CMC 2 Final Flashcards

1
Q

What does the acronym VINDICATE P stand for?

A

V- Vascular
I- Infectious
N- Neoplastic/Nutritional
D- Drug/Diet
I- Inflammatory
C- Congenital
A- Autoimmune
T- Traumatic
E- Endocrine/Environmental
P- Psych/Pregnancy

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2
Q

What is considred a normal response to the Babinski test (plantar reflex)?

A

Downgoing toes (plantar flexion)

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3
Q

What three situations most comonly exlicit an abnormal response to the Babinski test?

A
  1. Nerve disease involving CNS
  2. Alcohol intoxication
  3. Post-ictal phase after seizure
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4
Q

An abnormal response to the Babinski test is expected in children younger than what age?

A

12 months

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5
Q

What is the most common cause of a positive pronator drift exam?

A

CNS/upper motor neuron disease

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6
Q

What is the most common cause of a positive Romberg test?

A

Impaired proprioception from dorsal column disease

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7
Q

Which myotome is tested by shoulder abduction?

A

C5

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8
Q

Which mytotome is tested by elbow flexion?

A

C6

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9
Q

Which myotome is tested by elbow extension?

A

C7

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10
Q

Which myotomes are tested by wrist extension & flexion?

A

C6 & C7

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11
Q

Which myotome is tested by finger extension?

A

C8

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12
Q

Which myotome is tested by finger abduction & thumb opposition?

A

T1 (also ulnar & median nerve)

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13
Q

Which myotome is tested by hip flexion?

A

L2 (also L1)

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14
Q

Which myotome is tested by thigh adduction?

A

L3 (also L2)

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15
Q

Which myotome is tested by knee extension?

A

L4 (also L3)

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16
Q

Which myotome is tested by ankle dorsiflexion?

A

L5 (also L4)

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17
Q

Which myotome is tested by knee flexion?

A

S1

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18
Q

Which myotome is tested by ankle plantar flexion?

A

S1 (also S2)

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19
Q

What are major metabolic causes of distal sensory polyneuropathy?

A

Type 2 DM & prediabetes
Hyperlipidemia
B12 deficiency

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20
Q

Approximately what percent of distal sensory polyneuropathies are idiopathic?

A

40%

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21
Q

What is the most common toxic cause of distal sensory polyneuropathy?

A

Alcohol

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22
Q

What are 3 significant immunological causes of distal sensory polyneuropathy?

A

MGUS (monoclonal gammopathy of uncertain significance)
Sjogren’s syndrome
Gullain-Barre syndrome

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23
Q

Which muscles comprise the rotator cuff?

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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24
Q

What is an availability heuristic?

A

The tendency to rely disproportionately on information recently learned, or cases that are very memorable when considering a ddx

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25
Q

What is an anchoring heuristic?

A

The tendency to rely too heavily on the first piece of information offered when making decisions (i.e. anchoring too heavily on an ED dx when in the wards)

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26
Q

What is a representativeness heuristic?

A

A cognitive short-cut where a patient’s presentation is a compared to a ‘typical’ case of specific diagnoses; this may fail to account for ‘atypical’ or less characteristic signs or symptoms

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27
Q

Define pretest probability:

A

The percentage of patients having a disease to begin with, given what is already known

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28
Q

Define posttest probability:

A

The percentage of patients having the disease given a positive test result

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29
Q

What does the acronym HEADSS stand for?

A

H: Home environment
E: Education/Employment
A: Activities
D: Diet/Drugs
S: Sexuality
S: Safety/Suicide/Depresison

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30
Q

What is this finding on a breast exam called? What does it suggest?

A

Peau d’orange

Lymphatic obstruction

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31
Q

What is this finding on a breast exam called? What does it suggest?

A

Nipple retraction

Nothing necessarily, but new nipple retraction is a concern for cancer

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32
Q

What is this finding on a breast exam called? What does it suggest?

A

Breast dimpling

It can suggest cancer attached to the skin and fascia of pectoral muscles

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33
Q

What is a normal lymph node diameter for axillay nodes? For supraclavicular nodes?

A

Axilla: < 3cm

Supraclavicular: < 1cm

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34
Q

What questions are important for a menstrual history?

A

-Age at menarche
-First day of last menstrual period (LMP)
-Duration of cycle, duration of bleeding
-Hx of heavy bleeding, pain

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35
Q

What are the most current recommendations for the breast self-exam?

