Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

General Diagnosis (1.1) > General Diagnosis 1 > Flashcards

General Diagnosis 1 Flashcards

1
Q

Health History includes the following:

A
  1. Chief Complaint
  2. Past Health History
  3. Personal & Social History
  4. Review of Systems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

This covers the reason the patient is seeking care & should be obtained in the patients own words

A

Chief Complaint history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Present Illness: the attributes of a symptom should include:

A 
O - onset
P - palliative/provoking
Q - quality of pain
R - radiation/referral
S - site/severity/setting
T - timing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Past Health History should include:

A
  1. Serious Illnesses
  2. Previous Injuries
  3. Hospitalizations
  4. Surgeries
  5. Medications
  6. Allergies
  7. Immunizations - Measles DPT (Guillian Bar)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Family Health History should include:

A
  1. CVD
  2. Diabetes
  3. Stroke
  4. Cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Social/Personal History should include:

A
  1. Marital Status
  2. Occupation
  3. Diet
  4. Exercise
  5. Bowel/Urinary patterns
  6. Sleep
  7. Alcohol, Tobacco & Drug Use
  8. Stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If information is acquired during the history that indicates alcoholism, move to the CAGE questions:

A

C - Cutting down (felt the need to cut down your drinking?)
A - Annoyed by criticisms of others
G - Guilty feelings about drinking
E - Eye Openers (felt need for morning eye opener drink)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A general exploration of the various organs systems of the body

A

Review of Systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of scale should you use to take height & weight?

A

Standing platform scale w/ height attachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Temperature: Normal Values- Oral- Rectal & Tympanic- Axilla- Range

A

Oral: 98.6*
Rectal & Tympanic: 99.6*
Axilla: 97.6*
Range: 96.0-99.5* (35-37.5*C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pulse: Normal Values:- Adults- Newborns- Elderly

A

Adults: 60-100
Newborn: 120-160
Elderly: 70-80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Respiratory Rate: Normal Values:

  • Adult
  • Newborn
A

Adult: 14-18
Newborn: 44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Blood Pressure: Normal adult values

A

90-120 / 60-80

values increase in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hypertension & Hypotension

A

Hypertension: over 140/90
Hypotension: under 90/60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do you need to check for in a hypertensive patient?

A

Auscultatory Gap (by taking a palpatory systolic reading)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The loss or reappearance of the pulsatile sound while listening with the stethoscope during cuff deflation

A

Auscultatory Gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Low pitched sounds produced by turbulent blood flow in the arteries

A

Korotkoff Sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does a difference of 10-15mmHg in systolic readings indicate?

A

Arterial Occlusion such as Subclavian Steal Syndrome on side of decreased value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Blood pressure readings are _____ higher in lower exteremities

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some tests for Vertebrobasilar Artery Insufficiency?

A
  • Barre-Lieou
  • DeKleyn’s
  • Hallpike
  • Hautant’s
  • Underberg
  • Maigne’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Test for Vertebrobasilar Artery Insufficiency:
Pt seated, examiner instructs pt to rotate head maximally from side to side. Done slowly at first than accelerated to pts tolerance.

A

Barre-Lieou

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Test for Vertebrobasilar Artery Insufficiency:
Pt supine, examiner instructs pt to rotate and extend head off the table then turn to each side for 15-45 seconds. Dr can lend minimal support

A

DeKleyn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Test for Vertebrobasilar Artery Insufficiency:
Pt supine, head extended off the table. Examiner offers support for the skull. Examiner brings head into extension, rotation & lateral flexion

A

Hallpike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Test for Vertebrobasilar Artery Insufficiency:
Pt seated, arms are extended forward to shoulder level with hands supinated. Maintain position for a few seconds. Pt then closes the eyes, rotates & hyperextends the neck to one side. Repeated to opposite side.

A

Hautant’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Test for Vertebrobasilar Artery Insufficiency:
Pt stands with eyes open, arms at side, feet close together. Pt closes eyes, extends arms & supinates hands, then pt extends & rotates head to one side. Then in this position pt is instructed to march in place.

A

Underberg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Test for Vertebrobasilar Artery Insufficiency:

Pt seated, examiner brings head extension & rotation

A

Maigne’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Eyebrows:

  • Scaly indicates _____
  • Loss of Lateral 1/3 indicates _____
  • Quantitative loss is normal with age
A

Scaly = seborrhea

Loss of Lateral 1/3 = Myxedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Sluggish pupillary reaction to light that is unilateral & caused by parasympathetic lesion of CN III

A

Adie’s Pupil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Unequal pupil size

A

Anisocoria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Bilaterally small & irregular pupils that accommodate but do not react to light. Seem with Syphilis (prostitutes pupils)

A

Argyll Robertson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Sluggish pupillary reaction due to hypo-adrenalism (Addison’s Disease)

A

Arroyo Sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Inflammation of the eyelid seen with seborrhea, staph infection & inflammatory processes.

A

Blepharitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Opacities seen in the lens that are commonly seen with diabetes and in the elderly. Also has an absent red light reflex.

A

Cataracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

An infection of the meibomian gland causing a nodule which points inside the lid.

A

Chalazion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What do different colors of the Conjunctive indicate?

  • Pink
  • Pale
  • Bright Red
A

Pink = normal
Pale = anemia
Bright Red = infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Grayish opaque ring around the cornea

A

Corneal Arcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Affects the veins more than arteries & presents with microaneurysms, hard exudates & neovascularization.

A

Diabetic Retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Lid is turned outward. MC seen in elderly

A

Ectropion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Lid is turned inward. MC seen in elderly

A

Entropion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Lid lag/failure to cover the eyeball. Can be seen with graves (bilateral) or tumor (unilateral)

A

Exophthalmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Increased intraocular pressure causing cupping of the optic disc (cup to disc ratio is >1.2). Pt will notice blurring of their vision especially in the peripheral fields as well as rings around lights. Crescent sign will be present upon tangential lighting of the cornea.

A

Glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

An infection of the sebaceous glands causing a pimple or boil on the eyelid.

A

Hordoleum (sty)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Ptosis, Miosis & Anhydrosis on the same side as an interruption to the cervical sympathetics.

A

Horner’s Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Damage to the retinal vessels/background will show these signs:Copper wire deformity, silver wire deformity, A-V nicking, flame hemorrhages, & cotton wool soft exudates.

A

Hypertensive Retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Dilated pupil with ptosis & lateral deviation. Doesn’t react to light or accommodation. Multiple Sclerosis.

A

Internal Ophthalmoplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Inflammation of the Iris (colored portion of the eye) seen with Ankylosing Spondylitis.

A

Iritis/Uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

MC reason for blindness in the elderly, central vision lost, macular Drusen is an early sign; yellow deposits under the retina

A

Macular Degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Fixed & constructed pupils that react to light & accommodate. Seen with severe brain damage, pilocarpine medications & narcotic use.

A

Miosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Dilated & fixed pupils seen with anticholinergic drugs (atropine/mushrooms/death)

A

Mydriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Swelling of the optic disc due to increased intracranial pressure. NO visual loss (visual loss with optic neuritis). May be seen with a brain tumor or brain hemorrhage.

A

Papilledema aka Choked Disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Swelling around the eye seen with allergies, myxedema & nephrotic syndrome (HEP).

A

Periorbital Edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Yellowish triangular nodule in the bulbar conjunctiva that is harmless & indicates aging

A

Pinquecula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Triangular thickening of the bulbar conjunctiva that grows across the cornea & is brought on by dry eyes

A

Pterygium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Drooping of the eyelid. Seen with conditions such as horner’s, CN III paralysis, Myasthenia Gravis, Multiple Sclerosis

A

Ptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Painless sudden onset of blindness described as curtains closing over vision; lightning flashes and floaters are seen prior to visual loss.

