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Chiro Essentials General Diagnosis > General > Flashcards

General Flashcards

1
Q

History of the Presenting Complaint

O, M, P, P, P, Q, R, S, S, T, A

A 
Onset
Mechanism of injury
Previous care: Did you have any treatment for this? If so, what? Was it helpful?
Provocative factors
Palliative factors
Quality
Radiation
Site
Severity: how does this complaint affect your daily living activities
Timing
Associated symptoms
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2
Q

Past medical history

S, L, I, M, H, D

A

Serious Illness: What and when
Last physical exam: When? Anything noteworthy?
Injuries/accidents/trauma: what and when?
Medications: What, how much, for what?
Hospitalizations/surgeries: When, why?
Diagnostic imaging: X-rays or images taken recently? What did they show

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3
Q

Family and social history:

M, C, F, D, E, A (CAGE), R, S, H, O, T, S

A 
Marital status
Children
Family history
Diet
Exercise
Alcohol: cut down? annoyed by criticism of your drinking? Guilty about your drinking? Early morning eye opener drink?
Recreational drugs
Stress: 0-10 and what
Hobbies
Occupation
Tobacco use
Sleep
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4
Q

ROS

C, A, N, G, R, EENT, G, P, N, C, H, M, E

A

Constitutional: fatigue, weight loss, weight gain, fever
Allergy/immunological: Allergic? Sick easily/frequently? Take long to recover?
Neck: Problems in neck, swollen glands, neck stifness
GI: Nausea, vomiting, abdominal pain, diarrhea, constipaion? Colour of stool? Blood in stool? Jaundice? Black tarry stool?
Respiratory: Cough, SOB, chest pain?
EENT: eyesight, hearing, balance, problems swallowing
Genitourinary: problems with urine? Discharge from private parts? Wake up to pee? Dribble?
Psychological: sad? loss of interest? describe your mood
Integumentary: problems with skin? Itching, dark spots, sores?
Neurological: headaches? Dizziness? Lightheaded? Weakness? Numbness or tingling? Falls?
Cardiovascular: chest pain palpitations or ankle swelling
Hematological/lymphatic: Easy bruising? Lumps in armpit or groin?
Musculoskeletal: any pan in your muscle? Soreness? Stiffness? Cramps?
Endocrine: Increased thirst or intolerance to heat or cold? Any change in hat or shoe size?

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5
Q

Patient Agenda:

C, R, I, M, E, S

A

Concern: what bothers you most about this
Reason for visit
Ideas: What do you think is the cause of your problem?
Meaning to illness: if your body was trying to send you a message through this illness, what do you think your body would be trying to tell you?
Expectations: What would you like me to do for you today?
Support: what support do you have at home? Family? Friends? Finances? Faith?

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6
Q

What age of people get DJD? Disc herniations? Strain/sprain?

A

Old
Middle aged
Young

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7
Q

Do males or females more commonly get: Osteoporosis? AAA? SLE/RA? BPH?

A

Females
Males
Females
Males only

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8
Q

T/F: Obesity does not contribute to DJD, diabetes, hypertension?

A

False it so does

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9
Q

Which ethnic background is more likely to get sickle cell disease? Tay Sachs?

A

African

Ashkenazi Jews

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10
Q

Acute is how many months? Chronic? Which has a better prognosis?

A

<3 months
>6 months
Acute

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11
Q

What type of injury is likely to occur with a rear end collision? Rotation and extension or lateral bend and extension?

A

Whiplash

Facet problem

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12
Q

What type of injury is suspected if flexion aggravates pain? Lateral bend and extension?

A

Disc lesion

Facet problem

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13
Q

What type of injury is suspected if rest relieves pain? Not better with rest or NSAIDs?

A

Strain/sprain

Bone cancer

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14
Q

Burning is associated with what type of pathology? Deep dull ache?

A

Radiculopathy

Bone or muscle

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15
Q

Radiation pattern pathology for dermatomal? Loin to groin? Chest to left arm?

A

Radiculopathy
Kidney stones
MI

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16
Q

Pain worse at night pathologies?

A

Bone cancer or osteomyelitis

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17
Q

T/F Hyperflexion and hyperextension can cause vertebral fractures?

A

True

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18
Q

Lipitor side effect? Diuretics?

A

Muscle ache

Muscle cramp

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19
Q

Immunizations may be linked with what syndrome?

A

GBS

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20
Q

Foods rich in omega 6 make OA or RA worse?

A

RA

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21
Q

T/F alcohol abuse can lead to AVN, pancreatitis, psychological stress?

A

T

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22
Q

IV drug use can lead to what bone pathology?

A

Osteomyelitis

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23
Q

What drug can lead to an MI in a young adult?

A

Cocaine

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24
Q

Asbestosis = ??

A

mesothelioma

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25
Q

Miners are prone to getting?

A

Silicosis

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26
Q

Tobacco use increases your chance of getting which cancers?

A

Lung, bladder, esophageal cancers

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27
Q

Clay coloured stool is suggestive of what condition?

A

Pancreatic cancer

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28
Q

Blood in sputum is suggestive of?

A

TB or lung cancer

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29
Q

List the pathology associated with:
Silvery plaques
Butterfly rash
Red shin bumps

A

Psoriasi
SLE
Sacroidosis

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30
Q

Are muscle cramps associated with hypo or hyperparathyroidism?

A

Hypoparathyroidism

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31
Q

Is heat intolerance associated with hypo or hyperparathyroidism?

A

Hyperparathyroidism

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32
Q

Should you refer out to the hospital if BP <90/60, respiration >28/min, temperature >102oF, pulse is greater >120/min for some or all of these?

A

Yeppers get all those people to the ER

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33
Q

Normal temperatures? How does it differ if taking a rectal or axillary temperature?

A

98.4-99.5oF

Rectal 0.5-1oF higher and axillary is lower than oral

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34
Q

Normal pulse?
Tachycardia?
Brachycardia?

A

60-100
>100
<60

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35
Q

Does hyperparathyroidism cause tachycardia or bradycardia?

A

Tachycardia

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36
Q

Does sever anemia cause tachycardia or bradycardia?

A

Tachycardia

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37
Q

Does increased intracranial pressure cause tachycardia or bradycardia?

A

Bradycardia

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38
Q

Normal respiratory rate?
Tachypnea?
Bradypnea?

A

14-20
>20/min
<14/min

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39
Q

Does CHF cause tachypnea or bradypnea?

A

Tachypnea

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40
Q

Does diabetic ketoacidosis cause tachypnea or bradypnea?

A

Tachypnea

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41
Q

Does emphysema cause tachypnea or bradypnea?

A

Tachypnea

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42
Q

Does sarcoidosis cause tachypnea or bradypnea?

A

Tachypnea

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43
Q

Does a drug reaction cause tachypnea or bradypnea?

