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Exam Flashcards

1
Q

Coronary Artery Disease (CAD)

A

Chest pain, often exertional, improved with rest/Nitroglycerin (NTG)
Test: cardiac catheterization
Greatest factor for MI

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2
Q

Myocardial Infarction (MI)

A

Chest pain/pressure, diaphoresis, nausea/vomiting, SOB
Troponin (N-Stemi)
EKG (Stemi)

Stemi patients need to get to cath lab in 90 mins

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3
Q

Congestive Heart Failure (CHF)

A

SOB, bilateral extremity edema
Sx: Rales, JVD, pedal edema
Chest X-ray, elevated BNP

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4
Q

What other past histories would suggest that a patient has CAD?

A

MI, Angina, CABG, Stent, Angioplasty

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5
Q

Does a surgical history of angioplasty mean the patient has CAD?

A

Yes

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6
Q

Explain the difference between CAD and an MI

A

CAD is a broad term for heart disease. MI is included in CAD. It’s an active heart attack.

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7
Q

If someone has a PMHx of A-Fib or CHF, do they also have CAD

A

No

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8
Q

What are the “cardiac risk factors?”

A

HTN, DM, HLD, CAD, Smoking, FHx CAD < 55 y/o

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9
Q

How is CAD diagnosed

A

By a cardiologist during a cardiac catheterization. Not done in the ED.

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10
Q

Name two ways that an MI can be diagnosed?

A

STEMI- EKG, Non-STEMI- Troponin

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11
Q

What are some associated symptoms of an MI other than CP?

A

N/V, SOB, diaphoresis

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12
Q

What are some associated symptoms for CHF?

A

SOB (Orthopnea, PND, DOE), pedal edema

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13
Q

What 2 studies would diagnose CHF?

A

CXR or elevated BNP

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14
Q

What is A-Fib?

A

Electrical abnormality of the heart causing the top of the heart to quiver

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15
Q

What might someone feel with A-Fib?

A

Palpitations, fast, pounding, irregular heartbeat

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16
Q

How is AFib diagnosed?

A

EKG

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17
Q

What could be the CC of someone with a PE?

A

Pleuritic CP or SOB

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18
Q

What are the risk factors of PE?

A

Known DVT or PE, FHx of DVT or PE, recent surgery, CA, Afib, immobility, pregnancy, BCP, smoking

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19
Q

What study would diagnose a PE?

A

CTA Chest/VQ scan. D-dimer can only rule out

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20
Q

What part of the heart does CAD affect. Arteries, Veins, or Nerves?

A

Arteries

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21
Q

Can a CT Chest without IV contrast diagnose a PE? Why or why not?

A

No. Contrast in the vessels(IV) helps clearly see a blockage

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22
Q

What social history will most COPD patients also have?

A

Smoking

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23
Q

What is asthma?

A

Constricting of the airway due to inflammation and muscular contraction of the bronchioles. Also called Reactive Airway Disease

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24
Q

What physical exam finding is closely associated with asthma?

A

Wheezes/ing

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25
Q

What is PNA?

A

Pneumonia. Usually a bacterial infection (infiltrates) and inflammation inside the lung

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26
Q

What might a person with PNA complain of?

A

Productive cough and fever

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27
Q

How is PNA diagnosed?

A

CXR

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28
Q

Name all 7 areas of the abdomen

A

Epigastric, RUQ, LUQ, RLQ, LLQ, Suprapubic, Periumbilical (Right/ Left flank)

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29
Q

What is the layman’s name for GERD?

A

“Heartburn” or Acid Reflux

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30
Q

What might someone with GERD complain of?

A

Epigastric pain “burning”

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31
Q

For older patients with GERD symptoms, what life-threatening disease may also need to be ruled out?

A

MI

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32
Q

What does bile do? Where is it stored?

A

Bile emulsifies the fats in foods. It is stored in the gallbladder and made in the liver

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33
Q

What is the difference between Cholelithiasis and Cholecystitis?

A

Cholelithiasis is gallstones. Cholecystitis is acute gallbladder inflammation/infection.

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34
Q

What might be the chief complaint of a person with gallstones?

A

RUQ abdominal pain

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35
Q

What physical exam finding is closely associated with Cholecystitis?

A

Murphy’s Signs

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36
Q

How are gallstones diagnosed?

A

Abdominal Ultrasound of the RUQ

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37
Q

Name associated symptoms of appendicitis

A

Fever, N/V, decreased appetite (anorexia) Note: RLQ pain- gradual, constant, worse w/ movements is the CC (not associated sx)

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38
Q

How is appendicitis diagnosed?

