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T: Part 2 Boards > General Diagnosis > Flashcards

General Diagnosis Flashcards

1
Q

Where’s the best place to get headache information from you patient during case history?

A) CC
B) present illness
C) ROS
D) HPI

A

B) present illness (siqorra / opqrst)

You get majority of your ddx info here

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2
Q

How many vital signs do you have?

A) 2
B) 4
C) 6
D) 8

What are they?

A

C) 6

T
Pulse
BP
Heart rate
Height
Weight
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3
Q

Where do you find unrelated problems to the cc during history?

It’s mandatory to do if you are a portal of entry physician

A

ROS

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4
Q

What’s most accurate location for temperature?

What’s most common used locations? (2 options)

A

1) Anal

2) Otic & Oral

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5
Q

Unpredictable spikes of fever -> chills helps ddx what type of infection?

Sustained fever helps ddx what?

A

1) Viral infection

2) Bacterial infection

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6
Q

Blood pressure of 110/90 would be called _______, and pt is at risk of _______ due to standing up fast / poor diet

A

Orthostatic hypotension

Fainting / syncope

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7
Q

How do you find true systolic bp?

True diastolic bp?

A

palpating pulse disappearance

Listening all the way to 0

Auscultatory gaps may be present in hypertension and give false readings if you don’t go full range when doing bp

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8
Q

Icterus = ?

A

Jaundice

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9
Q

Absent red light reflex that’s appearing green ddx? (2)

1: cloudy appearance
2: Falling curtain / flashing lights

White reflex in babies eye ddx?

A

1: Cataracts
2: Retinal detachment
3: retinoblastoma

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10
Q

Enlarged disc cup due to intracranial pressure ddx? Pt usuall complains of HA

Intraoccular pressure ddx?

A

1: Papilledema
2: Glaucoma

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11
Q

developing cholesterol deposits around cornea/iris as a greyish/white ring + pupillary dialation under 30 yo ddx?

Over 30 yo?

Which one is significant?

A

1) corneal arcus (significant)

2) arcus senilis

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12
Q

Copper wire / cotton wool spots / flame hemorrhages are indicative of what over systemic issue occurring?

A

Hypertension

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13
Q

Scintillating scotomas identify a __________ problem. 2 Exs?

A

1) Neurovascular problem

Ex/ Ms or Migraines

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14
Q

Which way do you pull ear to straighten the tympanic canal in kids?

A

1) down & back

Adults = up & back

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15
Q

What causes a visibly retracted tympanum?

A

Blocked eustachian tube

Due to serous bubbly infections / high altitude

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16
Q

What causes a visibly bulged tympanic membrane?

A

Otitis media

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17
Q

Weber rest uses a _____ hz tuning fork?

Rhine is done on which ear?

A

512 hz tuning fork = screen

The ear sound lateralized to (hear louder)

“Rhine on the ear that can hear better”

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18
Q

When doing Rhinne test, you place tuninning fork ______ 1st, then move it to ______ 2nd.

Normal is _________________.

ddx of (conduction/sensorineural) on (tested/opposite) ear.

A

When doing Rhinne test, you place tuninning fork MASTOID 1st, then move it IN FRONT OF EAR 2nd.

Normal is AIR conduction TWICE as long as BONE conduction

ddx of SENSORINEURAL on OPPOSITE ear due to nerve problem (cn 8 - vestibule cochlear)

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19
Q

Pt comes in with ear infection in R ear. Weber would lateralize to which ear?

Rhinne would be (normal / abnormal)?

Pt has menieres in R ear. Weber would lateralize to which ear?

Rhinne would be (normal / abnormal)?

A

1) R

Abnormal

2) L

Normal

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20
Q

Cn 1-12 full names?

A

1) olfactory
2) optic
3) oculomotor
4) trochlear
5) trigeminal
6) abducens
7) facial
8) vestibulocochlear
9) glossopharyngeal
10) vagus
11) accessory
12) hypoglossal

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21
Q

Watery unilateral discharge from the nose ddx?

A

Cribriform plate fx

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22
Q

Epistaxis = ?

A

Nose bleed

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23
Q

Discharge:

Pale / blue / grey = ?

Green = ?

Foul = ?

A

1) allergies / chronic “itis”
2) infection
3) foreign object (usually in kids that don’t have any other signs/symptoms [ex fever] but have discharge for weeks)

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24
Q

Majority of your bodies lymphatic system drains to the ________ side of your body?

A

Left side

Right side is everything above diaphragm on r half of body

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25
Q

Palpating a firm hard enlarged nodule on the supraclavicular / sentinel lymph node known as a ______ is more dangerous on the (Right / Left) side of the body?

A

Virchows Node

Left

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26
Q

X-ray presents with a widening of the mediastinum. Ddx?

A

Lymphoma

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27
Q

When palpating a patients lymph nodes and you find a mobile, tender lump. What do you do?

A

Continue exam, it’s a normal finding.

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28
Q

Warning signs for Soft Tissue Cancers when palpating lymph nodes are ________ & _________ nodules when palpated

A

Non-mobile

Non-tender

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29
Q

4 signs of soft tissue cancers due to chronic irritation

How to dx it?

A 
1) 
Proliferating cells (greedy)
Firm / Rigid soft tissue (stubborn)
Painless mass (heartless)
Painless bleeding (bleeds you dry)

[Soft tissue Cancer = big business ceo]

2) biopsy

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30
Q

Where is the head of the pancreas located? Tail?

A

Epigastric region (retroperitoneal)

(below xyphoid with deudenum)

2)

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31
Q

Patient presents in slight postural flexion with epigastric pain below xyphoid straight back to T10 like a knife with posterior flank ecchymosis (painless), what’s your ddx?