A

Bradypnea

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44
Q

Does brain stem compression cause tachypnea or bradypnea?

A

Bradypnea

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45
Q

How do you diagnose hypertension?

A

3 readings where it is >140/90

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46
Q

What would blood pressure be in a patient with shock?

A

<90/60

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47
Q

How do you calculate pulse pressure?

What is normal pulse presure?

A

Systolic BP - Diastolic BP

30-40 mmHg

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48
Q

Does Cushing’s cause increased or decreased BP?

A

Increased

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49
Q

Does Conn’s cause increased or decreased BP?

A

Increased

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50
Q

Does pheochromocytoma cause increased or decreased BP?

A

Increased

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51
Q

Does Addison’s cause increased or decreased BP?

A

Decreased

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52
Q

Does shock cause increased or decreased BP?

A

Decreased

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53
Q

Body Mass Index classifications according to the WHO?

A 
<18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0-34.9 Class I obesity
35-39.9 Class II Obesity
>40 Class III Obesity
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54
Q

Snellen chart for farsightednes or nearsightedness? Rosenbaum?

A

Farsightedness

Nearsightedness

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55
Q

What tuning fork do you use for Weber and Rinne?

A

512 Hz

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56
Q

If the AC is 2x as long as BC is this normal or pathologicl?
If AC/BC are both decreased in one ear it is what type of deafness?
If BC >AC with Rinne is means?

A

Normal
Nerve conduction
Serous otitis Media

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57
Q

Bilateral dilated pupils can be caused by?
Bilateral pinpoint pupils?
Bilateral papilledema?

A

Cocaine, barbiturate, amphetamine abuse
heroin
Raised ICP, brain tumor

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58
Q

Blue sclera in infant with fractures can be caused by?

A

Osteogenesis imperfecta

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59
Q

Blurred margin of the macula or pigmentation?

A

Macular degeneration

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60
Q

Copper or silver wiring of retinal arterioles can be indicative of?

A

Hypertensive retinopathy

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61
Q

Cupped optic disc can be indicative of?

A

Chronic glaucoma

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62
Q

Macroglossia in infants can be caused by hypo or hyprethyroidism?
Lid lag?

A

Hypothryoidism

Hyperthyroidism

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63
Q

Exopthalmosis can be indicative of?

A

Hyperthyroidism or an orbital tumor

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64
Q

Flame hemorrhages and microaneurysms are seen in?

A

Diabetic retinopathy

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65
Q

Foul purulent unilateral nasal discharge is caused by?

A

Sinusitis or foreign body in the nose

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66
Q

goiter with brittle dry coarse hair?

Goiter with exophthalmos or tachycardia?

A

Myxedema (hypothyroidism)

Graves disease

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67
Q

Arcus senilis is what around the cornea? Caused by?

A

Gray ring

Hyperlipidemia

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68
Q

Hydrocephalus?

A

Lard head in child with open fontanelles

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69
Q

Loss of red pupil light reflex can be caused by?

A

cataracts or neuroblastoma

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70
Q

Loss of outer third of eyebrow can be caused by?

A

Leprosy, hypothyroidism

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71
Q

Midline neck mass that moves with tongue?

Midline bony mass in the hard palate?

A

Thyroglossal cyst

Torus palatinus

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72
Q

Mucopurulent discharge from the ear is caused by?

A

Otitis media

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73
Q

If a patient has nasal septum perforation you should suspect?

A

Cocaine abuse

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74
Q

Periorbital edema can be caused by?

A

Cellulitis, cavernous sinus thrombosis

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75
Q 
Painful boil on the margin of the eyelid is?
Painful red eye with purulent discharge?
Painful eye with circumcorneal redness?
Painful red eye with tense eyeball?
Painless boil on inside of eyelid?
A 
External stye (hordeolum)
Conjunctivitis
Iritis
Acute glaucoma
Internal style (chalazion)
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76
Q

Pain pulling ear up and backwards is indicative of?

A

Otitis externa

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77
Q

Pale swollen bluish nasal mucosae is indicative of?

A

Chronic allergie

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78
Q

Psotis billaterally could be? Unilaterally?

A

Myasthenia gravis, Lambert Eaton syndrome

Horner’s syndrome

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79
Q

Puffy eyelids esp in the AM is indicative of?

A

Renal dysfunction

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80
Q

If the pupil accommodates but doesn’t react to light?
If pupil dilates and reacts poorly to light?
If pupil is small and constricted (miosis)

A

Argyll Robertson pupil (3o syphilis)
Adie’s pupil
Horner’s syndrome

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81
Q

A red bulging tympanic membrane is indicative of?

A retracted tympanic membrane?

A

Otitis media

Eustachian tube blockage

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82
Q

Scales on eyebrows are indicative of?

Swollen itching eyelids?

A

Seborrheic dermatitis

Blepharitis

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83
Q

Tophus on the helix of the ear is indicative of?

A

Chronic gout

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84
Q

Beef red tongue is due to what deficiency?
Magenta tongue?
Pale tongue?

A

B12
Riboflavin
Iron

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85
Q

Triangular fleshy growth in the medial side of sclera?

A

Pterygium

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86
Q

Turned in lower eye lid? Out?

A

Entropion

Ectropion

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87
Q

Unilateral/swollen tonsil with sore throat is indicative of?

A

Peritonsillar abscess

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88
Q

Yellow thickening of bulbar conjunctiva is known as?

A

Pinguecula

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89
Q

Meniere’s disease

A

Vertigo ith hearing loss and tinnitus

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90
Q

Xerophthalmia is caused by what deficiency?

A

Vitamin A

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91
Q

Yellow sclera can be indicative of?

A

Jaundice (icterus) or carotenemia

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92
Q

Yellow plaque in upper medial eyelid is called? Caused by?

A

Xanthelasma

Hyperlipidemia

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93
Q

Acute glaucoma:
Is?
Presentation?
Refer to who?

A

Sudden increase in intra-ocular pressure seen with narrow angle between the iris and cornea which obstructs flow of aqueous humor into canal of Schlemm/sclera venous sinus
Painful red eye and hard eyeball, vision hazy in beginning
Hospital

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94
Q

Adie’s pupil/tonic pupil:
Is?
Presentation?
Refer to who?

A

Benign condition where one pupil is dilated and reacts poorly to light
Young women
Neurologist

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95
Q

Argyll Robertson pupil:
Is from what diseases?
Presentation?
Refer to who?

A

3o syphillis or MS
One pupil is small; react poorly to light but well to accommodation; CDRL will be +
Neurologist

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96
Q

Blepharitis:
Is from?
Presentation?
Refer to who?

A

Inflammed eyelids from staph infection, allergies, or seborrhea
Swollen itching and tender eyelids
Dermatologist

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97
Q

Cavernous Sinus thrombosis:
Is?
Presentation?
Refer to who?

