Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CCM CPD > CPD Written Midterm > Flashcards

CPD Written Midterm Flashcards

1
Q

What are the signs of Respiratory Distress?

A

Cyanosis, tachypnea, tri-pod position, use of accessory breathing muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the signs of Cardiac Distress?

A

Chest pain (may radiate to arm or jaw), clutching, sweating, nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the signs of Toxic Distress?

A

anxious, sweating, flushed, febrile, tachypneic, tachycardic, behavioral changes, obtundation (delirium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the Danger ranges of Blood Pressure?

A

above 180mmHg systolic & above 120mmHg diastolic is a hypertensive crisis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the Danger ranges of Pulse Rate and Respiration Rate?

A 
Bradycardia: below 60 bpm
Tachycardia: above 80 bpm
Tachypnea: above 20 rpm, 
Hyperpnea: deep rapid breaths
Apnea: suspension of breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the Danger ranges of Temperature?

A

Hypothermia: less than 35°C (95°F)
Fever: 41°C (106°F) and above is a medical emergency
above 40°C (104°F) can be life threatening
above 39°C (102°F) can cause convulsions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the Danger ranges of Body Mass?

A

below 18.5 is underweight
above 25 is overweight
above 30 is obese
above 40 is morbidly obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why is it important to palpate the radial pulse while taking blood pressure?

A

So that the systolic BP is not underestimated and diastolic BP is not overestimated due to a region lacking pulse sounds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the significance of skin discoloration, whether hypo, hyper, bluish, yellowish, etc.?

A

Hypopigmentation: vitiligo, anemia
Hyperpigmentation: Addison’s diesease
Erythema (red): infection, inflammation, fever
Cyanosis (blue, dusky):
- central-mouth, lips: COPD, Heart Disease
- peripheral-nail beds: Raynaud’s disease
Jaundice (yellow/orange):
- sclera, skin: hepatitis, carotenemia, uremic frost (KD Dz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 6 (+2) descriptors of skin lesions?

A
  1. Number
  2. Size
  3. Color
  4. Type
  5. Margination
  6. Shape
  7. Configuration
  8. Location/distribution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 5 signs of a suspicious skin lesion?

A 
Asymmetry
Border irregularity
Color variation
Dimension larger than 6mm
Evolving - change in size, shape, color, elevation, bleeding, itching, etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What kind of rashes are emergency conditions?

A
  1. Meningitis: purple or red spots on trunk or lower extremities with fever, headache, neck stiffness, altered mental status
  2. Pemphigus Vulgaris: large blisters or bullae caused by autoimmune dz against desmoglein in epidermis that can become infected
  3. Ulcers (skin):
    - arterial insufficiency: painful, dependent rubor, where skin rubs
    - venous insufficiency: not as painful, stasis dermatitis (brown)
    - diabetic: numb (neuropathy), arterial, weight-bearing
  4. Cellulitis: staph or strep infxn of skin or connective tissue, can lead to sepsis
  5. MRSA: Methicillin-resistant Staph - fever, red bumps, painful boils, can lead to sepsis or pneumonia
  6. Viral Exanthems: (reportable) Measles, Mumps, Rubella, Erythema infectiosum, Roseola infantum, Chickenpox, Viral hemorrhagic fever, Rocky Mountain spotted fever
  7. Stevens-Johnson Syndrome: immune rxn (drug or infxn) fever, skin & mucosal ulcers, can lead to epidermal necrosis
  8. Necrotizing fasciitis: at site of trauma, infxn spreading across fascial plane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are normal and abnormal breath sounds?

A

Normal:
Bronchial: over large airways
Bronchovesicular: over transitional areas
Vesicular: over distal airways

Abnormal or Adventitious breath sounds:
Wheezing: whistling through narrowed airways
Crackles: alveoli popping open on inspiration
Rhonchi: low pitched bubbles or wheezes in upper airways
Pleural Friction Rub: leathery sounds in chest wall
Bronchial breathing: loud breath in vesicular regions
Absent sounds: no breath sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is egophony and what does it test for?

A

Having a patient say E while auscultating over the lungs. If E changes to A, it is a positive sign for consolidation of tissue, usually due to pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What colors of sputum are a “red-flag” and why?

A

Hemoptysis: red or brown blood flecks are streaks
- smokers, pneumonia, lung cancer (late), tuberculosis
Clear: common cold, allergies, GERD, smoking, post-nasal drip
Yellow: (inflammatory) allergies, viral or bacterial infxn, asthma
Green: bacterial infxn, tuberculosis, post-nasal drip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is pleuritic chest pain and why is it important?

A 
Sharp localized pain on inhalation or coughing
can be life-threatening if due to to:
 - Bacterial or viral infxn
 - Pneumothorax
 - Advanced Lung Cancer
 - Chest injury - blunt trauma, rib fracture
 - Pulmonary embolism
 - Herpes Zoster - vesicular rash
17
Q

What are some common pulmonary conditions?