A

Retinal Detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Sclera colors:

  • White
  • Yellow
  • Blue
A 
White = Normal
Yellow = Jaundice
Blue = Osteogenesis Imperfecta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Fatty plaques on the nasal surface of the eyelids that may be normal or indicates hypercholesterolemia.

A

Xanthelasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Vision Terms:

  • Normal Vision
  • Nearsighted
  • Farsighted
  • Loss of lens elasticity d/t aging
A

Emmetropia (normal)
Myopia (near)
Hyperopia (far)
Presbyopia (loss of lens elasticity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Direct Light Reflex tests what CN?

A

II & III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Consensual Light Reflex tests what CN?

A

II & III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Swinging Light Test checks what CN?

A

II & III & eye pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Accommodation tests what CN?

A

II & III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is tested with the Snellen eye chart?

A

Visual Acuity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Cardinal Fields of Gaze tests what CN?

A

III, IV & VI

SO4,LR6,O3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Benign tumor of CN VIII (called schwannoma). Hearing loss, tinnitus, vertigo, & presence of tumor on CT or MRI.

A

Acoustic Neuroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Bacterial infection in the mastoid process. Presents clinically with the same signs & symptoms of acute otitis media, with the addition of inflammation & palpatory tenderness over the mastoid. Hearing loss is commonly associated.

A

Acute Mastoiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

An infection of the outer ear. Because this condition is often associated with swimming, especially if the water is contaminated, it is frequently referred to as swimmer’s ear. The individual will experience inflammation & pain of the outer ear. Tugging on the pinna will be painful.

A

Acute Otitis Externa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

A brief episode of vertigo brought on by a change of head position.
This is diagnosed by having the pt perform the Dix-Hallpike Maneuver. The pt rapidly moves from sitting to supine with head turned 45 degrees to the left & wait 30 seconds. Repeat on right side, if nystagmus is seen (+): nystagmus, nausea, vertigo.
Tx: Epley’s Maneuver

A

Benign Paroxysmal Positional Vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Retraction of the tympanic membrane

A

Eustachian Tube Block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

A disorder characterized by recurrent prostrating vertigo, sensory hearing loss, tinnitus, & a feeling of fullness in the ear.

A

Meniere’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Sensorineural hearing loss that occurs in people as they age & they may be affected by genetic or acquired factors.

A

Presbycussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

A bacterial or viral infection in the middle ear. The tympanic membrane presents with a red appearance, dilated blood vessels & bulging.

A

Purulent Otitis Media aka Bacterial Otitis Media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

An effusion in the middle ear resulting from incomplete resolution of acute otitis media or obstruction of the Eustachian tube. This condition is usually chronic & the fluid is amber with bubbles.

A

Serous Otitis Media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Ringing of the Ears

A

Tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

An abnormal sensation of rotary movement associated with difficulty in balance, gait & navigation of the environment.

A

Vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Neurological Evaluation of the Ear:

- Normal Hearing: Weber & Rinne?

A

Normal:

  • Weber: equal sound heard bilaterally
  • Rinne: AC>BC (Rinne +)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Neurological Evaluation of the Ear:

- Conduction Hearing Loss: Weber & Rinne?

A

Weber: Lateralizes to involved ear
Rinne: AC<BC or AC=BC (Rinne -)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Neurological Evaluation of the Ear:

- Sensorineural Hearing Loss: Weber & Rinne?

A

Weber: Lateralizes to uninvolved ear
Rinne: AC>BC with less time in bad ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Nasal mucosa appears pale or blue & boggy

A

Allergic Rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Thinning of the nasal mucosa with sclerosis, crust formation & foul odor

A

Atrophic Rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Typically occur as a consequence of chronic inflammation of the nasal mucosa

A

Polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Nasal mucosa appears red & swollen with a clear runny nose

A

Viral Rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Red sores at the corner of the mouth that are angular.

Can be caused by a Vitamin B2 (riboflavin) deficiency.

A

Angular Stomatitis aka Cheilosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

A deficiency of B-vitamins (B12) or iron that causes the tongue to appear smooth and glossy

A

Atrophic Glossitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Thick white fungal patches that are easily scraped off

A

Candidiasis aka Thrush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Deep furrows on the surface of the tongue that is considered a normal variant.

A

Fissured Tongue aka Scrotal Tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Pre-cancerous lesion of white patches that are adherent to the surface and not easily removed.

A

Leukoplakia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Excessive production of growth hormone beginning in middle age. Results in abnormal growth in hands, feel & facial bones

A

Acromegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Excessive production of growth hormone prior to skeletal maturation

A

Gigantism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

MC caused by Grave’s disease (autoimmune).
Thyroid Stimulating Hormone (TSH) production is decreased and the thyroid hormones (triiodothyronine/T3 & thyroxine/T4) are produced in excess.

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Hashimoto’s thyroiditis is the MC cause in the USCongenitally it’s called “cretinism” & causes a diminished physical & mental capacity

A

Hypothyroidism aka Myxedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Weight Loss w/ Increased Appetite
Irritable & NervousIntolerance to Heat
Moist Skin & Fine Hair

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Weight Gain w/ Decreased Appetite
Depression, Weakness & Fatigue
Intolerance to Cold
Coarse, Dry Hair & Skin

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Exophthalmos is associated with what thyroid disease

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Periorbital Edema is associated with what thyroid disease

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Possible neck swelling d/t goiter (thyroid condition)

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Macroglossia & loss of lateral 1/3 eyebrows (thyroid condition)

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

High T3, High T4, Low TSH

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Low T3 & T4, High TSH

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q
  • Childhood & early adulthood; females
  • Unilateral or bilateral
  • Photophobia, throbbing, worse behind one eye, nausea/vomiting, familial, decreasing w/ advancing age, pregnancy
  • Provoked by bright light, chocolate, cheese, tension, red wine, menstrual cycle
  • Follow up: dietary log, adjust, avoid provoking/triggering factors
A

Common Migraine HA”sick”“vascular”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q
  • Childhood & early adulthood; females
  • Typically UNILATERAL
  • AURA, photophobia, throbbing, worse behind one eye, nausea/vomiting, familial, decreasing w/ advanced age, pregnancy
  • Bright light, chocolate, cheese, tension, red wine, menstrual cycle
A

Classic Migraine HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q
  • Adult
  • Occipital Vertex
  • Throbbing, waking up with HA
  • Follow up: blood pressure, lipid profile
A

Hypertension HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q
  • Adolescent to adults; males
  • Unilateral, Orbital, Temporal
  • Wake up at night w/HA, lasts 15-180 minutes, rhinorrhea, lacrimation, facial sweating, red eye, miosis, not aggravated by exertion
  • Provoked by alcohol, seasonal
A

Cluster HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q
  • Any age
  • “Band-like”
  • Pressure, muscle tightness
  • Provoked by: fatigue, tension, stress, work
A

Muscular Tension HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q
  • Over 50yoa
  • Unilateral, Temporal, proximal mm pain/stiff
  • Persistent burning, aching, throbbing
  • Provoked by: scalp sensitive, tender
  • Follow up: ESR elevated, biopsy
A

Temporal Arteritis (Giant Cell)”Polymyalgia Rheumatica”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q
  • Adult
  • Occipital, Upper Cervical
  • Often daily, decreased ROM in upper cervical & occiput, pain in neck referred to head
  • Provoked by: head mvmt
  • Follow up: Flexion/Extension X-Rays, Adjust
A