A

Clot formation in cavernous sinus in brain from spread of infection from the face
Periorbital edema, diplopia due to damaged CN III, IV/VI (pass through cavernous sinus)
Hospital for antibiotics

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98
Q

Chalazion:
Is?
Presentation?
Refer to who?

A

Benign granulomatous lesion in tarsl (meibomian) gland of eyelid
Painless swelling on inside of eyelid; may become painful/infected
Ohthalmologist

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99
Q

Chronic glaucoma:
Is?
Presentation?
Refer to who?

A

Gradual increase in intra-ocular pressure due to excessive production of aqueous humor or gradual obstruction of canal of Schlemm (sclera venous sinus)
Gradual vision loss of periphery, increased cupping of optic disc
Ophthalmologist

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100
Q

Conjunctivitis:
Is?
Presentation?
Refer to who?

A

Most commonly a viral infection of the conjunctiva but could be bacterial or gonococcal in neonates
Itching, pain, tearing, red eye with discharge
Refer to Doctor

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101
Q

Diabetic Retinopathy:
Is?
Presentation?
Refer to who?

A

damage to retina in poorly controlled diabetes mellitus
Microaneurysms, flame hemorrhages in retina and blurred vision
Refer to ophthalmologist

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102
Q

Ectropion:
Is?
Presentation?
Refer to who?

A

Old age, external sagging of lower eyelid

Refer to plastic surgeon

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103
Q

Entropion:
Is?
Presentation?
Refer to who?

A

in turning of lower eyelid which may be congenital, acquired after scarring from trachomatis
Painful
Refer to ophthalmologist

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104
Q

Eustachian tube blockage:
Is?
Presentation?
Refer to who?

A

May follow URTI, opening to nasopharynx swollen and causes air w/in middle ear cavity to be absorbed creating a vacuum which pulls the tympanic membrane inwards
Partial deafness
Referral to ENT specialist if Chiropractic care is unsuccessful

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105
Q

Hordeolum:
Is?
Presentation?
Refer to who?

A

Infected hair follicle of eyelash (often staphyloccocal)
Red painful swelling on margin of eyelid
Medical doctor as ophthalmic antibiotics may be necessary

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106
Q

Horner’s Syndrome:
Is?
Presentation?
Refer to who?

A

Damage to sympathetic chain or ganglia in neck, from pancoast tumor, carotid A dissection, brain stem ischemia
Unilateral ptosis, miosis, anhydriosis
Neurologist

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107
Q

Iritis:
Is?
Presentation?
Refer to who?

A

Inflammation of the iris associated with SLE, UC, Crohn’s diseae, sarcoidosis
Painful gritty feeling with redness around iris
Refer to ophthalmologist

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108
Q

Macular Degeneration:
Is?
Presentation?
Refer to who?

A

Age related degeneration of the macula more common in caucasion
Central vision loss, macula (lateral to optic disc) blurred and pigmented
Ophthalmologist

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109
Q

Meniere’s disease:
Is?
Presentation?
Refer to who?

A

Recurring vertigo, tinnitus, hearing loss - progresive deafness
ENT specialist if dietary changes and Chiropractic care are unsuccessful

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110
Q

Myasthenia Gravis:
Is?
Presentation?
Refer to who?

A

Autoimmune disorder from antibodies to ACh receptors @neuromuscular junction in middle aged females with thymic disorder
Bilateral ptosis, and diplopia which worsen as day progresses, positive Tensilon test
Co-manage with neurologist

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111
Q

Otitis Eterna:
Is?
Presentation?
Refer to who?

A

Inflammation of external auditory canal; bacterial or fungal or allergy chronic may be related to impacted wax
Ear pain wore on traction, swollen canal, scant discharge
ENT specialist

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112
Q

Otitis Media:
Is?
Presentation?
Refer to who?

A

Inflammation of middle ear, viral or bacterial (Hem Influenza in kids) common in kids because of straight tubes
Ear pain, mild hearing loss, fever, loss of appetite, red and bulging tympanic membrane, Weber’s lateralize to affected side, Rinne BC>AC in affected ear
ENT specialist if Chiropractic care is unsuccessful

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113
Q

Peritonsillar abscess:
Is?
Presentation?
Refer to who?

A

Related to severe tonsillitis
Fever, severe sore throat, unilateral swollen pharyngeal tonsil, hot potato voice
ENT specialist

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114
Q

Pingecula:
Is?
Presentation?
Refer to who?

A

yellow triangular thickening of bulbar conjunctiva on inner and outer margins of the cornea with base pointing towards corners of eye and doesn’t grow on the cornea
No referral

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115
Q

Pterygium:
Is?
Presentation?
Refer to who?

A

Triangular thickening of bulbar conjunctiva from medial corner of eye to cornea with apex pointing towards the pupil from chronic irritation and hot dry climates
May encroach cornea
Ophthalmologist if starts to encroach cornea

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116
Q

Seborrheic Dermatitis:
Is?
Presentation?
Refer to who?

A

Inflammation of skin with high [sebaceous glands], Pityrosporum ovale may play a role
Dandruff, scaly itching eyebrows and eyelids
Dermatologist if tx with shampoo with selenium sulfide is not helpful

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117
Q

What position is the patient in for anterior chest examination? Posterior?

A

Supine

Seated

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118
Q

How do pleural effusion and pneumothorax affect breath sounds?

A

No breath sounds

119
Q

Abscence of nail bed angle or Schamroth space is known as?

A

Clubbing

120
Q

Biot’s respiration is? Caused by?

A

Irregularly irregular rhythm

Damage to medulla –> CVA, trauma, tumor

121
Q

Pneumonia and compression atelectasis causes what type of breath sounds? Known as?

A

Loud ones –> Bronchophony

122
Q

Cheyne-Stoke breathing is? Caused by?

A

Regularly irregular –> CHF, raised intracranial pressure

123
Q

Clubbing of fingers can be caused by what respiratory disorders?

A

TB, lung abscess, bronchiectasis, lung cancer

124
Q

Crackles can be heard with what lung pathologies?

A

Pneumonia, CHF, bronchiectasis

125
Q

Central cyanosis causes? Peripheral?

A

Severe respiratory distress, Fallot’s tetralogy

COPD, pleural effusion, asthma

126
Q

What happens to tactile fremitus in COPD, pleural effusion, asthma?

A

Decreased

127
Q

Egophony is when? Caused by?

A

E sounds like A

Pneumonia, compression atelectasis

128
Q

Gibbus formation goes with what disease?

A

Pott’s

When TB hits the spine

129
Q

Halitosis is seen with ?

A

Bronchiectasis and lung abscess

130
Q

Horizontal sloping ribs are seen in what lung pathology?

A

Emphysema

131
Q

What happens to percussion in pneumothorax, emphysema, and asthma?

A

Becomes hyper-resonant

132
Q

What lung pathologies increase tactile fremitus?

A

Pneumonia, TB

133
Q

What lung pathologies increase intercostal spaces? Decreases?

