Exam I Flashcards
1
Q
what is pruritus?
A
itching
2
Q
what is utricaria?
A
hives
3
Q
what is xeroderma?
A
extreme dryness of the skin
4
Q
what causes nail clubbing?
A
pulmonary conditions (80% of the time)
5
Q
what causes Leukonychia of nails? (3)
A
(1) alcohol
(2) nutrition defects
(3) MI
6
Q
what causes Splinter
hemorrhages of nails?
A
endocarditis
7
Q
what causes Koilonychia (spoon) of nails? (3)
A
(1) anemia
(2) thyroid
(3) syphilis
8
Q
what causes Beau’s lines in nails? (3)
A
(1) alcohol
(2) nutrition defects
(3) MI
9
Q
what causes nail pitting?
A
psoriasis
10
Q
what causes nail thickening?
A
poor circulation
11
Q
what causes melanoma in nails?
A
malignance
12
Q
the butterfly rash occurs with what condition?
A
lupus erythematosus (systemic) (NOT CHRONIC INTEGUMENTARY LUPUS)
13
Q
what are the ABCs of screening for skin cancer?
A
Asymmetry: unequal Border: irregular Color: multiple colors Diameter: > 6mm Elevation / Evolution: elevation or quick changes
14
Q
what is the most common and slowest metastasizing type of skin cancer?
A
basal cell carcinoma
15
Q
what is the second most common type of skin cancer?
A
squamous cell carcinoma
16
Q
where do 80% of squamous cell carcinoma lesions occur?
A
head and neck regions
17
Q
what is the most severe and fastest metastasizing skin cancer?
A
melanoma
18
Q
what is psoriasis? what is the most common complaint?
A
(1) chronic skin disorder; red patches covered by dry silvery scales
(2) itching
19
Q
what is systemic
sclerosis? what population is more affected?
A
(1) connective tissue disease that causes fibrosis of skin, joints, blood vessels, and organs
(2) women 2-3x more than men
20
Q
what is lyme disease? how do patients present?
A
(1) infection caused by a deer tick
(2) fever, headache, stiff neck; may only present with shoulder or knee pain initially
21
Q
what is herpes zoster? what are the symptoms?
A
(1) shingles; caused by varicella-zoster virus
(2) pain and tingling along affected spinal or cranial nerve dermatome; fever, chills, GI problems
22
Q
what is rosacea?
A
a form of adult acne
23
Q
what is tinea corporis?
A
ringworm
24
Q
what is palmar erythema commonly caused by?
A
hepatic disorders
25
how can you differentiate between anxiety and stress?
panic and fear are associated with anxiety
26
what are the DASS and GDS scales? what are scores that require referral?
(1) Depression, Anxiety and Stress Scale (scores >7 in any sub scale require referral)
(2) Geriatric Depression Scale (6 or >)
27
what are the 6 types of somatoform disorders?
(1) somatization
(2) undifferentiated
(3) hypochondriac
(4) somatoform pain disorder (5) body dysmorphic disorder
(6) conversion disorder
28
what demographic has the lowest suicide rates?
African American females
29
what are the 5 types of anemia?
(1) iron deficiency
(2) anemia caused by inflammation
(3) aplastic anemia
(4) renal insufficiency
(5) megaloblastic anemia (lack of vitamin B12)
30
what is the most severe type of anemia?
aplastic (type III)
31
what is often the first symptom of aplastic anemia?
bleeding
32
what anemia is due to synthesis of abnormal hemoglobin?
sickle cell anemia
33
what type of anemia is due to decreased synthesis of structurally normal hemoglobin?
thalassemia
34
what form of sickle cell is more severe?
homozygotes
35
what does sickle cell anemia put the patient at risk for?
increased clotting puts the patient at increased risk for stroke
36
which type of thalassemia is the most severe?
homozygotes
37
what are the normal hemoglobin and hematocrit values in males and females?
MALES
Hgb: 13-17
Hct: 39-49
FEMALES
Hgb: 12-16
Hct: 36-48%
38
what is polycythemia? what are the two types and what causes them?
increased hematocrit and hemoglobin
Types
I. primary: early bone morrow precursor cells
II. secondary: increased erythropoietin
39
what is a common physical finding with polycythemia?
pressure in left upper quadrant due to an enlarged spleen
40
what are common complications of polycythemia?
increased clot formation: stroke, MI, DVT, life threatening hermorrhage of upper GI tract
41
what is thrombocytopenia?
decreased number of platelets
42
what is nadir?
lowest point of WBC count following chemotherapy (usually occurs 7-14 days)
43
what are normal INR levels? what INR level is at risk for hemarthrosis?
