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PCM > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What length should be the cuff’s bladder at least be compared to the circumference of the upper arm?

What about the width?

A

at least 80%

at least 40%

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2
Q

how high should the blood pressure cuff be compared to the cubital fossa?

A

1 inch above

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3
Q

Technically which part of the stethoscope should you be using over the brachial artery?

A

Bell is technical, but most people use the diaphragm

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4
Q

What is the first knocking sound called and which pressure is this?

A

Korotkoff

Systolic

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5
Q

What is an Auscultory gap?

A

period of absent korotkoff sounds. so you can accidentally underestimate systolic or overestimate diastolic

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6
Q

patient should be free of what and for how many minutes before a bp reading?

A

smoking, caffeine, exercise 30 minutes prior

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7
Q

How can you get a falsely high reading for bp?

A

cuff too small
cuff too large on a large arm
brachial artery is below the heart

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8
Q

How can you get a falsely high reading for bp?

A

cuff too large for a small arm

brachial artery above heart

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9
Q

What’s the average respiratory rate?

A

15-20 per min

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10
Q

If you’re looking at someone’s right eye, how do you hold the ophthalmoscope?

A

hold it with right hand, with your right eye, and have them look over your right shoulder and look at their eye from lateral to medial

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11
Q

Which way do you pull the ear when looking in their ears for a kid less than 12 months?

A

Down and back

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12
Q

Which way do you pull the ear when looking in their ears for a kid greater than 12 months?

A

Up and back

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13
Q

What is sensitivity?

A

proportion of patients with the diagnosis who have the physical sign

I.e. have the positive result

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14
Q

What is “True positive” and is it with specificity or sensitivity

A

the “True Positive” rate

the probability that a person with the disease has a positive test

Sensitivity

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15
Q

What is Specificity

A

the proportion of patients without the diagnosis who Lack the physical sign (i.e. have the negative result)

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16
Q

What are you looking at with “red free” light on the Opthalmoscope?

A

visualize the vessels and hemorrhage

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17
Q

What are you looking at with “slit beam” light on the Opthalmoscope?

A

contour abnormalities

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18
Q

What are you looking at with “blue light” light on the Opthalmoscope?

A

abrasions and ulcers after fluorescein staining

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19
Q

What is the direct pupillary light reflex?

A

when the light is shined in the eye, the pupil constricts

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20
Q

What is the consensual pupillary light reflex?

A

when the light shined in the eye, the pupil of the other eye also constricts

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21
Q

What lasts longer, air conduction or Bone conduction

A

Air conduction lasts longer

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22
Q

Where do you hold the fork for air conduction

A

hold fork in front of external auditory meatus

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23
Q

Where do you hold the fork for bone conduction?

A

boney area behind the ear

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24
Q

Where do you put the tuning fork for the weber test?

A

forehead

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25
Q

Rinne Test: In normal ears and ears with sensorineural loss, what sounds louder, the air-conducted sound or the bone conduction sound?

A

air conducted

AC>BC

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26
Q

Rinne Test: In conductive hearing loss, what sounds louder, the air-conducted sound or the bone conduction sound?

A

BC>AC

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27
Q

What does 20/20 mean?

20/40

A

always X/Y, where X is the pt, Y is the normal

20 feet 20 feet

normal person sees 40 ft what you see in 20 feet

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28
Q

How do you percuss?

A

put your fingers over the thorax/abdomen. strike the distal knuckle with 3rd finger to elicit the sound

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29
Q

What is a dull sound of percussion mean?

A

fluid

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30
Q

What is a flat sound of percussion mean?

A

solid

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31
Q

What does a tympanic sound of percussion mean?

A

air

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32
Q

What does uremic fetor mean?

A

its a smell.. fishy, urine odor (ammonia like)

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33
Q

what is fetor hepaticas?

A

smell –> breath of the dead

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34
Q

bell is for what sounds?

A

low - bruits

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35
Q

diaphragm for what sounds?

A

high pitched. breath sounds/heart tones

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36
Q

What’s a normal bp?

A

120/80

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37
Q

what’s considered stage 1 hypertension?

A

140/90

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38
Q

what’s considered stage 2 hypertension?

A

160/100

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39
Q

hypertensive crisis?

A

180/120

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40
Q

Normal temperature is what?

