deformity of the joint connecting the big toe to the foot.. 1. Plantar fasciitis 2. Morton's neuroma 3. Cmpartment syndrome 4. Bunion deformity

4. bunion deformity hallus abducto valgus (or varus)

DAY5 Flashcards by Jacqueline Plachta

deformity of the joint connecting the big toe to the foot..

Plantar fasciitis
Morton’s neuroma
Cmpartment syndrome
Bunion deformity

bunion deformity

hallus abducto valgus (or varus)

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pain in the heel and bottom of the foot, usually most severe with the first steps of the day or following a period of rest..

Plantar fasciitis
morton’s neuroma
cmpartment syndrome
bunion deformity

plantar fasciitis

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benign neuroma of an intermetatarsal plantar nerve, commonly between 3rd and 4th intermetatarsal spaces

morton’s neuoma

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serious condition involving increased pressure, leads to muscle and nerve damage and problems with blood flow

emergency surgery.. compartment syndrome (fasciotomy)

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test for anterior cruciate ligament integrity or tear (ACL)

anterior drawer test..
more reliable is Lachman test.. knee flexed 20–30°, the tibia is displaced anteriorly relative to the femur; a soft endpoint or greater than 4 mm of displacement is positive

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test for meniscus both medial and lateral

McMurray test… pain on external rotation (medial meniscus) pain on internal rotation (lateral meniscus)

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unhappy triad …diagnosed orthopedic issues?

ACL, MCL, Medial meniscus… diagnosed with MRI

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drop arm test for?

weakness on external rotation, pain upon abduction of arm…Rotator cuff tear (also Hawkins - kennedy test)

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patients arm in shoulder flexion, external rotation, full elbow extension, forearm supination, manual resistance is then applied… test for bicipital tendonitis

Speed’s test (also can use yegarson’s test)

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types of spinal curvatures..

Kyphosis - thoracic curvature (hunchback)
Lordosis - anterior lumbar curvature (swayback)
Scoliosis - lateral curvature

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moderate scoliosis

cobb angle 20 to 40 degrees

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symmetrical joint pain, morning stiffness last 60 minutes, fatigue, anorexia, pain gets better during the day

Rheumatoid Arthritis (RA)

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needle shaped negatively birefringent crystals, in a middle aged obese man, severe pain, redness and swelling in the big toe,

Gout (uric acid accumulation), often put on purine restricted diet

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hip fractures, vertebral compression fractures, loss of height and progressive thoracic kyphosis, distal radius fractures (Colles’ fracture), following minimal trauma

osteoporosis (diagnosed with DEXA scan T score -2.5 and lower)

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vitamin D deficiency in adults and children

adults osteomalacia, children rickets

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osteoblasts vs osteoclast

build up bone vs breakdown

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too much PTH (parathyroid hormone) can cause?

osteoporosis…. PTH increases blood calcium, less for bones

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hypertension diagnosis…

130/90 pre hypertension
140./90 hypertension
grade 2 160/100
grade 3 180/110

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essential hypertension is caused by?

unknown…

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secondary hypertension is caused by…

Cushings
Hyperaldosterone
Aortic
Pheochromocytoma
Stenosis of renal

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major risk factors for ischemic heart disease..

Age>65
Male
Family history
Hyperttension
Smoking
Hyperlipidemia
DM

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medications for hypertension

ACE inhibitors
Beta Blockers
Calcium channel blockers
Diuretics

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fat deposits around the eyes showing excess fat in the body (think high levels of triglycerides)

Xanthoma

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factors contibuting to atherosclerotic vascular disease…

high LDL, low HDL

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total cholesterol LDL cholestoerol HDL cholesterol triglycerides

below 200 below 100 above 40 (this is the cleaner of the pathways) below 150

substernal chest tightness/pain or SOB with a consistent amount of exertion, relief is OBTAINED with rest or nitroglycerine... 1. Stable angina 2. unstable angina 3. myocardial infarction 4. acute coronary syndrome

1. stable angina because it is addressed with medication, unstable angina the pain would not improve

59 year old male in ER, history of DM, HTN, hypercholesterolemia, chest pain radiating to the jaw, pain started 6 hours ago, ECG confims anterior MI... what test?

Troponin I | CK-MB is for an attack that occured further into the past...(example 4 days ago)

``` when would you screen for Abdominal Aortic Aneurysm 1. 45 to 55 for everyone 2. 45 to 55 who ever smoked 3. 65 to 75 everyone 65 to 75 who ever smoked ```

an ultrasound screening for 65 to 75 year old who have smoked.. surgical candidate if 5.5 cm or larger

right side of the heart pumps blood ....?

to the lungs.. this is the pulmonary circuit and the blood is deoxygenated the systemic circuits pumps to the whole body

blood vessels that contain oxygenated blood...

pulmonary vein to the heart aorta oxygenated blood from heart to body the pulmonary artery takes blood away from the heart to the lungs and is deoxygenated.. the vena cava has deoxygenated blood (from body to heart)

normal ECG patter is composed of...

P QRS T

tachycardia in an adult..

resting heart rate over 100... for a fetus it is greater than 140

bradychardia in an adult is..

resting heart rate under 60bpm

blood pressure regulating hormones called...

renin-angiontensin-aldosteron system RAAS angiotensinogen (+renin) to angiontensin1 + ACE to angiotensin II to aldosterone (which is one of the ways BP is modified)

angiotensinogen to aniotensinI...

renin (produced in the kidneys)

angiotensin I to angiotensin II...

ACE (produced in the Lungs and Kidneys)

adverse effects for ACE inhibitors (meds that end in -pril)

dry cough.. not productive

actions of angiotension II...

increase symathetic activity increase aldosterone secretion increase Na+ reabsorption vaso constriction.. This increases BP

CPR response

Compressions... Airway... Breathing CAB

compression ventilation ration for an adult (or single resonder for child or infant)

30:2

exposure to threatened death or serious injury... male top causes: rape, combat Female top cuases: childhood abuse, rape

post traumatic stress disorder.. if less than a month acute stress disorder

