Final Flashcards
T or F
Ventricular Septal Defect always results in cyanosis at birth
False
The movement of blood is L-R and therefore only a little extra blood would flow into the RV. If the aorta was opening into both ventricles then we would see cyanosis.
What percentage of cases of Ventricular Septal Defect are self limiting?
80%
What happens to the Right ventricle if the septal defect does not self resolve?
R Ventricular hypertrophy -> too much pressure -> R Ventricular Failure = reversal of shunt & deoxygenated blood to the brain.
What causes Rheumatic Fever in younger people?
Recurrent inflammation of the tonsils. 6+ episodes.
Why does taking out the tonsils help with Rheumatic Fever?
Tonsils become a septic focus which can cause Bacteremia
T or F
After 15 yoa Rheumatic Fever from tonsillitis is not as much of a concern
True
Where are some other common septic focus areas in the body?
Men = prostate, tonsils, teeth Females = fallopian tubes, tonsils, teeth
Name 3 conditions discussed in class that will give you a high fever
Pneumonia
Nephritis
Tonsilitis
What is a high pitched heart murmur?
Low pitched?
HIGH = aortic or mitral regurgitation is produced by blood flowing through narrow orifices under increased pressure LOW = ventricular filling murmur are produced by blood flowing under relatively low pressure.
Describe a thrill
Vibratory sensation heard over a massive valvular lesion.
So loud you can hear and feel.
Turbulent blood flow
Where is the aortic, pulmonic, erbs, tri, mitral pulse felt on the thorax?
a = R side at 2nd ICS p = L side at 2nd ICS e = L side at 3rd ICS t = L side at 4th ICS m = L side at 5th ICS ~7-10cm lateral of sternum
What is an aka for apical impulse?
point of maximal intensity
T or F
At rates less than 100 bpm diastole is shorter than systole
False
Diastole will be longer than systole
T or F
Diastole = S2 to S1
True
T or F
S1 and S2 are best heard with the bell
False
Diaphragm
T or F
Cluster headaches are classified as sinister in headache basic classification
False!
Non-sinister
Common signs and symptoms of Cluster headaches
Temporal artery bulging & pulsating Severe headache, pain behind eye Unilateral ptosis, swelling & redness of eyelid Myosis Tearing Flushing of side of face, sweating Nasal congestions, rhinorrhea
List the sinister causes of headaches
Space occupying lesion Glaucoma Temporal Arteritis Meningitis Subdural hematoma
Red flags of headaches
Recent onset Positional headache Focal neurological sign Progressive headaches Vomiting without nausea Cognitive changes - confusion, drowsiness, giddiness Persistent or severe headache in a child
T or F
Vomiting without nausea is a sign of increased intracranial pressure
True
There is new anatomical research between the relationship of the cervical spine and headaches. What does the research find?
At the AO junction there appears to be connective tissue attachment between Rectus Capitis posterior minor muscle and the posterior spinal dura.
Name some of the criteria for a cervicogenic headache
Neck pn with headache
Local tenderness
Some restriction of motion
X-ray finding of abnormal, loss of curve, other distinct abnormalities.
Describe the criteria for Meningitis
Headache with fever Neck stiffness Photophobia Lightheadedness Positive test for meningeal irritation
What is the silent killer of the eye?
Glaucoma
What is temporal arteritis?
Tender nodule at the temporal part of the head (temporal artery)
Pain is originating from inflamed vessels of the scalp which are thickened and tender and show diminished pulsation
May effect intra/extra-cranial cerebral vessels.
How can Temporal Arteritis cause sudden blindness?
- May affect the opthalmic branch of the internal carotid artery.
- It involves also the ciliary arteries supplying the optic nerve and retina.
What is a lucid interval?
A period of time that lapses between head trauma and the appearance of neurological findings. Could last 24-48 hrs
When will we typically see a distended abd?
Usually with late stage liver pathology such as cirrhosis of the liver.
