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Bates Reviews > DIana's Tidbits > Flashcards

DIana's Tidbits Flashcards

1
Q

Parts of the Health History

A 
Identifying Data
CC
HPI with appropriate ROS in episodic
PMH
FH
Personal/Social Hx

ROS: for comprehensive

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2
Q

DTR regions

A 
Each DTR has region-abnormal can locate pathology
Ankle: Sacral 1
Knee: Lumbar 2,3,4
Brachioradialis: Cervical 5,6
Biceps: Cervical 5,6
Triceps: Cervical 6, 7
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3
Q

Grading Reflexes

A

4+: very brisk, hyperactive with clonus (rhythmic oscillations between flexion and extension)
3+: Brisker than average; possibly but not necessarily indicative of disease
2+: average, normal
1+: somewhat diminished; low normal
0: no response

If diminshed look for other findings such as atrophy, weakness, fasiculations

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4
Q

Delirium Clinical Features

A

Acute
Fluctuating with lucid intervals; worse at night
Hours to weeks
Sleep always disrupted
General medical illness and/or drug toxicity present

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5
Q

Delirium LOC

A

LOC: Disturbed-less aware of environment, less able to focus, sustain or shift attention

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6
Q

Delirium Behavior

A

Abnormally decreased (somnolent) or increased (agitation, hyper vigilance)

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7
Q

Delirium speech

A

Hesitant, slow, or rapid, incoherent

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8
Q

Delirium mood

A

fluctuating: labile-from fearful or irritable to normal or depressed

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9
Q

Delirium thought process

A

disorganized, incoherent

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10
Q

Delirium thought content

A

delusions common, often transient

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11
Q

Delirium perceptions

A

illusions, hallucinations, most often visual

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12
Q

Delirium judgement

A

impaired

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13
Q

Delirium orientation

A

disoriented-esp for time. a known place may be familiar

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14
Q

Delirium attention

A

fluctuates-easily distracted, unable to concentrate

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15
Q

Delirium memory

A

immediate and recent memory impaired

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16
Q

Delirium causes

A 
DTs
uremia
acute hepatic failure
acute cerebral vasculitis
atropine poisoning
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17
Q

Dementia clinical features

A 
insidious onset
slowly progressive
months to years duration
sleep fragmented
general medical illness or drug toxicity often absent, esp in alzheimers
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18
Q

Dementia LOC

A

usually normal until late

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19
Q

dementia behavior

A

normal to slow, may become inappropriate

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20
Q

dementia speech

A

difficulty finding words, aphasia

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21
Q

dementia mood

A

often flat, depressed

22
Q

dementia thought process

A

impoverished; speech gives little info

23
Q

dementia thought content

A

delusions may occur

24
Q

dementia perceptions

A

hallucinations may occur

25
Q

dementia judgement

A

increasingly impaired over the course of the illness

26
Q

dementia orientation

A

fairly well maintained, impaired in later stages

27
Q

dementia attention

A

unaffected until late

28
Q

dementia memory

A

recent and new learning impaired

29
Q

Dementia causes

A

reversible: vit b12 def; thyroid disorders
irreversible: alzheimers, vascular dementia (mutl infarcts); head trauma

30
Q

illusions

A

misinterpretation of real external stimuli

31
Q

hallucinations

A

subjective sensory perception in the absence of relevant ext stimuli. person may/may not recognize the experiences as false

32
Q

delusions

A

false, fixed, personal beliefs that are not shared by other members of the persons culture or subculture.
ex: del of grandeur
persecutions
jealousy
reference: person believes that external events, objects, or people have a particular or unusual personal significance (radio or tv commenting or giving person instructions)

33
Q

testing remote memory

A

inquire about birthdays, anniversaries, SSN, names of schools attended, jobs, past historical events as related to patient’s past

34
Q

Romberg

A

test of position sense. stand w feet together and eyes open and then close both eyes for 30-60 sec w/o support-note ability to maintain upright posture

  • -loses balance=positive
  • -maintains=neg
35
Q

cystocele

A

bulge of the upper 2/3 of the ANTERIOR bag wall, together w the bladder above it

36
Q

rectocele

A

herniation of the rectum into the posterior wall of the vagina resulting from a weakness or defect in the endopelvic fascia

37
Q

what is the opening between the eyelids

A

the palpebral fissure

38
Q

pronator drift

A

the pronation of one forearm. Is is both specific and sensitive for a corticospinal tract lesion originating in the contralateral hemisphere. down drift of the arm with flexion of the fingers and elbow may also occur. the pt should stnad for 20-30 seconds with both arms straight forward, palms up with eyes closed. Next tap the arms briskly downward. the arms normally return smoothly to the horizontal position. This response requires muscular strength, coordination, and a good sense of position

39
Q

romberg

A

test of position sense: pt stands with feet together and the eyes open and then close both eyes for 30-60 seconds w/o support. Note the pt ability to maintain an upright posture. In ataxia from dorsal columnar disease and loss of position sense, vision compensates for the sensory loss. The patient stands fairly well with eyes open but loses balance when eyes closed=+romberg. In cerebellar ataxia pt has difficulty holding position w eyes open or closed

40
Q

ptosis

A

drooping upper eyelid

41
Q

cup to disc ratio

A

<1:2

42
Q

Tinnitus

A

is a perceived sound that has no external stimulus-commonly a musical ringing or a rushing or roaring noise.

43
Q

Weber Test

A

tests for lateralization
Tuning fork to vertex of the head and ask the pt where they hear it: one side or both? Normal is to hear it equally on both sides. in unilateral sensorineural hearing loss, pt hears sound in the good ear.

44
Q

Rinne Test

A

Compares air conduction vs Bone conduction.
Place tuning fork to mastoid bone behind the ear and level with canal. When pt can no longer hear the sound, place close to the ear canal to see if the sound can be heard again. Normal Results:
pt can hear sound again because AC>BC.
Abnormal Results: the sound is heard longer or as long through bone as through air. If BC=AC or BC>AC then pt has conductive hearing loss.

45
Q

Lymph Nodes Drainage

A

Three chains of nodes drain into the Central Nodes:
1. Pectoral Nodes - anterior axillary
2. Subscapular Nodes - posterior axillary
3. Lateral Nodes - Upper Arm
Lymph drains from the central axillary nodes to the infraclavicular and supraclavicular nodes.

46
Q

Dermatomes - Sensory

A

A dermatome is a band of skin innervated by the sensory root of a single spinal nerve.
Knowledge and testing of dermatomes help localize a lesion to a specific spinal cord segment.

47
Q

How would you assess the frontal sinus?

A

Palpate for sinus tenderness by pressing up on the frontal sinus from under the bony brow, avoiding pressing on the eyes.

48
Q

What is the prostate gland assessed for?

A

Sweeping the finger across the surface, feel for the two lateral lobs, and the sulcus between them.
Note the size, shape (heart), and consistency. Identify any nodules or tenderness.
The normal prostate is smooth, rubbery, and non-tender.

49
Q

Each testis is palpated for what findings?

A

Note size, shape, consistency, and tenderness; feel for any nodules.

50
Q

75% of all breast cancers are located in this region of the breast tissue?

A

The upper outer quadrant.

51
Q

Assessing skin for yellowing most always look at the eyes, and mucous membranes, and…

A

The palms of the hands and the soles of the feet.

Bates Reviews (22 decks)

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