric decompression; ng tube

Question 36

What’s Hirschsprung’s disease? 3

Answer 36

1) new born refusal to pass meconium
By congenital defect

2) refusal to suck, weight loss
3) abd distention, constipation & diarrhea

Question 37

What’s intestinal obstruction? 3

Answer 37

1) high pitched bowel sounds above area of obstruction, decreased or absent bowel sounds below the area of obstruction
2) ng tube or mouth to DX
3) salem tube or levin tubes

Question 38

What’s cirrhosis? 3

Answer 38

1) dark urine, clay color stool, esophageal varices, hemorrhage, purities, ascites, edema in extremities
2) portal hypertension with esophageal varices that may lead to hemorrhage
3) high amonia levels that lead to altered level of consciousness; reduced with lactulose

Question 39

What’s Reye’s syndrome? 2

Answer 39

1) high fever and ICP, decreased LOC, decreased hepatic function, DX by liver biopsy
2) liked to aspirin & viral illness

Question 40

What’s cholelithias ? 4

Answer 40

1) dark urine clay color stools
2) check for bleeding
3) T-tube to ensure drainage of bile until edema diminishes: keep T-tube bag below level of gallbladder
4) low fat, high calorie and protein

Question 41

What’s pancreatitis? 4

Answer 41

1) abd pain after heavy meal or alcoholic beverage ingestion
2) pain relief by position changes
3) blue discoloration in flank and around umbilicus
4) autoimmunity by enzyme, principally by Trypsin

Question 42

What’s systemic lupus erythematous?

3

Answer 42

1) arthritis joint swelling, oral ulcers, alopecia, muscle skeletal inflammation
2) raynaud’s syndrome: pain and color changes of extremities during cold exposure
3) antinuclear antibodies ANA

Question 43

What’s Impetigo ? 3

Answer 43

1) reddish macular becomes honey colored crusted vesicles; than crusts
2) caused by staphylococcus streptococcus
3) monitor for acute glomeruli nephritis ( complications of untreated impetigo)

Question 44

What’s psoriasis? 3

Answer 44

1) chronic recurrent thick itchy papules/plaques covered with silver white scales with symmetrical distribution
2) tar preps may stain skin
3) methotrexate