Final Flashcards
What condition causes irritatation to the right hemidiaphragm and phrenic nerve causes right shoulder pain
biliary colic
what condition causes vomiting bile
small bowel obstruction
what condition is the pain exacerbated by ETOH intake
pancreatitis
what does the anterior drawer test for
ACL tear
what does the posterior drawer test for
PCL tear
pushing on the tib fib away from you while the knee is in flexion is what test
posterior drawer test for PCL tear
if a patient is unable to actively extend and lift their leg off the bed, what injury might they have
patellar tendon injury
what does the mcmurrarys test test for
meniscal tears
What is the name of the test when arms are internally rotated with thumbs down and pressure put on top of arms
empty can test
what does empty can test for
supraspinatous pathology
what is tested in lift off test
looking for subscapularis tendon integrity
what does bulge sign, ballotment and balloning test for
knee effusion
what causes swelling of synovial tissues in joints and tendon sheaths
RA
RA or OA causes morning stiffness
RA
RA or OA is worse after movement and activity
OA
what condition most commonly affects the first metacarpal and i ahs tophi in subcu tissue
gout
what does spurling test for
cervical root compression
why would you do a spurling test in shoulder pain presentaiton
to test for cervical radiculopathy that is causing the shoulder pain
what test involves extension of neck with head rotated towards affected side and axial load on head
spurling test
seborrheic keratosis is: benign or likely to metastisize
benign
Which skin CA is slow growing and which is aggresive: BCC and melanoma
BCC is slow growing and melanoma is aggressive
What would cause slow onset of vision loss that is bilateral
macular degeneration
true or false: seborrheic dermatitis includes redness and scaling
true
what condition causes a soft nodular thyroid with a bruit
graves
what would cause a firm thyroid
hashimoto or malignancy
what is Pemberton sign and what does it test for
flushing with neck hyperextension and arm elevation
Caused by compression of thoracic inlet from a goiter
what symptoms would you suspect a patient to have with a retrosternal goiter
hoarseness, SOB, stridor, dyspnea
what disease causes a stare, lid lag and exopthalmos
Graves
What is carotenosis and what disease may cause it
yellowing of the skin from increased carotene, from hypothyroidism
what disease causes a moon face, red cheeck and excess facial hair growth
Cushing
adrenal cortisol is increased or decreased in cushing syndrom
increased
nephrotic syndorme has increased or decreased albumin excretion
increased
what disease causes a pale, edematous face, periorbital edema worse in the morning and swollen lips
nephrotic syndrome
what disease may cause myxedema
hypothyroidsum
what is the name for the cluster of symptoms: non pitting periorbital edema; dry, coarse and thin hair; loss of lateral 3rd of the eyebrow
myxedema
what are some risk factors for developing parotid gland enlargement
obesity, diabetes, cirrhosis
what would cause an acute enlargement of the parotid gland
mumps
where would you see an enlarged parotid gland
anterior to ear lobe above angle of jaw
what disease would cause enlarged bones, elongated head with bony prominent forehead, enlarge and coarse facial features
acromegaly
what disease includes a loss of dopamine, masklike facies, oily skin and a forward flexed neck
parkinsons
what are some causes of a diffusely enlarged thyroid
graves, hashimotos, endemic goiter
what are some causes of a single nodule on the thyroid
cyst, benign tumor, one nodule within a multinodular gland
is a multinodular goiter a red flag finding for CA
not necessarily, they are more likely metabolic than neoplastic
what is stereopsis
3D depth perception
what is near reaction
when gaze shifts from a far object to a near object, pupils restrict
