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PCM2 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

What is the definition of overweight in children?

A

85-95% BMI percentile

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2
Q

What is the definition of obese in children?

A

Over 95% BMI percentile

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3
Q

True or false - you classify babies by birth weight and gestational age.

A

True

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4
Q

What is precocious puberty in a male?

A

Before age 9

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5
Q

What is precocious puberty in a female?

A

Before age 8

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6
Q

What is delayed puberty in a male?

A

No evidence of puberty by 14

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7
Q

What is delayed puberty in a female?

A

No evidence of puberty 13 or no menarche by 16

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8
Q

Describe Tanner Stages for the female.

A

2: breast budding and sparse hair
3: continued breast enlargement, darker, courser, curlier hair
4: areola and papilla form a secondary mound, adult type hair but decreased distribution
5: mature female breasts and adult hair

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9
Q

Describe Tanner Stages in a male.

A

2: Enlargement in testicles and change in texture, sparse pigmented hair
3: growth in length and circumference, darker courser curlier hair
4: develop glans penis, darkening of scrotal skin, adult hair, decreased distribution
5: adult

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10
Q

What is the HEADS mnemonic for psychosocial screening?

A 
H: Home
E: Education, Eating
A: Activities, Affect
D: Drugs
S: Sexuality, Safety
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11
Q

What are the aspects of guided questioning?

A
  1. Open ended to focused
  2. Eliciting a graded response
  3. Asking a series of questions one at a time
  4. Offering multiple choices
  5. Clarifying what the patient means
  6. Encouraging with continuers
  7. Echoing
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12
Q

What are the three parts of a plan?

A
  1. Diagnostic
  2. Therapeutic
  3. Education
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13
Q

What are reasons to admit a patient to the hospital?

A
  1. Concerned about a life threatening diagnosis
  2. Unstable condition like hypotension
  3. Need IV medication
  4. Unable to tolerate anything by mouth (vomiting/dehydration)
  5. Social reason (safety)
  6. Psych
  7. Treatment not available at home
  8. Failure to respond to appropriate outpatient regimen and getting worse
  9. Isolation
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14
Q

What is the mnemonic for admitting orders?

A

ADC
VAAN
DISML

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15
Q

What are the first three steps of admitting (ADC)?

A
  1. Admitting
  2. Diagnosis
  3. Condition
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16
Q

What are the next 4 steps of admitting (VAAN)?

A
  1. Vital signs
  2. Activity
  3. Allergies
  4. Nursing
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17
Q

What are the last 5 steps of admitting (DISML)?

A
  1. Diet
  2. IV fluids
  3. Special orders
  4. Medications
  5. Lab tests
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18
Q

What is heard best with the diaphragm?

A
  1. High pitched sounds (S1, S2, midsystolic click, AR, MR)
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19
Q

What is heard best with the bell?

A
  1. Low pitched sounds (S3, S4, MS)
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20
Q

Which is longer, systole or diastole?

A

Diastole (usually)

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21
Q

What is S1?

A

Closing of mitral and tricuspid valves (beginning of systole)

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22
Q

What is S2?

A

Closing of aortic and pulmonic valves (beginning of diastole)

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23
Q

In S1, which valve is heard first?

A

Mitral (before tricuspid)

24
Q

In S2, which valve is heard first?

A

Aortic (before pulmonic)

25
Q

Which heart sounds are louder, left or right?

26
Q

Where is S1 heard loudest?

27
Q

Where S1 heard quietest?

28
Q

Where is splitting of S1 normal?

A

Left lower sternal border (tricuspid area)

29
Q

Where is S2 heard loudest?

A

Aortic area

30
Q

When do we hear physiologic splitting of S2?

A

Inspiration at the pulmonic area

31
Q

What are the three types of pathologic splitting of S2?

A
  1. Fixed (A2 before P2)
  2. Paradoxical (P2 before A2, happens with expiration)
  3. Wide (increases with inspiration)
32
Q

What are 2 causes of pathologic fixed splitting of S2?

A
  1. ASD

2. RV failure

33
Q

What is 1 cause of pathologic paradoxical splitting of S2?

34
Q

What are 2 causes of pathologic widened splitting of S2?

A
  1. RBBB

2. Pulmonic stenosis

35
Q

What are the two extra heart sounds heard in systole?

A
  1. Early ejection sound

2. Systolic click

36
Q

What grade of murmur indicates the murmur can be palpated?

37
Q

What type of murmur can be innocent?

A

Midsystolic murmur

38
Q

If you hear an early ejection sound, what type of disease is usually implicated?

A

Aortic valve disease

39
Q

If you hear a systolic click, what disease is likely occurring?

A

MV prolapse

40
Q

The general cause of S3 is ___.

A

Fluid overload

41
Q

Which extra heart sound is always pathologic?

42
Q

The general cause of S4 is ___.

A

Stiff ventricle

43
Q

If you hear an opening snap, what is likely occurring?

A

Mitral/tricuspid stenosis - sound caused by restricted valve leaflet motion

44
Q

If you hear a murmur that is of musical quality, it is likely a ___ murmur.

45
Q

What are some of the causes of physiologic systolic murmurs?

A
  1. High flow in anemia
  2. Pregnancy
  3. Fever
  4. Hyperthyroidism
46
Q

Define echogenic.

A

Structure or medium capable of reflecting or transmitting ultrasound waves

47
Q

Define anechoic.

A

Image appears black (fluid)

48
Q

Define hyperechoic.

A

Image appears brighter/whiter than surroundings (bone)

49
Q

Define hypoechoic.

A

Image appears darker than surroundings

50
Q

Define isoechoic

A

Image appears similar in brightness to surroundings

51
Q

In a subxiphoid view what is seen at the top and bottom of the image?

A

Top: liver
Bottom: atria

52
Q

How is the probe oriented in a parasternal long view?

A

Indicator toward patient’s right shoulder or left hip

53
Q

In a parasternal long view what is seen at the top and bottom of the image?

A

Top: RV outflow tract
Bottom: inferior wall

54
Q

In a parasternal short view what is seen at the top and bottom of the image?

A

Top: RV
Bottom: LV/inferior wall

55
Q

What can be seen on ultrasound to indicate a pulmonary embolism?

A

Dilated right ventricle

PCM2 (16 decks)

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