A

Asthma: recurrent reversible airflow obstruction
COPD: chronic bronchitis or emphysema
Bronchitis: inflammation of mucus membranes in bronchi
Pneumonia: infection in alveoli
Tuberculosis: granulomatous bacterial lung infection
Pulmonary embolism: clot in pulmonary artery
Acute Respiratory Distress Syndrome: acute onset of lum parenchymal inflammation leading to hypoxia
Pneumothorax: air or gas in pleural space
Pleural Effusion: fluid (serous, blood, pus) in pleural space
Lung Cancer: chronic cough, hemoptysis, weight loss, dyspnea

18
Q

What creates the normal cycles of heart sounds?

A

S1 (lub): closure of Mitral and Tricuspid valves

S2 (dub): closure of Aortic and Pulmonic valves

19
Q

What are some possible abnormal heart sounds?

A

Splitting of S1 or S2: pathological if S2 split persists on expiration
S3: after S2 (Lub Dub da) - Congestive Heart Failure
S4: before S1 (ta Lub Dub) - CHF or MI (heart attack)
Murmurs:
- Regurgitation: valve not fully closing
- Stenosis: valve not fully opening
Pericardial friction rub: leathery murmur
Arrhythmias: irregularly irregular heart rhythm
Palpitations: sense of heart pounding, skipping, racing
Cardiogenic Heart Pain:
- Angina: Reversible
- Myocardial Infarction: heart attack (irreversible)

20
Q

When is it important to perform special heart exams?

A

If you hear additional sounds, you can position the patient or do a hemodynamic maneuver

1) Have patient sit up, lean forward and hold breath to hear aortic or pulmonic (base or top of heart) sounds better.
2) Have patient roll onto left side to hear tricuspid or mitral sounds better
3) Have the patient “bear down” (Valsalva maneuver) to see how it changes a murmur.

21
Q

Why is a change in PMI important?

A

Lateralized or wide PMI suggests heart enlargement (cardiomyopathy, CHF)

22
Q

What are common cardiovascular conditions?

A

A. Coronary artery disease (CAD): build up of plaque in the coronary arteries, leading to cardiac ischemia. Reversible in case of Angina (recurrent chest pain on exertion, relieved with rest.) Leading cause of death worldwide.
B. Myocardial Infarction (MI): rupture of plaque, blockage of coronary artery or vasospasm leading to irreversible ischemia and thus damage to heart muscle Atypical symptoms: back pain, nausea, and vomiting, indigestion, weakness, dizziness
C. Sudden Cardiac Death (SCD): rapid and unexpected death from cardiac causes. Typically from coronary atheroma, ventricular hypertrophy, ventricular fibrillation
D. Peripheral vascular disease (PVD): obstruction or narrowing of peripheral arteries leading to poor tissue oxygenation. Common in diabetics, smokers, hypertension, high lipids
SSx: intermittent claudication (pain, cramping, numbness in muscles), poor hair growth, change on coloration (pale or blue), painful ulcers
E. Cardiomyopathy: disease of the heart muscle—typically thickening in response to changes in function, eg hypertension. Can lead to arrhythmias and sudden cardiac death.
F. Congestive Heart Failure (CHF): inability of heart to keep up with demands. Associated with ischemic heart disease, hypertension, smoking, diabetes, valve disease SSx: fatigue, SOB, orthopnea, peripheral edema, hepatomegaly, ascites, S3, S4, laterally displaced PMI
G. Pericarditis: inflammation in pericardium from infection, trauma
SSx: chest pain, dry cough, fever, fatigue, friction rub
H. Mitral Valve Prolapse (MVP): billowing of mitral leaflet into L atrium during systole, presenting as a click or murmur. Depending on severity, may be no complications or may progress to regurgitation, CHF or arrhythmias. On Valsalva, the sounds get louder
I. Atrial Fibrillation (AF): irregular conduction of electrical impulses to the ventricles. Can be asymptomatic, but typically: tachypnea, palpitations, light-headedness
J. Endocarditis: Often referred to as “subacute bacterial endocarditis.” Inflammation of the inner layer of the heart typically involving the valves, septum and chordae tendineae. If infective form the organism is often streptococcus viridans which populates the mouth and throat. This is why individuals with heart murmurs need antibiotics prior to dental work.

23
Q

What are concerning findings on the gums?

A

Gingivitis: inflammation of gum tissue usually caused by plaque/bacterial biofilm
Dental abscess: Tooth infection leading to pus enclosed in the tooth root in jaw, tooth or jaw pain. Serious cases can lead to cavernous sinus thrombosis—emergency!
Leukoplakia: firmly attached white patches on the mucous membranes of the oral cavity. Leukoplakia is a premalignant lesion, often leading to oral cancer.

