exam 1 material Flashcards
1
Q
What are the 4 C’s to improve communication?
A
Call, Cause, Concern, and Cope
2
Q
What are the 4 C’s to improve communication?
A
Call, Cause, Concern, and Cope
3
Q
Acronym to check for depression
A
SIG-E-CAPS Sleep changes Interest Guilt Energy Cognition/concentration Appetite Psychomotor Suicide
4
Q
Alcohol thresholds
A
Men: 14/week, 4/day, 5 drinks/2hr binge
Women: 7/week, 3/day, 4 drinks/2hr binge
>65yrs: 1/day
5
Q
Alcohol acronyms
A
Concern Take (how many to feel buzzed) Annoyed Annoyed (by criticism) Guilty Cut (feel you should?) Eye-opener Eye-Opener (need drink in morning?)
6
Q
Domestic violence acronym
A
Hurt physically
Insult
Threaten
Scream at you?
7
Q
Types of notes/exams
A
Comprehensive: new pt, expanded, ~45 min
Focused: problem-oriented, based, ~10-15 min
8
Q
words to avoid
A
normal, within normal limits, poor, good
9
Q
CODIERS
A
Chronology Onset Description Intensity Exacerbating factors Remitting factors Symptoms associated
10
Q
OLDCARTS
A
Onset Location Duration Character Aggravating/alleviating factors Radiation Timing Severity
11
Q
Info about Medications
A
name, dose, number of tablets, route, frequency, last taken
12
Q
Info about Allergies
A
drugs, food, meds. type of rxn (side effect vs allergy)
13
Q
PMH acronym
A
THE CHADS Thyroid Hypertension Emphysema Cancer Heart Disease Asthma Diabetes Stroke
14
Q
Info about surgery
A
type, reasons, date, hospital, complications
15
Q
General survey at beginning of exam
A
appearance, LOC, nutritional status, comparison to state age, distress, position of comfort, skin color, hygeine, dress
16
Q
Vital signs
A
temp, pulse, respirations, BP, pain level
17
Q
Standard temperatures
A
Oral: 37 C, 98.6 F
Axillary: lower than oral by 0.6 C, 1 F
Rectal (elderly and children: higher than oral by 0.4-0.5 C, 0.7-0.9 F
Tympanic: higher than oral by 0.8 C, 1.4 F
18
Q
Afebrile
A
97-100.4 F rectal (36-38 C)
19
Q
febrile
A
> 100.4F, 38 C
20
Q
fever or pyrexia
A
elevated body temp
21
Q
hyperpyrexia
A
extreme elevation
>106 F, 41 C rectal
22
Q
hypothermia
A
23
Q
what temp to worry at for kids
A
> 103-104 F
24
Q
What temp to worry at for elderly
A
> 100-101 F
25
Standard resting pulse
60-100 bpm
26
Bradycardia
27
Tachycardia
>100bpm
28
Pulse scale
4+ bounding, aneurysmal: fever, fear, exercise, cocaine, thyroid issues
3+ full, increased: caffeine, fear, anxiety
2+ expected
1+ diminished, barely palpable: stenosis, hypervolemia, anemia, dehydration, shock, left ventricular failure
0 absent, not palpable: asystole, occlusion, thrombosis
29
Use doppler blood flow for
BP, fetal heart sounds, locate blood vessels, weak pulses, vessel patency
30
Standard respirations
12-20 breaths/min
31
Bradpnea
32
tachypnea
>20 bpm
33
Diaphragm of stethescope
larger, for high-pitched sounds (S1, S2), abdomen, lung, some heart
34
Bell of stethescope
open side, for low-pitched sounds (S3, S4), arteries, bad heart sounds in large vessels
35
JNC 8 standard BP
36
JNC 8 >60 y/o
systolic
37
JNC 8 >18 y/o with chronic kidney disease or diabetes
systolic
38
JNC 7 prehypertension
120-139/80-89
39
JNC 7 stage 1
140-159/90-99
40
JNC 7 stage 2
>160/>100
41
Orthostatic BP: When and how
if pt has lost fluids/anemic/hypovolemic
| sitting to standing, laying down
42
orthostatus BP changes
systolic drop 20 mmHg
diastolic drop 10 mmHg
pulse increase 15 beats
43
How to take an ideal BP
