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PCM2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Describe the technique/response to test for alertness (level of consciousness/arousal).

A

Speak to patient in normal tone of voice Response: opens eyes, looks at you, responds fully and appropriately

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2
Q

Describe the technique/response to test for lethargy (level of consciousness/arousal).

A

Speak to the patient in a loud voice Response: appears drowsy but opens eyes, looks at you, responds, falls asleep

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3
Q

Describe the technique/response to test for obtundation (level of consciousness/arousal).

A

Shake the patient gently as if awakening a sleeper Response: opens eyes, looks at you, responds slowly, is confused, alertness is decreased

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4
Q

Describe the technique/response to test for stupor (level of consciousness/arousal).

A

Apply a painful stimulus Response: arouses from sleep only after painful stimulus; verbal responses are slow/absent, minimal awareness of self/environment

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5
Q

Describe the technique/response to test for coma (level of consciousness/arousal).

A

Apply repeated painful stimuli Response: remains unarousable with eyes closed

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6
Q

What are the 12 major aspects of general appearance?

A
  1. General state of health 2. Level of comfort 3. Respiratory effort 4. Development stage 5. Height/weight 6. Posture, motor activity, gait 7. Deformities or distinguishing characteristics 8. Characteristic facies 9. Dress, grooming, personal hygiene 10. Odors 11. Level of awareness/consciousnes 12. Skin color/hair distribution
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7
Q

What are some descriptors of general state of health?

A

Frail, chronically ill, robust, vigorous

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8
Q

What are some indicators of level of comfort?

A

Wincing/grimacing, crying, doubled over in pain, clutching chest, hand around neck, resting comfortably in bed

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9
Q

What is an important physical cue for emphysema?

A

Tripod position/leaning forward

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10
Q

What are some indicators of abnormal respiration?

A

Gasping for breath, labored breathing, coughing, unable to speak in sentences, use of accessory muscles of respiration (SCM, trapezius, scalenus), audible wheezing/stridor

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11
Q

What is the Dahl sign?

A

Clinical sign in which areas of darkened and thickened skin are seen on the lower thighs and elbows

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12
Q

What are two potential causes of unusual shortness?

A
  1. Turner syndrome 2. Achondroplasia
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13
Q

What are two potential causes of unusual tallness?

A
  1. Marfan syndrome 2. Gigantism/acromegaly
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14
Q

What are some physical signs of Turner’s syndrome?

A

Short stature, webbed neck, increased carrying angle, swelling of feet

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15
Q

What are some physical signs of Marfan syndrome?

A

Tall, thin, disproportionate, chest deformity, thumbs stick out past the side of the hand when making a fist, can wrap hand around wrist and cross finger and thumb

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16
Q

What are the BMI ranges of underweight, overweight, obese, and morbidly obese?

A

Underweight: less than 18 Overweight: 25-29 Obese: 30-39 Morbidly obese: 40+

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17
Q

What is a weight-related sign of Cushing’s?

A

Buffalo hump, central obesity with thin limbs

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18
Q

What are some aspects to look for in posture/motor activity?

A
  1. Kyphosis 2. Scoliosis 3. Need arms to get out of a chair 4. Ambulation aids 5. Anxious/fidgeting 6. Sitting up (left sided heart failure) 7. Leaning forward sitting up (COPD)
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19
Q

What is a noticeable gait in Parkinson disease?

A

Shuffling

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20
Q

What is hemiplegic gait?

A

Circumduction of the paralyzed limb with the ball of the great toe touching the ground as it sweeps around; upper limb is flexed and internally rotated

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21
Q

What does stamping gait occur in?

A

Tabes dorsalis (proprioception loss)

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22
Q

What is scissor gait and when does it occur?

A

One leg crosses in front of the other as the patient walks; spastic paraplegia (cerebral palsy)

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23
Q

What are some possible deformities or distinguishing characteristics?

A
  1. Amputees 2. Scars 3. Piercings/tattoos
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24
Q

What is moon face associated with?

A

Cushing’s

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25
Q

What is prognathism associated with?

A

Acromegaly

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26
Q

What is a stare associated with?

A

Thyrotoxicosis

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27
Q

What are myxedema, loss of lateral 1/3 of eyebrows, puffy face, dry/dough skin, and brittle hair associated with?

A

Severe hypothyroidism

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28
Q

What are masked faced, hunched posture, resting tremor, no arm swing with walking, and minimal blinking associated with?

A

Parkinson

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29
Q

What is a butterfly rash associated with?

A

Lupus

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30
Q

What are some physical signs of Down syndrome?

