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Advanced Health Assessment > Final Exam > Flashcards

Final Exam Flashcards

1
Q

normal lymph nodes

A

less than 1/2 cm, movable, firm, non-tender

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2
Q

infected node

A

enlarged, tender

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3
Q

malignant lymph node

A

hard, non-tender, irregular, fixed

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4
Q

thyroid assessment

A

below cricoid, need to do labs to see hyper/hypo, have pt swallow

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5
Q

presbycusis

A

lose hearing of higher frequency

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6
Q

weber test

A

Tuning fork top of head or forehead
Should be equal in both ears
-lateralization is bad!

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7
Q

rinne test

A

air is twice as long as bone conduction (indicates conductive hearing loss, external and middle air)

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8
Q

acute closed angle glaucoma

A

medical emergency

  • dilated pupil, red sclera
  • pt can go blind
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9
Q

aging eyes

A

-thick cornea, astigmatism, arcus senilus, glaucoma, acuity issues, floaters, presyopia

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10
Q

arcus senilus

A

white fat deposits around rim of cornea

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11
Q

presbyopia

A

lose close vision as you age

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12
Q

exam far vision

A

snellen chart, 20 20 normal

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13
Q

glaucoma

A

Usually complain about peripheral vision

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14
Q

macular degeneration

A

loss of central vision

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15
Q

peritonsillar abscess

A

increasing difficulty with swallowing, speaking

-monitor airway, drooling is bad

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16
Q

mono

A

exudates on tonsils

-inflamed posterior nodes and spleen issues

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17
Q

group a strep

A

inflammation with white/gray tonsilar exudate

-anterior lymph nodes palpable

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18
Q

strep vs mono

A

anterior nodes-strep

posterior nodes-mono

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19
Q

infant skin

A
  • lanugo, vernix caseosa
  • stork bite, cradle cap, milia
  • more prone to fluid loss (poor temp regulation)
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20
Q

psoriasis

A

a plaque

  • silvery appearance
  • usually on extensor surfaces like knuckles or elbows
  • can have systemic changes like pitting nails
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21
Q

HARMM melanoma risk model

A

hx previous melanoma

  • age > 50
  • reg dermatologist absent
  • mole change
  • male gender
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22
Q

ABCDE for lesions

A 
A (asymmetrical)
B (borders) irregular
C (color) is it changing or multicolored
D (diameter) > ½ cm *head of an eraser
E (elevation)- is it enlarging?
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23
Q

basal cell carcinoma

A

translucent nodule, firm border with depressed center
Normally on sun exposed areas
Very common

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24
Q

squamous cell carcinoma

A

firm scale; often face or back of hand

scaly!

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25
Q

actinic keratosis

A

pre-cancerous squamous cell

-white scale

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26
Q

malignant melanoma

A
  • irregular, can be dark
  • blacks can get this in nail
  • can be anywhere on body
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27
Q

comprehensive health history

A
  • patient identifiers
  • reliability
  • chief complaint
  • HPI, PMH, FH, SH, ROS
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28
Q

Fungal

A

(tinea, candidiasis under skin folds) red, drainage, satellite lesions

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29
Q

papilledema looks like

A

a bright sun spot or blown up disc

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30
Q

pneumonia

A
  • bronchial breath sounds, rales, crackles, dullness, egophony, whispered pectoriliquoy , inc fremitis
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31
Q

COPD

A
  • dec breath sounds, dec tactile fremities, hyperresonance
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32
Q

pleural effusion

A
  • dullness and asymmetry
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33
Q

clubbing

A

> 180 degrees

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34
Q

s1

A

best heard at apex

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35
Q

s2

A

best heard at base

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36
Q

s3

A

worse sound, early diastolic, best heard with bell at apex, low sound, associated with CHF in adults

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37
Q

s4

A

late diastolic, stressed heart, assoc with HTN, CAD, best heard at apex, ventricular filling sound

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38
Q

PMI

A

shouldn’t be bigger than2 cm

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39
Q

grading scale murmurs

A
    • starting at 4 you can feel it, not normal, called a thrill if feel it
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40
Q

rubs

A
  • high pitched scratchy sounds, pericarditis (best heard at LLSB with diaphragm)- pt will have chest pain. Will be systolic and diastolic
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41
Q