A

pleural effusion and empyema

Severe asthma, upper airway obstruction

134
Q

Kussmaul’s breathing is? Caused by?

A

Deep rapid breathing

Diabetic ketoacidosis

135
Q

Musty breath is caused by what chemical compound? What pathology?

A

Ammonia –> Liver failure

136
Q

Pectus carinatum is also known as? Caused by? Pectus excavatum?

A

Pigeon sternum and funnel chest

Rickets or congenital abnormality

137
Q

Psoriasis does what to nails?

A

Pits them

138
Q

What lung pathology do you suspect in someone with purseld-lip breathing?

A

Emphysema

139
Q

Rachitic rosary is? From what pathology?

A

Swollen costochondral joints

Rickets

140
Q

Red currant jelly sputum suggests what lung pathology?

A

Klebsiella (Friedlander’s) pneumonia

141
Q

Rust coloured sputum suggests what lung pathology?

A

Pneumococcal pneumonia

142
Q

Stony dull percussion suggests what lung pathology?

A

Pleural effusion

143
Q

Sweating with chest pain suggests what pathology?

A

MI, PE, dissecting thoracic aorta

144
Q

Tender swollen costochondral joint is caused by what pathology?

A

Tietze syndrome

145
Q

Tracheal shift can be seen in what lung pathologies?

A

Pleural effusion, tension pneumothorax, TB

146
Q

Tracheal tug is suggestive of?

A

Aneurysm of the arch of the aorta

147
Q

Wheezes are heard with what lung pathologies?

A

Asthma, bronchiectasis, COPD

148
Q

Whispered pectoriloquy is heard with what lung pathologies?

A

Pneumonia, compression atelectasis

149
Q

Acute Bronchitis:
Is?
Presentation?
Refer to who?

A

Acute inflammation of bronchi viral in origin (usually) or in response to irritants
Productive cough with white-green sputum, low fever
Medical doctor if fever worsens and sputum becomes productive or Vit C/A/hydration don’t help

150
Q

Aneurysm of the arch of the aorta:
Is?
Presentation?
Refer to who?

A

Dilation of arch of the aorta MC cause atherosclerosis, 3o syphilis (also HTN, Marfan’s)
Bovine Cough, hoarseness, tracheal shift to right and tug, widening of superior mediastinum
Refer to vascular surgeon + confirm with CT

151
Q

Asthma:
Is?
Presentation?
Refer to who?

A

Chronic/episodic reversible airway disease mostly allergic in nature causing bronchospasm and inflammation of bronchial mucosa
Paroxysms of dyspnea and wheezing and Charcot Leyden crystals and Curschmann spirals in sputum, FEV1 decreased <80%
Refer to hospital if cyanosed or >28 breaths/min

152
Q

Bronchiectasis:
Is?
Presentation?
Refer to who?

A

Chronic dilation of bronchi caused by long standing lung infection maybe part of Kartagener’s syndrome (+ sinusitis, situs inversus)
Chronic cough, shortness of breath, excessive production of mucopurulent sputum in AM, halitosis, clubbing of fingers, saccular dilations of bronchi
Pulmonologist

153
Q

Chronic Bronchitis:
Is?
Presentation?
Refer to who?

A

Irreversible airway disease with chronic cough >3 months for at least 2 consecutive years with chronic inflammation of bronchi from smoking or irritants
Dyspnea, cough, cyanosis, bilateral ankle swelling (blue bloater)
Co-manage with pulmonologist; encourage cessation of smoking

154
Q

Dissecting Thoracic Aorta:
Is?
Presentation?
Refer to who?

A

Tear in tunica intima, associated with Marfan’s, HTN or severe chest trauma
Severe tearing chest pain, diminished upper limb pulse, Hypotension, widening of superior mediastinum
Call 911

155
Q

Emphysema:
Is?
Presentation?
Refer to who?

A

Irreversible airway disease from smoking, industrial pollutants, resulting in destruction of walls of alveoli causing overinflation of lungs - pink puffers
Dyspnea, barrel-chest horizontal sloping ribs, pursed-lip breathing, overinflated lungs, flattened diaphragm, large retrosternal and retrocardiac windows
Co-manage with pulmonologist; getting patient to stop smoking

156
Q

Fallot’s Tetralogy:
Is?
Presentation?
Refer to who?

A

MC cyanotic congenital heart disease; pulmonary stenosis, right ventricular hypertrophy, overriding aorta, ventricular septal defect
Cyanosis at birth, clubbing of fingers, easily fatigues, left parasternal heave, boot-shaped heart, upward displaced apex due to severe right ventricular hypertrophy, failure to thrive due to poor feeding, pansystolic murmur in 3rd left intercostal space
Refer to pediatric cardiologist

157
Q

Liver Failure:
Is?
Presentation?
Refer to who?

A

Failure of liver to detoxify, process bilirubin and manufacture important substances
Jaundice, fetor hepaticus, ascites, gynecomastia, high bilirubin, AST, ALT and alkaline phosphatase
Hospital

158
Q

Lung Abscess:
Is?
Presentation?
Refer to who?

A

Pus-filled cavity in chest associated with Staph. Aureus
Chills, fever, halitosis, foul smelling sputum, chest film shows cavity with air-fluid level
Hospital

159
Q

Lung Cancer:
Is?
Presentation?
Refer to who?

A

Malignant, associated with smoking, males more than females
Weight loss, chronic cough, hemoptysis, clubbing of fingers, solitary mass with irregular borders, fatigue
Thoracic Surgeon or pulmonologist

160
Q

Pericarditis:
Is?
Presentation?
Refer to who?

A

Inflammation of pericardial sac can be viral, bacterial or chemical
Sticking retrosternal chest pain relieved by sitting up and leaning forward, ST elevation on ECG
Hospital

161
Q

Pleural Effusion:
Is?
Presentation?
Refer to who?

A

Excess fluid in pleural cavity, from CHF, pneumonia, TB, mets
Dyspnea, decreased tactile fremitus, stony dull percussion note, absent breath sounds, local lag, chest film shows no costophrenic angle (50 cc of fluid) and sign of meniscus
Hospital

162
Q

Pneumonia:
Is?
Presentation?
Refer to who?

A

Inflammation of lung parenchyma due to viral, bacterial, fungal, or chemical
Chills, fever, dyspnea, pleuritic chest pain, productive cough, increased tactile fremitus, dull on percussion, crackles, rust coloured sputum = Strep. Pneumoniae, red currant jelly = Klebsiella P. Scanty sputum = Pneumo. Jiroveci or mycoplasma pneumoniae< local or patchy consolidation in one lung if lobar or both if bronchopneumonia
Hospital if Confused, Urea elevated, Respiration >30/min, BP <90/60 or >65 years

163
Q

Pneumothorax:
Is?
Presentation?
Refer to who?