Cervicogenic aka Vertebrogenic HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q
  • Any Age
  • Localized & changes with body position
  • Steady throb, local tenderness, worse in morning
  • Provoked by: chronic sinusitis
A

Sinus HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q
  • Any age
  • Basilar area ***
  • Abrupt onset, constant, stiff neck, excruciating pain like never before experienced
  • Provoked by: hypertension, stress
  • Follow up: High BP, Fever
A

Subarachnoid Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q
  • Any Age
  • Slow bleed following a trauma
  • s/s evident days
  • weeks post injury
  • Provoked by: Trauma
  • Follow up: Send to ER
A

Subdural Hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q
  • Any Age
  • Any place & changes with body position
  • Onset morning & evening, mild to severe, throbbing, progressively worse
  • Provoked by: tumor growth
  • Follow up: MRI or CT of brain; refer to neurosurgeon
A

Brain Tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q
  • Any Age
  • Neck
  • Intense, deep pain, never experienced before, stiff neck
  • Provoked by: worse in flexion
  • Follow up: Kernig/Brudzinski CSF tap
A

Meningeal Irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q
  • Generalized HA
  • Provoked by skipping meals
  • Follow up: FBS (?)
A

Hypoglycemic HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q
  • Any Age
  • Localized general pain
  • Loss of memory, visual disturbances
  • Provoked by: Fall, MVA, whiplash injury, trauma
  • Follow up: refer to neurologist/ER
A

Post Concussive HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Deformities of the Thorax:

  • AP = Lateral diameter (1:1 ratio)
  • Seen with COPD & Cystic Fibrosis
A

Barrel Chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Deformities of the Thorax:

- Marked depression noted in the sternum (sunken in)

A

Pectus Excavatum akaFunnel Chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Deformities of the Thorax:

Forward protrusion of the sternum (like keel of a ship)

A

Pectus Carinatum akaPigeon Chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Rapid, shallow breathing

A

Tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Slow Breathing

A

Bradypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Characterized by groups of quick, shallow inspirations followed by irregular periods of apnea (no pattern)

A

Biot’s Breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Breathing pattern characterized by alternating periods of apnea and hyperpnea (has pattern); Respiratory Acidosis

A

Cheyne Stokes Respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Breathing is first rapid & shallow but as metabolic acidosis worsens, breathing gradually becomes deep, slow, labored & gasping”Air hunger breathing”

A

Kussmaul’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Unguinal indentations in nails; seen with Psoriasis

A

Pitted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Subacute bacterial endocarditis (strep organism) in the nails

A

Splinter Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Transverse ridging associated with acute severe disease in the nails.

A

Beau’s Lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Inflammation of the nail fold near the cuticle

A

Paronychia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Nail base has an angle >180*

Hypoxia (early) / COPD (late)

A

Clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Spoon Nail

Iron deficiency anemia

A

Koilonychia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

How do you palpate for respiratory excursion?

A

Place hands over posterior ribs & have patient take a deep breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Palpable vibration when pt says “99”

A

Tactile Fremitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Tactile Fremitus: increased with fluid

A

pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Tactile Fremitus: decreased with air

A

Emphysema, Pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Tactile Fremitus: decreased with atelectasis and pleurisy because a _____ is created.

A

Sound Barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Tactile Fremitus is increased with…

A

Pneumonia (fluid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Tactile Fremitus is decreased with….

A

Emphysema, Pneumothorax, Atelectasis, Pleurisy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

When percussing over lung tissue what tone should you hear if normal?

A

Resonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

When percussing over lung tissue what causes the tone to be hyperresonant?

A

Increased air in the chest

Emphysema, Pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

When percussing over the lung tissue what causes the tone to be dull?

A

Increased density

Pneumonia, Atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Dr asks pt to exhale and hold it, percusses down the back in the intercostal margins (bone will be dull), starting below the scapula until the sounds change from resonant to dull. Dr marks this spot.Dr asks pt to take a deep breath in and hold it as Dr percusses down again, marking the spot where the sound changes from resonant to dull again.Dr will measure the distance between the 2 spots.

A

Diaphragmatic Excursion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

If diaphragmatic excursion is less than 3-5 cm, the pt may have…

A

Pneumonia or Pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Auscultation: Breath Sounds:

  • Duration: inspiration equal to expiration
  • Location: over trachea
A

Tracheal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Auscultation: Breath Sounds

  • Expiration longer than Inspiration
  • Over Manubrium
A

Bronchial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Auscultation: Breath Sounds:

  • Inspiration equal to Expiration
  • Between 1st & 2nd ribs anteriorly; between scapulae posteriorly
A

Bronchovesicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Auscultation: Breath Sounds:

  • Inspiration longer than Expiration
  • Remaining lung field
A

Vesicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Small clicking, bubbling or rattling sounds in the lung.
They are believed to occur when air opens closed air spaces.
Can be further described as moist, dry, fine & coarse (Bronchitis)

A

Rales

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Sounds in lung that resemble snoring.

They occur when air is blocked or becomes rough thru large airways (Bronchiectasis)

A

Rhonchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

High-pitched sounds produced by narrowed airways.
They can be heard upon exhalation.
Asthma in young people; Emphysema in elderly

A

Wheezes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Wheeze-like sound heard upon inspiration. Usually d/t blockage of airflow

A

Stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

If abnormal breath sounds are heard, proceed with _____

A

Vocal Resonance (stethoscope)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

If clear, distinct sounds are heard as the pt says “99”, consolidation is present.

A

Bronchophony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

If you hear “aaaaa” as the patient says “eeeee”, consolidation is present.

A

Egophony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

If the words “1,2,3” are heard clearly and distinctly, consolidation is present.

A

Whispered Pectoriloquy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Name the Condition:

  • Percussion: Resonant
  • Fremitus: Decreased
  • Breath Sound: Wheezing
A

Asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Name the Condition:

  • Percussion: Dull/Flat
  • Fremitus: Decreased
  • Breath Sound: Absent
A

Atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

Name the Condition:

  • Percussion: Resonant
  • Fremitus: Normal
  • Breath Sound: Rales
A

Bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

Name the Condition:

  • Percussion: Resonant
  • Fremitus: Normal
  • Breath Sound: Rales
A

Bronchitis

156
Q

Name the Condition:

  • Percussion: Hyperresonant
  • Fremitus: Decreased
  • Breath Sound: Wheezing
A

Emphysema

157
Q

Name the Condition:

  • Percussion: Dull
  • Fremitus: Decreased
  • Breath Sound: Crackles (friction rub)
A

Pleurisy

158
Q

Name the Condition:

  • Percussion: Hyperresonant
  • Fremitus: Decreased
  • Breath Sound: Decreased
A

Pneumothorax

159
Q

Name the Condition:

  • Percussion: Dull
  • Fremitus: Increased
  • Breath Sound: Egophony, Bronchophony, Whispered Pectoriloquy, Crackles
A

Pneumonia

160
Q

PPW productive cough (rusty brown sputum) for around 10 days & fever
Percussion is dull; Rales; Increased Tactile Fremitus
Silhouette sign & air bronchogram

A

Lobar Pneumonia

consolidation of the lung

161
Q

Productive/currant red jelly sputum & caused by Klebsiella pneumonia
Seen with old age or immune-compromised hosts

