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visceral diagnosis > final exam > Flashcards

final exam Flashcards

1
Q

Pain in RLQ
rebound tenderness over McBurneys point
Positive Rovsings sign

A

appendicitis

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2
Q

LLQ pain
radiating down left side of abdomen
inflammation of sac or pouch in walls of organ or canal

A

diverticulitis

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3
Q

what are the red flags of headaches?

A

recent onset
positional headaches = space occupying lesion
focal neurological sings = ringing in ears, tingling, weakness
cognitive changes in behavior
progressive headaches = getting worse no improvement

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4
Q

primary lymph node malignancies?

A

lymphosarcoma
hodgkin’s disease
lymphatic leukemia

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5
Q

secondary lymph node malignancy

A

due to metastasis from other parts of body = breast cancer

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6
Q

what are benign/inflammatory lymph node characteristics?

A

soft to firm
painful to tender (most likely due to inflammation)
movable

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7
Q

what are malignant/suspicious lymph node characteristics?

A

fixated
painless
hard
discrete

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8
Q

what is a virchow nodule?

A

signal or sentinel node
located at supraclavicular area
usually left side
due to metastic carcinoma (usually clue to thoracic/abdominal malignancy)

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9
Q

what is Sister Mary Joseph Nodule?

A

malignant lymph node around umbilicus that indicates intra-abdominal malignancy

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10
Q

heart murmur

A

audible turbulence of blood flow

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11
Q

mitral stenosis

A

narrowed mitral valve that restricts blood flow FORWARD

results in forceful ejection FROM left atrium into left ventricle

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12
Q

what can cause mitral stenosis?

A

rheumatic fever or cardiac infection

can also occur with mitral regurgitation

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13
Q

aortic stenosis

A

calcification of aortic valve cusps
restricts blood flow FORWARD
results in forceful ejection from LEFT VENTRICLE into SYSTEMIC circulation

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14
Q

what can cause aortic stenosis?

A

congenital bicuspid valve
rheumatic heart disease
arthersclerosis

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15
Q

pulmonic stenosis

A

pulmonic valve restricts FORWARD blood flow

results in forceful ejection from RV into PULMONIC circulation

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16
Q

tricuspid stenosis

A

calcification of tricuspid valve cusps
restricts forward blood flow
results in forceful ejection from RIGHT atrium into RIGHT ventricle

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17
Q

causes of tricuspid stenosis

A

rheumatic heart or congential defect

occurs with mitral stenosis usually

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18
Q

mitral regurgitation

A

mitral valve incompetence

allows BACKFLOW of blood from LV into LA

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19
Q

mitral valve prolapse

A

valve incompetency early in systole

prolapse into atrium later in systole

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20
Q

aortic regurgitation

A

aortic valve incompetence

allows backflow of blood from aorta into LV

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21
Q

pulmonic regurgitation

A

allows backflow of blood from pulmonary artery into RV

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22
Q

what causes pulmonic regurgitation?

A

congenital defect
bacterial endocarditis
pulmonary hypertension

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23
Q

tricuspid regurgitation

A

allows backflow of blood from RV into RA

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24
Q

what causes tricuspid regurgitation?

A

congenital defect
bacterial endocarditis
pulmonary hypertension
cardiac trauma

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25
Q

normal vital signs

A 
pulse 60-90 bpm
temp 98.6 F
bp 120/80 mmHg
pulse pressure (systolic - diastolic) NO MORE than 50 mm Hg
respiration rate 10-20 breaths per min
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26
Q

graves disease

A

hyperthyroidism -> cretinism and myxedema

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27
Q

cushing’s syndrome

A

moon face
Addison’s
excessive hormone production of adrenal cortex

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28
Q

systemic lupus erythematosus (SLE)

A

butterfly rash over face

autoimmune disease

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29
Q

acromegaly

A

abnormal increase in production of growth hormone by pituitary gland (hyperfunction)
occurs AFTER puberty