A

Air in pleural cavity can be spontaneous or traumatic
Chest pain, sudden dyspnea, hyper resonant percussion, absent breath sounds, collasped lung with absent lung markings
Hospital

164
Q

Psoriasis:
Is?
Presentation?
Refer to who?

A

Chronic skin condition due to rapid turnover of skin cells
Silvery scaly plaques on extensor aspects of neck, elbow, sacrum, knees, pitting of nails and joint pains, HLA B27+, cup and pencil deformity, sausage fingers
Co-manage with dermatologist and rheumatologist

165
Q

Pulmonary Embolism:
Is?
Presentation?
Refer to who?

A

Breakaway clot from DVT causing obstruction to pulmonary A or branch
Classic triad: sudden dyspnea, pleuritic chest pain, hemoptysis and +d-dimer test
911

166
Q

Raynaud’s Phenomenon:
Is?
Presentation?
Refer to who?

A

Vasospastic disorder of small A associated with CT disorders like SLE and scleroderma
Intermittent vasospasm, cyanosis, hyperactive hyperemia in response to cold and stress
Co-manage with internist or rheumatologist

167
Q

Rickets:
Is?
Presentation?
Refer to who?

A

Metabolic bone disorder of Vit D deficiency
Lethargy, muscle weakness, frontal bossing, bow legs, kyphoscoliosis
Padiatrician

168
Q

Sarcoidosis:
Is?
Presentation?
Refer to who?

A

Chronic multisystem disease of unknown origin, common in black females, characterized by non-caseous granulomas
Fatigue, dyspnea, Erythema nodosum, hypercalcemia, leucopenia, bilateral hilar lymphadenopathy, diffuse pulmonary fibrosis, ACE elev
Co-manage with pulmonologist

169
Q

Tension Pneumothorax:
Is?
Presentation?
Refer to who?

A

Air in pleural cavity caused by trauma to chest
Sudden dyspnea following chest injury, increasing cyanosis with tracheal deviation to opposite side
911

170
Q

Tietze Syndrome:
Is?
Presentation?
Refer to who?

A

Inflammation of 2nd-5th costochondral joint with repetitive microtrauma
Localized chest pain with swollen tender costochondral joint, if tender and not swollen costochondritis
Rheumatologist if Chiropractic care unsuccessful

171
Q

Tuberculosis:
Is?
Presentation?
Refer to who?

A

Chronic infection of Mycobacterium TB characterized by Ghon focus and complex with caseous necrosis and granulomas
Cough, night sweats, fever, hemoptysis, weight loss, apical consolidation and cavitation, Ziehl Neelsen staining bacilli in sputum which grow best in Lowenstein Jensen medium
Infection Disease specialist

172
Q

What position is the patient in for a cardiovascular exam?

A

Supine

173
Q

Causes of diastolic murmurs (PaRTS and ARMS)

A

Pulmonary Regurgitation, Tricuspid Stenosis, Aortic Regurgitation, Mitral Stenosis

174
Q

Causes of systolic murmurs (A Systolic Murmur Is Present Says The Instructor)

A

Aortic stenosis, mitral incompetence, pulmonary stenosis, Tricuspid Incompetence

175
Q

What positions exacerbate a mitral murmur? Aortic? Pulmonic?

A

Left lateral or decubitus
leaning forward, exhale and hold
Leaning forward, inhale and hold

176
Q

Diagonal earlobe creases signify increase risk of?

A

MI

177
Q

Dilated chest and arm veins are indicative of ?

A

SVC obstruction

178
Q

Where can you best hear aortic regurgitation diastolic murmur?

A

2nd right intercostal space

179
Q

CHF and cardiac tamponade do what to the JVP?

A

Elevate

180
Q

Where can you best hear mitral stenosis? Diastolic or systolic murmur?

A

5th left intercostal space, Diastolic

181
Q

If there is left ventricular hypertrophy where do you hear a displaced apex beat?

A

Outside 5th left intercostal space

182
Q

Erythema marginatum + Cardiac murmur + Joint Pain =

A

Rheumatic fever

183
Q

Hepatojugular reflex is? Seen with?

A

Increased JVP with RUQ pressure

CHF

184
Q

Koilonychia is? Seen with?

A

Spoon shaped nails

Severe iron defeciency anemia

185
Q

Left parasternal heave is seen with?

A

Right ventricular hypertrophy

186
Q

Malar flush is seen with what pathologies?

A

Mitral stenosis, carcinoid tumors

187
Q

What do you hear with mitral valve prolapse? Where?

A

Midsystolic click

5th left intercostal space

188
Q

What does mitral regurgitation sound like? Where?

A

Pansystolic murmur

5th left intercostal space

189
Q

Peripheral edema bilateral is seen with what pathologies? Unilateral?

A

CHF, chronic bronchitits, cirrhosis, renal failure

DVT, cellulitis

190
Q

Pulsus alternans is? From what? Bigeminus? Magnus? Paradoxus? Pavus?

A

Alternans: strong beat followed by weak, left ventricular failure
Bigeminus: Double beats, hypertrophic obstructive cardiomyopathy
Magnus: bounding pulse, fever, anemia, hyperthyroidism (AKA Water hammer pulse)
Paradoxus: decreased pulse on inspiration, >10mm Hg asthma, cardiac tamponade
Parvus: low volume pulse, shock and aortic stenosis

191
Q

Radio-femoral delay is seen with what pathology? Radial?

A

Coarctation of the aorta

Suclavian steal syndrome

192
Q

Is the S3 heart sound normally heard? If not with what pathology?

A

Normal in YA

CHF

193
Q

Is the S4 heart sound normally heard? If not with what pathology?

A

No - HTN and cardiomyopathy

194
Q

A split S1 sound that varies with breathing is normal in what population? A split S1 sound that is fixed indicates?

A

Normal: healthy young ~30 yr olds

ASD, ight bundle branch block

195
Q

Splinter hemorrhage is? Indicates what pathology?

A

Brown streaks on nails

Subacute bacterial endocarditis

196
Q

Aortic Incompetence:
Is?
Presentation?
Refer to who?

A

Valvular heart disease caused by rheumatic fever, Marfan’s, syphilitic aortitis
Titubation, diastolic murmur in 2nd right intercostal space
Cardiologist to confirm with Echocardiography

197
Q

Aortic stenosis:
Is?
Presentation?
Refer to who?

A

Valvular heart disease caused by rheumatic fever
Angina, systolic murmur in 2nd right intercostal space
Cardoiologist to confirm with echocardiography

198
Q

Bacterial endocarditis:
Is?
Presentation?
Refer to who?

A

Valvular heart disease of IV drug users MC caused by Staph. Aureus
Fatigue, fever, harsh murmur (MC tricuspid valve)
Hospital

199
Q

Cardiac Tamponade:
Is?
Presentation?
Refer to who?