A

Friedlander’s Pneumonia

162
Q

Caused by yeast/fungusMC seen in AIDS pts

A

Pneumocystis Carinii

163
Q

Caused by CMV

MC seen in AIDS pts

A

Cytomegalovirus

164
Q

PPW low-grade fever, night sweats, productive cough (yellow/green sputum)
Small white lesions called Ghon lesions seen on X-Ray
Positive Tine test/Mantoux test, Purified Protein Derivative
Most definite test for dx is Sputum culture

A

Tuberculosis (caused by mycobacterium tuberculosis)

165
Q

PPW stabbing chest pain worsened by respiration.
Dry/non-productive cough
Decreased respiratory excursion; decreased tactile fremitus; dull on percussion; friction rub is present
Positive Schepelmann’s Test

A

Pleurisy (inflammation of the pleura, usually producing an exudative pleural effusion)

166
Q

A ruptured lung causing air to b/c trapped in the pleural space
Decreased chest expansion, decreased tactile fremitus, hyperresonant on percussion, decreased breath sounds
Can occur in young, previously healthy individuals (spontaneous)

A

Pneumothorax

167
Q

Collapse of the lung that is usually the result of bronchial obstruction due to a mucous plug.
Presents with decreased tactile fremitus, dull percussion, decreased chest expansion, decreased or absent breath sounds

A

Atelectasis

168
Q

Irreversible focal bronchial dilation that presents w/ chronic, productive cough

A

Bronchiectasis

169
Q

Defined by a long-term cough with mucus
Shortness of breath & wheezing
Cigarette smoking is main cause
Long exposure to other things such as chemical fumes, dust & other substances may also cause this.

A

Chronic Bronchitis / COPD

170
Q

Bronchospasm constricting airways
Type I hypersensitivity reaction that is usually triggered by airborne allergens
PPW tachycardia, tachypnea, decreased tactile fremitus & wheezing
Eosinophils & IgE rise
Labs: Curshmann’s spirals & Charcot Laden Crystals (crystals & spirals in sputum from IgE)

A

Asthma

171
Q

Destruction of elastic pulmonary connective tissue results in permanent dilation of the alveoli air sacs.
Caused by deficiency of alpha 1 anti-trypsinPPW decreased tactile fremitus, hyperresonant on percussion, decreased breath sounds & wheezing

A

Emphysema

172
Q

Primary malignant lung tumor that starts in the area of the bronchus
Long-term history of smoking (20-30 years)
PPW coughing (non-productive) more than 30 days, afebrile, dyspnea & weight loss

A

Bronchogenic Carcinoma

173
Q

Inflammation that develops as a consequence of physical activity & is worse with exercise.
Pain increases while taking a deep breath
Palpable tenderness at the 3rd, 4th or 5th costosternal articulation
Similar to Tietze Syndrome which affects only one articulation & radiates pain.
Can be Chronic

A

Costochondritis

Inflammation of the cartilage connection b/t ribs & sternum

174
Q

Shingles
Painful rash following the course of a dermatome (usually single nerve)
Primarily involves the dorsal root ganglion, but when it does involve cranial nerves it is most commonly seen at CN V

A

Herpes Zoster

175
Q

Disease in which abnormal collections of inflammatory cells (granulomas) form as nodules. Most often appear in lungs or lymph nodes.MC seen in African descent in the US

A

Sarcoidosis

176
Q

Cancer of the lymphatic system that can spread to the spleen.
MC seen in young caucasian males
PPW fever, night sweats, weight loss, intense pruritis (release of IgE) & enlarged spleenBest diagnosed from biopsy

A

Hodgkin’s

177
Q

COPD (barrel chest)
Chronic, progressive & frequently fatal genetic disease of the body’s mucus glands.
The glands produce or secrete sweat and/or mucus
Thick accumulations of mucus in the intestines & lungs
Loss of excessive amounts of sale (sweat test)
Pancreatic insufficiency
Meconium ileus

A

Cystic Fibrosis

178
Q

Measures the pressure of the right side of the heart.
Can be made more pronounced when congestive heart failure is present by applying pressure to the liver (hepatojugular reflex)

A

Jugular Venous Pulsations

179
Q

Palpation: Peripheral Pulses:
Bounding
Increased cardiac output
Exercise, anxiety, fever, hyperthyroidism

A

Pulsus Magnus

180
Q

Palpation: Peripheral Pulses:
Weak or thready
Decreased stroke volume
Hypovolemia, aortic stenosis, CHF

A

Pulsus Parvus

181
Q

Palpation: Peripheral Pulses:
Alternates in amplitude
Left Ventricular failure

A

Pulsus Alternans

182
Q

Palpation: Peripheral Pulses:2 Strong systolic peaks separated by mid-systolic dip (best felt at carotid artery)Aortic regurgitation, Aortic stenosis

A

Pulsus Bisferiens

183
Q

Palpation: Peripheral Pulses:
Decreased amplitude on inspiration, increased w/ expiration (>10mmHG amplitude change)
COPD, bronchial asthma, emphysema, pericardial effusion

A

Pulsus Paradoxus

184
Q

Palpation: Peripheral Pulses:

A jerky pulse that is rapidly increasing then collapsing b/c of aortic insufficiency

A

Water Hammer Pulse

185
Q

Vibration produced by turbulent blood flow within the heart (murmurs)

A

Thrills

186
Q

When the ventricles of heart contract, it is called _____

A

Systole

187
Q

When the ventricles of the heart rest & are filling, it is called _____

A

Diastole

188
Q

Closure of AV valves (mitral & tricuspid)

A

S1

189
Q

Closure of semilunar valves (aortic & pulmonary)

A

S2

190
Q

Ventricular Gallop
Normal in children, young adults & athletes
>40 yo earliest sign of CHF

A

S3

191
Q

Atrial Gallop

Similar to S3 & is related to stiffness of the ventricular myocardium to rapid filling

A

S4

192
Q

Right sternal border at the 2nd intercostal spaceBest auscultated with pt seated, leaning forward & exhaling

A

Aortic Valve

193
Q

Left sternal border at the 2nd intercostal space

A

Pulmonic Valve

194
Q

Left sternal border at the 3rd intercostal space

A

Erb’s Point

195
Q

Left sternal border at the 4th or 5th intercostal space

A

Tricuspid Valve

196
Q

Mid-clavicular line at the 5th intercostal space

Best auscultated in the left lateral decubitus position

A

Mitral Valve

197
Q

Valve has trouble opening & the blood swirls thru a narrow opening.
This murmur has a low pitch & is best heard w/ bell of stethoscope

A

Stenosis

198
Q

Valve is insufficient & blood seeps or squirts back into the chamber.
This murmur has a high pitch & is best heard w/ diaphragm of stethoscope

A

Regurgitation

199
Q

What is the mnemonic for heart murmurs that occur in diastole? (opposite in systole)

A

ARMS & PRTS
Aortic Regurgitation & Mitral Stenosis
Pulmonic Regurgitation & Tricuspid Stenosis

200
Q

Failure of shunt to close between the aorta & left pulmonary artery.
Creates a continuous/machinery like murmur that can be heard in both phases of the heart cycle.

A

Patent Ductus Arteriosus

201
Q

Dextraposition/overriding of the aorta, right ventricular hypertrophy, interventricular septal defect & pulmonic stenosis.Creates loud ejection murmur during systole & severe cyanosis.

A

Tetralogy of Fallot

202
Q

Constriction of the descending aorta (usually distal to left subclavian)
Causes higher blood pressure in upper extremity by 20mmHg (diagnostic) when compared to the lower extremity.

A

Coarctation of the Aorta

203
Q

Proximal stenosis of the subclavian artery.

