Final Exam Material Flashcards
To pass the test
What are the 7 attributes of the History of Present Illness? (HPI)
- Location 2. Quality 3. Quantitiy (Severeity) 4.Timing 5. Setting 6. Exacerbating 7. Manifestations
What is the BMI at the border of normal and overweight?
25
What is the term given for describing the pulse of a pt with Atrial Fibrillation?
irregularly irregular
What is the standard positioning for a chest xray: PA or AP? What causes a difference? What is the most significant difference?
PA..gravity…enlargement of heart/mediastinum/ in AP view
How do you label ribs in a chest xray?
Anterior ribs on the left. Posterior ribs on the right. (We read left to right and A comes before P in the alphabet)
Which side will display a wider mediastinum?
patient’s left (placement of the heart)
What 2 conditions can cause BLUNTING of the ocstophrenic angle?
1.Pleural fluid 2. fibrosis
On a chest xray the LOWER margin of the _____ hilum is at the level of the UPPER margin of the _____ hilum
LEFT…..RIGHT (again position of the heart pushing left hilum more superior)
_______ _______ can cause misinterpretation of vascular and intersitial markings on a chest xray
Breast shadows (espescially lactating breasts)
On a side view chest xray which side of the diaphragm is partially obstructed?
Left (due to heart placement, the right diaphragm is completely visible)
Lou’s angle on side view chest xray divides what anatomical structure?
the mediastinum
What is the distinction between mallampati II and III as it relates to the uvula?
MII = about 1/2 the uvula visible and MIII = almost all of uvula hidden
What are the 2 clinical appearances of a fracture in the base of the skull (e.g. temporal bone)?
Raccoon eyes and battle sign
The pupillary reaction of a size change in the pupils in response to light and focusing is a funciton of which 2 cranial nerves?
II - optic (afferent sensory) & III - oculomotor (efferent reflex)
Eye movements: The left eye moving laterally is a function of which muscle and cranial nerve?
lateral rectus… VI abducens LR6(SO4)3
Eye movements: The left eye moving lateral and superior is a function of which cranial nerve?
superior rectus… III oculomotor LR6(SO4)3
Eye movements: The left eye moving superior and medial is a function of which cranial nerve?
inferior oblique… III oculomotor LR6(SO4)3
Eye movements: The left eye moving medial is a function of which cranial nerve?
medial rectus … III oculomotor LR6(SO4)3
Eye movements: The left eye moving medial and inferior is a function of which cranial nerve?
superior oblique… IV trochlear LR6(SO4)3
Eye movements: The left eye moving inferior and lateral is a function of which cranial nerve?
inferior rectus … III oculomotor LR6(SO4)3
The first aspect of ______ is CONDUCTIVE and the second is SENSOINEURAL
HEARING
Which hearing test? 256 hz tuning fork to the middle of the head.
weber
Which hearing test? 512 hz tuning for to the mastoid.
Rinne
What is the cut off Glasgow coma score for a patient to be comatose?
8 or less
CN Exam: Usually not tested. Eyes closed, occlude one nostril and test smell (coffee, vanilla, soap)
CN I - Olfactory
CN Exam: Visual Acuity / Visual fields
CN II - Optic
CN Exam: Extra-ocular movements –> EOMI (Please give 3 CN’s with the answer)
III - oculomotor, IV - trochlear, VI - abducens LR6(SO4)3
CN Exam: checking muscles of mastication
V - trigeminal
CN Exam: checking sensory of the skin of the face
V - trigeminal
CN Exam: checking the muscles of facial expression
VII - facial
CN Exam: What two nerves are checked with the corneal blink reflex
sensory of V-1-trigeminal and motor of VII - facial
CN Exam: Which cranial nerve are you checking with the webber, rinne test?
VIII - vestibulo-cochlear
CN Exam: the gag reflex and observing symmetrical position of the uvula during the ‘ahh’ sound?
IX - glossopharyngeal and X - vagus
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?
unaffected
CN Exam: Which nerve is checked by shrugging the shoulders (Traps) and turning the head? (SCM)
XI - accessory
CN Exam: Which nerve can present with a deviation of the tongue? Which side will it deviate towards?
XII - Hypoglossal…towards the affected side
What mechanism makes the first heart sound?
The AV valve closing
What mechanism makes the second heart sound?
The aortic valve closing
Which heart sound is called a “gallop” or “kentucky”(turbulence in the ventricle during early diastole)?
S3
Which heart sound is in late diastole and is known as the “atrial kick” or “Tennessee”?
S4
The sound caused by turbulent flow through a valve is called a ______
murmur
The sound made by an inflammed pericardial sac is called a ______
rub
A heart that makes S1, S2, and S3 is called a _____
gallop
What is the most common murmur?
innocent murmur during mid-systole
What are the 6 places to check a pulse?
carotid, brachial, and radial, popliteal, dorsalis pedis, post. tibial
What is the threshold for bradycardia and tachycardia?
brady <60bpm, tachy>100bpm
When measuring HR on an EKG, how many “big boxes” equal a second? Overall 1 EKG = how many seconds?
