General Diagnosis Flashcards
health history includes
chief complaint
past health history
personal and social history
review of systems
chief complaint
covers the reason patient is seeking care and should be obtained in the patient’s own words
present illness
OPQRST onset palliative/provoking quality of pain radiation/referral site/setting/severity timing
past health history
serious illness previous injuries hospitalizations surgeries medications allergies
family health history
cardiovascular disease
diabetes
stroke
cancer
social/personal history
marital status occupation diet exercise bowel/urinary patterns sleep alcohol, tobacco, drug use stress
CAGE questionnaire
for if you think the person might be an alcoholic
C- cutting down (have you ever felt you need to cut down on the amount of drinking you do?)
A- annoyed by others’ criticisms
G-guilty feelings
E- eye openers (do you feel like you need a morning eye opener drink?)
normal temperature values
oral 98.6
rectal and tympanic 99.6
axilla 97.6
range: 96-99.5F/35-37C
normal respiratory rates
adult: 14-18
newborn: 44
normal BP values
90-120/60-80
HTN value
140-90
hypotension value
90/60
auscultatory gap
take a palpatory systolic readiing
auscultatory gap is the loss and reappearance of pulsatile sound while listening with the stethoscope during cuff deflation
Korotkoff sound
low pitched sounds produced by turbulent blood flow in arteries
a difference of ____in systolic readings can indicate ___ such as…?
10-15mmHg
arterial occlusion
subclavian steal syndrome on the side of decreased value
blood pressure readings are ____in lower extremities
20% higher
barre-lieou
patient seated, examinera instructs the patient to rotate head maximally from side to side
done slowly at first, then accelererated to patient tolerance
pre-syncope, vertigo, nystagmus, nausea= positive for VBAI
DeKleyn’s
patient supine, the examiner instructs the patient to rotate and extend the head off the table and turn to each side for 15-45 seconds
nystagmus, dizzines, lightheadedness, blurred vision, nausea= positive for VBAI
Hallpike
an enhanced DeKleyn’s patient supine, head extended off table
examiner offers support for the skull
examiner brings head into extension, rotation and lateral flexion
nystagmus, dizziness, lightheadedness, blurred vision, nausea= positive for VBAI
Hautant’s
patient seated, arms extended forward to shoulder level with hands supinated
maintain for a few second
patient then closes eyes, rotates and hyperextends the neck to one side
repeat to other side
arms wave with eyes closed and head rotated and extended back= positive for VBAI
Underberg
patient stands with eyes open, arms at side, feet close together
patient closes eyes, extends arms and supinates hands, then patient extends and roates head to one side
then in this position patient is instructued to march in place
Maigne’s
patient is seated, examiner brings head into extension and rotation
scaly eyebrows indicates?
seborrhea
loss of lateral 1/3 of eyebrows indicates?
myxedema (hypothyroidism)
is eyebrow loss normal with age?
yes
adie’s pupil
sluggish pupillary reaction to light that is unilateral and caused by a parasympathetic lesion of CN 3
anisocoria
unequal pupil size (head injury, physiologic, pharmacologic, pathologic)
argyll robertson
bilaterally small and irregular pupils that accomodate but do not react to light
seen with syphilis (prostitute’s pupil)
arroyo sign
sluggish pupillary reaction due to hypo-adrenalism (addison’s disease)
blepharitis
inflammation of eyelid seen with seborrhea, staph infection and inflammatory processes
cataracts
opacities seen in lends that are commonly seen with diabetes and in the elderly
also has an absent red light reflex and blurred/clouded vision
chalazion
an infection of the meibomian gland causing a nodule which points insidethe lid, not painful
conjunctiva
pink=normal
pale=anemia
bright red=infection
corneal arcus
grayish opaque ring around the cornea
diabetic retinopathy
affects veins more than arteries and prsents with microaneurysms, hard exudates, neovascularization
cotton wool patches (early sign)
ectropion
lid turned outward
seen in elderly
entropion
lid turned inward
seen in elderly
exopthalmosis
lid lag/failure to cover eyeball
can be seen with graves (bilateral) or tumor (unilateral)
glaucoma
increased intraocular pressure causing cupping of optic disc
patient will notice blurring of their vision especially in peripheral fields as well as rings around lights
crescent signs will be present upon tangential lighting of cornea
hordeolum
AKA sty
an infection of sebaceous glands causing a pimple or boil on the eyelid
horner’s syndrome
ptosis, miosis, anhydrosis on same side as an interruption to the cervical sympathetics
hypertensive retinopathy
damage to retianl vessels/background will show copper wire deformity, A-V nicking, flame hemorrhages, cotton wool exudates
internal opthalmoplegia
dilated pupil with ptosis and lateral deviation
doesn’t react to light or accomodation
multiple sclerosi
iritis/uveitis
inflammation of iris
seen with AS
macular degeneration
most common reaction for blindness in elderly
central vision lost, macular drusen is an early sign of macular degeneration
miosis
fixed and constricted pupils that react to light and accomodated
seen with severe brain damage, pilocarpine medications, narcotic use
mydriasis
dilated and fixed pupils seen with anticholinergic drugs
papilledema
AKAchoked sidc
swelling of soptic disc due to increased intracranial pressure
NO VISUAL LOSS
may be seen with brain tumor or brain hemorrhage
periorbital edema
swelling around the eye seen with allergies, myxedema (hypothyroidism) and nephrotic syndrome
pinquecla
yellowish triangular nodule in bulbar conjunctiva that is harmless and indicates aging
pteryguim
triangular thickening of the bulbar conjunctiva that crows across the cornea and is brought on by dry eyes
ptosis
drooping of eyelid
seen in horner’s CN3 paralysis, myasthenia gravis, mlutiple sclerosis
retinal detachment
painless sudden onset of blindness described as curtains closing over vision
lightning flashes and floaters are seen prior to visual loss
sclera
white=normal
yellow=jaundice
blue=osteogenesis imperfecta
xanthelasma
fatty plaeuqs on the nasal surface of the eye lids that may be normal or indicates hypercholesterolemia
emmetropia
normal vision
myopia
near sighted
hyperopia
farsighted
presbyopia
loss of lens elasticity due to aging
direct light reflex
CN 2 and 3
consenual light refle
CN 2 and 3
swinging light test
CN 2 and 3
eye pathology
accomodation
CN 2 and 3
visual acutiy
snellen chart
cardinal fields of gaze
CN 3, 4, 6
what are the innervations of the muscles of the eye?
superior oblique CN4
lateral rectus CN6
inferior oblique, medial rectus, superior recus, inferior rectus CN3