A

Compression of heart by fluid/blood in pericardial sac; infective or traumatic in origin
Distant heart sounds, high jugular venous pressure, hypotension (Beck’s triad)
Hosptial, echocardiography

200
Q

Coarctation of Aorta:
Is?
Presentation?
Refer to who?

A

Congenital narrowing of aorta beyond left subclavian A
Hypertension in upper limbs, delayed radiofemoral pulse
Vascular surgeon - CT confirmation

201
Q

Hyperthyroidism:
Is?
Presentation?
Refer to who?

A

Overactive thyroid gland with excess production of thyroxin
Goiter, tachycardia, diarrhea, bilateral exophthalmos (Graves), unblinking stare, fine physiological tremor of outstretched hands; older patients with atrial fibrillation, high T3/T4, low TSH in primary
Co-manage with endocrinologist

202
Q

Mitral Incompetence:
Is?
Presentation?
Refer to who?

A

Valvular heart disease caused by rheumatic fever
Pansystolic murmur in 5th left intercostal space in midclavicular line
Cardiologist

203
Q

Mitral Stenosis:
Is?
Presentation?
Refer to who?

A

Valvular heart disease caused by rheumatic fever
Malar flush, diastolic murmur at 5th left intercostal space midclavicular, fatigue
Cardiologist –> echocardiography

204
Q

Mitral Valve Prolapse:
Is?
Presentation?
Refer to who?

A

Valvular heart disease of unknown origin, associated with Marfan’s
Atypical chest pain, mid-systolic click in 5th left intercostal space midclavicular
Cardiologist –> echography

205
Q

Subacute Bacterial Endocarditis
Is?
Presentation?
Refer to who?

A

Disease by infection of previously damaged heart valves by Strep Viridans, associated with dental caries
Fatigue, low grade fever, anemia, splinter hemorrhages, clubbing of fingers, splenomegaly
Hospital

206
Q

Subclavian Steal Syndrome:
Is?
Presentation?
Refer to who?

A

Congenital occlusion of subclavian A with shunting of blood via vertebral A
Syncope on upper body exercise and radio-radial delay, >10 mmHg difference between arms
Cardiologist

207
Q

SVC Obstruction:
Is?
Presentation?
Refer to who?

A

Obstruction of SVC by large mass in superior mediastinum, often seen in lymphoma
Edema of face and distended neck and upper limb V, wide superior mediastinum
Cardiothoracic surgeon

208
Q

If you hear an abdominal bruit in the middle of the epigastrium one should suspect what pathology?

A

AAA

209
Q

If you hear an abdominal bruit left of the midline of the epigastrium one should suspect what pathology?

A

Unilateral renal A stenosis

210
Q

Absent bowel sounds AKA _____ ____ signify ?

A

Paralytic ileus

Generalized peritonitis

211
Q

Ascites is? Caused by?

A

Fluid in the abdomen, a shifting dullness

Cirrhosis, nephrotic syndrome, cancer

212
Q

Bluish discolouration in flanks is what sign? Indicative of?

A

Grey Turner sign

Pancreatitis or ectopic pregnancy

213
Q

Bluish discolouration in umbilicus is what sign? Indicative of?

A

Cullen sign

Pancreatitis or ectopic pregnancy

214
Q

Caput medusa is? Signifies what?

A

Dilated veins radiating from the navel

Portal hypertension in cirrhosis

215
Q

Cessation of inspiration on RUQ pressure is what sign? Indicative of?

A

Murphy sign

Cholecystitis

216
Q

CVA tender on percusssion is what test and indicative of what pathology?

A

Murphy’s punch

Pyelonephritis

217
Q

Dull percussion note in Traube’s space is indicative of what pathology?

A

Splenomegaly

218
Q

Hyperactive bowel sounds w/borborygmi and hyper-resonance on percussion is indicative of?

A

Intestinal obstruction

219
Q

Kehr’s sign is? Indicative of?

A

Left shoulder pain in the acute abdomen

Ruptured ectopic pregnancy or spleen

220
Q

Left iliac fossa tenderness can be indicative of?

A

Diverticulitis and ulcerative collitis

221
Q

Non-tender hepatomegaly can be indicative of what pathologies?

A

Cirrhosis, hepatic mets

222
Q

What is the obturator internus test? What pathology does it indicate?

A

Pain on hip internal rotation

Appendicits

223
Q

What does a hard prostate indicate? Boggy?

A

Cancer

Prostatitis

224
Q

Prehn’s sign signifies what pathology?

A

Epididymo-orchitis

225
Q

Painless testicular indicates?

A

Testicular cancer

226
Q

Puddle sign = ?

A

Ascites

227
Q

A reproducible gurgling mass in the inguinal region indicates what pathology?

A

Inguinal hernia

228
Q

Right iliac fossa tenderness with recurrent diarrhea indicates what pathology?

A

Crohn’ disease

229
Q

Rogoff’s sign is indicative of?

A

Adrenal inflammation

230
Q

A scaphoid abdomen is indicative of?

A

Severe malnutrition

231
Q

AAA:
Is?
Presentation?
Refer to who?

A

saccular or fusiform dilation of aorta below renal A; caused by atherosclerosis, often asymptomatic may present w/LBP, a pulsatile midline mass in abdomen above umbilicus and bruit in epigastric region
X-ray may show curvilinear lines of calcification adjacent to lumbar vertebrae, US will confirm and determine size
Vascular surgeon esp if >5cm

232
Q

Acute pancreatitis:
Is?
Presentation?
Refer to who?

A

Acute inflammation of pancreas from alcohol abuse, stone in ampulla of Vater or viral infxn (mumps)
Severe epigastric pain radiates through to back
Cullen and Grey Turner signs in small percentage, serum amylase and lipase elevated, CT shows swollen pancreas
Hospital

233
Q

Appendicitis:
Is?
Presentation?
Refer to who?

A

Acute inflammtion of appendix maybe from fecalith obstructing orifice of appendix or viral infxn
Periumbilical pain, nausea, vomiting, fever, pain radiates to right iliac fossa, positive Rovsing, psoas, obturator signs
Hospital, CT confirmation

234
Q

Celiac disease:
Is?
Presentation?
Refer to who?

A

Gluten hypersensitivity causing chronic disease of SI, associated with iron def anemia or folic acid/B12 def
Weight loss, fatigue, diarrhea, steatorrhea, failure to thrive, dermatitis herpetiformis, elevated IgA and IgG
Gastroenterologist formucosal biopsy

235
Q

Cholecystitis:
Is?
Presentation?
Refer to who?

A

acute inflammation of gallbladder MC E.Coli, in fair, fat, fertile females in 40’s, 95% associated with gallstones
RUQ pain may radiate to right infrascapular region, Murphy’s sign may be present with fever, nausea, vomiting
Hospital for US

236
Q

Cirrhosis:
Is?
Presentation?
Refer to who?