what is miosis and can cause it
excessive constriction of pupil, can be caused by a lesions anywhere along the sympathetic pathway
pupil constriction is controlled by the (sympathetic or parasympathetic) pathyway
parasympathtic
what is CN 3
occulomotor
what is hyperopia and myopia
hyperopia = farsighted
myopia = near sighted
what may cause a sudden, painless, unilateral loss of vision
vitreous hemorrhage from diabetes or trauma, macular degeneration, retinal detachment, retinal vein occlusion, central artery occlusion
what are causes of sudden vision loss that is painful
corneal ulcer, uveitis, traumatic hyphema, acute angle closure glaucoma
what are some causes of painless bilateral vision loss
vascular etiologies, stroke, non physiologic causes
what are some causes of painful bilateral vision loss
intoxication, trauma, chemical or radiation exposure
what are some causes of gradual vision loss
cataracts, glaucoma, macular degeneration
what are some causes of gradual central vision loss
nuclear cataracts, macular degeneration
what causes gradual peripheral vision loss
advanced open angle glaucoma
what are scotomas
fixed defects in vision likely from lesion in retina, visual pathway or brain
what causes a red and painless eye
subconjunctival hemorrhage or episcleritis
what causes a red eye with a gritty sensation
viral conjunctivitis or dry eye
what causes a painful red eye
corneal abreasions, FB, corneal ulcers, acute angle closure glaucoma, herpes keratitis, fungal keratitis, hyphema, uveitis
what would you expect for a complain regarding vision to be of a patient with palsy of CN III, IV or VI
diploplia
what would cause eyelid retraction, restricted occular motility, occular pain, lacrimation and dry eye
thyroid disease
what visual test rules out optic nerve damage
color vision test
what is esotropia and exotropia
esoptropia = inward deviation of eyes
exotropia = outward deviation of eyes
what is hypertropia and hyoptropia
hypertropia = upward deviation of eyes
hypotropia = downward deviation of eyes
what is proptosis
abnormal protrusion of eyes
what causes scaly eyebrows
seborrheis dermatisis
what causes lateral sparesness of eyebrows
hypothyroidsim
what causes red, inflamed and crutying eyelids
blepharitis
what is lagophthalmos
failure of eyelids to close - urgent optho referral
what would cause dryness of the lacrimal apparatus
sjorgren syndrome
what is chemosis
nodules or swelling of conjunctiva
when shining a tangential lite across the iris, there is a crescent shadow on the opposite side of the iris. What does this indicate and what is the significance
indicated iris has bowed abnormally forward and is an increased risk for acute narrow angle glaucoma
what is strabismus
dysconjugate gaze
what is mydriasis
pupil dilation
what is the significance of an absent red reflex
cataracts, detached retina, mass, retinoblastoma
what is papilledema
optic nerve swelling from increased ICP like meningitis, subarachnoid hemorrhage, trauma
what would you see on a fundoscopy exam with papilledem
swelling of optic disc and anterior bulging of physiologic cup
what are Drusen
occular cellular debris
what is afferent pupillary defect or a marcus gunn pupil
light in the normal eyes causes constriction of both pupils and light in abnormal eyes causes partial dilation of both pupils
optic nerve damage in abnormal eye
what condition would cause a fixed dilated pupile with severe pain and decreased vision
acute angle closure glaucoma
what condition would cause a small and irregular pupile with photophobia and decreased vision
acute iritis
what would cause a steamy or cloudy cornea
acute angle closure glaucoma
what is bitemporal hemianopsia (optic chiasm) and what causes it
vision loss on the temporal or outer half of each eye
lesions at optic chiasm (pituitary tumor)
what is left homonymous hemianopsia and what causes it
vision loss on the right or left side of both eyes.
