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Clinical Skills > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

list 7 constitutional symptoms

A

fatigue
weakness
fever
chills
night sweats
weight changes
pain

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2
Q

what temperature is a fever?

A

100.4F or 38C

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3
Q

what do chills indicate for temperature?

A

rising temperature

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4
Q

what does sweaty indicate for temperature?

A

falling temperature

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5
Q

list temperature routes and relative differences

A

pulmonary artery-gold standard
rectal- higher than oral
tympanic- higher than oral
oral- lower than core body temp
axillary- lower than oral
temporal- lower than oral

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6
Q

what factors might influence temperature?

A

time of day
recent exposures
smoking
technique/ route
medications

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7
Q

what 2 conditions might night sweats indicate?

A

TB or malignancy

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8
Q

BMI 25-29

A

overweight

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9
Q

BMI >30

A

obese

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10
Q

define weight loss

A

unintentional 5% loss or more over 6 mo

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11
Q

consequence of BP cuff being too narrow

A

false elevated pressure

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12
Q

consequence of cuff too wide on small arm

A

false low

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13
Q

consequence of cuff too wide on large arm

A

false high

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14
Q

normal BP

A

<120 / <80

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15
Q

elevated BP

A

120-129 / <80

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16
Q

stage 1 HTN BP

A

130-139 / 80-89

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17
Q

stage 2 HTN BP

A

> 140 / >90

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18
Q

normal HR

A

60- 90 to 100 bpm

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19
Q

normal RR

A

20 breaths per min

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20
Q

normal core body temp

A

37C or 98F

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21
Q

this type of pain is associated with tissue damage, lasts less than 3-6mo, and resolves as an injury heals

A

acute pain

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22
Q

this type of pain is not associated with cancer or other conditions that persist more than 3-6mo. this is pain lasting more than one month beyond course of acute illness or injury, it may recur at certain intervals of moths or years

A

chronic pain

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23
Q

this type of pain is linked to tissue damage of the skin, muscoskeletal system, or viscera

A

nociceptive (somatic)

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24
Q

what type of pain is sensitized by inflammatory mediators and psychological processes and neurotransmitters?

A

nociceptive (somatic)

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25
Q

what type of pain is described as dull, pressing, pulling, throbbing, boring, spasmodic, or colicky?

A

nociceptive (somatic)

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26
Q

this type of pain is linked to lesion or disease affecting the somatosensory system

A

neuropathic pain

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27
Q

this type of pain may become independent of cause and may include referred pain and “neuronal plasticity”

A

neuropathic pain

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28
Q

what type of pain is described as burning, stabbing, shock like, or pins and needles?

A

neuropathic

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29
Q

list several functions of the skin

A

protection
retains fluid
body temp
synthesis of vitamin D

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30
Q

what are the “appendages” of the skin?

A

hair
nails
sebaceous glands
sweat glands

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31
Q

what pigment is brownish, genetically determined, and increased with sunlight?

A

melanin

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32
Q

what pigment is golden yellow, present in fat and heavily keratinized areas which includes palms and soles?

A

carotene

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33
Q

what pigment circulates in RBCs and carries most of the oxygen?

A

hemoglobin

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34
Q

which pigment is bright red and predominates in the arteries and capillaries?

A

oxyhemoglobin

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35
Q

which pigment is darker and bluer in pigment and is responsible for cyanosis?

A

deoxyhemoglobin

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36
Q

what pigment is yellow-brown and is a breakdown product of heme?

A

billirubin

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37
Q

this type of cyanosis occurs because oxygen levels in the arterial blood flow is low

A

central

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38
Q

this type of cyanosis occurs when oxygen levels are normal or moderately low and when cutaneous blood flow slows or decreases

A

peripheral cyanosis

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39
Q

this type of hair is short, fine, inconspicuous and relatively unpigmented

A

vellus hair

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40
Q

this type of hair is thick, more conspicuous and usually pigmented

A

terminal hair

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41
Q

list 3 types of hair loss

A

alopecia areata
trichotillomania
tinea capitis

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42
Q

this type of sweat gland is widely distributed, opens directly to skin surface, and is important for body temp regulation

A

eccrine glands

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43
Q

this type of sweat gland is present in the axilla and genital regions, usually opens onto hair follicles and bacterial decomposition of the sweat leads to body odor

A

apocrine glands

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44
Q

this is a method of viewing skin lesions with a magnifier using either oil or gel interface or cross polarizing light filters

*limits the amount of reflected light so that it’s easier to visualize deeper pigmented or vascular structures

A

dermoscopy

45
Q

this is 80% of all skin cancer, it’s usually in sun exposed areas, it grows slowly and almost never metastasizes

appearance- pearly erythematous translucent papules or as subtle red macules

A

basal cell carcinoma

46
Q

this is 16% of all skin cancer, it’s composed of more mature cells usually resembling spinous layer of epidermis

appearance- crusted hyperkeratotoic with rough surface of flat reddish patches with inflamed or ulcerated appearance

A

squamous cell carcinoma

47
Q

this is the least common type of skin cancer, is the most lethal, and spreads rapidly to lymph system

A

malanoma

48
Q

what is ABCDE when referring to skin cancer?

A

Asymmetry
Borders- ragged, notched, or blurred
Colors- more than 2
Diameter- >6mm
Evolution and elevation- changes in size or morphology

49
Q

true or false- intermittent sun exposure is more harmful than chronic exposure

A

true

50
Q

this artery is a branch of the external carotid artery and lies in front of the ear and supplies the upper and lateral parts of the scalp

A

superficial temporal artery

51
Q

what are acanthosis nigricans and skin tags associated with?