A

CT A/P with PO contrast

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39
Q

What might a person with a SBO complain of?

A

Abd pain/bloating, vomiting, abdominal distention, no BM’s, constipation

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40
Q

What is pyelo?

A

Pyelonephritis, Kidney infection (different and worse than a UTI), usually spread from an UTI

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41
Q

What will be the CC of someone with a UTI?

A

Painful urination (dysuria), frequency, burning, hesitancy, malodorous urine

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42
Q

Where would a patient feel pain if they had pyelo?

A

Flank pain, fever and dysuria

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43
Q

How is a UTI diagnosed?

A

Urine dip or urinalysis (UA) showing white blood cells, bacteria and nitrites

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44
Q

What might a person with kidney stones c/o?

A

Flank pain, sudden onset, radiating to groin

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45
Q

How are kidney stones diagnosed?

A

CT A/P or RBC in UA

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46
Q

Name the 2 types of CVA’s (strokes)

A

Hemorrhagic CVA. Ischemic CVA. (TIA is not a type of a stroke)

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47
Q

What sx might a person with a brain bleed c/o?

A

HA- sudden (“thunderclap”) onset, worst HA of their life, changes in speech, vision, motor (weakness), sensation (numbness), AMS

48
Q

What study would diagnose a brain bleed?

A

CT Head or Lumbar Puncture

49
Q

What sx might a person with an ischemic CVA c/o?

A

Focal Neurological Deficit: changes in speech, changes in vision, one-sided motor changes (weakness), one-sided sensation changes (numbness

50
Q

How is an ischemic CVA diagnosed?

A

Clinically, potentially normal CT head

51
Q

What is a TIA?

A

Transient Ischemic Attack. Mini-stroke. Temporary loss of blood supply to the brain

52
Q

How does a TIA differ from a CVA?

A

TIA - mini stroke, symptoms usually resolve in less than a hour. CVA - Stroke, symptoms last longer, and potentially may not go away

53
Q

What is the name of the state after a seizure?

A

Postictal

54
Q

What are 3 symptoms of meningitis?

A

Fever, neck pain/stiffness, headache

55
Q

What study would diagnose meningitis?

A

LP- Lumbar puncture

56
Q

What are 4 important things to document for syncopal episodes?

A

How they felt before, during, after, and how they currently feel

57
Q

Name 4 causes of altered mental status.

A

Hypoglycemia, infection, intoxication, neurological

58
Q

How is AMS different from a focal neuro deficit?

A

AMS is generalized and typically caused by something that can affect the whole brain (drugs, low BS). FND are localized (weakness/ numbness/speech/vision) to one specific area and corresponds with damage to specific spot in the brain

59
Q

What is a DVT?

A

Deep venous thrombosis

60
Q

What are the risk factors for a DVT?

A

Known DVT, PMHx of DVT or PE, FHx of DVT or PE, recent surgery, CA, immobility, pregnancy, BCP, smoking

61
Q

What are common signs of a DVT?

A

Extremity pain, swelling (atraumatic)

62
Q

What is an AAA?

A

Abdominal Aortic Aneurysm

63
Q

What is an aortic dissection?

A

The separation of the muscular wall from the membrane of the artery, putting the pt at risk for aortic rupture and death

64
Q

Name three important things to document for any trauma patient.

A

LOC, head injury, neck pain, back pain, numbness, weakness

65
Q

How would you document the GPA for a patient who is currently pregnant, has been pregnant 4 times in the past, and has one child at home?

A

G:5 P:1 A:3

66
Q

List five body systems found in the ROS and provide two symptoms for each system.

A

General (fever, chills, weight loss). Cardio (chest pain, palpitations). Resp (cough, SOB, wheezing) Neuro (headache, seizures, numbness). Skin (rashes, itching, redness). Psych (anxiety, hallucinations, depression).

67
Q

What does PERRL stand for?

A

Pupils are equal round and reactive to light

68
Q

What does AT/NC mean?

A

Atraumatic/ Normocephalic

69
Q

What does NAD stand for?

A

No acute distress

70
Q

​​If a patient has pale conjunctiva, what does that indicate?

A

Anemia

71
Q

What is scleral icterus, and what does it indicate?

A

Yellowing of the eyes, indicates liver failure

72
Q

In which body system would you document “TM erythema and bulging”?

A

Ears

73
Q

To describe a “runny nose” would the doctor use the word “epistaxis” or “rhinorrhea”

A

Rhinorrhea

74
Q

What would dry mucous membranes indicate?