Arterial insufficiency

A
  • no pulses, cool feet, shiny pale hairless, can be ruddy, get sores on toes first
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42
Q

venous insufficiency

A
  • edema, pulses, thick leathery skin, brownish coloring, get sores at ankles
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43
Q

DVT

A

what are risk factors? On the pill, smoke, calf pain and swelling and redness, pregnancy

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44
Q

ABI

A

test for arterial insufficiency, can’t use with diabetics

-test for peripheral artery disease

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45
Q

ascites

A
  • shifting dullness, fluid wave
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46
Q

gray turner

A

flank bruising

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47
Q

cullen

A

bruising around umbilicus

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48
Q

murphys

A

gallbladder test, have pt hold breath and they have pain with palpation

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49
Q

appendicitis tests

A

rebound pain upon release in RLQ, Rovsing (pain R when feeling L), Psoas (lay left when right leg is bent), Obturator (flex right leg and knee)

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50
Q

hepatitis

A
  • jaundice, pain in RUQ, dry itchy skin, icteric sclera, darkening urine
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51
Q

Abdominal pain

A

gallbladder can be referred to shoulder, triple A can be back pain, GERD can have sore throat and cough

52
Q

diverticulitis

A

LLQ pain

53
Q

most common disability

A

speech impediment or other communication disorders

54
Q

effects of disability

A

access to care is problem

55
Q

changes in elderly

A

-incontinence not normal, weak pelvic floor, kyphosis, more prone to PNAs and atelectasis

56
Q

Muscle grading system

A
  • 0 = paralysis, no muscle contraction
    • 1 = slight muscle contraction
    • 2 = movement with gravity
    • 3 = movement against gravity
    • 4 = movement against gravity with some resistance
    • 5 = movement against gravity with full resistance
57
Q

kyphosis

A

bend over, accentuated thoracic curve

58
Q

Scoliosis

A

have patient lean forward and you look at scapula, look at scapula and iliac crest to see if they are even

59
Q

Lordosis

A
  • accentuated lumbar curve, flatten back out against wall? pregnancy
60
Q

RA

A

systemic, fever, rash, ulcers, younger patients, can be multiple joints
-swan neck, ulnar deviation, boutineer

61
Q

DJD/osteo

A

wear and tear, herbertans on dip, bochards on pips

62
Q

swan neck

A

hyperextension of the PIP with flexion of the DIP

63
Q

boutineer

A
  • flexion of PIP with hyperextension of DIP
64
Q

carpal tunnel tests

A
  • numb and tingle up to 3rd finger

phalen and tineal

65
Q

phalens

A

put back of palms together

66
Q

tineal test

A

tap on median nerve and get a zinger

67
Q

herniated disc test

A

pain on straight leg raise and cross-over test

68
Q

cauda equina syndrome

A
  • pressure on cord that leads to permanent damage, ask about bowel and bladder function
69
Q

Tennis elbow

A

lateral epicondylitis

70
Q

Golfers elbow

A

medial epicondylitis

71
Q

nerve root compression can cause

A

absent or depressed DTR

72
Q

McMurray test

A
  • meniscus tear, Flex the knee, place forefingers on lateral side of joint line, then with applying valgus stress and internal rotation of leg, extend the knee looking for both pop/click and pain
73
Q

Apley’s Test

A

with knee flexed apply pressure to foot and counter pressure to knee, twist and listen for clicks.