A

97.8-99

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41
Q

what locations reflect a higher temperature?

A

Axillary .3 to .4 higher

rectally .5 to .7 higher

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42
Q

what temperature reflects core temperature?

A

Ear

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43
Q

When should you get an annual lung cancer screening?

A

30 pack years between 55 and 80 and currently quit or have quit within the past 15 years

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44
Q

CAGE stands for what?

A

Cut Back
Annoyed
Guilt
Eye Opener

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45
Q

How many drinks for women?

A

3 per day 7 per week

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46
Q

drinks for men?

A

4 per day 14 per week

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47
Q

Spirituality and religion mnemonic?

A

FICA

Faith and belief
Importance
Community
Address in Care or Assessment and plan

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48
Q

What does SAFE stand for?

A

Stress
Afraid
Friends
Emergency plan

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49
Q

5 p’s of sexual history?

A 
Partners
Practices
Prevention of Pregnancy
Protection from STIs
Past History of STIs
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50
Q

Which model are patients more likely to adhere to the treatment?

A

patient-centered

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51
Q

Sprain Vs strain?

A

LISP

ligament = sprain
pop

MUST

muscle strain
grabbing feeling

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52
Q

Nipple line is what dermatome?

What about the belly button?

A

T4

T10

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53
Q

8mm is what edema classification?

A

4+

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54
Q

What tests indicate a glenohumeral instability?

A

Apprehension Test

Sulcus Sign

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55
Q

What are the tests for unstable bicipital or bicipital tendonitis?

A

Yergasons and Speed’s test

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56
Q

What Indicates a rotator cuff pathology?

A

Empty Can Test

Drop Arm Test

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57
Q

What indicates a rotator cuff impingement?

A

Painful Arc Test

Neer Impingement

hawkins Test

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58
Q

What indicates a subscapularis weakness?

A

Lift Off Test

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59
Q

AC joint pathology test?

A

Cross Arm Test

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60
Q

Genu Valgum vs Genu Varus, which has an increased q angle?

A

valgum

varus has less

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61
Q

Q angle normal? who has a bigger one?

A

15

females

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62
Q

Valgus test indicates what?

A

MCL disruption

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63
Q

Varus test indicates what?

A

LCL disruption

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64
Q

McMurray tests what

A

lateral or medial meniscus

valgus = medial meniscus
varus = lateral meniscus
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65
Q

apley grind test with compression tests what?

A

could be meniscus or Collateral ligament injury or both

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66
Q

Apley grind test with distraction does what?

A

if you have relief, it’s a possible meniscus injury

if it’s painful then it’s a collateral ligament problem

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67
Q

What goes into the Subjective of a soap note?

A

CC, HPI, ROS, PMH, PSH, Meds, All, FH, SH

what you learn by taking the patient’s history

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68
Q

what goes into objective

A

physical exam findings including structural findings, labs and radiology

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69
Q

what goes in Assessment

A

what you think is going on with the patient

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70
Q

What’s the difference between diagnosis and differential diagnosis

A

diagnosis is the art of identifying disease from its signs and symptoms

differential is the probable causes of the assessment, listed in order from most likely to least likely

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71
Q

What is the patellar laxity test? patellar apprehension?

A

pushing against the medial side of the patella laterally

if there is apprehension or laxity it’s a previous patellar dislocation or severe instability

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72
Q

What do you do for a patellar compression (grind test)

A

push down on the patella with one hand while moving the patella medial and lateral

pain with compression

inflammation, chondromalacia, injury to the patellofemoral articular surfaces

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73
Q

What’s the patella-femoral grinding test?

A

compress patella caudally into trochlear groove and instruct the patient to tighten quads

you should feel it go up

positive would be pain and indicates roughness of articulating surfaces

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74
Q

Fundoscopic refers to what instrument?

A

opthalmoscope

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75
Q

Tachypnea means what?

A

increased respiratory rate

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76
Q

any treatments, including OMT should be put in what?

A

PLAN

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77
Q

Which one is 40%, stance phase or swing phase?

A

Swing phase

78
Q

What’s the proper order of examination? Mnemonic

A

I’m A PP

Inspection, Auscultation, Percussion, Palpation

79
Q

FH what degree of family do you document?

A

first degree relatives = because strongest genetic risk.

80
Q

ROS is for what?

