final exam part 2 Flashcards
What is a hacking cough?
persistent and dry
How long is a chronic cough?
3 weeks.
Expiratory dyspnea
wheezing copd associated SOB
R or L HF for paroxismal SOB
L
wheezing is caused by what
obstruction
inflammation
foreign body
secretion
orthopnea has difficulty breathing while..
supine
cheyne
Cheyne-Stokes respirations are a gradual increase in depth of respirations, followed by gradual decrease and then a period of apnea.
Kussmaul
respirations that are regular but abnormally deep and increased in rate (Thompson, 2018, pg. 210)
Hyperventilation causes increased minute volume which is common in…
hyperventilation causes hypocapnia which is common in asthma, metabolic acidosis, pulmonary embolism, anxiety, pulmonary edema
COPD lips are
whisling to reduce the work of breathing
Asthma is what
symptoms as well
A reactive airway disease
- mucous
- narrow bronchi
-cough, congestion, SOB, wheezing
What is pectus excavatum
Funnel
Abdnormally sunken in chest
Pectus carinatum
pidgeon
sternum protrudes
Barrel ratio is
1:1 AP to transverse ratio
(normal is 1:2)
What is the most reliable way to palpate internal organs
deep palpation
What organs are solid in the liver
adrenal, kidney, liver, ovaries
The midline of the abdominal exam is
aorta, uterus, bladder
When is hyperactive heard
gastroenteritis
early intestinal obstruction
laxatives
diarrhea
they are high pitched
Where does paracentesis remove fluid
the peritoneal cavity during abdominal or respiratory distress
Where does ammonia come from
protein metabolism causing removal of aa
ammonia is converted to urea in the liver
Patient labs show ammonia is abnormally high. What does this indicate?
Liver is compromised
impaired portal blood flow
McBurney’s point significance
Appendix is long and narrow measuring 1 to 9 inches.
RLQ, 2 cm below the ileocecal valve where mcburneys point is
If it fills with fluid from cecum it can get infected causing appendicitis
Pancreas disorder increases what
glucose, because it decreases insulin
Hepatitis symptoms
MC cause
abdominal pain
nausea
fatigue
poor appetite
MCC from travel outside the US. Cause by infection
Fiber does what to stool
increases weight
softens
a bulky stool is easier to pass
What is the significance of projectile vomit WITHOUT nausea?
Central medulla stimulation
caused by injury or disease
Why could an abdomen be distended
Fluid
Fat
Feces
Flatulence
Fibroids (non cancer growth)
Fetus
What kind of stool happens from an obstruction (partial) in the intestine
narrow and long
where is the fluid in ascites
In the peritoneal cavity
Define pyrosis
heartburn in epigastric area which RADIATES to the THROAT
define GERD
- a motility disorder
- stomach content goes back into the esophagus
- symptoms are heartburn
what is the 3rd MC cancer in the US
colon
Rec. screening for GI w/ no family hx
- 50-75
*sigmoid Q5 y - colonoscopy q 10 y
- barium q 5 y
- CT q 5 y
What are hemorrhoids exactly?
Dilated veins.
They protrude from anus or lower rectum from increased pressure.
Hemorrhoids s/s
- Bleeding
- Itching
- Irritation
What part of the hands are essential for fine discrimination
finger pads
What can be felt with finger pads
Texture, shape, pulses, crepitus
What can RA lead to
joint deformities. mostly affects hands and feet
how many things can the skin do
thermoreg
sensation
perception
fluid balance
excretion
immunity
immunity because its a physical barrier
excretion (sweat out toxins)
fluid bal (sweat out h20 and salt)
thermoreg (sweat + hairs on arms)
Normal finding for fingernails and nail base
even thickness and 160 degree angle of attachment
What temp is normal (cool, warm, etc?)
warm
cellulitis
- a bacterial skin infection where the skin appears red and swollen, and feels hot and tender.
macule
circle, flat, up to 1 cm.