A

insulin resistance

52
Q

these lymph nodes have the highest risk of malignancy

A

supraclavicular

53
Q

which lymph node may indicate cancer in the mediastinum, lungs, or esophagus?

A

right sided supraclavicular node

54
Q

which lymph node receives the thorax, abdomen, testes, ovaries, kidneys, pancreas, stomach, and gallbladder?

A

left sided supraclavicular node (Virchow’s)

55
Q

what disease is exophthalmos associated with?

A

Graves disease (hyperthyroidism)

56
Q

nearsightedness

A

myopia

57
Q

farsightedness

A

hyperopia

58
Q

imperfection of the cornea or lens causing distortion

A

astigmatism

59
Q

legally blind

A

20/200

60
Q

list 2 visual acuity tests

A

snellen chart- stand 20ft away
rosenbaum chart- 14in from pt’s eyes

61
Q

visual field test

A

static finger wiggle test

62
Q

vision- color function test

A

pseudoisochromatic (ishihara) color plates

63
Q

lesion location that leads to complete loss in right eye

A

R optic nerve lesion

64
Q

list the effect and the location of lesion for bitemporal hemianopia

A

effect- bilateral peripheral vision loss
lesion location- optic chiasm

65
Q

list the effect and location of lesion for left nasal hemianopia

A

effect- loss of medial vision of left eye
location- lateral to the optic chiasm

66
Q

list the effect and location for right homonymous hemianopia

A

effect- loss of right vision field bilaterally
location- lesion at L optic tract

67
Q

miosis

A

constricted pupil

68
Q

mydriasis

A

dilation of pupils

69
Q

anisocoria

A

unequal pupil sizes >0.4mm

70
Q

what 3 things does the pupillary near reaction test?

A

convergence, lens shape, pupil size

71
Q

what are 4 aspects of Horner’s syndrome?

A

Ptosis
Anhydrosis
Miosis
Anisocoria

72
Q

this is a condition where the affected pupil is larger than the other and responds to accommodation and convergence in a slow fashion and only responds to light only after prolonged expoure

A

Adie’s pupil (tonic pupil)

73
Q

this pupil condition is usually bilateral, the pupils are small, and constrict with near vision and dilate with far vision but do not react to light

A

argyll robertson

74
Q

explain marcus gunn pupils

A

when light is shone in affected eye, it and the contralateral eye will dilate

75
Q

what does the swinging flashlight test test for?

A

functional impairment of the optic nerves (when light shone in affected eye, both pupils will dilate)

76
Q

which CN controls the lateral rectus?

A

CN6- abducens

77
Q

which CN controls the superior oblique?

A

CN4- trochlear

78
Q

this eye condition is noticed when a rim of the sclera is visible above the iris with downward gaze

A

lid lag

79
Q

in this eyelid condition, the upper lids sag and cover the sclera

A

ptosis

80
Q

what 2 conditions is ptosis seen in?

A

horner’s syndrome and myasthenia gravis

81
Q

name and function of CN1

A

olfactory
sensory
smell

82
Q

name and function of CN2

A

optic
sensory
vision

83
Q

name and function of CN3

A

oculomotor
motor
most eye movements

84
Q

name and function of CN4

A

trochlear
motor
moves eye down and out

85
Q

name and function of CN5

A

trigeminal
both motor and sensory
face sensation and mastication

86
Q

CN6 name and function

A

abducens
motor
outward movement of eye

87
Q

CN7 name and function

A

facial
both motor and sensory
facial expression, taste

88
Q

CN8 name and function

A

vestibulocochlear
sensory
hearing and balance

89
Q

CN9 name and function

A

glossopharyngeal
both sensory and motor
taste, gag reflex

90
Q

CN10 name and function

A

vagus
both sensory and motor
PS innervation

91
Q

CN11 name and function

A

accessory
motor
shoulder shrug

92
Q

CN12 name and function

A

hypoglossal
motor
swallowing, speech

93
Q

CN1 test

A

smell out of each nostril
ex- coffee beans

94
Q

CN2 test

A

snellen
color
visual fields
fundoscopy
reflexes/ light reaction

95
Q

CN3 test

A

EOM- make a big “H”

96
Q

CN4 test

A

EOM- make a big “H”

97
Q

CN5 tests

A

palpate temporal and masseter muscles while asking pt to clench teeth
move jaw side to side
test sensory of forehead, cheeks, and jaw
corneal reflex- corneal sensitivity test with wisp of cotton

98
Q

CN6 test

A

EOMs

99
Q

CN7 tests

A

raise eyebrows
close eyes against resistance
frown and smile
show upper and lower teeth
puff out both cheeks

100
Q

CN8 test

A

gross hearing test (whisper test)
weber-rinne if unilateral HL

101
Q

CN9 test

A

gag reflex

102
Q

CN10 test

A

“ahhhh”

103
Q

CN11 tests

A

shrug test- trapezius
turn head to each side against resistance- SCM

104
Q

CN12 test

A

stick out tongue and move side to side

105
Q

what happens to tongue with a CN12 upper motor neuron lesion?

A

tongue deviates away from lesion

106
Q

what happens to tongue with a CN12 lower motor neuron lesion?

A

tongue deviates towards the lesion

107
Q

list 2 CN2 and CN3 tests

A

pupillary light reaction- direct and consensual
pupillary near reaction- accommodation, convergence, lens accommodation

108
Q

list 3 CN3, CN4, and CN6 tests

A

hirschberg/ corneal light reflex
EOMs
cover and uncover test

109
Q

list 2 CN3, CN4, CN6, CN7 and CN8 tests

A

oculocephalic reflex- doll’s eyes
cold calorics- normal is slow, then fast nystagmus

Clinical Skills (6 decks)

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