Brainscape's Knowledge GenomeTM

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


See full index

Step2 CS > CS Hx > Flashcards

CS Hx Flashcards

1
Q

head

A

atraumatic, normocephalic

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

eyes

A

EOMI
PERRLA
normal eye fundus

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

nose

A

no nasal congestion

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

throat

A

no tonsillar erythema, exudates or enlargement

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

neck

A

supple
no JVD
normal thyroid
no cervical LAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

neurologic mental status

A

alert and oriented X 3

good concentration

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

cranial nerves

A

II-XII grossly intact

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

motor

A

strength 5/5 in all muscle groups

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

DTR

A

2+ intact and symmetric

babinski (-)

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

sensation

A

intact to sharp and dull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cerebellum

A

Romberg (-)

intact finger to nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

chest and lungs

A

clear to percussion bilaterally
no rales, wheezing, ronchi or rubs
no tenderness to palpation
tactile fremitus WNL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

heart

A

PMI not displaced
regular rate and rhythm
normal S1, S2
nomurmurs, rubs or gallops

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

abdomen

A 
soft
 nontender
 nondistended
 BS (+)
 no hepatosplenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

extremities

A

no clubbing, cyanosis or edema

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

mental status exam components

A 
speech
 cooperation
 affect
 eye contact
 attention
 registration/recall
 distant memories
 orientation
 three-step command
 serial 7s
 judgement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

headache associated neurologic symptoms

A 
paresthesia
 visual stigmata
 weakness
 numbness
 ataxia
 photophobia
 dizziness
 auras
 neck stiffness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

headache exacerbating factors

A 
stress
 fatigue
 menses
 exercise
 certain foods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

headache alleviating factors

A

rest

medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

headache associated systemic symptoms

A 
nausea/vomit
 jaw claudication
 recent trauma
 dental surgery
 sinusitis symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

headache physical exam

A

inspection and palpation of head
ENT inspection
complete neurologic exam
funduscopic exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

confusion/memory loss

A 
include history from family members
 time course (chronic Vs. acute)
 associated symptoms --> constitutional, incontinence, ataxia, hypothyroid symptoms, depression
 delirium --> waxing/waning level of alertness
 falls
 medications --> recent and changes
 history of stroke or vascular disease
 syphillis
 alcohol use
 vitamin B12
 family history of Alzheimer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

confusion/memory loss physical

A

neurologic exam
mini-mental
gait
general physical exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

depressed mood history

A 
onset
 duration
 sleep pattern
 apetite
 weight change
 drug and alcohol use
 life stresses
 excessive guilt
 suicidality
 social function
 anhedonia
 decreased energy
 decreased concentration
 psychomotor agitation or retardation
 family history of mood disorders
 prior episodes
 medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

depressed mood physical

A 
head and neck
 neurologic exam
 mental status exam
 mini-mental exam
 insight
 judgement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

psychosis history

A

positive symptoms –> delusions, hallucinations, disorganized thoughts, catatonic behavior
negative symptoms –> blunted affect, social withdrawal, decreased motivation, decreased speech/thought
cognitive symptoms –> disorganized speech or thought patterns, paranoia
age of first symptoms, hospitalizations
previous medications
alcohol and substance abuse
mental status exam

27
Q

dizziness history

A

lightheadedness Vs. vertigo +- hearing loss or tinnitus
duration
context (positioning, head trauma)
associated symptoms –> visual disturbance, URI, nausea
neck pain or injury
medications
history of atherosclerosis

28
Q

dizziness physical exam

A 
neurologic exam
 Romberg
 nystagmus
 tilt test
 gait
 Webber/Rinne
 head/neck exam
 cardiovascular exam
29
Q

loss of consciousness history

A

presence or absence of preceding symptoms –> nausea, diaphoresis, palpitations, pallor, lightheadedness
context –> exertional, postural, traumatic, stressful, painful, dehydration
associated signs –> tongue biting, incontinence, tonic-clonic movements, confusion
pulmonary embolism risk factors
history of heart disease, hypertension, diabetes, alcohol, drug use

30
Q

loss of consciousness physical

A 
vital signs
 orthostatics
 neurologic exam
 carotid and cardiac exam
 lung exam
 exam of lower extremities
31
Q

numbness/weakness

A 
distribution --> unilateral, bilateral, proximal, distal
 duration
 progression
 pain
 constitutional
 other neurologic symptoms
 history of diabetes, alcoholism, atherosclerosis
 neurologic exam
 musculoskeletal exam
 vascular exam
32
Q

fatigue and sleepiness history

A 
duration
 sleep hygine
 snoring
 waking up choking/gasping
 witnessed apnea
 overexertion
 stress
 depression
 emotional problems
 lifestyle changes
 shift changes at work
 diet/weight changes
 constitutional symptoms
 thyroid symptoms
 history of bleeding or anemia
 medications
 alcohol and drug use
33
Q

fatigue and sleepiness physical

A

head and neck exam –> conjunctival pallor, oropharynx, lymphadenopathy, thyroid exam
heart, lung, abdominal, neurologic exam
consider rectal exam and occult blood test