An advanced liver disease with distended veins and arteries around umbilicus is known as
Capute Medusa
What are some causes of Jaundice
- increased bilirubin
- liver problem - 90%
- rupture of RBC
- Obstruction
Where is the best place to observe jaundice?
Sclera of the eye
T or F
Palpation is done before auscultation of the abdomen
False
T or F
Bowel sounds are heard using the diaphragm
True
What is a friction rub?
Inflammation of peritoneal surface of an organ
What is the predominate sound heard during percussion of the abdomen?
Tympani
What is hematemesis? What can cause it?
Vomiting of blood - peptic ulcer
What is melena?
Black tarry stool due to presence of digested blood
What is a hiatal hernia?
Occurs when part of the stomach has passed through the esophageal hiatus in the diaphragm into the chest cavity
What are some common factors contributing to hiatal hernias?
Obesity Pregnancy Ascites Use of tight fitting belts and clothes Muscle weakness** primary factor
What is the most common form of peptic ulcer disease?
Duodenal Ulcer
T or F
Duodenal ulcer happens twice as often in women than men.
False!
Other way around
Blue appearance around the umbilicus would indicate what condition?
Cullen’s Sign
What can cause blue appearance around the umbilicus?
Intra-abd hemorrhage
Generalized and pain upon manual rebound after applying pressure is a positive….
Blumberg’s
What can cause portal hypertension?
Liver cirrhosis
Hepatitis A is transmitted how?
Ingestion of contaminated food
Patient presented with LLQ pn, nausea, vomitting, and altered bowel habits. Rebound tenderness was present in the LLQ what is most likely the cause?
Meckel’s Diverticulitis
T or F
Percussion of the lower border of the liver is performed at the mid-clavicular line
True
The most common cause of bleeding per-rectum is?
Hemorrhoids
When palpating the epigastric area you felt pulsations coming from superior to inferior this patient is suffering from?
R ventricular hypertrophy - Cor Pulmonale
T or F
Gallbladder is found at the right sternal border
False!
Midclavicular line
Diastasis recti is caused by?
Weakness of the linea alba
Referred pain is categorized under which reflexes?
Viscero-somatic
T or F
Apex beat is formed by right ventricular contraction
False
Left
What side of the heart is associated with precordial heaving ?
Right
Apex beat is palpated at what ICS?
5th
The type of pain associated with pleurisy
Knife Like
Long term use of NSAID can cause?
Peptic ulcers
Who discovered the link between H.Pylori and peptic ulcers
10%Barry Marshall
What is the percentage of the world suffering from peptic ulcers?
10%
What is a last resort tx for peptic ulcers?
Vagotomy
What part of the heart occupies most of the anterior surface?
Right Ventricle
What are Fallot’s Tetrology
VSD
Pulmonary Stenosis
Aorta overriding on both ventricles
Ventricular Septal Defect
What muscle is associated with cervicogenic headaches?
Rectus Capitis Posterior Minor
T or F
A classical migraine patient will see an aura before onset
True
What is Dejerine’s Triad
For space occupying lesions
-pain upon coughing, sneezing or straining
What is the most common injured abd organ from trauma?
Spleen
T or F
Hep A is more severe than B
False
B = more severe
Pain in LUQ could be caused from: (name all)
ruptured spleen peptic ulcer gastritis myocardial infarction pneumonia rib fracture pleurisy nephritis bowel obstruction
RLQ pain could be stemming from….
Appendicitis
Ruptured appendix
Structural abnormalities of the chest is usually associated with?
TB, Emphysema, Malignancy
Clubbing of the fingernails occurs due to?
Chronic hypoxia
A condition most likely caused by systemic hypertension is…
Left Ventricular Hypertrophy
The 4th heart sound occurs physiologically due to?
Passive blood flow from the atria to the ventricles
Positive egophony, bronchophony, and whispered pectoriloquy during auscultation of the lung indicate…
Lung consolidation
What valvular lesion could cause drop attacks?
Aortic
What concoction is sufficient to remove anything infectious from a table like HIV
one portion bleach to nine water