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30
Q

gigantism

A

abnormal increase in production of growth hormone by pituitary gland (hyperfunction)
occurs BEFORE puberty

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31
Q

vitiligo

A

lack of pigment occurring in various areas on body especially face

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32
Q

exopthalmos

A

extrusion of eyeballs pushed by excessive fat behing the eyes (retroorbital fat)

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33
Q

george’s test

A

vertebrobasilar system assessment
bilateral pulse and bp = look for diff of 10 mm Hg
auscultate subclavian and carotid arteries
VBAI maneuver = head rotation

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34
Q

murphy’s sign

A

application of any one of 3 feeling liver edge tests and gallbladder palpation
patient experiences relfex apnea and pain
caused by acute cholecystitis

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35
Q

murphy’s punch

A

doctor strikes patient’s posterior costovertebral angle
blow should not cause pain or tenderness
pain caused by nephritis

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36
Q

blumberg’s sign

A

rebound tenderness and pain in any 4 quads indicates peritonitis

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37
Q

rovsing’s sign

A

rebound tenderness and pain in LLQ referred to RLQ over McBurneys point indicates appendicitis

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38
Q

caput medusa

A

portal hypertension -> advanced liver cirrhosis

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39
Q

HIV to AIDs clinical latency?

A

10 years

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40
Q

emphysema/COPD

A

air takes over and dominates space to disrupt function
reduces number of alveoli
permanently hyperinflates lung

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41
Q

signs and symptoms of emphysema

A 
barrel chest 
decreased chest expansion 
hyperresonant
decreased tactile fremitus
decreased breath sounds 
patient older, smoking, weight loss, malaise 
polycythemia 
decreased oxygen
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42
Q

nails of emphysema patients are _____

A

clubbed

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43
Q

hemoptysis means

A

cough up blood

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44
Q

hemoptysis is seen in

A

tuberculosis or malignancy

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45
Q

hematemesis is

A

vomiting blood

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46
Q

hematemesis is seen in

A

peptic ulcer

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47
Q

somato-somatic reflex

A

neck pain shooting down arm or lumbar disc problem

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48
Q

somato-visceral reflex

A

hand in cold water increase heart rate (nerve to organ)

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49
Q

viscero-somatic reflex

A

heart problem down left side of body (organ to nerve)

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50
Q

vesicular lung sound

A

heard over lung field

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51
Q

bronchovesicular lung sound

A

heard over main stem of bronchi

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52
Q

bronchial

A

heard over trachea

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53
Q

what muscle implicated in cervicogenic headaches?

A

rectus capitis posterior minor

54
Q

classic migraine

A

aura

55
Q

tension headache

A

muscular in nature - hat band

56
Q

cluster headache

A

worst kind of pain
unilateral and alcohol makes worse
short duration accompanied by tearing and nose running
cyclic in nature

57
Q

CDC definition of AIDS

A

HIV positive and CD4 (T-cell) count below 200

presence of one or more opportunistic infections

58
Q

time from AIDS to death

A

2-3 years

59
Q

cullen’s sign

A

blue appearance around umbilicus

60
Q

intra-abdominal hemorrhage and blue

A

cullen’s sign

61
Q

generalized abdominal pain upon manual rebound

A

blumberg’s sign

62
Q

what condition is associated with hematemesis

A

peptic ulcer

63
Q

portal hypertension is caused by what

A

liver cirrhosis

64
Q

what is likely to occur due to ingestion of contaminated food

A

hepatitis A

65
Q

abdominal aorta is normally palpated at the ___ and up to the ____

A

umbilicus and up to left

66
Q

what is associated with peptic ulcer?

A

melena - black tarry stool due to presence of blood

67
Q

patient presents with pain in LLQ, nausea, vomiting, altered bowel habits. upon exam rebound tenderness present in LLQ. what is most likely diagnosis

A

Meckel’s diverticulitis

68
Q

syndrome where tumors secrete hormone called gastrin that causes the stomach to produce too much acid causing dudodenal and stomach ulcers

A

zollinger-ellison syndrome

69
Q

sister mary joseph nodules may suggest

A

malignancy

70
Q

tests performed at midclavicular line

A

murphy’s sign
percussion of the upper border of liver
percussion of the lower border of liver
auscultation of the mitral area of the heart

71
Q

patient presents with right shoulder and scapular pain exam is unrewarding but positive murphy’s sign. what is the origin of the pain? what reflex is this an example of?

A

cholecystitis and viscero-somatic

72
Q

most common cause of bleeding per rectum is

A

hemorrhoids or piles

73
Q

anal fissure

A

small crack that can happen from chronic constipation

74
Q

a 40 year old flight attendant presents for abdominal pain. it is worse after eating especially is she has a meal that is spicy or high in fat. over the counter antacids have not helped. you strongly suspect a condition that requires which sign on examination?

A

murphy’s sign

75
Q

while palpating the epigastric area you felt pulsations coming from S to I. this patient may be suffering from what?

A

cor pulmonale

76
Q

which area is most painful regarding kidney stone?

A

ureter

77
Q

15 year old high school student present with 1 day history of nausea and anorexia. hes describes pain as generalized but today it has localized to RLQ. you palpate LLQ and patient experiences pain in the RLQ. what is the name of this?

A

rovsings

78
Q

with liver disease you have a decreased amount of ____

A

serum albumin

79
Q

what indicates weakness of the linea alba?

A

diastasis recti

80
Q

referred pain is categorized under which of the following reflexes

A

viscero-somatic reflex

81
Q

apex beat is normally located at mid axillary line (T or F)

A

false

82
Q

apex beat is formed by LV contraction (T or F)

A

true

83
Q

precordial heaving is associated with LV contraction (T or F)

A

false - right

84
Q

apex beat is located where?

A

5th left intercostal space

85
Q

character of cardiac pain is usually ___ like

A

pressure

86
Q

character of pleurisy is usually ___ like

A

knife

87
Q

28 year old man complains of periodic episodes of severe headaches that occurred nightly for past two weeks. pain awakens him 2 or 3 hours after he has been asleep and lasts for about one hour the pain always around right eye and makes eye water. pain is aggravated by alcohol intake. he had similar episodes about 2 years ago. clinical impression?

A

cluster headache - lacrimation, rhiorrhea

88
Q

world population that has peptic ulcers

A

10%

89
Q

part of the heart that occupies most of the anterior surface is

A

the right ventricle

90
Q

which cardiac problem is a primary cause of cyanosis at birth

A

overriding aorta on both ventricles

91
Q

fallot’s tetrology

A

pulmonary stenosis
aorta overriding on both ventricles
ventricular septal defect
RV hypertrophy

92
Q

will ventricular septal defect create cyanosis at birth?

A

no

93
Q

a COMMON migraine patient will see an aura before onset

A

false - CLASSIC

94
Q

A 28 year old man compains of periodic episodes of severe headaches that have occurred nightly for the past two weeks. The pain awakens him two or three hours after he has been asleep and lasts for about one hour. The pain is always around the right eye and makes the affected eye water. Pain seems to be aggravated by alcohol intake. he had a similar episode of headaches about two years ago. What is the clinical impression?

A

cluster

95
Q

Angela is a 48 year old female. She is a secretary for bell south, complaining of headaches started three months ago with slow and progressive course. She got worse last month. Head movement, leaning forwards, coughing and sneezing tend to worsen the attacks. Partially relieved with over counter medications. Mostly behind eyes, temporal and occipital areas and associated with visual difficulties. Worse in the morning and sometimes during nighttime. She has a hard time sleeping.
No past history of headaches/trauma/hospitalization/major illness

A

space occupying lesion and refer patient

96
Q

dejerine’s triad

A

pain upon coughing sneezing or straining indicates space occupying lesion

97
Q

Giovanni is 25 year old male complaining of acute abdominal discomfort for several days. Initial eval. revealed that a tinge of yellowish discoloration in his sclera. Examination reveals tenderness in right upper quadrant. Which of the following…

A 
Gastrointestinal system (for the liver)
nature of jaundice is INFECTIOUS
98
Q

which of the following inquiries for patient’s history (choose two)

A

sexual history/ illicit drug use

history of ingestion of contaminated food

99
Q

what is the most commonly injured abdominal organ from trauma

A

spleen

100
Q

what are two presentations that may be caused by peptic ulcers

A

hematemesis and melena

101
Q

two causes of bleeding per rectum

A

colorectal cancer

hemorrhoids

102
Q

While palpating the epigastric area you felt pulsations coming from superior to inferior. This patient may be suffering from which of the following?

A

cor pulmonale (RV enlargement)

103
Q

hep A

A

fecal oral

104
Q

hep B

A

more severe than A
blood is transmission
post-hepatitis cirrhosis

105
Q

hep A prevention

A

proper hygiene

106
Q

h. pylori is strongly related to development of peptic ulcer T/F

A

true

107
Q

The proper protocol for abdominal exam is inspection, palpation, percussion, and auscultation T/F

A

false

108
Q

Diastases recti (bulging of linea alba) may suggest weak abdominal muscles T/F

A

true

109
Q

You are assessing a patient with abdominal pain and fever. You are performing an abdominal examination to assess for peritoneal signs. Which one of the following is NOT a peritoneal sign?

A

voluntary guarding

110
Q

acute abdomen condition possible causes

A 
appendicitis
cholecystitis
IBS
kidney stone
nephritis
gall stone
diverticulitis
cholitis
pancreatitis
111
Q

pain in LUQ possible causes

A 
ruptured spleen
peptic ulcer
gastritis
myocardial infarcation
pneumonia
rib fracture
pleurisy
cholitis
nephritis
gas
food poisoning
bowel obstruction
112
Q

RLQ possible causes

A

appendicitis

ruptured appendix

113
Q

most common congenital heart disease

A

ventricular septal defect

114
Q

cor pulmonale is

A

right ventricular enlargement due to pulmonary pathology

115
Q

structural abnormalities of the chest is usually associated with

A

TB

emphysema

116
Q

clubbing of fingernails due to

A

chronic hypoxia

117
Q

OPQRST falls under which major patient history category

A

present problem

118
Q

start at the superior vena cava, a drop of blood will follow the following valvular sequence

A

tricuspid
pulmonic
mitral
aortic

119
Q

constant low-back pain which is unrelieved by position, activity or rest is most likely the result of which of the following?

A

visceral disease

120
Q

a condition most commonly caused by systemic hypertension

A

LV hypertrophy

121
Q

apex beat is located

A

at midclavicular line

122
Q

tricuspid valve stenosis may lead to?

A

RA enlargement

123
Q

fourth heart sound occurs physiologically due to

A

passive blood flow from the atria to the ventricles

124
Q

positive egophony, brochophony and whispered pectoriloquy during auscultation of the lung indicate

A

lung consolidation

125
Q

periphery of lung during auscultation of an asthmatic patient is

A

generalized wheezing

126
Q

aortic stenosis can cause

A

blackouts

127
Q

diff btwn myocardial infarction and angina pectoris is based on what

A

the duration of the pain

128
Q

sinister headaches?

A

subdural hematoma

129
Q

amino acids which increase production of human growth hormone
need weight lifting for human growth hormone (needs to be enough weight to make 7th rep very difficult)

A

secretagogues

130
Q

arginine, ornithine, lysine, and glutamine. black beans and white meat chicken have these

A

secretagogues

visceral diagnosis (1 decks)

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