A

Epicanthal folds, increased space between 2 digits of feet, shorter 5th finger, crease across palm, small ears

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31
Q

What might untied shoes indicate?

A

Edema

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32
Q

What might cut holes in shoes indicate?

A

Bunions or gout

33
Q

What are some important odors to pay attention for?

A
  1. Alcohol 2. Fruity odor (ketoacidosis) 3. Fecal odor (anaerobic infection) 4. Urine 5. Tobacco
34
Q

What is yellow skin color associated with?

A

Jaundice Hypercarotenemia

35
Q

What is blue skin associated with?

A

Cyanosis, silver ingestion

36
Q

What is red skin associated with?

A

Sunburn, rash, allergy

37
Q

What is alopecia?

A

Loss of hair

38
Q

What is hirsutism?

A

Increased hair growth

39
Q

What does yellow skin with a white sclera indicate?

A

Carotenemia

40
Q

What might circumduction of the leg and/or a flexed upper limb indicate?

A

Stroke

41
Q

What is acute otitis media?

A

Acute inflammation of the middle ear (red, bulging)

42
Q

What is serous otitis media?

A

Fluid in the middle ear (can see an air-fluid level)

43
Q

What is hemotympanum?

A

Blood behind the eardrum (bulging, black/red)

44
Q

What is tympanosclerosis?

A

Scar tissue on the ear drum (white)

45
Q

What is a tympanic membrane perforation?

A

Partial hole, can see into the inner ear

46
Q

What is cholesteatoma?

A

Keratin debris in the middle ear behind the ear drum

47
Q

What is otitis externa and how is it treated?

A

External auditory canal infection; wick (steroid and antibiotic drops funneled into the EAC)

48
Q

What is serumen?

A

Wax

49
Q

What will you see in allergic rhinitis?

A

Swelling, serous fluid

50
Q

What will a CT scan look like in sinusitis?

A

Areas that should be black (air filled) are grey

51
Q

What does the nose look like when the septum collapses?

A

Saddle nose

52
Q

What happens in a peritonsillar abscess?

A

Red bulging, can’t see tonsils, uvula deviates to contralateral side, muffled speech

53
Q

What is a ranula?

A

Sublingual gland cyst

54
Q

What is parotitis?

A

Inflammation of the parotid gland

55
Q

80% of tumors in major salivary glands are ___. 80% of tumors in minor salivary glands are ___.

A

Benign; malignant

56
Q

This cyst moves up and down when a patient sticks out their tongue

A

Thyroglossal duct cyst

57
Q

Lateral neck swelling anterior to the SCM might be indicative of a ___.

A

Branchial cleft cyst

58
Q

The part of the eardrum above the malleus is the ___; everything else is the ___.

A

Pars flaccida; pars tensa

59
Q

What is bullous myringitis?

A

Painful hemorrhagic vesicles appear on the tympanic membrane, the ear canal, or both

60
Q

What are the 5 steps to the eye exam?

A
  1. Visual acuity/fields 2. Pupils 3. External eye exam 4. Extra-ocular muscles 5. Fundus exam
61
Q

Bitemporal hemianopia is commonly seen with a ___.

A

Pituitary tumor

62
Q

What is ptosis?

A

Droopy eyelid

63
Q

What is entropion?

A

Lid turning in

64
Q

What is ectropion?

A

Lid sagging out

65
Q

Which CN control which extra-ocular muscles?

A

LR6, SO4, all else 3

66
Q

What is esotropia?

A

Turning in of the eye

67
Q

What is exotropia?

A

Turning out of the eye

68
Q

What happens in paretic strabismus

A

Paralysis of an extra-ocular muscle

69
Q

___ leads to increased cupping and atrophy of optic nerve cells.

A

Glaucoma

70
Q

If you see “cotton wool spots” in the retina, what is this a sign up?

A

Hypertensive retinopathy

71
Q

What causes a horizontal defect in the eye?

A

Occlusion of a branch of the central retinal artery

72
Q

What causes blindness in the right eye?

A

Lesion of the right optic nerve

73
Q

What causes bitemporal hemianopsia?

A

Lesion at the optic chiasm

74
Q

What causes homonymous left superior quadrantic defect?

A

Partial lesion of the right optic radiation

75
Q

What causes left homonoymous hemianopsia?

A

Lesion of the right optic radiation

76
Q

Draw the optic tracts.

A
77
Q

What will the physical exam show with CN III paralysis?

A

Dilated pupil fixed, ptosis of upper eyelid, lateral deviation of eye

78
Q

What will the physical exam show in Horner’s syndrome?

A

Ptosis of eyelid

PCM2 (16 decks)

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