pt rests for 5 min, no nicotine or caffeine for 30 min prior, no clothing, palpate artery, keep arm at heart level, estimate systolic, wait 15-30 sec, use bell
44
Head circum. used
birth-24 months
45
Universal precautions from CDC
used for blood, fluids, excretions, oral mucosa
46
supine
on back
47
prone
on stomach
48
dorsal recumbent
supine knees bent and feet on table
49
lateral recumbent
On side, legs extended or flexed
50
lithotomy
dorsal recumbent with legs in stirrups
51
sims
lateral recumbent with top leg flexed at hip and knee
52
Examination techniques
Inspection
palpation
percussion
auscultation
53
female athlete triad
disordered eating, amenorrhea, osteoporosis
54
Autonomy
the pt's need for self-determination
55
beneficence
the ethical principle that means 'do good' for the pt
56
chief complaint
a brief statement telling why the pt is seeking care
57
HPI
step by step evaluation surrounding the pt's reason for seeking care
58
nonmaleficence
the ethical principle that means 'do no harm' to the pt
59
PMH
a statement of the pt's overall health prior to the onset of the present complaint
60
family Hx
information about the health of family members to identify a possible health risk for the pt: this should include ages (ages at death) and causes of death
61
social Hx
work, relationship status, diet, exercise, sexual and military experiences, use of tobacco, alcohol, illicit drugs
62
review of systems
identifies the presence or absence fo health-related issues in each body system
63
utilitarianism
a theory that defines the appropriate use of resources as that which results in the greatest good for the greatest number
64
values
the ideals, customs, institutions, and behaviors regarded by a specific group
65
O in OPQRSTAE
onset
66
Ps in OPQRSTAE
provoke (what makes them worse)
palliate (what makes them better)
progression (have they changed)
prior episodes
67
Q in OPQRSTAE
quality, quantity (description)
68
R in OPQRSTAE
region, radiation (where is it, does it spread)
69
S in OPQRSTAE
severity (rate 1-10)
70
T in OPQRSTAE
timing (when does it occur, how long does it last, constant or intermittent)
treatment
71
A in OPQRSTAE
Associated symptoms (ROS)
72
E in OPQRSTAE
environment (anyone else with similar symptoms)
73
substance abuse screening acronym for adolescents
```
Car
Relax
Alone
Forget
Family or Friend (asked to cut down)
Trouble
```
74
darkened skin on neck
acanthosis nigricans
75
raised and red skin, scar tissue
keloid
76
tool used to examine eye
ophthalmoscope
77
tool used to measure oxygenated Hb
pulse oximeter
78
tests the membrane and bones in ear
tympanometer
79
splotchy sores, sometimes open
hidradenitis suppurativa
80
line of hair during pregnancy
linea nigra
81
tool used to examine ear
otoscope
82
stretch marks
striae
83
splotchy dark spots
Kaposi's sarcoma
84
raised, round spots
neurofibromatosis
85
straight line across palm, Down syndrome
palmer crease
86
allergic salute
transverse crease
87
Acronym to check for depression
```
SIG-E-CAPS
Sleep changes
Interest
Guilt
Energy
Cognition/concentration
Appetite
Psychomotor
Suicide
```
88
Alcohol thresholds
Men: 14/week, 4/day, 5 drinks/2hr binge
Women: 7/week, 3/day, 4 drinks/2hr binge
>65yrs: 1/day
89
Alcohol acronyms
```
Concern Take (how many to feel buzzed)
Annoyed Annoyed (by criticism)
Guilty Cut (feel you should?)
Eye-opener Eye-Opener (need drink in morning?)
```
90
Domestic violence acronym
Hurt physically
Insult
Threaten
Scream at you?