Seen in younger females who faint (syncope/drop attacks) while exercising

A

Subclavian Steal Syndrome

204
Q

MC cause of left sided heart failure is _____ (35-55yoa)

A

Hypertension

205
Q

2nd MC cause of left sided heart failure is…

A

Aortic Stenosis

206
Q

What are some early signs of left sided heart failure?

A

Pulmonary edema (fluid in the lungs) causing shortness of breath (exertional dyspnea) and orthopnea.Fluid collects first at the costophrenic angles.

207
Q

MC cause of Right sided heart failure

A

Left sided heart failure

208
Q

MC cause of Mitral Stenosis (asso w/ right sided heart failure)

A

Rheumatic Fever(ASO-titer)

209
Q

When the right side fails by itself — lung condition that causes right sided heart failure

A

Cor Pulmonale

210
Q

Right sided heart failure backs up to the ______ and down the _____

A

Up to the SVC & Down to the IVC

211
Q

What leads to:

  • Edema & fluid in extremities
  • Jugular venous distention (SVC)
  • Liver/Spleen enlargement
  • (+) Hepatojugular reflex
  • Ascites (fluid in abdomen from portal hypertension)
  • Caput Medusa/Spider angioma
  • Pitting Edema
  • Stasis Dermatitis
A

Right Sided Heart Failure

212
Q

Right Sided Heart Failure causes:

  • _____ heart rate
  • _____ gallop
  • _____ blood pressure
A

Increased HR
S3 gallop
Decreased BP

213
Q

An interruption of the intima allowing blood into the vessel wall with immediate “tearing” pain. Acute surgical emergency.Associated w/ Hypertension/Arteriosclerosis (Descending Aorta) & Marfan’s (Ascending Aorta)

A

Aortic Dissection

214
Q

Inherited connective tissue disorder with ventricular weakening & enlargement. PPW tall, long fingers/limbs, lens subluxation, cardiovascular & lung problems

A

Marfan’s Syndrome

215
Q

Comes on with Exertion
Printzmetal angina comes on with rest (atypical)
Relieved by vasodilators under tongue (nitroglycerin)

A

Angina Pectoris - Coronary vasospasm

216
Q

Acute heart failure
Comes on with rest
Caused by Atherosclerosis
CK-MB is elevated, LDH increased & SGOT increased

A

Myocardial Infarction

217
Q

Abnormal widening that involves all 3 layers; defect in elastic-media tissues

A

Aneurysm

218
Q

ECG: Normal atrial depolarization

A

P-wave

219
Q

ECG: Depolarization of ventricles; repolarization of atria hidden here

A

QRS complex

220
Q

ECG: Repolarization of ventricles

A

T-wave

221
Q

ECG: Repolarization of papillary muscles

A

U-wave

222
Q

Increased PR interval - prolonged AV nodal delay

A

Primary Heart Block

223
Q

Two P-waves before QRS complex

A

Weinkbochs
block of bundle of HIS
Secondary Heart Block

224
Q

No QRS pattern

A

Complete Heart Block
no ventricle contraction
no atrial repolarization

225
Q

Enlarged or Inverted ST segment

A

MI (acute heart failure)

226
Q

What is an echocardiogram/Doppler used for?

A

Used to evaluate heart valves

227
Q

Increased bowel sounds indicate…

A

Early intestinal obstruction

228
Q

Absent bowel sounds indicate…

A

Late intestinal obstructionAdynamic (paralytic) Ileus

229
Q

Vomiting up blood is called…

A

Hematemesis

230
Q

Coughing up blood is called…

A

Hemoptysis

231
Q

Blood in stool is called…

A

Hematochesia

232
Q

Abdomen & GI Labs:

What labs are non-specific for the liver?

A
  • Increased Alkaline Phosphatase
  • Serum.Glutamate.Oxaloacetate.Transaminase (SGOT)
  • Aspartate Transaminase (AST)
  • Lactate Dehydrogenase (LDH)
233
Q

Abdomen & GI Labs:

What labs are classic for liver?

A
  • Gamma.Glutamyl.Transpeptidase (GGT)
  • Serum.Glutamic.Pyruvic.Transaminase (SGPT)
  • Alanine Transaminase (ALT)
234
Q

Yellowing of the skin, sclera & mucous membranes. Can occur with any liver disorder

A

Jaundice

235
Q

What is the MC cause of liver destruction?

A

Alcoholism

236
Q

Causes portal hypertension, ascites, esophageal varices

A

Cirrhosis

237
Q

Coughing, tearing esophageal blood vessels & hematemesis with palmar rash d/t bile salts
Cirrhosis***

A

Mallory Weiss Syndrome

238
Q

Thiamin deficiency from alcoholism that leads to dementia

Cirrhosis ***

A

Wernicke Korsakoff syndrome

239
Q

Thiamin deficiency without alcoholism that causes cirrhosis

A

Beri Beri

240
Q

Liver may be tender & enlarged but the edge remains soft & smooth

A

Hepatitis

241
Q

Caused from food thru fecal/oral route, self-limiting, not a carrier

A

Hepatitis A

242
Q

Caused from dirty needles & sexual contact, carrier for life, MC to b/c liver cancer

A

Hepatitis B

243
Q

Caused from blood transfusions

A

Hepatitis C

244
Q

MC site for metastatic disease in abdomen & GI

A

Liver Cancer

245
Q

Describe a liver with Liver Cancer

A

Liver will be enlarged, with a hard & irregular border

246
Q

What is the tumor marker specific for hepatocellular carcinoma?

A

Alpha fetoprotein

247
Q

What is performed for definitive diagnosis of liver cancer?

A

Liver biopsy

248
Q

Type of Bilirubin:-

  • water soluble
  • increases with duct obstruction (gallstones), hepatic disease, pancreatic cancer
  • increased amounts in blood may cause bilirubin in urine (urobilinogen)
A

Direct/Conjugated Bilirubin

249
Q

Type of Bilirubin:

  • Not water soluble
  • Increases with hemolytic disease, drugs & spleen disorders
  • Dx Hemolytic anemia
A

Indirect/Unconjugated Bilirubin

250
Q

Increase in reticulocyte count (Coomb’s test) dx:

A

Hemolytic anemia

251
Q

Pain referral to right shoulder or tip of right scapula (viscerosomatic)

A

Gallbladder

252
Q
  • MC seen in overweight females >40yoa
  • MC cause of cholelithiasis
  • Severe URQ pain, nausea, vomiting, & precipitated by eating large fatty meal
  • Murphy’s sign
  • Inspiratory arrest sign
  • Tests: diagnostic Ultrasound, Oral Cholecystogram
A

Cholecystitis

253
Q

Calcification that can become malignant d/t chronic inflammation

A

Porcelain Gallbladder

254
Q

Epigastric pain going straight thru the T10-T12 area like a knife (viscerosomatic)Chronic: seen in alcoholismAcute: 911 emergencyTests: increased Amylase & Lipase

A

Pancreatitis

255
Q

Pancreatitis bleeding into flank

A

Grey Turner Sign

256
Q

Periumbilical ecchymosis caused by intraperitoneal hemorrhage or seen with a ruptured ectopic pregnancy

A

Cullen’s Sign

257
Q

Usually at the head of the pancreas

Presents with dark urine, clay colored stools & jaundice

A

Pancreatic Cancer

258
Q

A condition in which the pancreas does not produce a sufficient amount of insulin to take the sugar out of the blood and transport it to the tissues of the body.These starved tissues force the breakdown of fats in order to obtain energy.- Polydypsia, polyphagia & polyuria are all seen

A

Diabetes Mellitus

259
Q

What labs test DM?