A

It is no longer recommended on a monthly regular basis, and has evidence of harm due to increased intervention with benign lesions

36
Q

Define gravidity:

A

The number of times a woman has been pregnant

37
Q

Define parity:

A

The outcome of a woman’s pregnancies

38
Q

How are gravity and parity reported using the TPAL system?

A

G - # of pregnancies
P - (TPAL)

T- Term births (>37 weeks)
P- Preterm births (20 >#>37)
A- Abortions (any kind)
L- Living children

39
Q

Define oligomenorrhea:

A

Menstrual periods with >35 days between cycles

40
Q

Define primary amenorrhea:

A

No history of menarche

41
Q

Define secondary amenorrhea:

A

No menses for > 6 months

42
Q

Define metorrhagia:

A

Menstrual bleeding at irregular intervals

43
Q

Define menarche:

A

The first menstrual period

44
Q

What word could be used to describe the primary lesion pictured here?

A

Macule

45
Q

What word could be used to describe the primary lesion pictured here?

A

Patch

45
Q

What criteria is shared by a macule and a patch? What criteria differentiates them?

A

Flat lesion

Macule: < 1cm diameter
Patch: > 1cm diameter

46
Q

What word could be used to describe the primary lesion pictured here?

A

Papule

47
Q

What word could be used to describe the primary lesion pictured here?

A

Plaque

48
Q

What criteria is shared by a papule anda plaque? What criteria differentiates them?

A

Raised lesion

Papule: < 1cm diameter
Plaque: > 1cm diameter

49
Q

What word could be used to describe the primary lesion pictured here?

A

Vesicle

50
Q

What word could be used to describe the primary lesion pictured here?

A

Bulla

51
Q

What criteria is shared by a vesicle and a bulla? What criteria differentiates them?

A

Fluid-filled lesion

Vesicle: < 1cm diameter
Bulla: > 1cm diameter

52
Q

What word could be used to describe the primary lesion pictured here?

A

Nodule

53
Q

What word could be used to describe the primary lesion pictured here?

A

Tumor

54
Q

What word could be used to describe the primary lesion pictured here?

A

Pustule

55
Q

What word could be used to describe the primary lesion pictured here?

A

Comedo

56
Q

What characterizes a pustule?

A

A vesicle filled with purulent fluid

57
Q

What characterizes comedo?

A

Lesions of acne, with pilosebaceous units filled with keratin

58
Q

What word could be used to describe the primary lesion pictured here?

A

Cyst

59
Q

What word could be used to describe the primary lesion pictured here?

A

Wheal

60
Q

What characterizes a wheal?

A

A pink, edematous papule or plaque, often annular

61
Q

What characterizes a scale?

A

Scales are accumulation of stratum corneum due to increases proliferation or delayed desquamation

62
Q

What characterizes a crust?

A

Serum, blood, or purulent material that appears scaly

63
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Excoriation

Exogenous injury to epidermis

64
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Fissure

Linear clefts in skin

65
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Erosion

Partial loss of epidermis

66
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Ulcer

Full thickness loss of epidermis. May have loss of dermis or subcutis

67
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Petechiae

Non-blanchable macules < 2mm diameter

68
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Purpura

Non-blanchable macules, patches, papules or plaques

69
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Atrophy

Depression of skin from thinning of epidermis, dermis or fat

70
Q

What secondary characteristic describes the lesion pictured here? What characterizes it?

A

Lichenification

Thickening of the epidermis and accentuation of natural skin lines

71
Q

What characteristic best describes the shape of these lesions?

A

Annular

72
Q

What characteristic best describes the shape of these lesions?

A

Nummular

73
Q

How are annular and nummular lesions differentiated?

A

Annular lesions are ring shaped

Nummular lesions are coin shaped

74
Q

How would skin lesions in a coalescing circle, ring, or incomplete ring be described?

A

Polycyclic

75
Q

How would snakelike or serpentine skin lesions be described?

A

Serpiginous

76
Q

What word best describes the lesions presented?

A

Polycyclic

77
Q

What word best describes the lesions presented?

A

Serpiginous

78
Q

How would lesions found in the distal extremities be characterized?

A

Acral

79
Q

How would skin lesions found in skin creases and folds be characterized?

A

Intertriginous

80
Q

How would the configuration of this skin lesion be characterized?

A

Linear

81
Q

How would the distribution of this skin lesion be characterized?

A

Clustered

82
Q

How would the presentation of this skin lesion be characterized?

A

Targetoid

83
Q

How would the distribution of this skin lesion be characterized? What events might precede its presentation?

A

Photodistributed

Exposure to sunlight

84
Q

A skin lesion distribution that resembles a geometric shape would be characterized how?

A

Geometric