91
Types of notes/exams
Comprehensive: new pt, expanded, ~45 min
Focused: problem-oriented, based, ~10-15 min
92
words to avoid
normal, within normal limits, poor, good
93
CODIERS
```
Chronology
Onset
Description
Intensity
Exacerbating factors
Remitting factors
Symptoms associated
```
94
OLDCARTS
```
Onset
Location
Duration
Character
Aggravating/alleviating factors
Radiation
Timing
Severity
```
95
Info about Medications
name, dose, number of tablets, route, frequency, last taken
96
Info about Allergies
drugs, food, meds. type of rxn (side effect vs allergy)
97
PMH acronym
```
THE CHADS
Thyroid
Hypertension
Emphysema
Cancer
Heart Disease
Asthma
Diabetes
Stroke
```
98
Info about surgery
type, reasons, date, hospital, complications
99
General survey at beginning of exam
appearance, LOC, nutritional status, comparison to state age, distress, position of comfort, skin color, hygeine, dress
100
Vital signs
temp, pulse, respirations, BP, pain level
101
Standard temperatures
Oral: 37 C, 98.6 F
Axillary: lower than oral by 0.6 C, 1 F
Rectal (elderly and children: higher than oral by 0.4-0.5 C, 0.7-0.9 F
Tympanic: higher than oral by 0.8 C, 1.4 F
102
Afebrile
97-100.4 F rectal (36-38 C)
103
febrile
>100.4F, 38 C
104
fever or pyrexia
elevated body temp
105
hyperpyrexia
extreme elevation
| >106 F, 41 C rectal
106
hypothermia
107
what temp to worry at for kids
>103-104 F
108
What temp to worry at for elderly
>100-101 F
109
Standard resting pulse
60-100 bpm
110
Bradycardia
111
Tachycardia
>100bpm
112
Pulse scale
4+ bounding, aneurysmal: fever, fear, exercise, cocaine, thyroid issues
3+ full, increased: caffeine, fear, anxiety
2+ expected
1+ diminished, barely palpable: stenosis, hypervolemia, anemia, dehydration, shock, left ventricular failure
0 absent, not palpable: asystole, occlusion, thrombosis
113
Use doppler blood flow for
BP, fetal heart sounds, locate blood vessels, weak pulses, vessel patency
114
Standard respirations
12-20 breaths/min
115
Bradpnea
116
tachypnea
>20 bpm
117
Diaphragm of stethescope
larger, for high-pitched sounds (S1, S2), abdomen, lung, some heart
118
Bell of stethescope
open side, for low-pitched sounds (S3, S4), arteries, bad heart sounds in large vessels
119
JNC 8 standard BP
120
JNC 8 >60 y/o
systolic
121
JNC 8 >18 y/o with chronic kidney disease or diabetes
systolic
122
JNC 7 prehypertension
120-139/80-89
123
JNC 7 stage 1
140-159/90-99
124
JNC 7 stage 2
>160/>100
125
Orthostatic BP: When and how
if pt has lost fluids/anemic/hypovolemic
| sitting to standing, laying down
126
orthostatus BP changes
systolic drop 20 mmHg
diastolic drop 10 mmHg
pulse increase 15 beats
127
How to take an ideal BP
pt rests for 5 min, no nicotine or caffeine for 30 min prior, no clothing, palpate artery, keep arm at heart level, estimate systolic, wait 15-30 sec, use bell
128
Head circum. used
birth-24 months
129
Universal precautions from CDC
used for blood, fluids, excretions, oral mucosa
130
supine
on back
131
prone
on stomach
132
dorsal recumbent
supine knees bent and feet on table
133
lateral recumbent
On side, legs extended or flexed
134
lithotomy
dorsal recumbent with legs in stirrups
135
sims
lateral recumbent with top leg flexed at hip and knee
136
Examination techniques
Inspection
palpation
percussion
auscultation
137
female athlete triad
disordered eating, amenorrhea, osteoporosis
138
Autonomy
the pt's need for self-determination
139
beneficence
the ethical principle that means 'do good' for the pt
140
chief complaint
a brief statement telling why the pt is seeking care
141
HPI
step by step evaluation surrounding the pt's reason for seeking care
142
nonmaleficence
the ethical principle that means 'do no harm' to the pt
143
PMH
a statement of the pt's overall health prior to the onset of the present complaint
144
family Hx
information about the health of family members to identify a possible health risk for the pt: this should include ages (ages at death) and causes of death
145
social Hx
work, relationship status, diet, exercise, sexual and military experiences, use of tobacco, alcohol, illicit drugs
146
review of systems
identifies the presence or absence fo health-related issues in each body system
147
utilitarianism