A
  • Glucose Tolerance Test
  • Fasting Plasma Glucose (FPG)
  • HbA1C (Glycosylated Hemoglobin)
260
Q

Type of Diabetes:- Juvenile, under 30, usually thin

A

Insulin Dependent Type I

261
Q

Type of Diabetes:- Adult, over 40, usually obese

A

Non-Insulin Dependent Type II

262
Q

Condition of the posterior pituitary gland in which there is insufficient ADH.
May have polydypsia, polyuria, but NOT polyphagia

A

Diabetes Insipidus

263
Q

Upward reflux of acid contents of the stomach into the esophagus.
Caused by sliding hiatal hernia.
Worse when lying down, after big meal, valsalva, or bearing down.
Tests: X-Ray or upper GI series

A

Reflux Esophagitis

264
Q
  • Includes gastric & duodenal ulcers
  • Caused by H.pylori bacteria
  • Burning pinpoint epigastric pain
  • Coffee ground emesis
A

Peptic Ulcers

265
Q

Ulcer with no consistent pain pattern

A

Gastric Ulcer

266
Q

MC type of peptic ulcer

  • pain occurs 2 hours after eating
  • black/tarry stool
  • Guaiac test: occult blood in the stool
A

Duodenal Ulcer

267
Q

Projectile vomiting in the newborn

A

Pyloric Stenosis

268
Q

Gastric Carcinoma is MC found on the _____

A

Lesser Curvature

269
Q

What node is MC involved in Gastric Carcinoma?

A

Virchow’s Node - left supraclavicular lymph node involvement

270
Q

Spleen:
Caused by the Epstein Barr Virus & is seen in young adults (18-25yo)
Presents w/ symptoms similar to the flu such as fever, HA, fatigue, lymphadenopathy in the cervical region, splenomegaly

A

Mononucleosis

271
Q
  • Atypical lymphocytes in blood (Downey cells)
  • Monospot
  • Heterophile Agglutination
  • Paul Bunnell
A

Mononucleosis

272
Q

The bone marrow b/c sclerotic, thus the RBC’s are not made properly.
Liver & Spleen b/c enlarged

A

Osteropetrosis “Marble Bone”

273
Q

Referral of pain is Periumbilical

A

Small Intestines

274
Q
  • Nonspecific inflammatory disorder that affects distal ileum & colon
  • Presents with RLQ pain, chronic diarrhea, cobblestone appearance on sigmoidoscopy
  • Leads to malabsorption of B12
  • Non-tropical Sprue / Celiac Sprue (gluten allergy) can cause this condition
A

Regional Heitis aka Crohn’s Disease(right side of intestines)

275
Q
  • MC at the colon & rectum
  • Presents w/ bloody diarrhea
  • Diagnosed with sigmoidoscopy
A

Ulcerative Colitis(left side of intestines)

276
Q

Variable degrees of constipation & diarrhea in response to stress
Seen more commonly in females
Abdominal pain & gas relieved by bowel movements

A

Irritable Bowel Syndrome aka Spastic Colon

277
Q

Dull periumbilical or epigastric pain that radiates to LRQ (McBurney’s Point)- presents with fever, nausea, vomiting, anorexia- increased WBC (shilling shift to the left)- Tests: Rebound Tenderness (peritonitis), Rovsing’s sign, Psoas sign, Obturator sign- Special Test: CT Scan- Refer to ER

A

Appendicitis

278
Q

Consequence of inadequate fiber in the diet

Chronic constipation which causes small outpouchings within the colon that b/c infected

A

Diverticulitis

279
Q

Increased production of adrenal cortex hormone; hyperadrenalism; hypercortisolism
Moon face “pie face”, buffalo hump, pendulous abdomen w/ purple striae, hirsutism, weakness, hypertension

A

Cushing’s Disease

280
Q

Decreased aldosterone; hypoadrenalism; hypocortisolism
Increased ACTH causes melanin deposition (hyperpigmented mouth & face)
Thin person, decreased blood pressure, weakness, fatigue, lethargy, nausea, vomiting, hair loss

A

Addison’s Disease

281
Q

Tumor of the Adrenal Medulla
Increased catecholamine production (epi & norepi)
May appear similar to hyperthyroidism but this produces extreme hypertension

A

Pheochromocytoma

282
Q

Made of Calcium: Calcium oxalates (MC), Calcium urates, Calcium phosphates- Flank pain described as writhing- Murphy’s Test (kidney punch)- Evaluate by increased BUN, uric acid, creatinine clearance & KUB study- Hydronephrosis can cause a staghorn calculi

A

Nephrolithiasis

283
Q

Caused by group A hemolytic strep

RBC casts in urine with small amount of protein

A

Acute Glomerulonephritis aka Nephritic syndrome

284
Q

HEP = Hypertension, Edema, massive Proteinuria
In pregnant women is called pre-eclampsia
Waxy or fatty casts in urine

A

Nephrotic syndrome

285
Q

E-coli from UTI

WBC casts in urine

A

Pyelonephritis

286
Q

Inherited disorder characterized by many bilateral renal cysts that increase renal size but reduce functioning renal tissue

A

Polycystic Kidney Disease

287
Q

This diagnosis is classified as gonococcal (caused by Gonorrhea) or non-gonococcal (caused by Chlamydia).- caused MC by E. Coli in females- Nitrites in urine

A

Urethritis

288
Q

Noninfectious bladder inflammation that causes burning, painful & frequent urination with incontinence. Pt will also have suprapubic & LBP.

A

Cystitis

289
Q

Malignant tumor of the kidney; less than 5 yoa, abdominal mass, hematuria

A

Nephroblastoma aka Wilm’s Tumor

290
Q

Urinary Incontinence often called “overactive bladder”. The urgent need to get to the bathroom.

A

Urge

291
Q

Urinary Incontinence - an increase in abdominal pressure such as exercise, cough, sneeze, laugh. Due to weakened pelvic floor muscles.

A

Stress

292
Q

Urinary Incontinence - inability to completely empty your bladder when you urinate. As a result, the patient has a constant or frequent dribble of urine.

A

Overflow

293
Q

Urinary Incontinence - MC among older adults with arthritis, Parkinson’s, Alzheimer’s (disorders that involve moving, thinking, or communicating)

A

Functional

294
Q

MC type of hernia
This hernia passes down the inguinal canal & exits at the external inguinal ring into the scrotum.
MC in children & young adults

A

Indirect Inguinal Hernia

295
Q

Does not pass thru the inguinal canal but exits directly thru the external inguinal ring instead. It is usually acquired from obesity or heavy lifting. This hernia is felt when the patient coughs or bears down. MC in adults over the age of 40

A

Direct Inguinal Hernia

296
Q

Not an inguinal hernia. It appears as a bulge lateral & inferior to the external inguinal ring at the site of the femoral pulse.

A

Femoral Hernia

297
Q

Protrusion of the stomach above the diaphragm.
Presents with palpable tenderness in LUQ, reflux esophagitis (acid reflux), dyspepsia (indigestion), made worse after eating large meal or when lying down.