A

refers to other potential problems in systems OTHER than what the CC falls in

81
Q

Foot drop is considered what muscle strength?

A

0/5

82
Q

Extrinsic causes of shoulder pain refers to what?

A

have no shoulder pathology at all.

intrinsic relates to the shoulder itself

83
Q

Step off refers to what?

A

acromioclavicular joint separation

84
Q

Assessment portion should be from what to what?

A

broad to specific

85
Q

snuffbox tenderness, what should you be worried about

A

scaphoid fracture, sometimes can’t be seen on first xray

86
Q

pain over greater trochanter, what’s the problem?

A

trochanteric bursitis usually

87
Q

when the patient lifts up their left leg, what happens to their right leg

A

the right leg is bearing weight so the left hip drops because the right gluteus medium is not doing its job

88
Q

O sign refers to what nerve?

A

anterior interesses N.

89
Q

What is in the central compartment of the hip?

A

Labrum, Ligamentum Teres, Articular Surfaces

90
Q

What is in the peripheral compartment of the hip?

A

Femoral Neck, Synovial Lining

91
Q

What is in the lateral compartment of the hip?

A

gluteus medius, gluteus minimus, piriformis, IT band, trochanteric bursae

92
Q

What is in the anterior compartment of the hip?

A

iliopsoas insertion, iliopsoas bursae

93
Q

What muscle is the primary flexor of the hip?

A

iliopsoas

94
Q

What is the primary extensor of the hip

A

gluteus Maximus followed by the hamstrings

95
Q

what ab the primary abductors of the hip?

A

gluteus medius and minimus

96
Q

what is the primary adductor of the hip?

A

adductor longus

97
Q

what are the external rotators of the hip to know?

A

sartorius, gluteus medius, gluteus maximus

98
Q

What does the Ober test evaluate?

A

external snapping hip, greater trochanteric pain syndrome

99
Q

What are the three evaluated muscles of the Ober test?

A

Tensor Fascia Lata

Gluteus Medius

Gluteus Maximus

100
Q

Trendelenburg tests what?

A

labral tear, transient synovitis, Legg Calve Perthes Disease

101
Q

What side does the hip drop on in the trendelenburg test?

A

the side that has the lifted leg

102
Q

What test do you use for piriformis syndrome?

A

PACE or FAIR test

Log Roll

103
Q

What are the two tests that are done for dysplasia of the hip?

what happens if they’re positive

A

ortolani test and the Barlow test

if positive they do ultrasound

104
Q

what tests do you do to check for trochanteric bursitis?

A

FABER and Ober tests

105
Q

when is Legg-Calve-Perthes disease happening?

A

3-12 year old kids, male more often.

shows osteochondral loose bodies

106
Q

When does SCFE usually present?

what happens during SCFE?

A

obese kids, or a growth spurt, but mostly obese kids

femoral epiphysis slips posteriorly, leads to pain and limitation

107
Q

What sign is seen for piriformis syndrome?

A

wallet sign

108
Q

What is septic arthritis?

A

infection in the joint, need to aspirate the joint fluid to make sure. person can have fever

109
Q

what tests do you do for a femoroacetabular impingement?

A

C sign, FABER, FADIR

110
Q

What happens to kids that are held by the arm from 1-5 years old?

how is it treated

A

subluxation of the radial head

hyperpronation

111
Q

what motion with the hand is with tennis elbow?

A

extension, lateral epicondylitis

112
Q

What motion with the and is with golfers elbow?

A

Flexion, Medial epicondylitis

113
Q

What’s the difference between bursitis and effusion?

A

bursitis = can fully extend the elbow without severe pain

effusion = pain with extension due to increased pressure at the joint

114
Q

What’s the classical presentation of De Quervian Tenosynovitis?

what test do you do?

A

radial wrist pain at the base of thumb especially with movement of the thumb

mom picking up child

finkelstein’s test

115
Q

What is Trigger Finger?

A

pain, locking, and clicking of MCP joint. common in the 5th and 6th decade of life. usually the ring finger

116
Q

What is depuytren’s contracture?

A

fibrosis of the palmar fascia. thickening of that due to fibroblastic proliferation

more common in white males.

cord-like structure and flexed digit w/ palpable cord

117
Q

Most common FOOSH injury?

A

Colles

118
Q

What do you see in rheumatoid arthritis people?

A

commonly seen in MCP and PIP joints of the fingers but can affect large and small joints

119
Q

What test do you do for an suspected MCL injury?

A

Valgus Stress test

120
Q

what test do you do for a suspected MCL injury?

A

Varus Stress test

121
Q

Meniscal injury, what tests do you do?

A

McMurray

Apley Grind Test

122
Q

What test do you do for patellofemoral pain

A

Have them squat

patellar glide

123
Q

Osteoarthritis is what?

A

occurs in many large joints

degenerative wear and tear and inflammation

pain worsens as day progresses

124
Q

Tibial tubercle is being stretched.. what is the disease

A

Osgood Schlatter

125
Q

What are the Ottawa knee rules

A

55 or older

tenderness at head of fibula

isolated tenderness of the patella

inability to flex knee to 90 degrees

can’t walk 4 weight bearing steps in the ER

126
Q

What is the Pittsburgh decision rules

A

younger than 12 years or older than 50 years

more specific for knee injuries

127
Q

what do you do for diabetic neuropathy?

A

pressure sensation using monofilament testing

vibration sensation using tuning fork

superficial pain using pinprick

checking pulses, checking for skin lesions, and check between the toes

128
Q

What’s the most common ankle sprain?

A

aTFL

129
Q

What decides if you get imaging?

A

Ottawa ankle and foot rules or just the rules in general

130
Q

Ottawa foot rules?

A

pain in the mid foot zone and any of the following: bone tenderness at 5th metatarsal, navicular bone, or the inability to walk 4 steps immediately after the injury

131
Q

Ottawa ankle rules?

A

pain in the malleolar zone and any of the following findings:

bone tenderness at the lateral malleolus or posterior edge of the medial malleolus or the inability to walk 4 weight bearing steps

132
Q

What is a syndesmotic ankle injury?

A

high ankle sprain

injury to one or more ligaments in the distal tibiofibular syndesmosis

133
Q

What test do you use for a syndesmotic ankle injury?

A

squeeze test

134
Q

Where is the pain localized on plantar fasciitis?

what’s the treatment

A

heel pain

there’s specific exercises you can do

135
Q

what is Morton neuroma?

A

pain between the metatarsal heads from the plantar digital nerve, most commonly affecting the 3rd web space

136
Q

What is the most common presentation of Morton neuroma?

what symptoms do they have?

A

stress due to tight fitting shoes, typically high heels

typically have burning pain in the 3rd metatarsal space

137
Q

What sign is used for Morton Neuroma?

A

Mulder’s Sign: clicking sensation when palpating the third inter metatarsal space

138
Q

Gout

A

monosodium urate crystals in the joint space

139
Q

what are the risk factors for gout?

A

high red meat

140
Q

Hallux Rigidus?

A

Stiffness of the grey toe, due to osteoarthritis

141
Q

Hallus Valgus?

A

valgus malformation of the great toe

142
Q

What is tinea pedis?

A

fungal infection of the foot…

athletes foot

143
Q

Onchomycosis?

A

weird ass nails

fungal infection

144
Q

What is the mnemonic for social history?

A

FEDTACOS

145
Q

if you can’t go into flexion, what muscle is affected

A

coracobrachialis

146
Q

How does the sensitivity/sensitivity chart look?

A

True positive, False Positive
False Negative, True Negative

It’s sensitivity then specificity

147
Q

Other than picking your baby up, what else causes de-quarvians?

A

playing video games

148
Q

what’s the normal carrying angle?

A

10-15 degrees

149
Q

what is a galeazzi fracture?

A

fracture of distal radius with dislocation of the ulna

150
Q

what’s a nightstick fracture

A

fracture of mid/distal ulna from direct blow

151
Q

What is the monteggia fracture?

A

fracture of proximal ulna and dislocation of radial head (FOOSH injury)

152
Q

What is jersey finger?

A

can’t flex finger at DIP

153
Q

What is mallet finger?

A

can’t extend finger at DIP

154
Q

What’s the most common dislocation of the glenohumeral joint

A

anterior then posterior then inferior

155
Q

What’s the log roll good for?

A

Piriformis syndrome testing

156
Q

Ober = 1st positioning?

what does it test

A

lateral recumbent, knee and hip extended and passively adducting.

tests the IT band/TFL

157
Q

Ober #2 = positioning?