a theory that defines the appropriate use of resources as that which results in the greatest good for the greatest number
148
values
the ideals, customs, institutions, and behaviors regarded by a specific group
149
O in OPQRSTAE
onset
150
Ps in OPQRSTAE
provoke (what makes them worse)
palliate (what makes them better)
progression (have they changed)
prior episodes
151
Q in OPQRSTAE
quality, quantity (description)
152
R in OPQRSTAE
region, radiation (where is it, does it spread)
153
S in OPQRSTAE
severity (rate 1-10)
154
T in OPQRSTAE
timing (when does it occur, how long does it last, constant or intermittent)
treatment
155
A in OPQRSTAE
Associated symptoms (ROS)
156
E in OPQRSTAE
environment (anyone else with similar symptoms)
157
substance abuse screening acronym for adolescents
```
Car
Relax
Alone
Forget
Family or Friend (asked to cut down)
Trouble
```
158
darkened skin on neck
acanthosis nigricans
159
raised and red skin, scar tissue
keloid
160
tool used to examine eye
ophthalmoscope
161
tool used to measure oxygenated Hb
pulse oximeter
162
tests the membrane and bones in ear
tympanometer
163
splotchy sores, sometimes open
hidradenitis suppurativa
164
line of hair during pregnancy
linea nigra
165
tool used to examine ear
otoscope
166
stretch marks
striae
167
splotchy dark spots
Kaposi's sarcoma
168
raised, round spots
neurofibromatosis
169
straight line across palm, Down syndrome
palmer crease
170
allergic salute
transverse crease
171
The best probe for image density while sacrificing depth is
linear array
172
You need to image in great detail a superficial structure so you choose a probe in
linear array
173
When studying a distant structure, one would select a probe that uses
longer wavelength
174
You are interested in a structure that is at a distance from the skin. you select a probe that
uses a longer wavelength
175
When ultrasounding a structure, a more complete picture can be obtained by moving the probe. To create a new image in a plane that is parallel to the current plane, you would
Sweep
176
You visualize a circular structure with an anechoic center. You theorize it is a blood vessel so you want to insert a needle. you would like to see the needle from when it enters the skin to when it comes to rest within what you theorize is the lumen. you maneuver the probe by
rotation
177
To differentiate structures using Doppler effect, one
must angle the probe pointing the beam toward the heart
178
when using the doppler setting on the ultrasound machine, one must
select the image showing the structure in cross section
179
```
Ultrasound waves are attenuated differently by different tissues. Select the tissues that most highly attenuates ultrasound:
air
bone
water
muscle
fat
```
air
180
```
Obtaining a good image by ultrasound requires the wave energy from the probe be carried through tissues. Which structure or pathology will most poorly propagate the sound wave?
abscess collection
fractured bone
blood in abdomen
pneumonia
ruptured lung
```
ruptured lung
181
Leading edge
side with marker, usually pointed toward pt's head or right
182
higher frequency, lower wavelength
better resolution
183
lower frequency, higher wavelength
better penetration
184
focused US exam
physician acquired and interpreted
185
comprehensive US exam
technician acquired, radiologist interpreted
186
sweep
perpendicular to plane of leading edge, large motion
187
slide
in plane of leading edge, large motion
188
rock
in plane of leading edge, pivoting on point, small motion
189
fan
like sweep, pivoting on point, small motion
190
rotate
used to switch from short to long axis
191
anechoic
black, fluids (blood, bile, urine)
192
hypoachoic
gray, soft tissue and solid organs (lung, liver, spleen, muscle)
193
hyperachoic
white, air (pericardium, periosteum, diaphragm)
194
anisotropy
color of a tissue can change with changing the angle of insonation
195
curved/convex probe
medium resolution, medium penetration, abdominal, OB/GYN
196
phased array
low resolution, high penetration, cardiac, abdominal, OB
197
linear array
high resolution, low penetration, vascular, musculoskeletal, superficial
198
Does ultrasound travel faster through air or tissues?
soft tissues
