Final

Question 1

liver pain referral

Answer 1

R cervical/UT

Question 2

lung pain referral

Answer 2

cervical

Question 3

galbladder pain referral

Answer 3

R UQ, R scapular area

Question 4

uterus and cervix pain referral

Answer 4

sacral region

Question 5

melena

Answer 5

dark sticky feces containing partially digested blood. Can be from swallowing blood or following internal bleeding

Question 6

laboratory test that would provide the most useful information about potential tissue injury?

Answer 6

prolonged coagulation times

Question 7

increased serum ammonia

Answer 7

decreased level of consciousness, asterixis, impaired function of peripheral nerves

Question 8

urologic pain to shoulder

Answer 8

distended kidney pushes on diaphgram; phrenic nerves share close connections to spinal cord with cervical plexus

Question 9

common musculoskeletal symptoms associated with endocrine disorders

Answer 9

myalgia, carpal tunnel pain, periarthritis, adhesive capsulitis, proximal mm weakness

Question 10

myxedema

Answer 10

swelling of skin and underlying tissues giving waxy consistency; form of hypothyroidism

Question 11

3 most common symptoms of diabetes mellitus

Answer 11

polydipsia, polyuria, polyphagia

Question 12

cushing’s syndrome

Answer 12

hypercortisolism (gain weight); may present with decreased bone density, muscle wasting, slow healing rates; hypertension; easy bruising

Question 13

parathyroid hormone

Answer 13

increases blood calcium; excessive production can produce pathological fractures

Question 14

A1C levels

Answer 14

normal range is

Question 15

grave’s disease

Answer 15

hyper-reflexia with decreased mm strength

Question 16

fibromyalgia: type of disorder

Answer 16

neurosomatic disorder: deregulation of autonomic ns as it interfaces with neurohormonal system

Question 17

shober’s sign

Answer 17

sign of ankylosing spondylitis: patient cannot flex lumbar spine

Question 18

lhermitte’s sign

Answer 18

disc protrusion or multiple sclerosis

Question 19

kaposi’s sacroma symptoms

Answer 19

purple red blotches or bumps on trunk or head

Question 20

AID’s dementia complex

Answer 20

altered mental status in HIV-infected patient

Question 21

beau’s lines

Answer 21

impaired nail formation; temporary cessation of cell division in nail matrix; could have systemic cause i.e. cancer

Question 22

diclofenac

Answer 22

NSAID: treat pain, migraines, arthritis

Question 23

painless enlarged skin lesion or lymph node in presence of immunosuppressant drugs

Answer 23

consider lymphoma

Question 24

most common sites of referred pain from systemic diseases

Answer 24

shoulder and back

Question 25

blumberg's sign

Answer 25

rebound tenderness; may indicate peritonitis

Question 26

mcburney's point

Answer 26

1/2 the distance from ASIS to umbilicus

Question 27

screening for cancer may be necessary for anyone with hip pain who is:

Answer 27

younger than 20, older than 50

Question 28

murphy's sign

Answer 28

palpate under costal margin at mid-clavicular line; ask to inspirate: if painful then this suggests cholecystitis

Question 29

vascular disease that may refer pain to hip

Answer 29

aortic aneurysm: back pain may radiate to buttock, hip

Question 30

chest pain can be caused by trigger points of which muscle

Answer 30

SCOM

Question 31

malignant lump palpation

Answer 31

hard, immovable, nontender

Question 32

cardiac pain symptoms in women

Answer 32

unusual fatigue, shortness of breath, weakness, sleep disturbance

Question 33

organ systems that can cause simultaneous bilateral shoulder pain include:

Answer 33

heart

Question 34

risk for ectopic pregnancy (causing sudden onset of L shoulder pain)

Answer 34

young, sexually active, late period

Question 35

nixon's percussion

Answer 35

test for spleen; midpoint between xiphoid and midaxillary line

Question 36

castell's percussion

Answer 36

spleen: anterior axillary line at 8th/9th intercostal

Question 37

well's algorithm

Answer 37

greater than or equal to 2: DVT likely

Question 38

carcinoma

Answer 38

cancer of epithelial tissues (account for 85% of all cancers); malignant

Question 39

sarcoma

Answer 39

cancer of connective tissue, fleshy growth

Question 40

three most common skin cancers

Answer 40

basal cell carcinoma, squamous cell carcinoma, malignant melanoma

Question 41

classic migraine

Answer 41

preceded by aura, visual changes

Question 42

common migraine

Answer 42

not preceded by aura

Question 43

aneurysmal rupture (headache)

Answer 43

rapid onset of headache, loss of consciousness, nuchal rigidity

Question 44

horner's syndrome

Answer 44

ptosis, miosis, anhydrosis

Question 45

immediate referral

Answer 45

``` acute hernia ectopic pregnancy dissecting aneurysm unstable angina, serious arrhythmia suicide risk loss of body function, cauda equina black starry stools acute increase in HTN ectopic pregnancy temporal arteritis ```