caused by lesions of optic tract
what is ptosis and what are some causes
drooping eyelid
myasthenia gravis, damage to CN III, horner syndrome
what is entropion
inward turing of lif margin and lower lashes may irritate conjunctiva
more common in elderly
what is trichaisis
inward growth of lashes but eyelid position remains normal
what is ectropion
lower lid margin turns outward
what are pinguecula
yellowish triangular nodule in conjunctiva to side of iris
harmless, comes with aging
what is episcleritis
localized occular inflammation
bengign and usually painless, resolves spontaneously
what is a chalazion
non tender, painless noduled that point inside the lid instead of on lid margin like a stye
what is a xanthelasma
slightly raised, yellowing, well circumscribed cholesterol filled plaque along nasal protion of eyelids
what is blepharitis
chronic inflammation of eyelids at base of hair follicles
what is corneal arcus
this grayish white arc or circle edge of cornea, normal in aging
what is the diagnosis if you see an opactiy of the lens when looking through the pupil
cataracts
what is a kayser fleischer ring and what causes it
golden to red brown ring from copper deposition
from wilson disease
what would cause a spoke like shadow in the eye
peripheral cataract
what would cause a small unilateral pupil that reacts briskly to light but dilates slowly and large anisocoria
horner syndrome
what is the classic triad of horner syndrome
miosis, ptsosis and anhidrosis
what is argyll robertson pupils and what causes it
bilat small and irregular pupils with normal near test but do not react to light
causes by neurosyphilis
what would diploplia persisting in one eye when the other is closed indicate
problem in the cornea or lens
when would you see listing of the trunk
herniated disc
What causes physiologic cupping
glaucoma
what are you testing when you test confrontation
peripheral vision
what would demonstrate accomodation of the eyes
eyes dilate looking further away and constrict looking close up
what does the the cover uncover test test for
strabismus (looking for lazy eye)
during the cover uncover test, is it normal to see the uncovered eye move or focus on you once you cover up the other eye
no
what is the name for flame shaped red streaks in fundi and what causes it
superifical retinal hemorrhages, caused by HTN, papilledema
what are cotton wool spots in the fundi
soft exudates that are white or grayish caused by DM and vascular dysplasia
what parts of the ear have conductive hearing loss and what parts have sensorineural hearing loss
external and middle aar are conductive
inner ear is sensorineural
in normal hearing, is air condition or bone conduction longer
air conduction
complaining that others mumble, and noisy environment making hearing worse is conductive or sensorinueral hearing loss
sensorineural
what kind of hearing loss would noisy environments making hearing better
conductive
what are the 3 typical symptoms of meinier disease
tinnitus
fluctuating hearing loss
vertigo
what is the tug test
moving auricle and tragus is painful on OE but not in OM
what would cause pain on palpation behind the ear
OM and mastoiditis
what causes painful hemorrhagic vesciles on the TM and what is the management
bullous myringitis, urgent surgical management
what are osteomas or exostoses
non painful skin colored nodules in the ear
when would you seen a prominent short process and prominent handle of malleus in the ear
retracted TM
what test is used to test for lateralization of hearing
weber test
how you do you determine conductive vs sensinureal hearing loss with the weber test
in conductive, sound is heard better in impaired ear, in sensorineural, sound is heard better in good ear
what test is used to compare a conduction to bone conduction hearing
rinne test
what would the findings of the rinne test be in conductive hearing loss
BC=AC or BC>AC
what would the fingings of the rinne teste be in sensorineural hearing loss
AC>BC
what is the main difference between peripheral vertigo caused by BPPV and vestibular neuronitis
BPPV lasts a few seconds, vestibular neuronitis is hours to weeks
true or false acute labrinthitis does not affect hearing
false, it can cause unilateral sensorineural hearing loss
what would a raised nodule with a lustrous surface on or near the ear indicate
basal cell carcinoma
what is a monomer of the TM
thin transparent section of previous perf that has healed
what would cause a black line in the gums
lead poisoning
what is the name for a bony benign growth on the roof of the mouth
palanitus
paralysis to what cranial nerve would cause one side of the soft palate to note rise and uvula deviation
cranial nerve X paralysis
what condition causes skin softening at the angles of the mouth and then fissuring
angular cheilitis
what causes lips to lose normal redness, become scaly and thick and slightly everted
actinic cheilitis, precancerous from excessive sunlight
what causes the throat to be dull red with a thin grey exudative membrane
diptheria
what causes deep purple colored lesions on the roof of the mouth
kaposi sarcoma
fever, pharyngeal exudate and posterior cervical lymphadenopathy are a classic triad of what condition
mononucleosis
