CMC 2 Final Flashcards
What does the acronym VINDICATE P stand for?
V- Vascular
I- Infectious
N- Neoplastic/Nutritional
D- Drug/Diet
I- Inflammatory
C- Congenital
A- Autoimmune
T- Traumatic
E- Endocrine/Environmental
P- Psych/Pregnancy
What is considred a normal response to the Babinski test (plantar reflex)?
Downgoing toes (plantar flexion)
What three situations most comonly exlicit an abnormal response to the Babinski test?
- Nerve disease involving CNS
- Alcohol intoxication
- Post-ictal phase after seizure
An abnormal response to the Babinski test is expected in children younger than what age?
12 months
What is the most common cause of a positive pronator drift exam?
CNS/upper motor neuron disease
What is the most common cause of a positive Romberg test?
Impaired proprioception from dorsal column disease
Which myotome is tested by shoulder abduction?
C5
Which mytotome is tested by elbow flexion?
C6
Which myotome is tested by elbow extension?
C7
Which myotomes are tested by wrist extension & flexion?
C6 & C7
Which myotome is tested by finger extension?
C8
Which myotome is tested by finger abduction & thumb opposition?
T1 (also ulnar & median nerve)
Which myotome is tested by hip flexion?
L2 (also L1)
Which myotome is tested by thigh adduction?
L3 (also L2)
Which myotome is tested by knee extension?
L4 (also L3)
Which myotome is tested by ankle dorsiflexion?
L5 (also L4)
Which myotome is tested by knee flexion?
S1
Which myotome is tested by ankle plantar flexion?
S1 (also S2)
What are major metabolic causes of distal sensory polyneuropathy?
Type 2 DM & prediabetes
Hyperlipidemia
B12 deficiency
Approximately what percent of distal sensory polyneuropathies are idiopathic?
40%
What is the most common toxic cause of distal sensory polyneuropathy?
Alcohol
What are 3 significant immunological causes of distal sensory polyneuropathy?
MGUS (monoclonal gammopathy of uncertain significance)
Sjogren’s syndrome
Gullain-Barre syndrome
Which muscles comprise the rotator cuff?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
What is an availability heuristic?
The tendency to rely disproportionately on information recently learned, or cases that are very memorable when considering a ddx
What is an anchoring heuristic?
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)
What is a representativeness heuristic?
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
Define pretest probability:
The percentage of patients having a disease to begin with, given what is already known
Define posttest probability:
The percentage of patients having the disease given a positive test result
What does the acronym HEADSS stand for?
H: Home environment
E: Education/Employment
A: Activities
D: Diet/Drugs
S: Sexuality
S: Safety/Suicide/Depresison
What is this finding on a breast exam called? What does it suggest?
Peau d’orange
Lymphatic obstruction
What is this finding on a breast exam called? What does it suggest?
Nipple retraction
Nothing necessarily, but new nipple retraction is a concern for cancer
What is this finding on a breast exam called? What does it suggest?
Breast dimpling
It can suggest cancer attached to the skin and fascia of pectoral muscles
What is a normal lymph node diameter for axillay nodes? For supraclavicular nodes?
Axilla: < 3cm
Supraclavicular: < 1cm
What questions are important for a menstrual history?
-Age at menarche
-First day of last menstrual period (LMP)
-Duration of cycle, duration of bleeding
-Hx of heavy bleeding, pain