5 big boxes = 1 second……….1 ekg = 10 seconds (10 sets of 5 big boxes)
When counting HR on an EKG: what is the rule of 300?
divide 300 by the number of boxes between each QRS rate (so 6 boxes in between each QRS is 50bpm)
What type of EKG block? PR interval fixed and > 0.2 seconds (prolonged)
First degree block
What type of EKG block? PR gradually lengthened, then DROP QRS?
Second degree block, Mobitz Type 1
What type of EKG block? PR fixed, but drops QRS randomly
Second degree block, Mobitz Type 2
What type of EKG block? PR and QRS dissociated
third degree block
Which wave on an EKG points out ischemia the best?
T wave
Which EKG segment can indicated sub endocardial infarction?
ST segment depression
WHICH ECG SEGMENT GIVES EVIDENCE OF AN ACUTE MI?
ST segment ELEVATION
Irregularly irregular on an EKG indicates A fib, whereas irregularly regular indicates ______
Atrial flutter
What two organs can present with the clinical symptoms of dysphasia or odontophagia?
liver or kidney (bleeding diathesis vs dialysis)
On the abdominal exam, which area do you palpate last?
area of pain/concern (*same as oral exam)
What liver condition might present as enlarged and hard on palpation?
cirrhosis
Ascites can be indicative of what organ’s end stage disease?
end stage liver disease
What condition can present with costovertebral angle tenderness?
PYELO-nephritis
Appendicitis classically pain begins near the umbilicus and radiates to the RLQ…this area is known as _______
Mc Burney’s Point (McBurney Sanders lol)
Whats the differential dx assuming appendicitis?
Tubo-ovarian abscess or ovarian torsion
What is MURPHY’s sign?
Acute cholecystitis - sharp increase in tenderness with a sudden stop in inspiratory effort
What condition? Fertile, fat, forty, female…
Cholecystitis
A GUAIAC exam is to look for what condition?
Colon cancer
What condition? Newborn, 3-7 wks, projective vomiting, OLIVE SIGN,
Pyloric stenosis (corrected with pyloromyotomy)
What condition? Bowel telescopes itself, infants, colicky, intermittent pain, classic BLOODY DIARRHEA, air enema for diagnosis/therapy
IN-TUS-SUCEPTION
How many ribs are attached to the sternum? Which two ribs are “floating”?
RIbs 1-7 attached, Ribs 11 and 12 floating
Always perform your respiratory exam in the same order, which is…
IPPA: Inspect, Palpate, Percuss, Auscultate
What condition is associated with a barrel shaped chest?
COPD
Asthma (narrowed airway) can sound like _______ upon auscultation
wheezing
Bronchitis (secretions in LARGE airways) can sound like ______ upon auscultation
Rhonchi
Crackles on pulmonary auscultation can indicate what 3 situtations in the lung?
- fluid 2.atelectasis (alveoli collapse) 3.pneumonia
STRIDOR on pulmonary auscultation indicates narrowing of the _______ airway
UPPER
A pleural friction rub sound can indicate what three situations in the lungs?
1.pleuracy 2. TB 3. embolism
Medialstinal CRUNCH is associatated with what condition?
mediastinal EMPHYSEMA
Respiratory conditions: Tightness can indicate _______
asthma
Respiratory conditions: sharp, stabbing, pleuritic pain can indicate what three scenarios?
pneumothorax, pleural effusion, pulmonary embolism
Respiratory conditions: burning, crushing, squeezing can indicate what etiology of pain?
cardiac
Elective dental care is best avoided during which trimester (s)?
1st and 3rd
What is the SAFEST trimester to deliver dental care?
2nd
When is pregnancy gingivitis at its peak? What two hormones can cause a decreased performance in the immune system?
8th month…estrogen and progesterone
What positioning is best for a pregnant patient in their 3rd trimester to avoid occluding the aorta and IVC?
left lateral position
Dental radiography during pregnancy: max risk attributable to __ cGy (>1000FMS) of in utero radiation exposure estimated to be about 0.1%
1cGy
Xylocaine/Lidocaine is a category __ for pregnant patients
B
Bupivicaine/Marcaine is a category __ for pregnant patients
C
Septocaine/Articaine and Mepivicane/Carbocaine are category __ for pregnant patients
C
What is the analgesic drug of choice for pregnant patients?
acetaminophen
What two analgesic drugs/NSAIDS are contraindicated in prganacy?
Aspirin and codeine
Which antibiotic is contraindicated with a pregnant patient?
tetracycline
Which antibiotic is controversial to give to pregnant patients, studies show carcogenesis in rodents…
metronidazole
Which antibiotic MUST be avoided in the 3rd trimester?
Sulfonamide
What anxiolytic agent is NOT recommended during pregnancy?
Diazepam
What is the main cause of hyperkalemia?
renal failure
What is the normal range for the pH of blood?
7.35 - 7.45
The principle ACID in the body is ____ and it is a RESPIRATORY parameter
CO2
The principle BASE in the body is ____ and it is a METABOLIC parameter
HCO3
Elevated CO2 =
Respiratory acidosis
Decreased HCO3 =
Metabolic acidosis
The ALLEN test is to check for what?
collateral perfusion between radial and ulnar arteries
Homan’s sign is associated with what condition?
(Homan’s = calf pain on dorsifelxion) DVT