what would cause palatal petichia and splenic enlargement
mononucleosis
when pushing down on outstretched arms and checking strength, what are you testing
supraspinatus tendon
what does the empty can test test for
supraspinatus
with elbows bent and hands in suppination, getting pt to resist you pushing their hands together tests what
infraspinatus and teres major
what does the lift off test test for
subscalpularis
what are the 3 tests for shoulder impingement
neers, empty can test, hawkins kennedy test
what is the neers test and what does it test for
internall rotate (turn palm facing outward) and lift hand above head forward, if it replicates pain it indicates impingement
what is speeds test
resist forward flexion of arm, checks biceps tendon
reduced active and passive ROM of the shoulder, asymmetry of the scapula, and pain along the trapezius is from what
adhesive capsulitis
cross arm adduction test is for what
tests for AC joint pathology
what does thompson test for and how to you do it
achilles tendon rupture, squeeze calf while pt is lying on stomach, if ruptured the feet wont flex
what is the type of pain produced by organs forcefully contracting
visceral
what type of pain is steady, aching, severe and caused by inflammation of the peritoneum
somatic
what disease causes metaplastic changes in the esophageal lining from normal squamous to columnar epithelium
barrets esophagus
what is xerostomia
insufficient saliva
what is the Rome IV criteria
criteria for constipation
what is the difference between primary and seconday constipation
primary no cause, secondary has a cause
what condition causes pink or purple striae on the abdomen
cushing syndrome
what conditions may cause dilated abdo verins
cirrhosis or IVC obstruction
the spleen is palpable below the costal margin, is this a normal finding
no this indicates splenic enlargement
duodenal or gastric ulcers are more painful and may wake pt at night
duodenal
what causes epigastric and RUQ pain that radiated to right shoulder and worsened by fatty meals
biliary colic
what causes severe epigatric pain that radiates into back and other parts of the abdo that is worsened with movement
pancreatitis
what causes vague nonspecific abdo pain that is out of proportion to the physical exam
meesenteric ischemia
OA or RA gets worse with pain and improves with rest
OA
OA or RA causes subcutaneous nodules
RA
what are the SITS muscles
supraspinatus, infraspinatus, teres minor, subscapularis
what kind of injury would cause infraspinatus atrophy
rotator cuff injury
what causes scapular winging
weak trapezius from muscular dysptrophy
what does the scratch test for
adhesive capsulitis
what is the painful arc test and what does it test for
lifting arm all the way to 180 degrees and if pain at 60-120 degrees, positive for subacromial impingement or rotator cuff tenditnitis
what test is used to test the AC joint independenlty
crossover
what test is used for bicep tendinitis
speeds test
what test is used to test for GH instability
apprehension
what tests are used to test the supraspinatus muscle
drop arm and empty can
how do you test the infrapsinatus and teres minor
external rotation against resistance
how do you test the subscapularis
lift off
varus stress is used on what ligaments and puts pressure towards the medial or lateral side
the lateral or radial ligament of elbow and knee, put stress pushing towards medial side
the valgus stress tests what ligaments and puts pressure towards the medical or lateral side
the medial or ulnar collateral ligament of elbow and knee, put pressure outward or towards the lateral side
what bone in the wrist has decreased blood supply and can have impaired healing and how is it teseted
scaphoid or navicular bone, tested with snuff box tenderness
what is an important test to do on the wrist after a FOOSH fall
snuff box tenderness
what is the name of the test when you tap over the palmar aspect of the wrist and what does it test for
tinells test, carpal tunnel
how do you do phalens test and what does it test for
backs of hands together and hold for 60 seconds
what is the name of a lesions that is flat and <1cm
macule
what are some examples of macules
freckles, flat moles, port wine stains
what is the name of a lesions that is flat and >1cm
patch
what is the name of a lesions that is solid, elevated and <1cm
papule
what are some examples of papules
nevi, warts, seborrheic keratosis, actinic keratoses
what is the name of a lesion that is elevated, solid and >1cm
plaque
what is a condition that would have plaques
psoriasis
what s lichenification
hardening of the skin from excessive itching
what does mcmury test test for and how do you do it
knee bent, rotate knee out or in and extend looking for clicking or pain
checks for meniscus in knee
what does the valgus stress test at the knee test for
tests the MCL
what does the varus stress test at the knee test for
tests the LCL
does glaucoma cause the physiologic cup to enlarge or shrink
enlarge
what skin condition causes hard and keratotic scaling
actinic keratoses and SCC
a pink patch of skin that does not heal may be what kind of skin condition
BCC
what might a dry, sandpaper, skin colored or light brown lesion be
actinic keratosis
