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Fundamentals 1 > Clinical Medicine > Flashcards

Clinical Medicine Flashcards

1
Q

CAGE

A

Alcohol dependency assessment: Cut, Annoyed, Guilty, Eye Opener

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2
Q

Five steps of the “Evidence Cycle”

A
  1. ask foreground questions, 2. access the best evidence, 3. appraise the evidence critically, 4. apply the evidence to the patient/situation, 5. assess the performance of your plan
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3
Q

The four parts of a ‘foreground’ question (a question answerable by EBM) are?

A

patient population, intervention, comparison/control, outcome

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4
Q

Three questions to ask when appraising a study

A
  1. is it valid?, 2. what are the results?, 3. how can it be applied to your situation
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5
Q

criteria for the validity of a diagnostic study

A
  1. diagnostic uncertainty? 2 blind comparison btw the test and an independent gold standard, 3. the results of the test must not influence the decision to use the gold standard (verification bias)
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6
Q

hand grasp reflex

A

after birth to 3 months, grasp increases as the finger is withdrawn

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7
Q

head righting

A

one month lag, 2-3 month no lag, 5-6 month anticipation

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8
Q

asymmetric toni neck reflex

A

2-3 weeks to 6 months, fencer’s position

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9
Q

moro reflex

A

birth till 4 months, startle reflex (pick me up)

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10
Q

parachute response

A

9 months till death, superman stance

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11
Q

protective equilibrium response

A

6 months till death, when pushed laterally stakes hand on opposite side

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12
Q

rooting reflex

A

lowered lip and tongue movement towards the stimulated part

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13
Q

differences of a pediatric history

A

birth history, nutrition, growth assessment, developmental history, immunizations, social history in an adolescent BDINGS

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14
Q

diet: birth to two years

A

formula/fruit juice/solids/vitamins

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15
Q

HEADSS

A

Social history: Home, Education/Employment, Activity, Drugs/Drinking, Sexuality, Suicide/Depression/Self Image

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16
Q

growth vs. development

A

growth is the process of growing larger, development is the gradual progression towards potential as a mature adult

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17
Q

development

A

proceeds from cephalic to caudal and proximal to distal. from generalized reflexes to discrete voluntary actions

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18
Q

a child’s developmental stage impacts

A

how you approach the history and physical exam

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19
Q

gross motor

A

goal is to gain independent movement, is not predictive of intelligence

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20
Q

fine motor

A

use of upper extremities to engage with and manipulate the environment

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21
Q

receptive vs. expressive language

A

receptive: hearing/seeing, understanding, and responding appropriately; expressive: speech development (audible/oral expressions of language)

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22
Q

cognitive development

A

ability to respond to changes in environment

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23
Q

social and emotional development

A

understanding of self, bonding, attachment, and trust in caregivers, adaptability, temperament, and response to new stimuli

24
Q

term gestation

A

37-42 weeks

25
Q

three of the most often evaluated signs of postnatal growth

A

length/height, weight, and head circumference

26
Q

genetic channel for growth

A

child enters this from 3-18 months

27
Q

primary short stature

A

intrinsic disorder present at birth, normal bone age

28
Q

normal variants in height

A

include genetic short stature and constitutional delay (delayed bone age)

29
Q

examples of primary sort stature

A

turners, noonan, down’s, achondroplasia, IUGR

30
Q

secondary short stature

A

delayed bone age, results from factors outside the skeletal system that effect growth

31
Q

secondary short stature examples

A

major organ disease, nutritional deficiency, endocrine abnormalities (cushing’s, hypothyroidism), poorly controlled diabetes, metabolic disorders, meds (steroids)

32
Q

failure to thrive

A

defined as weight below the third percentile for age or inadequate weight gain resulting in crossing of percentile lines

33
Q

three broad causes of FTT

A

inadequate caloric intake, malabsorption, inappropriate utilization

34
Q

most brain growth

A

occurs during the first year of life

35
Q

macro/microcephaly, FOC (head circumference)

A

> 97th percentile, <3rd percentile, macro due to hydrocephalus, micro due to primary and secondary reasons

36
Q

Fetal Alcohol Syndrome (FAS)

A

facial anomalies, growth retardation, CNS neurodevelopmental, unexplained behavioral abnormalities

37
Q

requirements to diagnose FAS

A
  1. confirmed maternal alcohol exposure, 2. facial anomalies, 3. growth retardation, 4. CNS neuro-developmental findings
38
Q

normal age of puberty

A

precocious is before 7yrs in females, 9yrs in males; early is before 9(f), 10(m), late is after 12 (m/f)

39
Q

secondary sexual development

A

development as a result of androgen secretion – tanner stages

40
Q

earliest signs of secondary sexual development

A

breast budding in females and testicular enlargements in males

41
Q

adrenarche

A
  1. none, 2. light, 3. thick, 4. full genital, 5. some on thighs
42
Q

know tanner stages!!

A

do it

43
Q

newborn

A

R:30-60, P:120-160, BP:60-80

44
Q

6mo-1yr

A

R:30-40, P:120-140, BP:70-80

45
Q

2-4yrs

A

R:20-30, P:100-110, BP:80-95

46
Q

5-8yrs

A

R:14-20, P:90-100, BP:90-100

47
Q

8-12yrs

A

R:12-20, P:80-100, BP:100-110

48
Q

> 12yrs

A

R:12-20, P:60-90, BP:100-120

49
Q

proper BP cuff

A

is wide enough to cover 2/3 of the upper arm

50
Q

coarctation of the aorta

A

higher BP in upper vs. lower extremities

51
Q

stranger anxiety

A

at 9 months of age

52
Q

PMI

A

located just left of the sterna border at the 4th intercostal space

53
Q

at 11 years of age you can

A

ask parents to leave the room for a personal history

54
Q

peds exam

A

is no different than adult exam

55
Q

scoliosis screening at

A

10 & 12 in girls, once at 13/14 in boys

Fundamentals 1 (4 decks)

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