``` Palpitation Abdominal distress Numbness Intense fear of death Choking, chills, chest pain Sweating, shaking, shortness of breath ```

panic disorder

Cut down? Annoyed you by criticism? Guilty for your behavior? Eye-opener to stead your nerves?

questionnaire for alcohol abuse

``` Sleep either decreased or increased Interests decreased Guilt Energy decreased Concentration decreased Appetite decreased or increased Psychomotor agitation or retardation Suicidal ideation ```

major depressive disorder

``` Distractibilit Insomnia decreased need for sleep Grandiosity (inflated self esteem) Speech pressed Flight of ideas Agitation, psychomotor Recklessness, risky behavior ```

bipolar disorder

hallucinations, delusions, disorganized speech, bizarre behaviors, no feeling of enjoyment, speaking less

schizophrenia

8 year old boy for last 7 month, easily distracted, difficulty following instructions, disorganization, fidgeting, interrupting others... occured for more that 6 moths in more that 2 settings

attention deficit hyperactivity disorder

18month old, non verbal, rarely gestures or points at things and always plays alone. DOES NOT RESPOND TO HIS NAME OR MAKE EYE CONTACT.

autism spectrum disorder

90 minutes after falling asleep, penile/clitoral tumescence occur,

REM

meds to help with nicotine addiction

Chantix

substance intoxication that causes belligerence, psychosis, VIOLENCE, impulsiveness, psychomotor agitation

phencyclidine hydrochloride PCP marijuana -slowed sense of time LSD -delusion, visual hall, pupil dilation Opioids -pupil contraction (pinpoint), euphoria, CNS depression, resp. depression Amphetamine, cocaine -psycomotor agitation, pupil dilaion

toxicity: restlessness, insomnia, diuresis, muscle twitching, arrhythmias, psychomotor agitation withdrawal: headache, lethargy, depression, irritability, craving 1. alcohol 2. nicotine 3. caffeine 4. sugar

3. caffeine

signs.. parotitis, orchitis, meningitis

mumps mumps - epidemic parotitis measles -rubeola german measles -rubella

koplik spots, descending maculopapular rash, cough, coryza, conjunctivitis C(K)oplik spots Cough Coryza (runny nose) Conjunctivitis

measles rubeola

what is 3 day measles

rubella (german measles)

``` What is passed from mother to baby? T O R C H ```

``` toxoplasmosis other infections...Hep B rubella cytomegalovirus herpes simplex 2 ```

causative agent of whooping cough

bordatella pertussis...

most common STI

HPV

most common viral STI

HPV

most common bacterial STI

Chlamydia

vaccines are available for

Hep A and B ``` A 15 to 150 fecal/o abrupt yes(vaccine) no(chronic) B 45 to 160 blood insidious yes depends C 14 to 180 blood insidious no 75 to 85% D n/a n/a insidious no n/a E 15 to 60 f/o abrupt no no ```

abrupt onset

hep A and E

blood borne

hep b and C

incubation of hep C

14 to 180 days

fecal oral transmission high mortality in women

HEP E

common cause of infantile diarrhea, major cause of acute diarrhea in the US during the winter esepcially in day care centers and kindegartens

ROTAVIRUS

non bacterial outbreak of gastroenteritis, spread quickly in closed places like daycare centers, nursing homes, schools, CRUISE SHIPS

NOROVIRUS

primary target of HIV

CD4 helper T cells when CD4 cells fall below 200 you are considered to have progressed to AIDS, or develop one or more oppotunistic ILLNESSES, regardless of CD4 count

super bug resistant to antibiotics

MRSA meth resistant staph aureus related to hospital stays because too much antibiotics NOSOCOMAL

not a sign or symptom of meningitis 1. fever 2. neck stiffness 3. mental status change 4. babinski sign

Babinski sign is for UMN.. scraping bottom of foot and fanning of toes

neck is flexed and knee and hip flex involuntarily

brudzinski sign for meningitis

hip/knee flexed,inability to straighten knee

kernig sign for meningitis

test for HIV

start with ELISSA and confirm with western blot

poor night vision damage to cornea dry or cracked skin

VITAMIN A deficiency.. mucosa

hemorrhage, rare except in newborn infants

VIT K deficiency

dry beriberi, wet beriberi, wernicke korsoakoff syndrome

VIT B1 thiamine deficiency... WK is caused by alcohol, amnesia, psychiatric

pellagra... dermatitis, diarrhea, dementia (scaly sores, mucosal changes, mental symptoms)

vitamin B3 deficiency .. Niacin

megaloblastic anemia and pernicious anemia

caused by B12 deficiency cobalamin

autoimmune disease in the fundus of the stomach .. no parietal cells which creates intrinsic factor.. without intrinisic factor no absorption of B12

pernicious anemia

vit B9 deficiency .. folate.. in pregnancy

megaloblastic anemia

weakness, anemia, bruising, bleeding glums, loose teeth

Vit C deficiency.. scurvy

b1 deficiency from alcohol abuse..

Wernicke Korsakoff syndrome wernicke encephalopathy.. ataxia. ophthalmoplegia confusion korsakoffs psychosis imparied short teerm memory confabulation may be accompanying. (this is the homeless person on the street that makes up stories regarding how they got there)

vitamin d deficiency in children

causes rickets.. this is not a calcium deficiency.. same as osteomalacia in adults