34
Q

night sweats history

A 
onset, duration, severity, frequency, timing, patterns
 recent URIs, cough, hemoptsis, pleuritic chest pain
 lymphadenopathy, fever, rash
 malaise, weight loss
 itching, diarrhea, nausea/vomiting
 early satiety, anorexia
 alcohol history
 sexual exposure
 sick contacts
 exposure to high-risk populations
 menstrual history
35
Q

night sweats physical

A 
HEENT exam including throat and lymphadenopathy
 skin exam
 musculoskeletal for joint pain
 heart and lung
 abdominal for hepatosplenomegaly
36
Q

insomnia

A 
primary Vs. secondary
 duration
 trouble falling asleep Vs. multiple awakenings Vs. early morning awakening
 daytime sleepiness
 problems keeping patient awake --> arthritis pain, diabetes polyuria
 snoring
 nightmares
 depression
 caffeine use
 recreational drug use
 jet lag
 shift work
 stressors
 sleep hygine
 mental status exam
37
Q

sore throat

A 
duration
 fever
 ear pain
 URI
 odynophagia
 swollen glands
 cough
 rash
 sick contacts
 HIV risk factors
 ENT exam --> oral thrush, tonsillar exudate, lymphadenopathy
 lung, abdominal, skin exams
38
Q

cough/shortness of breath history

A 
acute Vs. chronic
 description of sputum
 associated symptoms --> constitutional, URI, postnasal drip, dyspnea, wheezing, chest pain, heartburn
 exacerbating/alleviating factors
 timing, exposures
 smoking history
 lung disease
 allergies
 medications (ACEIs)
39
Q

cough/shortness of breath physical

A 
pulse oximetry
 nasal mucosa
 oropharynx
 heart
 lungs
 lymph nodes
 extremities --> clubbing, cyanosis, edema
40
Q

chest pain history

A

location, quality, severity, radiation, duration
context –> exertional, postprandial, positional, cocaine, trauma)
associated symptoms –> nausea, sweating, dyspnea, palpitations, sense of doom
exacerbating/alleviating factors –> medications
prior history of similar symptoms
history of heart, lung disease and diagnostic testing
cardiac risk factors
pulmonary embolism risk factors

41
Q

chest pain physical

A

BP in both arms
CV exam –> JVD, PMI, chest wall tenderness, heart sounds, pulses, edema
lung exam
abdominal exam

42
Q

palpitations hystory

A 
gradual Vs. acute
 context --> exertion, caffeine, anxiety
 associated symptoms --> lightheadedness, chest pain, dyspnea
 hyperthyroid symptoms
 bleeding or anemia
 heart disease
43
Q

palpitations physical

A 
endocrine/thyroid exam
 exophthalmos
 lid retraction
 lid lag
 gland size
 bruit
 tremor
 CV exam
44
Q

weight loss

A 
amount
 duration
 intentional?
 Diet history
 body image
 anxiety
 depression
 constitutional symptoms
 palpitations
 tremor
 diarrhea
 family history of thyroid disease
 HIV risk factors
 alcohol and drug use
 medications
 history of cancer
45
Q

weight gain

A 
amount
 duration
 timing --> relation to medication changes, smoking cessation, depression
 diet history
 hypothyroid symptoms
 menstrual irregularity
 past medical history
 alcohol and drug use
 physical --> complete exam including signs of Cushing --> hypertension, central obesity, moon face, buffalo hump, purple abdominal striae
46
Q

dysphagia

A 
solids Vs. solids and liquids
 progressive?
 Constitutional symptoms
 drooling
 regurgitation
 odynophagia
 GERD
 medications
 HIV risk factors
 history of smoking
 head and neck exam
 skin exam looking for scleroderma
47
Q

nausea/vomitting

A 
acuity of onset +- abdominal pain
 relation to meals
 sick contacts
 possible food poisoning
 possible pregnancy
 neurologic symptoms --> headache, stiff neck, vertigo, focal numbness
 associated symptoms --> GI or chest pain
 exacerbating and alleviating factors
 medications
 funduscopic exam
 complete exam
48
Q

abdominal pain history

A 
onset
 duration
 frequency
 quality
 intensity
 radiation
 timing (relation to meals)
 associated symptoms --> constitutional, GI, cardiac, pulmonary, renal, pelvic
 exacerbating and alleviating factors
 history of abdominal surgeries
 gallstones
 renal stones
 atherosclerosis
 alcohol and drug use
 domestic violence
49
Q

abdominal pain physical

A

heart and lung exams
abdominal exam –> guarding, rebound, Murphy, CVA palpation
rectal exam
pelvic exam (women)

