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Part II/III Board Review > General Diagnosis > Flashcards

General Diagnosis Flashcards

1
Q

The CAGE questionaire indicates alcoholism. What does CAGE stand for?

A

Cutting down (felt the need to cut down)
Annoyed by other criticisms
Guilty Feelings
Eye openers (felt the need for a morning “eye opener” drink)

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2
Q

What are normal values of the following temps;
Oral?
Rectal & Tympanic?
Axilla?

A

Oral = 98.6F
Rectal & Tympanic = 99.6F
Axilla = 97.6F

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3
Q

What are normal pulse values in adults? Newborns? Elderly?

A

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

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4
Q

What are normal respiratory rates for adults? Newborns?

A

Adult: 14-18
Newborn: 44

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5
Q

What is normal BP ranges for adults?

A

90-120/60-80

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6
Q

Low pitched sounds produced by turbulent blood flow in arteries when a BP cuff is deflated. (Sounds you hear when taking a BP)

A

Korotkoff sounds

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7
Q

A difference of 10-15mmHg b/w sides in systolic readings can indicate what?

A

Arterial occlusion such as subclavian steal syndrome on the side of decreased value

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8
Q

BP readings are what % higher in the LE?

A

20%

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9
Q

What are ortho tests for vertebrobasilar artery insufficiency?

A 
Barre-Lieou
DeKleyn's
Hallpike
Hautant's
Underberg
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10
Q

Scaly eyebrows indicates what?

A

Seborrhea

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11
Q

Loss of lat. 1/3rd of eyebrows indicates what?

A

Myxedema

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12
Q

Drooping of the eyelid

A

Ptosis

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13
Q

Ptosis is assoc. w/ what conditions?

A

Horner’s (also see meiosis & anhydrosis)
CN 3 paralysis (also see dilated pupil)
Myastenia Gravis

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14
Q

Lid lag/failure to cover the eyeball seen w/ Graves (bilateral) or tumor (unilateral

A

Exophthalmosis

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15
Q

Lid is turned outward & seen in the elderly

A

Ectropion

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16
Q

Lid is turned inward & seen in the elderly

A

Entropion

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17
Q

Swelling around the eye seen w/ allergies, myxedema, & nephrotic syndrome (HEP)

A

Periorbital edema

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18
Q

Inflammation of the eye seen w/ seborrhea, staph infection, & inflammatory processes

A

Blepharitis

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19
Q

Opacities seen in the lens that are commonly seen w/ diabetes & in the elderly. Also has an absent red light reflex

A

Cataracts

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20
Q

Grayish opaque ring around the cornea. Early (50yoa) is normal

A

Corneal Arcus

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21
Q

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

A

Pterygium

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22
Q

A yellow sclera indicates what? Blue sclera?

A

Yellow =Jaundice

Blue = Osteogenesis Imperfecta

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23
Q

A pale conjuctiva indicates what? Bright red?

A

Pale = anemia

Bright red = Infection

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24
Q

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

A

Hordoleum (sty)

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25
Q

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

A

Chalazion

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26
Q

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

A

Pinquecula

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27
Q

Fatty plaques on the nasal surface of the eyelids that is normal or indicates hypercholesterolemia

A

Xanthelasma

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28
Q

Bilaterally small & irregular pupils that accommodate but don’t react to light. Seen w/ syphilis (AKA prostitutes pupil)

A

Argyll Robertson pupils

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29
Q

Dilated pupil w/ ptosis & lat. deviation. Doesn’t react to light or accommodation. Assoc. w/ MS

A

Internal Opthalmoplegia

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30
Q

Dilated & fixed pupils seen w/ anticholinergic drugs

A

Mydriasis

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31
Q

Fixed & constricted pupils that react to light & accommodate. Seen w/ severe brain damage, pilocarpine medications, & narcotic use

A

Miosis

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32
Q

Unequal pupil size

A

Anisocoria

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33
Q

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

A

Adie’s pupil

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34
Q

Sluggish pupillary reaction d/t hypoadrenalism (Addison’s ds)

A

Arroyo Sign

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35
Q

Ptosis, miosis, & anhydrosis on the same side as an interruption to the cervical sympathetics

A

Horner’s syndrome

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36
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. Cresecent sign will be present upon tangential lighting of the cornea

A

Glaucoma

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37
Q

Swelling of the optic disc d/t increased intracranial pressure. No visual loss. May be seen w/ a brain tumor or brain hemorrhage

A

Papilledema AKA Choked disc

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38
Q

Painless sudden onset of blindness described as curtains closing over vision lightening flashes & floaters

A

Retinal detachment

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39
Q

M/C cause of blindness in the elderly, central vision lost

A

Macular degeneration

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40
Q

What is an early sign of Macular degeneration?

