Exam 1 Flashcards
What are the 5 P’s of sexual history?
Partners, practices, protection, prevention, past history
Intimate partner violence screening
HITS Hurt you physically? Insult or talk down to you? Threaten you with physical harm? Scream or curse at you?
What side do you examine a patient from?
Right side
Use palmar surface of finger/finger pads for…
Palpating position, texture, size, consistency, fluid, form of a mass
Use ulnar surfaces of hand and fingers for…
Palpating vibration
Use dorsal surface of hand for…
Palpating for temperature
Tympani
Loud, high, drum like
Hyper resonance
Very loud, low, booming
Resonance
Loud, low, hollow
Dullness
Soft, moderate, thud like
Flatness
Soft, high, dull
Averag oral temperature
37 degrees Celsius (98.6 F)
Rectal is … Compared to oral
1 degree F greater than oral
Axillary temperature is … Compared to oral
1 degree less than oral
Tympanic temperature is… Compared to oral
1.5 degrees greater than oral
Tachycardia is…
Greater than 100 bpm
Bradycardia is …
Less than 60 beats per minute
Carotid pulse points
60-70
Radial pulse point
Greater than 80
Femoral pulse point
70-80
Pulsus paradoxus
Decrease in SBP and pulse amplified with inspiration
Pulsus biferiens
Biphasic pulse
Double peak
Pulsus parvus et tardus
Pulse is weaker and slower than expected
Pulsus alternans
Alternating strong and weak beats
Expected pulse
60-100 bpm
Expected respiration rate
12-20 breaths per minutes
Blood pressure normals
Less than 120 systolic and less than 80 diastolic
Pre hypertension
120-139 systolic and 80-89 diastolic
Hypertension stage 1
140-159 systolic and 90-99 diastolic
Hypertension stage 2
160 or higher systolic and 100 or higher diastolicb
BMI for a child
18.5-24.9
Width and length of the inflatable bladder for taking blood pressure
Width- 40% of upper arm circumference
Length- 80% of upper arm circumference
Why do older adults often not report pain?
They do not want to lose their independence
A digoxin toxicity can cause…
Yellow vision
Do you assess visual acuity with or without corrective lenses?
Both, but always without correction first
If vision is less than 20/20…
Conduct a pinhole test to see if lack of vision is related to refraction
Myopia
Nearsightedness
Hyperopia
Farsightedness
Presbyopia
From old age, reading up close is difficult
Astigmatism
Corneal asymmetric curvature = burriness
Unilateral field loss is a lesion on…
The optic nerve
Bitemporal field loss is a lesion of…
Chiasmal compression from pituitary tumor
Homonymous hemianopia is a lesion….
From a cerebrovascular event on one hemisphere of the brain
Common causes of exophthalmos?
Grave’s disease
Tumor
Trauma
Ptosis
Drooping eyelid
Corneal arcus senilis
Lipids deposited in the periphery of the cornea, it is on the iris, looks like a cataract
Miosis
Pupillary constriction less than .2 mm
Mydriasis
Pupillary dilation greater than 6 mm
Argyll Robertson pupil
Associated with neurosyphilis, fail to constrict with light but constrict with convergence
Myelinated retinal nerve fibers
White area, will defined margins continuous with optic disc
Absence of pigment and feathery margins with full visual field
Papilledema
Increased cranial pressure
Loss of definition of optic disc margin, venous pulsation and possible hemorrhage
Cupping
Disc margins are raised with a lowered central area, can’t see blood vessels
Glaucoma
Drusen bodies
Spots slightly more yellow than retina, signaling start of macular degeneration (age related)
Cotton wool spot
Ill defined, yellow area caused by infarction of nerve layer of the retina
Caused by elevated blood pressure
Cataracts
Opacity in lens
Usually aging, but steroids can cause them
Diabetic retinopathy
Cotton wool spots, flame and dot hemorrhages
**neovascularization
Hypertensive retinopathy
Can have AV nicking, hemorrhage, cotton wool spots, and even optic disc edema Papilledema
Three Down syndrome features of eyes
Epicanthal fold
Upslant palpebral fissures
Brush field spots on iris
Horner syndrome
Ipsilateral miosis, mild Ptosis, and loss of hemifacial sweating
Weber test
Top of head, sound heard louder in impaired ear with unilateral CONDUCTIVE hearing loss
Rinne test
Mastoid and air
Normal- longer in air than in bone
Conductive hearing loss- bone conduction heard longer than air conduction
Sensorineural hearing loss- air conduction heard longer, but less than 2:1 ratio
CN I special test
Sense of smell with various odor recognition
Sniff test
Patency of nares
In children, maxillary sinuses are developed by…
4 years of age
In children frontal sinuses are developed by…
5 to 6 years of age
CN XII test
Stick out tongue, hypoglossal nerve
CN IX and X tests
Palate and uvula deviation (X)
Gag reflex (IX)
Boggy turbinates indicate…
Allergies
Kopliks spots
Measles!!
If greater than or equal to 60 years old, what is the blood pressure goal?
Less than 150/90