50
Q

constipation/diarrhea

A 
frequency and volume of stools
 duration of change in bowel habits
 associated symptoms --> constitutional, abdominal pain, bloating, sense of icomplete evacuation, melena
 thyroid disease symptoms
 fiber and fluid intake
 medications (recent antibiotics)
 sick contacts, travel
 camping
 HIV risk factors
 diabetes
 pancreatitis
 alcohol and drug use
 history of colon cancer
 thyroid/endocrine exam
 abdominal and rectal exam
 female pelvic exam
51
Q

upper GI bleeding

A

amount
duration
context –> after severe vomiting, alcohol ingestion, nosebleed
associated symptoms –> constitutional, nausea, abdominal pain, dyspepsia
medications –> warfarin, NSAIDs
history of peptic ulcer
liver disease
osthostatic exam
ENT, heart, lung, abdominal and rectal exams

52
Q

blood in stools

A 
melena Vs. bright blood
 amount
 duration
 associated symptoms --> constitutional abdominal/rectal pain, tenesmus, constipation/diarrhea
 trauma
 prior history
 prior colonoscopy
 medications (warfarin)
 history of bleeding or atherosclerosis
 orthostatics
 abdominal and rectal exam
53
Q

hematuria

A 
amount
 duration +- clots
 associated symptoms --> constitutional, renal colic, dysuria, irritative voiding
 medications
 history of vigorous exercise
 trauma
 smoking
 stones
 cancer
 easy bleeding
 lymph nodes
 GI, GU and rectal exams
54
Q

urinary symptoms

A

duration
obstructive symptoms –> hesitancy, diminished stream, incomplete bladder emptying, straining, postvoid dribbling
irritative symptoms –> urgency, frequency, nocturia
constitutional symptoms
bone pain
medications
UTIs
urethral stricture
abdominal exam –> suprapubic percussion for distended bladder
genital and rectal exam

55
Q

erectile dysfunction

A 
duration
 severity +- nocturnal erections
 libido
 stress or depression
 trauma
 associated incontinence
 medications
 past medical history --> hypertension, diabetes, high cholesterol, prostate surgery
 smoking, alcohol and drugs
56
Q

amenorrhea

A 
primary Vs. secondary
 duration
 possible pregnancy
 associated symptoms --> headache, decreased peripheral vision, galactorrhea, hirsutism, virilization, hot flashes, vaginal dryness, symptoms of thyroid disease
 history of anorexia nervosa
 excessive dieting
 vigorous exercise
 pregnancies
 D&Cs
 uterine infections
 breast exam
 complete pelvic exam
57
Q

vaginal bleeding

A 
pre Vs. postmenopausal
 duration
 amount
 menstrual history
 relation to last menstrual period
 associated discharge
 pelvic or abdominal pain
 urinary symptoms
 trauma
 medications
 history of easy bleeding or bruising
 abnormal pap smears
58
Q

vaginal discharge

A 
amount
 color
 consistency
 odor
 duration
 associated vaginal burning
 pain
 pruritus
 recent sexual activity
 last menstrual period
 contraceptives
 tampons
 history of similar symptoms
 history of STDs
 abdominal and pelvic exams
59
Q

dyspareunia

A 
duration
 timing
 associated symptoms --> vaginal discharge, rash, painful menses, GI symptoms, hot flashes
 adequacy of lubrication
 libido
 sexual history
 sexual trauma
 domestic violence
 history of endometriosis or PID
60
Q

abuse

A 
establish confidentiality
 directly question about physical, sexual or emotional abuse
 question about fear and safety
 history of frequent accidents/injuries
 mental illness
 drug use
 complete + pelvic exam
61
Q

joint/limb pain

A 
location
 quality
 intensity
 duration
 pattern
 small Vs. large joints
 number of joints involved
 swelling
 redness
 warmth
 associated symptoms --> constitutional, red eye, oral or genital ulceration, diarrhea, dysuria, rash
 exacerbating and alleviating factors
 trauma
 medications
 DVT risk factors
 alcohol and drug use
 family history of rheumatic disease
 HEENT, musuloskeletal and neurovascular exam
62
Q

low back pain

A 
location
 quality
 intensity
 radiation
 context --> moving furniture, bending/teisting, trauma
 timing --> disturbs sleep
 associated symptoms --> cosntitutional, incontinence
 exacerbating and alleviating factors
 history of cancer
 recurrent UTIs
 diabetes
 renal stones
 IV drug use
 smoking
63
Q

child with fever

A 
severity
 duration
 associated localizing symtoms
 appetite
 rash
 sick contacts
 day care
 immunizations
 past history
 HEENT, neck, heart, lung, abdominal and skin exams
64
Q

behavioral problems in childhood

A 
onset
 severity
 duration
 triggers
 psysical violence
 use of weapons
 substance use
 developmental history
 environment
 school performance
 neurologic exam

Step2 CS (4 decks)

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