A

Macular drusen (yellow deposits under the retina)

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41
Q

Damage to the retinal vessels. Background will show these signs; copper wire deformity, silver wire deformtiy, A-V nicking, flame & splinter hemorrhages, & cotton wool soft exudates

A

HTN Retinopathy

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42
Q

This affects the veins more than the arteries in the eyes & presents w/ microaneuryms, hard exudates, & neovascularization

A

Diabetic Retinopathy

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43
Q

Inflammation of the iris. Seen w/ AS

A

Iritis

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44
Q

Normal vision is called what?

A

Emmetropia

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45
Q

Nearsighted is AKA?

A

Hyopia

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46
Q

Farsighted is AKA?

A

Hyperopia

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47
Q

Loss of lens elasticity d/t aging

A

Presbyopia

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48
Q

Direct light reflex test what CN’s?

A

CN II

CN III

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49
Q

Consensual Light reflex tests what CN’s?

A

CN III

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50
Q

Accommodation tests what CN’s?

A

CN II

CN III

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51
Q

Visual acuity is tested w/ what?

A

Snellen Chart

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52
Q

Cardinal fields of gaze tests what CN’s?

A

CN III
CN IV
CN VI

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53
Q

The presence of ringing in the ears.

A

Tinnitus

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54
Q

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

A

Presbycussis

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55
Q

An infection of the outer ear. Pt experiences inflammation & pain of the outer ear. Tugging on the pinna will be painful.

A

Acute Otitis Externa (Swimmer’s Ear)

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56
Q

Bacterial infection in the mastoid process. Presents clinically w/ the same s/s of acute otitis media, w/ the addition of inflammation & palpatory tenderness over the mastoid. Hearing loss is commonly assoc.

A

Acute Mastoiditis

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57
Q

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

A

Purulent Otitis Media AKA Bacterial Otitis Media

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58
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 w/ bubbles

A

Serous Otitis Media

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59
Q

An abnormal sensation of rotary movement assoc. w/ difficulty in balance, gait, & navigation of the environment

A

Vertigo

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60
Q

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

A

Meniere’s Disease

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61
Q

A brief episode of vertigo brought on by a change of head position.

A

Benign Paroxysmal Positional Vertigo

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62
Q

How is BPPV dx?

A

Perform the Dix-Hallpike Maneuver

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63
Q

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

A

Acoustic Neuroma

64
Q

Nasal mucosa appears red & swollen w/ a clear runny nose

A

Viral Rhinitis

65
Q

Nasal mucosa appears pale or blue & boggy

A

Allergic Rhinitis

66
Q

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

A

Atrophic Rhinitis

67
Q

These typically occur as a consequence of chronic inflammation of the nasal mucosa

A

Polyps

68
Q

Red sores at the corner of the mouth. Can be caused by a Vit. B2 (riboflavin) deficiency

A

Angular Stomatitis AKA Cheilosis

69
Q

Thick white fungal patches on the tongue/mouth that are easily scraped off

A

Candidiasis AKA Thrush

70
Q

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

A

Leukoplakia

71
Q

A deficiency of B vitamins or iron that causes the tongue to appear smooth & glossy

A

Atrophic Glossitis

72
Q

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

A

Fissured tongue AKA Scrotal tongue

73
Q

Excessive production of growth hormone prior to skeletal maturation

A

Gigantism

74
Q

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

A

Acromegaly

75
Q

M/C’ly caused by Grave’s ds. TSH production is decreased & the thyroid hormones (T3 & T4) are produced in excess

A

Hyperthyroidism

76
Q

Hypothyoidism (AKA Myxedema) is M/C’ly caused by what in the US?

A

Hashimoto’s thyoiditis

77
Q

Congential hypothyroid is AKA what?. Causes a diminished physical & mental capacity.

A

Cretinism

78
Q

What are charac. of hyperthyoidism?

A
  • Weight loss w/ increased appetite
  • Irritable & nervous
  • Intolerance to heat
  • Moist skin & fine hair
  • Exophthalmos
  • Possible neck swelling d/t goiter
  • Increased T3, T4, & decreased TSH
79
Q

What are charac. of hypothyroidism?