A

Dehydration

75
Q

Why is midline bony tenderness “worse” than paraspinal tenderness?

A

Bony tenderness (aka vertebral point tenderness) points towards a spinal fracture and therefore concern for spinal cord injury. Paraspinal tenderness points toward a muscle sprain or strain

76
Q

If you saw “RRR” written in the cardiac exam, what do you think it might mean?

A

Regular Rate and Rhythm

77
Q

Name the rhythm that the physician would hear if the patient was in Afib

A

Irregularly irregular rhythm

78
Q

If the physician checks the pulse on the right wrist and says “The pulses are fine”

A

Wrist pulse 5/5, right; Radial pulse OK; Right wrist pulse is fine; Right radial pulse is 2+

79
Q

Name two “Peritoneal signs” in the abdominal exam?

A

Guarding, rebound, rigidity

80
Q

What abdominal exam sign is indicative of Cholecystitis?

A

Murphy’s Sign

81
Q

If the doctor takes 1 finger and presses in a specific spot in the RLQ, what is the name of the finding they are investigating?

A

McBurney’s point tenderness

82
Q

Which of these findings is NOT a peritoneal sign: Guarding, Rebound, Tenderness, Rigidity

A

Tenderness

83
Q

What is bony tenderness a sign of?

A

Bone deformity, fracture, or injury

84
Q

What is CVA tenderness?

A

Flank tenderness (costovertebral angle
tenderness). Tenderness over the kidney(s)

85
Q

What is fluctuance a sign of?

A

Abscess

86
Q

What does A&Ox4 mean?

A

Alert and oriented to person, place, time, and situation

87
Q

What section of the neurological exam would you document “Normal Finger-Nose-Finger test” and “Normal Heel-to-Shin”?

A

Cerebellar/ Coordination

88
Q

Point to the general area of your body that Cranial Nerves (CN) control

A

Face

89
Q

In the neurological exam, what does “Normal gait” mean

A

Walking normally

90
Q

What is a normal GCS?

A

15

91
Q

How do you document normal strength?

A

On a scale 5/5

92
Q

What would you guess “TTP” means?

A

Tender to palpation

93
Q

What is the medical term for “Swollen lymph nodes?”

A

Lymphadenopathy

94
Q

If you document “There is right pronator drift” in the neurological exam, can you also document “No focal neurological deficits”?

A

No

95
Q

If you documented “NAD” in the constitutional section, would you be contradicting yourself if you wrote “There is mild respiratory distress” in the pulmonary exam?

A

Yes

96
Q

What organ do the LFTs investigate?

A

Liver

97
Q

A high potassium is called ________ and this is commonly due to __________

A

Hyperkalemia, renal failure

98
Q

What are the 3 reasons to consult another physician?

A

Admit the patient, seek advice from a specialist, gather information from the PCP

99
Q

List 4 CCT qualifying Dx and 4 CCT qualifying procedures.

A

MI, PE, Severe GI bleed, CVA, Lumbar puncture, Central line, Cardioversion, Chest Tube

100
Q

Hyponatremia is _______ and indicates________.

A

Low sodium, dehydration.

101
Q

The _______ shows the pH only, while the _______ shows the pH plus HCO3, CO2, and PaO2.

A

VBG, ABG.

102
Q

Aneurysm

A

Localized ballooning of a vessel due to a weakened vessel wall

103
Q

Arrhythmia

A

Irregular heartbeat

104
Q

Bradycardia

A

Slow heart rate (HR<60)

105
Q

Normal sinus rhythm NSR

A

Rhythm of a healthy heart

106
Q

Regular rate and rhythm (RRR)

A

Normal heart sounds with regular rate (60-100 bpm)

107
Q

Stenosis

A

Narrowing of a body opening or passage

108
Q

Tachycardia

A

Fast heart rate (HR>100 bpm)

109
Q

Dyspnea on exertion (DOE)

A

Feeling short of breath during very light exercise

110
Q

Rales

A

Crackles, wet crackling heard in lungs, typically due to pneumonia or CHF

111
Q

McBurney’s point

A

RLQ point tenderness indicative of appendicitis

112
Q

Murphy sign

A

Pain with palpate on of the RUQ during a deep breath, indicative of cholecystitis

113
Q

Peritoneal signs

A

Signs indicative of acute abdominal inflammation (peritonitis)

114
Q

Cephalgia

A

Headache

115
Q

Coronary Artery by Pass Graft (CABG)

A

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