A

Condition of chronic liver damage by alcohol abuse, hepatitis C infection
Liver cell necrosis, fibrosis and regeneration nodules, fatigue, jaundice, palmar erythema, enlarged non-tender, gynecomastia, hemorrhoids, elevated AST, ALT, Alkaline phosphatase, bilirubin
Co-manage with gastroenterologist

237
Q

Crohn’s Disease:
Is?
Presentation?
Refer to who?

A

Chronic inflammatory bowel disease of unknown etiology with cobblestone appearance of mucosa of terminal ileum, skip lesions and non-caseous granulomas
Recurrent RLQ pain, diarrhea, fatigue, macrocytic normochromic anemia Vit B12 deficiency
Co-manage with gastroenterologist

238
Q

Diabetic Ketoacidosis:
Is?
Presentation?
Refer to who?

A

Condition in poorly controlled T1DM with excess ketone production from beta oxidation of fats
SoB with acetone smell, polyuria, polydypsia, polyphagia, Kussmaul breathing, 50% with ab pain, ketonuria, elevated FBG, hyperkalemia
Hospital

239
Q

Diverticulitis:
Is?
Presentation?
Refer to who?

A

Acute inflammation of diverticula in LI associated w/lack of fiber, MC >70
Lower left-sided ab pain with blood in stool and low grade fever
Hospital if bright red rectal bleeding - barium enema or colonoscopy to confirm

240
Q

Ectopic Pregnancy:
Is?
Presentation?
Refer to who?

A

Pregnancy outside of uerus MC fallopian tube associated with gonorrhea or chlamydia hx
6-8 weeks of amenorrhea followed by lower ab pain and vaginal spotting, Kehr’s sign
Hospital, 911 if BP <90/60 - ab US to confirm

241
Q

Epididymo-orchitis:
Is?
Presentation?
Refer to who?

A

Acute inflammation of epididymis and testis caused by Neisseria infxn, Gonorrhea, Chlamydia
Pain in scrotum, swollen testis and epididymis and periumbilical region, hx of dysuria and urinary frequency, Prehn’s test +
Hospital

242
Q

Femoral Hernia:
Is?
Presentation?
Refer to who?

A

Defect in femoral canal; MC in females
Irreducible swelling inferior and lateral to pubic tubercle
General surgeon

243
Q

Generalized Peritonitis:
Is?
Presentation?
Refer to who?

A

Acute inflammation of peritoneum caused by rupture of bowel or ectopic pregnancy
Severe generalized ab pain, guarding, fever, absent bowel sounds, Blumberg’s sign +, X-ray show distended loops of bowel with multiple air-fluid levels
Hospital

244
Q

Hepatitis:
Is?
Presentation?
Refer to who?

A

Acute/chronic inflammation of liver caused by viral infxns (Hep A, B, C, E)
Nausea, fever, vomiting, jaundice, tender swollen liver, AST/ALT/Alkaline phosphotase and bilirubin elevated
Gastroenterologist

245
Q

Inguinal hernia:
Is?
Presentation?
Refer to who?

A

Congenital defect or traumatic, direct or indirect, MC type, more in males
Reducible mass in inguinoscrotal region
General Surgeon

246
Q

Intestinal obstruction:
Is?
Presentation?
Refer to who?

A

Blockage of small/large bowel due to mass inside bowel or adhesions from previous surgery obstructing bowel from outside
Cramping, ab pain, ab distension w/hyperactive bowel sounds, X-ray show distended loops of bowel w/multiple air fluid levels
Hospital

247
Q

Irritable Bowel Syndrome:
Is?
Presentation?
Refer to?

A

Chronic functional gut disorder of unknown etiology
Bouts of abdominal pain relieved by defecation along w/diarrhea or constipation, closed eyes sign
Co-manage w/gastroenterologist

248
Q

Mesenteric Vascular Occlusion:
Is?
Presentation?
Refer to?

A

Sudden blockage of a mesenteric A/V, associated w/atherosclerosis
Severe ab out of proportion to ab findings, blood in stool, shock
Hospital, angiography confirmatory

249
Q

Nephrotic Syndrome:
Is?
Presentation?
Refer to?

A

Chronic kidney disease affecting BM, associated w/DM and SLE
Fatigue, bilateral ankle swelling, ascites, Muehrcke’s lines (curved transverse lines on nails) and frothy or foamy urine, massive proteinuria >3.5g/day, hypoproteinemia, hyperchoesterolemia
Hospital –> renal biopsy confirms

250
Q

Pelvic Inflammatory Disease:
Is?
Presentation?
Refer to?

A

Inflammatory disease of uterus, fallopian tube and surrounding pelvic CT caused by N. gonorrhea or Chlamydia trachomatis
Fever, lower ab pain, cervical motion tenderness and mucopurulent discharge
Hospital

251
Q

Peptic Ulcer Disease:
Is?
Presentation?
Refer to?

A

Ulceration of either stomach or duodenum, assocated w/H. Pylori, NSAIDs, smoking, alcohol
Epigastric pain made worse w/food (gastric ulcer) or better w/food (duodenal ulcer), melena if ulcer bleeds
Co-manage w/gastroenterologist w/stress reduction and dietary modification, gastroscopy/biopsy to confirm diagnosis

252
Q

Portal HTN:
Is?
Presentation?
Refer to?

A

Complication of cirrhosis in which flow of blood from portal V to liver is obstructed due to increased fibrosis seen in cirrhosis
Fatigue, caput medusae, esophageal varices and internal hemorrhoids and ascites
Gastroenterologist

253
Q

Prostatitis:
Is?
Presentation?
Refer to?

A

Acute/chronic inflammation of prostate often E. Coli or Chlamydia
Suprapubic/perineal discomfort, dysuria, frequency of urination and tender/soft/boggy prostateg
Urologist

254
Q

Pyelonephritis
Is?
Presentation?
Refer to?

A

Acute/chronic inflammation of the pelvis of the kidney and the ureter, E. coli MC
Chills, fever, nausea, vomiting, flank pain w/costovertebral angl tenderness, + Murphy’s punch, urinalysis will show increased WBC, casts, bacteria
Hospital

255
Q

Tertiary Syphilis:
Is?
Presentation?
Refer to?

A

3rd stage caused by Treponema pallidum, devo 3-15 years after exposure
Lightning pains in abdomen, chronic non healing ulcers with gumma, Romberg’s sign, Argyll Roberston pupils in neurosyphilis, VDRL/FTA-abs test +
Neurologist

256
Q

Testicular Cancer:
Is?
Presentation?
Refer to?

A

MC type is seminoma
Dull ache in scrotum, enlarged irregular testis, gynecomastia can spread to para-aortic lymph nodes
Urologist - US confirm echodensity of mass and biopsy

257
Q

Torsion of testis:
Is?
Presentation?
Refer to?

A

Long mesorchium
Sudden onset testicular/scrotal pain (periumbilical region), nausea, vomiting, - Prehn’s sign, affected testis higher than other
Hospital - surgical correction

258
Q

Ulcerative Colitis:
Is?
Presentation?
Refer to?

A

Chronic inflammatory bowel disorder of unknown etiology, characterized by superficial ulcerations of descending and sigmoid colon
Left sided ab pain, fatigue, anemia, recurrent bloody diarrhea, microcytic hypochromic anemia due to blood loss
Co-manage w/gastroenterologist - colonoscopy and biopsy confirm

259
Q

Volvulus:
Is?
Presentation?
Refer to?

A

Acute twisting of bowel on itself, MC sigmoid colon
Severe ab pain and distension w/hyperactive bowel sounds, X-ray show coffee-bean (Inverted U) sign
Hospital

260
Q

Bag of worms sensation in the scrotum is indicative of what pathology?

A

Varicocele

261
Q

Buboes in groin are? and is indicative of what pathology?

A

Draining lymph nodes

Lymphogranuloma venereum

262
Q

Cheesy white curds in the vagina is indicative of what pathology?

A

Cadidiasis

263
Q

Erosion of the cervix is indicative of what pathology?

A

Cervical cancer

264
Q

Irregular uterine enlargement is indicative of what pathology?

A

Uterine fibroids

265
Q

Frothy malodorous vaginal discharge is indicative of what infection?

A

Trichomonas

266
Q

Non-healing penile or vulvar ulcer is indicative of what pathology?

A

Carcinoma of penis/vulva

267
Q

Painful bluish mass from anal orifice is indicative of what pathology?

A

Thrombosed external hemorrhoid

268
Q

Painful nodules in the adnexa is indicative of what pathology?

A

Endometriosis

269
Q

Painless fleshy mass protruding from anal orifice is indicative of what pathology?

A

Internal hemorrhoid

270
Q

Painful soft yellow genital ulcer is indicative of what pathology?

A

Chancroid

271
Q

Painless soft red genital ulcer is indicative of what pathology?

A

Granuloma inguinale

272
Q

Painless firm genital ulcer is indicative of what pathology?

A

Syphillis

273
Q

Pelvic mass in a postmenopausal woman is indicative of what pathology?

A

Ovarian cancer

274
Q

Sign of the groove (swollen inguinal nodes w/groove) is indicative of what pathology?

A

Lymphogranuloma venereum

275
Q

Strawberry cervix is indicative of what pathology?

A

Trichomons

276
Q

Tenderness on motion of the cervix is indicative of what pathology?

A

Pelvic inflammatory disease

277
Q

Transilluminable mass in the scrotum is indicative of what pathology?

A

Hydrocele

278
Q

Watery, fishy vaginal discharge is indicative of what pathology?

A

Bacterial vaginosis

279
Q

Bacterial vaginosis:
Is?
Presentation?
Refer to?

A

Inflammatory condition of vagina asociated with overgrowth of Gardnerella species
Fishy smelling watery vaginal discharge often after sex or menstruation, pH >4.5, + amine test
Gynecologist

280
Q

Cancer of the penis:
Is?
Presentation?
Refer to?

A

Associated w/chronic HPV infxn
Non-healing ulcer or mass on glans penis or foreskin w/inguinal node spread
Urologist

281
Q

Cancer of the vulva:
Is?
Presentation?
Refer to?

A

Often associated with chronic HPV infection
Non-healing ulcer/mass in vulva w/spread t involve inguinal nodes
Gynecologist for biopsy to confirm

282
Q

Candidiasis:
Is?
Presentation?
Refer to?

A

Infxn of vulva and vagina overgowth of Candida albicans, after broad-spectrum antibiotic and diabetics
Severe vulvar/vaginal itching w/thick cottage-cheese discharge, buds and branching hyphae
Gynecologist

283
Q

Cervical Cancer:
Is?
Presentation?
Refer to?

A

Neoplasia of cervix MC associated w/chronic HPV infxn (16 and 18)
Post-coital bleeding and non-healing erosion of cervix
Gynecologist –> Pap smear

284
Q

Chancroid:
Is?
Presentation?
Refer to?

A

STD caused by H. Ducreyi
Painful yellow genital ulcers w/swollen tender inguinal lymph nodes
M.D. –> Tissue culture

285
Q

Endometriosis:
Is?
Presentation?
Refer to?

A

Deposition of endometrial tissue outside uterine cavity (broad ligament, ovary, pelvis)
Severe dysmenorrhea, painful nodules in adnexa, retroverted uterus, infertility, chocolate cysts
Co-manage w/gynecologist

286
Q

Granuloma Inguinale:
Is?
Presentation?
Refer to?

A

STD caused by Klebsiella granulomatis
Painless beef red ulcer in genital region
M.D.

287
Q

Herpes Genitalis:
Is?
Presentation?
Refer to?

A

STD from Herpes simplex type 2
Painful recurrent multiple vesicles and shallow ulcers in genital region
M.D.

288
Q

Lymphogranuloma Venereum:
Is?
Presentation?
Refer to?

A

Uncommon STD from Chlamydia trachomatis L1-3
Fleeting rah, swollen painful draining inguinal lymph nodes (buboes), rectal structures, sign of groove
M.D. for antibiotics

289
Q

Prostate Cancer:
Is?
Presentation?
Refer to?

A

Slow growing malignancy of prostate gland
Asymptomatic, may have hematuria and hard irregular prostate, LBP, fatigue, weight loss, Elevated PSA, alkaline phosphatase, hypercalcemia
Urologist

290
Q

Ovarian Cancer:
Is?
Presentation?
Refer to?

A

Malignancy of ovary MC >50
Bloating, ab discomfort, ascites, enlarged ovary
Gynecologist for ultrasound and biopsy

291
Q

Thrombosed external hemorrhoid:
Is?
Presentation?
Refer to?

A

Painful thrombosed tributary of inferior rectal V
Constipation, tender blue swollen nodule at end of anal orifice below pectinate line
Proctologist if conservative care w/sitz bath and Preparation H are not helpful

292
Q

Trichomonas:
Is?
Presentation?
Refer to?

A

STD from protozoan called Trichomonas vaginalis
Vulvar itching, malodorous frothy yellow-green vaginal discharge in females, asymptomatic in males, motile flagellates on microscopic exam
Gynecologist

293
Q

Uterine Leiomyome (fibroids):
Is?
Presentation?
Refer to?

A

Benign smooth muscle tumor of uterus, related to estrogen stim
Polymenorrhagia, irregularly enlarged uterus, anemia if chronic - microcytic hypochromic
Gynecologist

294
Q

Varicocele:
Is?
Presentation?
Refer to?

A

Varicose V in pampiniform plexus, MC on left
Dragging sensation in scrotum and bag of worms on palpation
Urologist

Chiro Essentials General Diagnosis (3 decks)

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