A
  • Weight gain w/ decreased appetite
  • Depression, weakness, & fatigue
  • Intolerance to cold
  • Coarse, dry hair & skin
  • Periorbital edema
  • Macroglossia & loss of lat. 1/3rd of eyebrows
  • Decreased T3, T4, & increased TSH
80
Q

Barrel chest is seen w/ what ds’s?

A

COPD

Cystic fibrosis

81
Q

Marked depressio nnoted in the sternum

A

Pectus Excavatum AKA Funnel Chest

82
Q

Forward protrusion of the sternum

A

Pectus Carinatum AKA Pigeon Chest

83
Q

Rapid, shallow breathing

A

Tachypnea

84
Q

Slow breathing

A

Bradypnea

85
Q

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

A

Biot’s Breathing

86
Q

Breathing pattern charac. by alternating periods of apnea & hyperpnea (has pattern); Respiratory acidosis

A

Cheyne-Stokes Respiration

87
Q

Breathing is first rapid & shallow but as metabolic acidosis worsens, breathing gradually b/co deep, slow, labored, & gasping. “Air hunger breathing”

A

Kussmaul’s

88
Q

Pitted nails are assoc. w/ what condition?

A

Psoriasis

89
Q

Splinter hemorrhage in the nails is assoc. w/ what?

A

Subacute bacterial endocarditis (Strep organism)

90
Q

Transverse ridging of the nails assoc. w/ acute severe ds is called what?

A

Beau’s Lines

91
Q

Inflammation of the nail fold near the cuticle

A

Paronychia

92
Q

When the nail base has an angle >180 deg. & may indicates hypoxia/COPD

A

Clubbing

93
Q

Koilonychia AKA Spoon nails are assoc. w/ what condition?

A

Iron deficiency anemia

94
Q

Small, clicking, bubbling, or rattling sounds in the lung. They are believed to occur when air opens closed air spaces. Can be described as moist, dry, fine, & coarse. Assoc. w/ bronchitis

A

Rales

95
Q

Lung sounds that resemble snoring. They occur when air is blocked or b/co rough through the large airways. Assoc. w/ Bronchiectasis

A

Rhonchi

96
Q

Lung sounds that a high-pitched sounds produced by narrowed airways. They can be heard upon exhalation. Assoc. w/ asthma in young people & emphysema in older people

A

Wheezes

97
Q

A wheeze-like sound heard upon inspiration. Usually d/t a blockage of airflow

A

Stridor

98
Q

Consolidation of the lung. Occurs in 4 stages (consolidation, red hepatization, grey hepatization, resolution). Percussion is dull (over fluid), rales aka crackles, increased tactile fremitus, productive cough at 10 days, rusty brown sputum, possible fever, silhouette sign, & air bronchogram

A

Lobar Pneumonia

99
Q

Productive/currant red jelly sputum & caused by Klebsiella pneumonia. Seen w/ old age or immunocompromised hosts

A

Friedlander’s Pneumonia

100
Q

Lung condition caused by yeast/fungus. M/C seen in AIDS pts.

A

Pneumocystis Carinii

101
Q

Caused by CMV. M/C seen in AIDS pts

A

Cytomegalovirus

102
Q

Presents w/ low grade fever, night sweats, productive cough, yellow/green sputum, small white lesions called Ghon lesions seen on x-ray, starts in apices of the lung, crackles in upper lobe, tine test/Mantoux test, positive purified protein derivative. Most definitive test for dx is sputum culture

A

TB (caused by mycobacterium tuberculosis)

103
Q

Inflammation of the pleura, usually producing an exudative pleural effusion & stabbing chest pain worsened by respiration & cough. Dull on percussion, dry/non-productive cough, decreased respiratory excursion, decreased tactile fremitus, dull on percussion, friction rub is present, decreased breath sounds, (+) Schepelmann’s Test

A

Pleurisy

104
Q

A ruptured lung causing air to b/co trapped in the pleural space. Decreased chest expansion, decreased tactile fremitus, hyper-resonant, decreased breath sounds. Can occur in young, previously healthy individuals. Unilateral darkening of the chest d/t collapse of the lung; tracheal shift away from lesion.