A

Hiatal Hernia

298
Q

Abnormal endometrial tissue found outside its normal location.
(ex: myometrium, Fallopian tubes, peritoneum)
MC found in ovaries.
LaparscopyPresents w/ abdominal pain, back pain, menorrhagia, painful intercourse & possible infertility

A

Endometriosis

299
Q

Benign uterine tumors of smooth muscle origin (Leiomyoma)
Presents w/ heavy menstrual bleeding, pelvic pain & painful intercourse. Uterus will have painless nodules that are irregular & firm

A

Uterine Fibroids

300
Q

An infection of the upper female genital tract. It is the MC complication of an STD (usually Chlamydia or Gonorrhea).Includes salpingitis (inflammation of the Fallopian tubes)

A

Pelvic Inflammatory Disease

301
Q

Pregnancy in which implantation occurs outside the endometrium/endometrial cavity.
Presents with spotting, decreased BP, decrease in HCG

A

Ectopic Pregnancy

302
Q

Increase HCG, nausea, weight gain, & breast tenderness

Blood test - HCG (human chorionic gonadotropin)

A

Normal Pregnancy

303
Q

A non-viable embryo which develops in the placenta & presents with all the signs of pregnancy. Very high HCG

A

Hydatiform mole

304
Q

A malignancy of the placenta due to abnormal epithelium

A

Choriocarcinoma

305
Q

Multiple, round, freely movable masses can be palpated.
Bilateral breast tenderness that is made worse w/ caffeine intake, ovulation or menses.
Can be common among overweight diabetics.

A

Fibrocystic Breast Disease

306
Q

MC benign breast tumor, usually <30yo, non-tender, singular lump, 75% unilateral

A

Fibroadenoma

307
Q

2nd MC cause of cancer death in women, MC >50yoa, MC location is upper/outer quadrant.
Presents with nipple retraction, bleeding, orange peel appearance & dimpling (Paget’s disease of the breast).
Metastasis to axilla via the lymphatic system & will most likely be lytic when seen in the bone.

A

Breast Cancer

308
Q

Tortuous dilation of the spermatic veins. “Bag of worms” feeling upon palpation that diminishes from standing to supine

A

Varicocele

309
Q

A fluid filled mass in the epididymis. It is painless, moveable, pea sized lump located superior & posterior to the testicle. it transilluminates light because it is fluid filled.

A

Spermatocele

310
Q

Excess accumulations of water in the testicle. It feels swollen, painless, heavy & tight. The ability to palpate above the mass distinguishes it from a scrotal hernia. It transilluminates.

A

Hydrocele

311
Q

Usually a consequence of an STD. The scrotum is enlarged & tender but tenderness may be relieved somewhat by raising the testicle.

A

Epididymitis

312
Q

MC form of cancer in males age 20-34. Painless nodule appears on or in the testicle. MC type is a Seminoma. Does NOT transilluminate light.

A

Testicular Cancer

313
Q

Enlarged, non-tender, firm, smooth, with loss of median sulcus

A

Benign Prostatic Hyperplasia

314
Q

Boggy, soft, enlarged & tender. Urinary problems such as increased urgency.

A

Prostatitis

315
Q

Posterior lobe is hard, nodular, painless & enlarged. MC place to metastasize is to the lumbar spine via Batson’s Plexus

A

Prostatic Carcinoma

316
Q

Muscle pain classically in the calf muscle, which occurs during exercise

A

Claudication

317
Q 
Artery or Vein:
Temp: Cool
Color: Pale or Blue
Pulse: Absent or Weak
Numb: Yes
Swelling: No
Raynauds: Yes
Trophic Changes: Thin Skin
Valve Incompetence: N/A
A

Artery

318
Q 
Artery or Vein:
Temp: Warm
Color:  Normal or Discolored
Pulse:  Normal
Numb:  No
Swelling:  Yes
Raynauds:  No
Trophic Changes: Stasis Dermatitis
Valve Incompetence: Yes
A

Vein

319
Q

Type of Claudication:- Non-predictable pattern- Position related relief (seated with flexion)- Common Cause: DJD, Spinal Canal Stenosis

A

Neurogenic

320
Q

Type of Claudication:

  • Predictably reproducible pattern
  • Relief always with rest
  • Common Cause: Arteriosclerosis, Buerger’s
A

Vascular

321
Q

Test: pt walks at a rate of 120 steps/minute for 1 minute

(+) = pain in calves

A

Claudication Timeindicates: Vascular Claudication

322
Q

Test: pt pedals fast until painful, rest until painless, repeat.
(+) = pain in calves

A

Bicycle Test(indicates: vascular claudication)

323
Q

Seen in 20-40yo males & is associated w/ excess tobacco smoking.
Presents with intermittent vascular claudication, non-healing ulcers & gangrene.
Test: Claudication Time

A

Buerger’s akaThromboangitis Obliterans

324
Q

Seen in pts >15yoa. Disease associated with Buerger’s, Collagen Disease & Scleroderma. It’s brought on by cold, stress, emotion. Presents with arterial spasms, triphasic color changes (white-blue-red), finger tip ulcers, gangrene & cold sensitivityTest: Allen’s test

A

Raynaud’s

325
Q

Seen in pts >20yo, pregnant women or overweight adults

Presents w/ incompetent valves, dilated tortuous channels

A

Varicose Veins

326
Q

Presents with tenderness, edema & pain
Test: Homan’s - pt is supine w/ leg extended while examiner raises the leg off the table 45*, dorsiflexes the foot & squeezes the calf
(+) = pain in calf

A

Deep Vein Thrombosis

327
Q

A blockage of an artery in the lung by a substance that has traveled from elsewhere in the body thru the bloodstream (embolus). Usually this is due to a thrombus (blood clot) from the deep veins in the legs.Symptoms include difficulty breathing, chest pain on inspiration & palpitation.Risk is increased in various situations, such as flying & prolonged bed rest

A

Pulmonary Embolism

328
Q

A chronic pain condition
The key symptom is continuous, intense pain out of proportion to the severity of the injury, which gets worse rather than better over time.
Typical features include dramatic changes in the color & temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating & swelling

A

Reflex Sympathetic Dystrophy aka

Complex Regional Pain Syndrome

329
Q

Small superficial dilated blood vessels. They can develop anywhere on the body but are commonly seen on the face around nose, cheeks & chin.

A

Telangiectasia

330
Q

Pinpoint hemorrhage (local trauma)

A

Petechia

331
Q

RBC - Red Blood Cells

  • Definition
  • Normal Level
  • Increased?
  • Decreased?
A

Def: Absolute # of RBC per unit volume of blood
Norm: 4-6 million/cm3
Inc: 1= Polycythemia Vera, 2=High Altitude
Dec: Anemia

332
Q

Hb (Hemoglobin)

  • Definition
  • Normal Level
  • Increased
  • Decreased
A

Def: Direct measure of weight of hemoglobin/unit volume of blood
Level: 15 gm%
Inc: Dehydration (loss of blood fluid volume) & Polycythemia Vera
Dec: Anemia

333
Q

Hct (Hematocrit)

  • Definition
  • Normal Level
  • Increased
  • Decreased
A

Def: Packed Cell Volume, ratio of volume of RBC’s to that of whole blood
Level: 42 (+/-) 5%
Inc: Dehydration & Polycythemia Vera
Dec: Anemia

334
Q

MCV (Mean Corpuscular Volume)

  • Definition
  • Normal Level
  • Increased
  • Decreased
A

Def: Calculated measure of the size of the average circulating RBC
Level: 90
Increased: Macrocytic Anemia (>100)
Decreased: Microcytic Anemia (<80)

335
Q

MCH (Mean Corpuscular Hb)

  • Definition
  • Normal Level
  • Increased
  • Decreased
A

Def: Calculated weight of Hb in the average circulating RBC
Level: 30
Inc: Macrocytic Anemia (>100)
Dec: Microcytic Anemia (<80)