74
Q

propulsive

A

parkinsons

75
Q

scissor

A

cerebral palsy

76
Q

spastic

A

hemiplegic, CVA

77
Q

waddling

A

toddlers, hip dislocation

78
Q

steppage

A

neuropathy, MS

79
Q

Romberg

A

for balance

80
Q

pronator

A

shows balance

81
Q

torn meniscus tests

A

apley and mcmurrary

82
Q

torn ACL tests

A

Lachman, if tug on tibia and fibula they shouldn’t move

83
Q

referred gallbadder pain

A

right scapular pain

84
Q

rotator cuff injury

A

cant raise hand above shoulder

85
Q

rotator cuff tests

A

abduct and bring down slowly the arm just stops (drop arm test), empty can movement and arm drops

86
Q

ligament tear tests

A

lachman or drawer

87
Q

NIH

A

don’t want a high score

88
Q

first test for stroke

A

=pre-hosp screen
will make a decision at that point to call stroke alert (smile, droop, slurred speech, look for pronator drift) CT, vitals and glucose then NIH

89
Q

Cushings

A

(widening pulse pressure, bradycardia, irregular breathing)

90
Q

DTR

A
  • Biceps- indirect, will have contraction
  • Triceps- will have extension
  • Brachioradialis- may have a slight supination and flexion of hand
  • Patellar- extension of leg
  • Achilles- will have plantar flexion
91
Q

cerebellar function

A

balance, Romberg test (feet together eyes open then closed), ability to walk, 4 inch base of support, stride length 14 inches

92
Q

pronator drift

A

muscle weakness

-hold out hands like holding a pizza

93
Q

cystic breast

A

occur 20-30s, tender, change according to point in cycle, can be affected by chocolate and caffeine

94
Q

Fibroadenoma

A

one round firm non-tender mass, often in teens-20s

95
Q

Breast cancer

A
  • hard irregular non-tender, occur more when older
96
Q

Inflammatory breast ca

A
  • red and inflamed, can have orange peel skin
97
Q

Pagets

A
  • breast ca around nipple, will see redness/discharge/flaking
98
Q

when to check breast tissue

A

4th to 7th day after cycle pre-menopausal

-can do exam anytime when post-menopausal

99
Q

gonorrhea

A

bacterial, white/yellow discharge, burning urination

100
Q

herpes

A

hurts, small ulcers on red bases, recurrent outbreaks

101
Q

genital warts, HPV

A

cauliflower

102
Q

primary syphilis

A
  • one painless lesion, develops into a rash covering entire body
103
Q

bacterial vaginosis

A

(fishy smell)- inc risk with multiple partners, douching or smoking

104
Q

candidiasis

A

cottage cheese

105
Q

prostate

A

digital rectal exam, specific antigen, usually first present as urinary problems

106
Q

testes

A

torsion, severe pain, one sided, cremasteric (stroke inner aspect of thigh, normal testes will move up)

107
Q

vaginal complaint also checks

A

associated urinary symptoms (CVA tenderness)

108
Q

PID can lead to

A

infertility

109
Q

Apgar

A

initial then 5 min

- Assesses neurologic recovery from delivery and adaptation to extrauterine environment

110
Q

low APGAR 1 min

A

nervous system depression, very low scores need resuscitation

111
Q

low APGAR 5 min

A
  • high risk for ongoing developmental problems
112
Q

Examine older infant

A
  • use a toy or other distractor, do exam in parents lap, gather developmental info from parent, make sure infant is fed beforehand
113
Q

milia

A
  • pin-head sized white papular lesions on nose, chin, forehead caused by sebum retained in sebaceous glands; also clear in a few weeks
114
Q

Acrocyanosis

A

common in 1st few days of life and early infancy & into infancy- caused by exposure to cold

115
Q

Mongolian spots

A

dark bluish or dark pigmentation over the buttocks & lower back- these tend to fade with age, but should be documented to avoid concern about bruising later.

116
Q

Jaundice

A

physiologic occurs in half of infants, appearing 2-3 days after birth, jaundice within first 24 hours is hemolysis, jaundice longer than 2 weeks is liver or biliary disease

117
Q

peds respiratory

A

obligatory nose breathers, nasal flaring is bad

118
Q

normal newborn HR

A

120s

119
Q

Social development in infants

A
  • relationship between them and caregiver is critical
120
Q

gross motor age

A

1-4 years

121
Q

fine motor age

A

4 years

122
Q

age 5-10 development

A
  • is goal directed, concrete operational stage, learn from school and family
123
Q

early adolesence

A

10-14, start puberty

124
Q

middle adolesence

A

15-16

125
Q

late adolesences

A

appear as adults

Advanced Health Assessment (3 decks)

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