A

Pneumothorax

105
Q

Collapse of the lung that is usually the result of bronchial obstruction d/t a mucous plug. Presents w/ decreased tactile fremitus, dull on percussion, decreased chest expansion, decreased or absent breath sounds, on x-ray the collapsed lung will display increased density, & mediastinal shift to the same side

A

Atelectasis

106
Q

Irreversible focal bronchial dilation that presents w/ a chronic, productive cough. CT is necessary to dx/confirm

A

Bronchiectasis

107
Q

Defined by a long term cough w/ mucus, shortness of breath & wheezing. Cigarette smoking is the main cause. Lon g exposure to other things such as chemical fumes, dust & other substances may cause this

A

Chronic bronchitis/COPD

108
Q

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

A

Asthma

109
Q

Destruction of elastic pulmonary connective tissue results in permanent dilation of the alveoli air sacs & caused by a deficiency of alpha I anti-trypsin. Presents w/ decreased tactile fremitus, hyperresonant percussion, decreased breath sounds, & prolonged expiration w/ an expiratory wheeze likely. Fluid will accumulate first in the costophrenic recesses. X-ray findings: bilat. darkened lung fields; narrowed compressed heart; horizontal ribs; flattening of the diaphragmatic domes

A

Emphysema

110
Q

Primary malignant lung tumor that starts in the area of the bronchus. Long term hx of smoking (20-30yrs). Coughing (non-productive) more than 30 days, afebrile, dyspnea, weight loss & clubbing of the fingernails

A

Bronchogenic Carcinoma

111
Q

Inflammation of the cartilage connection b/w the ribs & sternum. It develops as a consequence of physical activity & is worse w/ exercise. The pain increases while taking a deep breath. There will be palpable tenderness at the costosternal articulation.

A

Costochondritis AKA Tietze Syndrome

112
Q

Painful rash following the course of a dermatome usually a single nerve. Primarily involves the DRG but when it does involve CN it is M/C’ly CN V

A

Herpes Zoster aka Shingles

113
Q

A ds in which abnormal collection of inflammatory cells (granulomas) form as nodules. Most often appear in the lungs or lymph nodes. M/C seen in African descent in the US. X-ray: bilat. hilar lymphandenopathy

A

Sarcoidosis

114
Q

Cancer of the lymphatic system that can spread to the spleen. M/C seen in young Caucasian males. Presents w/ fever, night sweats, weight loss, intense pruritis (release of IgE), & enlarged spleen. Best dx from biopsy looking for Reed Sternberg cells. X-ray: Unilateral hilar lymphadenopathy.

A

Hodgkin’s

115
Q

Chronic, progressive, & frequently fatal genetic (inherited) ds of the body’s mucus glands; an abnormality in the glands that produce or secrete sweat & mucus; Loss of excessive amounts of salt; Thick accumulation of mucus in the intestines & lungs; COPD, barrel chest, pancreatic insufficiency, meconium ileus.

A

Cystic fibrosis

116
Q

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

A

Jugular Venous Pulsations

117
Q

“Bounding” pulse; Seen w/ increased cardiac output; exercise anxiety, fever, hyperthyroidism

A

Pulsus Magnus

118
Q

Weak or thready pulse. Seen w/ decreased stroke volume, hypovolemia, aortic stenosis, CHF

A

Pulsus Parvus

119
Q

Pulse that alternates in amplitude. Seen w/ L ventricular failure

A

Pulsus Alterans

120
Q

2 strong systolic peaks separated by mid-systolic dip (best felt at carotid artery; Seen w/ aortic regurgitation, aortic stenosis

A

Pulsus Bisferiens

121
Q

Pulse w/ decreased amplitude on inspiration, increased w/ expiration (>10mmHg amplitude change); Seen w/ COPD, bronchial asthma, emphysema, pericardial effusion

A

Pulsus Paradoxus

122
Q

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

A

Water Hammer Pulse

123
Q

Vibration produced by turbulent blood flow w/i the heart

A

Thrills (murmurs)

124
Q

This heart sound is normal in children, young adults, & athletes. In >40yoa it is the earliest sign of CHF

A

S3 (Ventricular gallop)

125
Q

This heart sound is related to stiffness of the ventricular myocardium to rapid filling

A

S4 (atrial gallop)

126
Q

This type of murmur has a low pitch & is best heard w/ the bell of the stethoscope

A

Stenosis

127
Q

This type of murmur has a high pitch & is best heard w/ the diaphragm of the stethoscope

A

Regurgitation

128
Q

The mnemonic for heart murmurs which occur in diastole is ARMS & PRTS. What does it stand for?

A

Aortic Regurgitation, Mitral Stenosis
Pulmonic Regurgitation, Tricuspid Stenosis
(opposite occurs during systole)

129
Q

Failure of shunt to close b/w the aorta & L pulmonary art. Creates a continuous/machinery like murmur that can be heart in both phases of the heart cycle

A

Patent Ductus Arteriosus

130
Q

Dextraposition of the aorta, R ventricular hypertrophy, Interventricular septal defect, & Pulmonic stenosis. Creates a loud ejection murmur during systole & severe cyanosis

A

Tetralogy of Fallot (DRIP)

131
Q

Constriction of the descending aorta (usually distal to the L subclavian). Causes higher blood pressure in the UE by 20mmHg (diagnostic) when compared to the LE. Commonly assoc. w/ Marfan’s Syndrome.

A

Coarctation of the Aorta

132
Q

Narrowing prox. to the vertebral art. Seen in younger females who faint (syncope/drop attacks) while exercising.

A

Subclavian Steal Syndrome (“Subclavian steals from the vertebral”)

133
Q

What are the M/C causes of L-sided heart failure?

A

HTN (M/C)

Aortic stenosis

134
Q

What is the M/C cause of R-sided heart failure?

A

L-sided heart failure

135
Q

What is the M/C cause of mitral stenosis?

A

Rheumatic fever

136
Q

Lung condition that causes R-sided heart failure. When the R-side fails by itself

A

Cor Pulmonale

137
Q

On an ECG, an increased PR interval indicates what?

A

Prolonged AV nodal delay (primary heart block)

138
Q

On an ECG, two P waves before the QRS is what?

A

Weinkbochs-block of bundle of HIS (Secondary heart block)

139
Q

On an ECG, no QRS wave indicates what?

A

Complete heart block (no ventricular contractions)

140
Q

On an ECG, if the ST segment is enlarged or inverted it indicates what?

A

MI (acute heart failure)

141
Q

Increase in what lab values indicate MI?

A

Creatine Phosphokinase (CPK)
SGOT
LDH

142
Q

BUN is used to test what organ(s) functions?

A

Liver

Kidneys

143
Q

Tumor marker specific for hepatocellular carcinoma

A

Alpha fetoprotein

144
Q

Calcification of the gallbladder that may b/co malignant d/t chronic inflammation

A

Porcelain Gallbladder

145
Q

This organ can refer pain to the R shoulder or tip of R scapula

A

Gallbladder

146
Q

Epigastric pain going straight through the T10-T12 area like a knife should make you think what organ?

A

Pancreas (pancreatitis)

147
Q

Bleeding into the flank assoc. w/ pancreatitis is what sign?

A

Grey Turner sign

148
Q

Periumbilical ecchymosis assoc. w/ pancreatitis is what sign?

A

Cullen’s Sign

149
Q

Pancreatic cancer usually affects what part of the pancreas?

A

Head

150
Q

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

A

Diabetes Insipidus

151
Q

Protrusion of the stomach above the diaphragm. PResents w/ palpable tenderness in LUQ, reflux esophagitis, dyspepsia, made worse after eating large meal or when lying down

A

Hiatal Hernia

152
Q

Projectile vomiting in the newborn

A

Pyloric Stenosis

153
Q

Presents w/ symptoms similar to the flu such as fever, HA, fatigue, lymphadenopathy in the cervical region, splenomegaly. Atypical lymphocytes in blood (Downey cells). Tested w/ Monospot AKA Heterophile Agglutination AKA Paul Bunnell Test. Caused by Epstein Barr Virus

A

Mononucleosis

154
Q

A systemic or metabolic condition that involves every bone. The bone marrow b/co sclerotic so RBCs aren’t made. The liver & spleen make RBCs & b/co enlarged

A

Osteopetrosis “Marble Bone”

155
Q

Nonspecific inflammatory disorder that affects distal ileum & colon. Inflammation is patchy w/ healthy tissue b/w the patches, which is referred to as a ‘cobblestone’ appearance. Doesn’t absorb B12.

A

Regional Ileitis AKA Crohn’s Ds

156
Q

M/C at the colon & rectum. Presents w/ bloody mucous in diarrhea, fever. Can lead to sacroiliitis (enteropathic arthropathy)

A

Ulcerative Colitis

157
Q

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

A

IBS AKA Spastic colon

Part II/III Board Review (15 decks)

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