336
Q

MCHC (Mean Corpuscular Hb Concentration)

  • Definition
  • Normal Levels
  • Increased
  • Decreased
A

Def: Average concentration of Hb in a given volume of packed cells
Levels: 33
Inc: Macrocytic Anemia
Dec: Microcytic Anemia

337
Q

Platelets Thrombocytes

  • Def
  • Level
  • Inc
  • Dec
A

Def: Absolute quantification of circulating thrombocytes/volume
Level: 200,000-350,000 mm3
Inc: Polycythemia, Trauma, Blood Loss
Dec: Anemia, Extensive or Burns, Thrombocytopenia

338
Q

WBC (Leukocyte Count)

  • Def
  • Level
  • Inc
  • Dec
A

Def: Absolute quantification of total circulating WBC/unit of blood
Level: 5,000-10,000/mm3
Inc: Acute Infection, Inflammation, Leukemia (over 50,000)
Dec: Overwhelming infection, Viral conditions

339
Q

WBC Differential Count: List Normal Level & Increased

  • Neutrophilia
  • Lymphosytosis
  • Monocytosis
  • Eosinophilia
  • Basophilia
A 
N:   60% - Bacterial Infection
L:    30% - Virus
M:   8% - Chronic Inflammation
E:    2% - Allergies, Parasites
B:    0% - Heparin Production/Histamine Release
340
Q

How do you test for Excessive Hemolysis?

A

(+) Coombs Test

  • Increased indirect bilirubin
  • Increased reticulocytes
341
Q

Presents w/ nucleated RBC’s

Caused by Hgb S & seen in 10% of African Americans

A

Sickle Cell Anemia

342
Q

Presents with microcytic, target cells.

Caused by decreased beta chain synthesis & is seen in Mediterranean, North Africa & South East Asia

A

Thalassemia aka Mediterranean Anemia

343
Q

Caused by Rh+ father & baby, and Rh- mother

A

Erythroblastosis Fetalis

344
Q

Name the 3 types of Excessive Hemolytic Anemia & Name the 3 types of Defective Erythopoiesis Anemia

A

EHA: “SET”

  • Sickle Cell
  • Erythroblastosis Fetalis
  • Thalassemia (mediterranean)

DEA: “AIM”

  • Aplastic
  • Iron Deficiency
  • Megaloblastic
345
Q
  • Macrocytic Normochromic- B9/Folic Acid: seen w/ chronic alcoholics, pregnancy, malabsorption
  • Used to prevent neural tube defects
  • B12/Cyanocobalamin Pernicious Anemia
  • Progresses to posterolateral sclerosis (PLS) of SC, which is also known as, combined systems disease
A

Megaloblastic Anemia

346
Q

Anemia asso. w/ lack of IF due to chronic atrophic gastric mucosa causing loss of parietal cells.
Dx: Shilling Test (24 hour urine)
Tx: (?)

A

B12 / Cyanocobalamin Pernicious Anemiatx: B12 shots

347
Q

Hypochromic Microcytic anemia

Seen with Chronic blood loss & pregnancy

A

Iron Deficiency Anemia

348
Q

Normochromic Normocytic Anemia
Panhypoplasia of the bone marrow, decrease in all blood cells
Seen w/ drugs, chemo, radiation, MM, RA, leukopenia, acute blood loss, benzene poisoning & thrombocytopenia

A

Aplastic Anemia

349
Q

UA: Color- Straw

A

Normal

350
Q

UA Color: REd

A

Blood or Food Pigments

infection, cancer, food dyes

351
Q

UA Color: Green

A

Biliverdin

biliary duct obstruction, pseudomonas infection, bad protein digestion

352
Q

UA Color: Blue

A

Diuretic Therapy, Pseudomonas infection, Bad protein digestion

353
Q

UA Color: Brown

A

Bile Pigments or Blood

biliary duct obstruction, occult blood, homogentisic acid

354
Q

UA Color: Black

A

Homogentisic Acid or Urobilin

Ochronosis, hemolysis, bacteria

355
Q

Hazy or Cloud appearance in UA

A

Epithelial cells, WBC’s, RBC’s, crystals, sperm, microorganisms

356
Q

Milky appearance of UA

A

WBC’s or fat

357
Q

What is normal pH of a UA

A

4-8

358
Q

What is specific gravity of UA?

A

1.01-1.03

359
Q

What causes an increase of specific gravity in UA

A

Bacterial infection, DM, kidney abnormalities

360
Q

Glucose in UA indicates…

A

DM, shock, head injury, pancreatic disease, renal tubular disease

361
Q

Ketones in UA indicates…

A

Starvation
DM
Weight Loss Diets
Inadequate Carb Intake

362
Q

Protein in UA indicates…

A

Kidney Disorders
Toxemia of Pregnancy
DM
MM

363
Q

Increased Urobilinogen in UA indicates….

A

Hemolytic Disease or Hepatic Disease

364
Q

Decreased Urobilinogen in UA indicates…

A

Biliary Obstruction

365
Q

Bilirubin in UA indicates…

A

Hepatic Disease or Biliary Obstruction

366
Q

Blood in UA indicates…

A 
Tumors
Trauma
Kidney Infection or Stones
Hypertension
Bleeding Disorders
367
Q

UA Casts:

  • Hyaline
  • Epithelial
  • RBC
  • WBC
  • Waxy
A 
Hyaline - normal
Epithelial - tubular damage
RBC - glomerulonephritis
WBC - pyelonephritis
Waxy - Renal Failure, Nephrosis
368
Q

Increased Acid Phosphatase (PAP)

A

Prostatic Carcinoma

369
Q

Reversed Albumin/Globulin (A/G) Ratio

A

Multiple Myeloma

370
Q

Increased Alkaline Phosphatase

A

Osteoblastic Lesions
Hepatic Disease
Hyperparathyroidism (HPT)

371
Q

Increased Amylase

A

Acute Pancreatitis

372
Q

ANA (FANA) in labs

A

Collagen disease (SLE, Scleroderma)

373
Q

Increased Antistreptolysin - O (ASO) Titre

A

Rheumatic Fever

Acute Glomerulonephritis

374
Q

Increased Direct Bilirubin

A

Hepatitis

Duct Obstruction

375
Q

Increased Indirect Bilirubin

A

Hemolytic Disease

376
Q

Increased BUN (Blood Urea Nitrogen)

A

Renal Disease
Dehydration
Hypotension
Urinary Tract Obstruction

377
Q

Decreased BUN

A

Hepatic Disease

Pregnancy

378
Q

Increased Calcium (Ca)

A

Muscle Weakness
HPT
Hypervitaminosis D
Metastatic Disease

379
Q

Decreased Calcium (Ca)

A

Muscle Tetany
Chvostck’s Sign (facial tetany)
Renal failure
Malnutrition

380
Q

CPK (Creatine Phosphokinase)

  • CK BB
  • CK MB
  • CK MM
  • Increased:
A

BB - Brain Tissue
MB - Myocardial Tissue
MM - Skeletal Muscle
Increased - Muscle Necrosis

381
Q

Increased Creatine

A

Kidney Disease

Hypovolemic Shock

382
Q

Decreased Creatine

A

Muscular Dystrophies

383
Q

Increased C-Reactive Protein (CRP)

A

Tissue Necrosis
Infections
RA

384
Q

ELISA

A

Screening test for AIDS

385
Q

Increased Erythrocyte Sedimentation Rate (ESR)

A

Infection
RATB
Temporal Arteritis
MM

General Diagnosis (1.1) (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions