Extra Clinical Exams Flashcards
Jaundice
Yellow eyes, bad breath (rotten egg/garlic- fector hepaticus- v serious, unliekly to see)
Can be increased billirubin- yellowish pigment during breakdown of RBC- liver not clearing bilirubin properly, liver damage/disease
Liver disease, hepatitis (light coloured stool, dark urine)
Central cyanosis
Severe asthma, pulmonary embolism
Blue ish purple tone to skin
Lips, mouth, ear lobes
Peripheral cyanosis
Raynards, low blood pressure, hypothermia
Fingers
Capillary return, cold extremities, blue/purple tinge
Anaemia
Not enough haemgolobin
Pale lower lid- not enough iron
Yellow- haemolytic or sickle cell anaemia= yellowish sclera
Alongside fatigue, weakness, SOB, dizziness, irregular heartbeat
Horners syndrome
Partial ptosis- dropping of face/upper lid
Miosis- pupil constriction (occulomotor)
Facial anhidrosis- absence of facial sweat
Disruption to sympathetic nerve supply
From hypothalamus–> face and eyes
Cerebellar ataxia
Dysdidochokinises
Ataxia (posture, gait)
Nystagmus (h-test)
Intention stutter (finger-nose)
Speech (slurred, syllables)
Hypotonicity
Heel-shin
MS
Female, 20-40
System attacks myelin (loss of myelin= scar tissue= sclerosis)
Vision changes, cognitive disturbances, family Hx, difficulty walking
Heel to shin- lower coordination
Dysmetria
Lack of coordination, under or over shoot of intended position with hand, arm, leg or eyes
Symptom of cerebellar damage
MS, stroke, brain injury
Finger nose- upper coordination
Heel to shin- lower coordination
Parkinsons
Change in memory, movement, speaking slower, tremor at rest
MRI
Dopamine transporter scan
Tone
Dysdiadochokinesia
Finger to nose
Heel to shin
Cerebellar ataxia
Bells palsy
Temporary weakness or lack of movement that usually affects one side of the face
LMNL- because it affects the facial nerve (MOTOR), leading to symptoms
Facial nerve test- facial asymmetry, expressions
No lab test for it
ALS
Amytrophic lateral sclerosis
Upper and lower MNL
First symptom is a limp, cramping/twitching in hands or feet, clumsiness, loss of motor control, slurred speech
Symptoms usually start in dominant arm
Dysdiadochokinesia
Finger to nose
Heel to shin
Cerebellar ataxia
5, 7, 9, 10, 12 CN test
B12 deficiency
Metformin
Muscle weakness
AAA
Male, 50+, Hx smoking/alcohol, obesity, family Hx
Sweating, pallor, possible LBP, pulsatile mass in abdomen, dizziness/lightheadedness
Auscultate- bruits, murmurs
Still suspecting- maybe palpate
Meningitis
Inflammation to meninges in spine
Fever, H/A, neck stiffness
Brudzinkis- supine, flex head so chin is on chest, +ve= flex hips or knees to lessen stretch on inflamed meninges)
Kernigs- supine, flex hip/knee bring it near chest, extend knee- +ve= flexion of back, resistance or P, inability to extend knee beyond 135 (Bi)
DVT
Homans
Wells criteria
Active Ca +1
Paralyis, splint Lexx +1
Bedridden (3/7, last 12/52) +1
Localised tenderness +1
Swollen leg +1
Pitting oedema +1
Collateral superficial veins +1
Previous DVT +1
Alternate diagnosis making DVT less likely -2
Alternative diagnosis as likely as DVT -2
Likely <2
Unlikely >2