(1) normal: 0.8-1.2
| (2) at risk: >3
44
what are the two types of hemophilia?
(1) type A: hereditary (x-chromosome linked)
| 2) type B: acquired (liver failure, vitamin K deficiency, coumadin therapy
45
what is the difference in clinical presentation between platelet disorders and clotting factor deficiencies?
(1) platelet disorder: bleed in superficial sites
| (2) clotting factor: bleeding into muscles, joints, and cavities
46
what is the most common finding with hemophilia? where does this usually occur?
(1) hemarthrosis (muscle bleeding 2nd most common finding)
| 2) knee, shoulder, hip, ankle elbow (larger joints
47
what type of angina do women usually have and where does it present?
(1) microvascular disease
| (2) localized to chest and mid back
48
what type of angina do men usually have and where does it present?
(1) coronary artery disease
| (2) pain that radiates into the shoulder, traps, and down the arm
49
what is the difference between stable and unstable angina?
stable: predictable
unstable: can occur anytime, during sleep, throughout day etc.
50
what is orthopnea?
shortness of breath while lying down
51
what is syncope?
fainting
52
what is vasovagal syncope?
fainting due to very strong parasympathetic response
53
what are abnormal vital signs for CVD with exercise?
(1) systolic BP that doesn't increase with intensity
(2) systolic BP that falls during exercise
(3) increased in diastolic BP >15-20 mm Hg
54
with patients taking beta blockers, how is exercise prescribed?
RPE
55
what is myalgia?
myotoxic event associated with statins
56
what is rhabdomyolysis associated with?
impaired renal and liver function
57
what are classic signs of liver impairment?
dark urine, white stools, asterixis (liver flap), bilateral carpal tunnel syndrome, ascites
58
what is the most common symptom of HTN?
headache
59
what is considered HTN?
>140 systolic
| >90 diastolic
60
what is the number 1 risk factor that predisposed a person to CHF?
hypertension
61
what is orthostatic hypotension?
(1) decrease of systolic BP by 20 mm HG or more
| (2) decreased systolic and diastolic BP by 10 mm Hg AND increased HR by 15bpm
62
what is a common MSK symptom of infective endocarditis?
(1) arthralgia (joint pain) most commonly the shoulder
| (2) 1/3 of these patients have low back pain
63
what can pericarditis mimic?
MI (pain radiates to the left shoulder)
64
how do you differntiate between pericarditis and MI?
patient position wont be affected by MI; leaning forwards or going to all 4s makes pericarditis pain decrease
65
what is an aneurysm?
stretching of the wall of an artery (50% greater than normal); most common site for arterial aneurysm is the aorta
66
what are the most common symptoms of abdominal aorta aneurism?
(1) pulsating mass in abdomen (with or without pain)
| (2) abdominal and back pain
67
where do 95% of aortic aneurysms occur?
just below the renal arteries near the belly button
68
who is at a higher risk for abdominal aorta aneurism?
(1) males
| (2) congenital heart defects / diseases
69
how is well's clinical prediction rule for DVT graded?
0 - less than 5% chance of DVT
1-2 - 25% chance of DVT
3+ - 50% chance of DVT
70
what are O2 saturation ranges required for exercise?
D/C exercise if O2 falls below:
- 90% for medically monitored patients
- 92% for outpatient
71
what should O2 levels be at rest?
>96% in young / adults at rest
| >94% for healthy elderly at rest
72
when should you send a patient for immediate referral with the use of nitroglycerin?
15-20 minutes if angina doesn't subside following administration of nitroglycerin
73
what is the most powerful risk factor for stroke?
HTN (>140mm Hg)
74
what is the difference between hypoxemia and hypoxia?
hypoxemia: deficient oxygenation of arterial blood
hypoxia: diminished availability of oxygen to the body tissues
75
what is hemoptysis?
coughing up blood
76
what is hypercapnia?
a condition that decreases ventilation increases the retention of CO2
77
what is pneumothorax?
collapsed lung; causes mediastinal shift towards unaffected side
78
what is the primary symptom of pneumothorax?
dyspnea
79
what is the most common symptom of GI disease? what is the 2nd most common?
(1) abdominal pain (including heart burn)
| (2) nausea
80
why do some people have back pain with constipation?
muscle guarding
81
what is the difference in abdominal exam between diverticulitis and appendicitis?
(1) diverticulitis presents usually in left lower quadrant
| (2) appendicitis usually presents in the right lower quadrant
82
what does the heel jar test for?
peritonitis and appendicitis
83
what MSK disorder can Crohn's disease cause?
arthritis
84
what is the most common GI problem?
IBS
85
what is Kern's sign most commonly associated with?
ruptured spleen or bleeding in peritoneal cavity