red, brown, white
different shapes
papule
solid, elevated spot
rough texture
less than 1 cm
pink, red, brown
vesicle
raised
blood or clear fluid inside
less than 0.5 cm
herpes
Nodule
solid
elevated
less than 0.5 cm
fatty lipoma
jaundice
too much bilirubin in blood
causes of alopecia
poor nutrition (think opp of preg vitamens)
meds (obvious)
illness (stress on body)
endocrine (hypothyroid)
radiation (cancer treatment)
aging
Folliculitis
inflamed hair follicule
face arm legs butt
looks like white pustules (pus filled)
Seborrhea dermatitis
greasy scales +/- redness
can be on face too
Tinea capitis
scalp ringworm fungus
-scales
-hair loss
-patches
keloid
excessive collagen
thick and raised beyond borders
excoriation
hollow crusted area
exposed dermis
complete loss of epidermis
erosion
loss of superficial dermis
moist and shiny, depressed area
like being rubbed raw
scar
discolored fibrous tissue appearing over wounds
Fissure
Linear break in dermis and epidermis
small deep red fissures
fungus
crust
dried blood, pus, serum
NORMAL HEALING
scale
flakes off usually but its a collection of dead skin
psoriasis
causes of a rash
diet
stress
meds
allergies
hormones
autoimmune
renal
toxic
digestion (gluten intolerance)
chemicals
sun (sunburn)
very broad
impaired kidney function leads to a buildup of waste products in the blood, causing itchy skin rashes due to the body’s inability to properly filter toxins
stress causes inflammation and cortisol tries to oppose the inflammation as a response
Nevi
Melanocyte cluster
Even pigment
Defined border
Less than 6 mm
Hair can grow them too
Psoriasis
Loss of subcutaneous fat.
Bruising and capillaries breaking
Annular
ring shaped
Diffuse
distributed over whole body
Localized
discrete area
CN 5
sensory and motor
sensory nose, mouth, teeth, jaw, forehead, scalp, facial skin
CN 6
Abducens
CN 7 sensory, motor or both
just motor of facial expressions
CN 8
hearing and equilibrium (snail shell plus vestibules)
CN 9
motor swallowing
CN 10
vagus motor - speak and swallow
sensory - pharynx larynx
sensory + motor for cardio
CN 11
motor only
CN 12
motor only
tongue
Causes of headaches
genetics
stress
nerve dysfunction
meds oversuse
lesions
less CSF
straining
Balance
vestibular
Romberg tests what
positional sense, cerebellar function, balance, coordination
they look ahead for 30 s then close eyes 30 s
what if the cerebellum is damaged
balance and coordination
sleep deprivation affects
cerebral function
When someone has a TBI, what is decorticate
Decorticate posturing is INTERNAL rotation and ADDuction of the arms with flexion of the elbows, wrists, fingers, plantar surfaces of the feet, and stiff leg extension; indicative of severe brain injury
de- core-ticate
arms toward the core
stroke fast acronym
Face, Arms, Speech, and Time.
What is decerebrate posturing
Decerebrate posturing is arms stiffly extended, adducted, and HYPER PRONATED with hyperextension of the legs and plantar flexion of the feet.
Clinical breast exam positions
breasts + axilla
seated - arms at side
seated - arms above head
seated - hands on hips
standing - leaning forward
What is the best technique for a breast SELF exam
vertical strip and nipple
CLINICAL breast exam three techniques
- spiral pattern starting from nipple
- outside to inside in wedge sections
- vertical strips starting by the sternum and ending at axilla
WEAR GLOVES in case of discharge
and educate patient on self exam
Why don’t males have breasts like women
because testosterone inhibits growth of breasts
Describe a normal breast finding
- Round/oval areola
- No nipple discharge
- No crust
- Everted
- Striae
- no retractions
- no dimpling
- Uniform skin
Who gets mastitis
inflamed red breast from being post partum and breast feeding
Who gets a mammo?
- 40-44 by choice annual
- 45-54 required annual
- 55+ required biannually
stop when death is within 10 yards
Where do benign painless lumps come from inside a womans breast
its called fibrocystic breast. it is thickening of tissue associated with hormone levels changing due to menstrual cycle
Sign of breast cancer telltale sign
Peau d orange
pitting dimpling or swelling
because skin resembles skin of an orange
dimpling/pitting looks like the small tiny holes on an orange
is breast self exam recommended
no
(unless specific exceptions)
When MRI used as a SCREENING
screening is for all patients regardless of symptoms
screening high risk only.
they dont rely on clinical breast exam anymore since they go straight to MRI
Instruction for patient before GYN exam
no sex, douche, or vag creams sprays 24 before
what is included in a routine cancer related checkup
males
doctor giving a clinical testicular exam
How does a male perform a testicular exam
1st and 2nd fingers below, thumb on top
Epididymitis cause
related to an STI
inflamed epididymitis
MC male cancer? symptoms?
prostate
asymptomatic early
hard time urinating
hematuria
impotence
Metrorrhagia
irregular uterine bleed
due to dysfunctional ovaries
Normal male ureathra
urethral meatus in center of glands
Monorrhagia
excessive OR prolonged