24
Q

What are concerning findings on the tonsils?

A

Tonsillitis: swelling of tonsils from bacteria, viruses. Lymph nodes swollen. Common cause is streptococcus (GABHS=group A beta-hemolytic Strep), which if not treated well can lead to serious sequelae to heart or kidneys (rheumatic fever)
Centor criteria used as clinical guide: absence of cough, swollen/tender anterior chain lymphadenopathy, fever, tonsillar exudate (pus)

25
Q

What are concerning findings on the mouth and throat?

A
  • Rapid tongue swelling (with hives, SOB, tachypnea): anaphylactic reaction
  • Severe throat pain: tonsillar exudate (strep pharyngitis—sequellae, carriage, contagion)
  • Drooling, difficulty swallowing, high fever, dysphagia suggest epiglottitis
  • Excessively dry mouth (xerostomia) from Sjögren’s disease
26
Q

What are concerning findings of the cervical lymph nodes?

A

Enlarged, non-tender lymph nodes

27
Q

What are concerning findings on the thyroid exam?

A

Enlarged thyroid or nodules

  • Grave’s Disease (autoimmune toxic): goiter, exophthalmos, pretibial edema
  • Thyroid Storm: fever, tachycardia, agitation, tremulousness, psychosis
28
Q

What are some common ear conditions?

A
  1. Presbycusis: Degeneration of hair cells in cochlea with age leads diminished hearing
  2. Sensorineural hearing loss/conductive hearing loss: SN—cochlear cause; Conductive—problem with sound wave conduction from outside to middle ear
  3. Acute otitis media: Infection within middle ear, often viral. Visualized as red, swollen TM
  4. Vertigo: dizziness due to dysfunction of vestibular function of the middle ear
29
Q

What are common conditions of the eyes?

A
  1. Conjunctivitis: redness in conjunctiva caused by viral, bacterial, irritative causes
  2. Age-related macular degeneration (ARMD): central vision loss from cellular debris deposits in the macula, screen for with geriatric population
  3. Presbyopia: Age-related weakening of muscles around lens and loss of elasticity in lens leads to poor near-vision
30
Q

What are concerning findings of the eyes?

A

1) Conjunctival hemorrhage/ciliary injection: from infection, injury
2) Corneal abrasion: history of injury, foreign object/debris
3) Sudden vision changes: Loss of vision/double vision (diplopia)
4) Eye pain
5) Pupils of unequal size
6) On ophthalmoscopic exam: papilledema or retinal hemorrhages

31
Q

What are some common conditions of the nose?

A

Rhinosinusitis: frontal head/maxillary pressure, with or without nasal discharge. Viral or bacterial or fungal causes

32
Q

What are some common conditions of the throat?

A
  1. Tonsillitis: swelling of tonsils from bacteria, viruses. Lymph nodes swollen. Common cause is streptococcus (GABHS=group A beta-hemolytic Strep), which if not treated well can lead to serious sequelae to heart or kidneys (rheumatic fever)
    Centor criteria used as clinical guide: absence of cough, swollen/tender anterior chain lymphadenopathy, fever, tonsillar exudate (pus)
  2. Hypothyroid: low functioning of gland leads to fatigue, weight gain
  3. Hyperthyroid: over-functioning of gland (often auto-immune cause) leads to rapid heart rate, anxiety, weight loss
33
Q

How should you chart vitals?

A 
O: Pt appears in NAD, WNWD.          
Ht: 65 in; Wt 135 lbs  
BMI is 21, WHR is 0.85          
BP: 110/70 mmHg  LAS  (left arm sitting)          
Temp: 97.8°F po          
Resp rate: 12 breaths/min          
HR: 70 bpm, regular
34
Q

How would you chart a Lung exam?

A

Normal exam:
Lungs—CTAB, normal chest expansion, normal chest configuration
(Clear To Auscultation Bilaterally)

35
Q

How would you chart a heart exam?

A 
Normal exam:  
Auscultation: RRR s MRG*. 
Normal S1 and S2.
PMI in 5th intercostal space 
MCL, 2 cm diameter        
(*regular rate and rhythm, without murmurs, rubs, gallops)
36
Q

How would you chart an EENT exam?

A

Normal exam sample:
Eyes: no lesions, swelling or discharge
Ears: no lesions, no tenderness
Nose: no discharge, no visible lesions in nares
Mouth: normal coloration of buccal mucosa and gingival. Normal dentition. Normal tongue movement and no lesions on any surface.
Tonsils: 1+, no erythema or exudate*.
Pharynx and pillars: no lesions or erythema
Neck: no lymphadenopathy
Thyroid: normal size and consistency

CCM CPD (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions