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Physical Diagnosis > Final Exam Material > Flashcards

Final Exam Material Flashcards

To pass the test

1
Q

What are the 7 attributes of the History of Present Illness? (HPI)

A
  1. Location 2. Quality 3. Quantitiy (Severeity) 4.Timing 5. Setting 6. Exacerbating 7. Manifestations
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2
Q

What is the BMI at the border of normal and overweight?

A

25

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3
Q

What is the term given for describing the pulse of a pt with Atrial Fibrillation?

A

irregularly irregular

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4
Q

What is the standard positioning for a chest xray: PA or AP? What causes a difference? What is the most significant difference?

A

PA..gravity…enlargement of heart/mediastinum/ in AP view

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5
Q

How do you label ribs in a chest xray?

A

Anterior ribs on the left. Posterior ribs on the right. (We read left to right and A comes before P in the alphabet)

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6
Q

Which side will display a wider mediastinum?

A

patient’s left (placement of the heart)

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7
Q

What 2 conditions can cause BLUNTING of the ocstophrenic angle?

A

1.Pleural fluid 2. fibrosis

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8
Q

On a chest xray the LOWER margin of the _____ hilum is at the level of the UPPER margin of the _____ hilum

A

LEFT…..RIGHT (again position of the heart pushing left hilum more superior)

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9
Q

_______ _______ can cause misinterpretation of vascular and intersitial markings on a chest xray

A

Breast shadows (espescially lactating breasts)

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10
Q

On a side view chest xray which side of the diaphragm is partially obstructed?

A

Left (due to heart placement, the right diaphragm is completely visible)

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11
Q

Lou’s angle on side view chest xray divides what anatomical structure?

A

the mediastinum

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12
Q

What is the distinction between mallampati II and III as it relates to the uvula?

A

MII = about 1/2 the uvula visible and MIII = almost all of uvula hidden

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13
Q

What are the 2 clinical appearances of a fracture in the base of the skull (e.g. temporal bone)?

A

Raccoon eyes and battle sign

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14
Q

The pupillary reaction of a size change in the pupils in response to light and focusing is a funciton of which 2 cranial nerves?

A

II - optic (afferent sensory) & III - oculomotor (efferent reflex)

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15
Q

Eye movements: The left eye moving laterally is a function of which muscle and cranial nerve?

A

lateral rectus… VI abducens LR6(SO4)3

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16
Q

Eye movements: The left eye moving lateral and superior is a function of which cranial nerve?

A

superior rectus… III oculomotor LR6(SO4)3

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17
Q

Eye movements: The left eye moving superior and medial is a function of which cranial nerve?

A

inferior oblique… III oculomotor LR6(SO4)3

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18
Q

Eye movements: The left eye moving medial is a function of which cranial nerve?

A

medial rectus … III oculomotor LR6(SO4)3

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19
Q

Eye movements: The left eye moving medial and inferior is a function of which cranial nerve?

A

superior oblique… IV trochlear LR6(SO4)3

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20
Q

Eye movements: The left eye moving inferior and lateral is a function of which cranial nerve?

A

inferior rectus … III oculomotor LR6(SO4)3

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21
Q

The first aspect of ______ is CONDUCTIVE and the second is SENSOINEURAL

A

HEARING

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22
Q

Which hearing test? 256 hz tuning fork to the middle of the head.

A

weber

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23
Q

Which hearing test? 512 hz tuning for to the mastoid.

A

Rinne

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24
Q

What is the cut off Glasgow coma score for a patient to be comatose?

A

8 or less

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25
Q

CN Exam: Usually not tested. Eyes closed, occlude one nostril and test smell (coffee, vanilla, soap)

A

CN I - Olfactory

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26
Q

CN Exam: Visual Acuity / Visual fields

A

CN II - Optic

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27
Q

CN Exam: Extra-ocular movements –> EOMI (Please give 3 CN’s with the answer)

A

III - oculomotor, IV - trochlear, VI - abducens LR6(SO4)3

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28
Q

CN Exam: checking muscles of mastication

A

V - trigeminal

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29
Q

CN Exam: checking sensory of the skin of the face

A

V - trigeminal

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30
Q

CN Exam: checking the muscles of facial expression

A

VII - facial

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31
Q

CN Exam: What two nerves are checked with the corneal blink reflex

A

sensory of V-1-trigeminal and motor of VII - facial

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32
Q

CN Exam: Which cranial nerve are you checking with the webber, rinne test?

A

VIII - vestibulo-cochlear

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33
Q

CN Exam: the gag reflex and observing symmetrical position of the uvula during the ‘ahh’ sound?

A

IX - glossopharyngeal and X - vagus

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34
Q

CN Exam: If the uvula deviates when the pt is making the ‘ahh’ sound, which side will it deviate towards? The affected or unaffected side?

A

unaffected

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35
Q

CN Exam: Which nerve is checked by shrugging the shoulders (Traps) and turning the head? (SCM)

A

XI - accessory

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36
Q

CN Exam: Which nerve can present with a deviation of the tongue? Which side will it deviate towards?

A

XII - Hypoglossal…towards the affected side

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37
Q

What mechanism makes the first heart sound?

A

The AV valve closing

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38
Q

What mechanism makes the second heart sound?

A

The aortic valve closing

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39
Q

Which heart sound is called a “gallop” or “kentucky”(turbulence in the ventricle during early diastole)?

A

S3

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40
Q

Which heart sound is in late diastole and is known as the “atrial kick” or “Tennessee”?

A

S4

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41
Q

The sound caused by turbulent flow through a valve is called a ______

A

murmur

42
Q

The sound made by an inflammed pericardial sac is called a ______

A

rub

43
Q

A heart that makes S1, S2, and S3 is called a _____

A

gallop

44
Q

What is the most common murmur?

A

innocent murmur during mid-systole

45
Q

What are the 6 places to check a pulse?

A

carotid, brachial, and radial, popliteal, dorsalis pedis, post. tibial

46
Q

What is the threshold for bradycardia and tachycardia?

A

brady <60bpm, tachy>100bpm

47
Q

When measuring HR on an EKG, how many “big boxes” equal a second? Overall 1 EKG = how many seconds?

A

5 big boxes = 1 second……….1 ekg = 10 seconds (10 sets of 5 big boxes)

48
Q

When counting HR on an EKG: what is the rule of 300?

A

divide 300 by the number of boxes between each QRS rate (so 6 boxes in between each QRS is 50bpm)

49
Q

What type of EKG block? PR interval fixed and > 0.2 seconds (prolonged)

A

First degree block

50
Q

What type of EKG block? PR gradually lengthened, then DROP QRS?

A

Second degree block, Mobitz Type 1

51
Q

What type of EKG block? PR fixed, but drops QRS randomly

A

Second degree block, Mobitz Type 2

52
Q

What type of EKG block? PR and QRS dissociated

A

third degree block

53
Q

Which wave on an EKG points out ischemia the best?

A

T wave

54
Q

Which EKG segment can indicated sub endocardial infarction?

A

ST segment depression

55
Q

WHICH ECG SEGMENT GIVES EVIDENCE OF AN ACUTE MI?

A

ST segment ELEVATION

56
Q

Irregularly irregular on an EKG indicates A fib, whereas irregularly regular indicates ______

A

Atrial flutter

57
Q

What two organs can present with the clinical symptoms of dysphasia or odontophagia?

A

liver or kidney (bleeding diathesis vs dialysis)

58
Q

On the abdominal exam, which area do you palpate last?

A

area of pain/concern (*same as oral exam)

59
Q

What liver condition might present as enlarged and hard on palpation?

A

cirrhosis

60
Q

Ascites can be indicative of what organ’s end stage disease?

A

end stage liver disease

61
Q

What condition can present with costovertebral angle tenderness?

A

PYELO-nephritis

62
Q

Appendicitis classically pain begins near the umbilicus and radiates to the RLQ…this area is known as _______

A

Mc Burney’s Point (McBurney Sanders lol)

63
Q

Whats the differential dx assuming appendicitis?

A

Tubo-ovarian abscess or ovarian torsion

64
Q

What is MURPHY’s sign?

A

Acute cholecystitis - sharp increase in tenderness with a sudden stop in inspiratory effort

65
Q

What condition? Fertile, fat, forty, female…

A

Cholecystitis

66
Q

A GUAIAC exam is to look for what condition?

A

Colon cancer

67
Q

What condition? Newborn, 3-7 wks, projective vomiting, OLIVE SIGN,

A

Pyloric stenosis (corrected with pyloromyotomy)

68
Q

What condition? Bowel telescopes itself, infants, colicky, intermittent pain, classic BLOODY DIARRHEA, air enema for diagnosis/therapy

A

IN-TUS-SUCEPTION

69
Q

How many ribs are attached to the sternum? Which two ribs are “floating”?

A

RIbs 1-7 attached, Ribs 11 and 12 floating

70
Q

Always perform your respiratory exam in the same order, which is…

A

IPPA: Inspect, Palpate, Percuss, Auscultate

71
Q

What condition is associated with a barrel shaped chest?

A

COPD

72
Q

Asthma (narrowed airway) can sound like _______ upon auscultation

A

wheezing

73
Q

Bronchitis (secretions in LARGE airways) can sound like ______ upon auscultation

A

Rhonchi

74
Q

Crackles on pulmonary auscultation can indicate what 3 situtations in the lung?

A
  1. fluid 2.atelectasis (alveoli collapse) 3.pneumonia
75
Q

STRIDOR on pulmonary auscultation indicates narrowing of the _______ airway

A

UPPER

76
Q

A pleural friction rub sound can indicate what three situations in the lungs?

A

1.pleuracy 2. TB 3. embolism

77
Q

Medialstinal CRUNCH is associatated with what condition?

A

mediastinal EMPHYSEMA

78
Q

Respiratory conditions: Tightness can indicate _______

A

asthma

79
Q

Respiratory conditions: sharp, stabbing, pleuritic pain can indicate what three scenarios?

A

pneumothorax, pleural effusion, pulmonary embolism

80
Q

Respiratory conditions: burning, crushing, squeezing can indicate what etiology of pain?

A

cardiac

81
Q

Elective dental care is best avoided during which trimester (s)?

A

1st and 3rd

82
Q

What is the SAFEST trimester to deliver dental care?

A

2nd

83
Q

When is pregnancy gingivitis at its peak? What two hormones can cause a decreased performance in the immune system?

A

8th month…estrogen and progesterone

84
Q

What positioning is best for a pregnant patient in their 3rd trimester to avoid occluding the aorta and IVC?

A

left lateral position

85
Q

Dental radiography during pregnancy: max risk attributable to __ cGy (>1000FMS) of in utero radiation exposure estimated to be about 0.1%

A

1cGy

86
Q

Xylocaine/Lidocaine is a category __ for pregnant patients

A

B

87
Q

Bupivicaine/Marcaine is a category __ for pregnant patients

A

C

88
Q

Septocaine/Articaine and Mepivicane/Carbocaine are category __ for pregnant patients

A

C

89
Q

What is the analgesic drug of choice for pregnant patients?

A

acetaminophen

90
Q

What two analgesic drugs/NSAIDS are contraindicated in prganacy?

A

Aspirin and codeine

91
Q

Which antibiotic is contraindicated with a pregnant patient?

A

tetracycline

92
Q

Which antibiotic is controversial to give to pregnant patients, studies show carcogenesis in rodents…

A

metronidazole

93
Q

Which antibiotic MUST be avoided in the 3rd trimester?

A

Sulfonamide

94
Q

What anxiolytic agent is NOT recommended during pregnancy?

A

Diazepam

95
Q

What is the main cause of hyperkalemia?

A

renal failure

96
Q

What is the normal range for the pH of blood?

A

7.35 - 7.45

97
Q

The principle ACID in the body is ____ and it is a RESPIRATORY parameter

A

CO2

98
Q

The principle BASE in the body is ____ and it is a METABOLIC parameter

A

HCO3

99
Q

Elevated CO2 =

A

Respiratory acidosis

100
Q

Decreased HCO3 =

A

Metabolic acidosis

101
Q

The ALLEN test is to check for what?

A

collateral perfusion between radial and ulnar arteries

102
Q

Homan’s sign is associated with what condition?

A

(Homan’s = calf pain on dorsifelxion) DVT

Physical Diagnosis (1 decks)

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