What does it test

A

lateral recumbent but instead of hip and knee extended the knee is now flexed. same movement of adduction but it’s testing the gluteus medius

158
Q

Ober #3 positioning?

What does it test

A

modified lateral recumbent with your shoulders on the table and your leg extended off the table. you then go up and it tests the gluteus maximus

159
Q

McMurray’s Test for medial meniscus

A

Varus + Internal rotation

160
Q

McMurray’s Test for Lateral Meniscus

A

Valgus + external rotation

161
Q

Normal bpm? Tachycardia? bradycardia?

A

60-100
above 100 = tachycardia
below 60 = bradycardia

162
Q

normal breaths per minute? Bradypnea? Tachypnea?

A

12-20
20+ tachypnea
less than 12 = bradypnea

163
Q

What are the 5 central compartment tests?

A 
C-Sign
Labral Loading
Labral Distraction
Scour
Apprehension Faber 1/3
164
Q

What is the 1 peripheral compartment test?

A

Rectus Femoris Test

165
Q

What are the 4 lateral compartment tests of the hip?

A

Jump Sign
Straight Leg Test
Piriformis Test
Patrick Faber 2/3

166
Q

What are the 2 anterior compartment tests?

A

Patrick faber 3/3

Thomas Test

167
Q

Anterior Drawer Test of the foot and ankle tests what?

A

ATF ligament (lateral ankle sprain)

168
Q

What way are you tilting the foot in the Talar Tilt Test? What is it testing?

A

Inversion

ATFL

169
Q

Eversion Test tests what?

A

Deltoid

170
Q

Squeeze test tests what?

A

syndesmosis pathology (high ankle sprain)

171
Q

What else besides squeeze test tests syndesmosis pathology

A

Cross Leg test

172
Q

What is the Thompson test? Not the Thomas test

A

you’re testing for achilles tendon rupture..

grabbing at the calf and seeing plantarflexion

173
Q

What is the Homan’s Sign

A

Put them into dorsiflexion (can apply lateral compression of the calf). if pain you can have Deep vein thrombosis

174
Q

What is the Moses Sign?

A

also looking for DVT like Homan’s sign

you’re putting an anterior compression on gastrac muscle and looking with pain in the anterior compartment

175
Q

Turf Toe?

A

inflammation and pain at the base of 1st MTP

caused by hyperextension of the great toe causing damage to joint capsule

176
Q

What is Achilles Tendonitis?

A

sharp heel pain and stiffness.

micro tears in tendon causes swelling and thickening

177
Q

Pretty much what’s the Ottawa rules for ankle and foot

A

if they have pain in the malleolar zone / mid foot zone AND

either pain in the posterior edge or tip of lateral or medial malleolus / 5th metatarsal or navicular

OR

can’t walk 4 weight bearing steps

178
Q

Medial Meniscus for McMurray’s?

A

Valgus and External Rotation

179
Q

lateral Meniscus for McMurrays

A

Varus and Internal Rotation

180
Q

Olecranon Bursitis is also known what

A

student’s elbow or miner’s elbow.

181
Q

“little league elbow”?

A

pain over medial epicondyle, initially after throwing. progresses to persistent pain.

182
Q

OK sign =

A

Anterior Interosseus N.

183
Q

Handlebar Palsy is also what and what area is affected

A

Ulnar Nerve Entrapment

Guyon canal

184
Q

Gamekeeper’s thumb/skier’s thumb?

A

tear of ulnar collateral ligament of MCP due to hand positioning when killing game or falling on ski pole

185
Q

Ganglion cyst?

A

fluid filled sac along tendon sheath or joint

186
Q

Clubbed fingers

A

focal bulbous enlargement of terminal fingers

187
Q

What tests for glenohumeral instability?

A

apprehension

sulcus

188
Q

What tests for bicipital tendon pathology?

A

yergason

speeds

189
Q

Rotator Cuff pathology?

A

Empty Can

Drop Arm

190
Q

Rotator cuff impingement?

A

Painful Arc
Neer
Hawkins

191
Q

Subscapularis?

A

lift off test

192
Q

Acromioclavicular joint pathology?

A

Cross Arm Test

PCM (8 decks)

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