What test do you order?

A

Pancreatitis / cancer
(HEAD of pancreas)

(bruising from bleeding leaking into flanks due to pancreas head located retroperitoneal)

2) amylase lipase

Distractor: kidneys / UA

(Kidneys = PAINFUL FLANKS)

(Pancreas = PAINLESS BRUISING OVER FLANKS, pain straight through like knife xyphoid -> t10)

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32
Q

Diabetes mellitus type ____ is insulin dependent

A

Type 1

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33
Q

Diabetes mellitus type ______ is a insulin receptor / insulin manufacturer malfunction due to excess consumption of _______ ________ sugars

TX: ?

A

Type 2

High glycemic sugars

Tx: 
Chromium 
Protein
Essential fats
Exercise
Probiotics
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34
Q

Obese patient that is fatigued / short tempered / cranky always after eating.

Potentially heading towards what ddx?

A

Hypoglycemia aka hyperinsulinemia
(Diabetes mellitus type 2)

[non obese pt = not diabetes related]

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35
Q

Why does diabetes mellitus type 2 lead to “crud in the blood” (short answer)

What does this cause in patients?

What is the main test for dx?

A

1) Sugar can’t be stored in muscles, they begin to starve.
Liver pulls out fat to make ketones to compensate.
Causes ketoacidosis, fruity breathe & fat storage depletion which increases hunger drive (body thinks it’s starving)
Sugar attracts bacteria/fungus to blood.

Blood becomes full of sugar, bacteria, fungus, fat, ketones

Glycosylation: Sugar is sticky & coats everything leading to increase thirst. classic triad: Polydipsia / polyuria / polyphasia

2) hypertension / arteria disease / infections
(more so lower extremities)

3) A1C

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36
Q

Sugar combining with protein in the blood causing inflammation/ free radicals is known as _______?

A

Glycation

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37
Q

Classic triad due to glycosylation in Diabetes mellitus type 2 is?

A

Polydyspia
Polyuria
Polyphasia

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38
Q

What is the main test to dx type 2 diabetes mellitus?

A

A1C

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39
Q

Diabetes mellitus affects which part of the pancreas? Is there pain present with this?

A

Tail

No

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40
Q

What are the 4 f’s that relate to the gallbladder and what do they dx?

A

Female
Forty
Fat
Flatulence

Cholecystitis (infection) / Cholelithiasis (stones)

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41
Q

Patient presents with RUQ pain is known as ______ sign and identify problem of what organ?

A

Murphy’s sign

Gallbladder

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42
Q

Pt presents with RLQ pain, and has a rapid (acute: 2-3 days) increase of WBC (~17,500). Ddx?

What is this rapid increase of wbc called?

What is the point midway between umbilicus & ASIS known as.

A

Appendicitis

Schilling shift (medical emergency: er immediately)

McBurney’s point

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43
Q

Orthopedic tests to dx appendicitis?

5 options

A

Psoas test

Obturator test

Blumbergs rebound test (quick pressure test to each of 4 Quadrants)
- pain in all 4 = peritonitis

Rovsing llq pressure

Markle (pt goes on ball of foot and slams down on heels)
- pain location = infection at that location

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44
Q

Gastric / stomach cancer would present with a virchows node on (left/right) side

A

Left

Since stomach is in epigastric area below hemidiaphragm

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45
Q

Which peptic ulcer is more common from excess acid.

Which peptic ulcer is caused by h. Pylori?

A

1) Duodenal ulcers
(duodenum = basic area, gastric is more acidic so acid doesn’t cause ulcers there commonly)

2) Gastric ulcers

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46
Q

Chronic gastritis leads to __________ deficiencies.

What is the 3 layers of combined systems disease associated with this deficiency?

A

B12

Combined system disease:

Step 1) Chronic gastritis from diet / proton pump inhibitors / medications (nexus)
- causes parietal cell degradation, preventing b12 absorption

Step 2) pernicious anemia occurs causing fatigue/ pale skin

Step 3)posterolateral sclerosis occurs causing stocking/glove paresthesia

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47
Q

What vitamin does RBCs need to mature from a reticulocyte?

What type of anemia is this known as?

RBCs are born as (tiny/huge) reticulocytes and _______ vitamin helps them (grow/shrink) to mature

A

B12

Megaloblastic / pernicious anemia

RBCs are born as HUGE reticulocytes and B12 vitamin helps them SHRINK to mature

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48
Q

Cobalamin is responsible for what two things in the body?

A

RBC maturation

Nerve mylenation

(Cobalt = b12)

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49
Q

Glove / sock paraesthesia is common with b12 deficiencies because it affects __________ columns & _________ tracts.

How to test for this?

A

Posterior columns

Lateral tracts

(Aka posterolateral sclerosis)

2) Schilling test

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50
Q

How and where is cobalamin absorbed?

A

B12 is absorbed in small intestine (ilium)

HCL & intrinsic factor from parietal cells combines with extrinsic factor from animal products (cyanocobalamin)

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51
Q

What test do you use to make sure the patient is absorbing b12?

Is it good to find b12 in the urine?

How to treat this?

A

Shilling test: chronic gastritis

(Not shilling sign: appendicitis)

2) yes! B12 in urine means it was absorbed and unused is being excreted appropriately

B12 in stool means it isn’t being absorbed and just passing through

3) B12 injections

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52
Q

How long do RBCs live for?

What organ recycles them?

What portion of the RBC is saved when recycled?

A

120 days

Spleen

Heme

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53
Q

Outpouching of the colon due to weakening of the wall with age, mc in the descending portion.

A

Diverticulosis

Diverticulitis is inflammation when seeds/etc get stuck and body flushed with diarrhea

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54
Q

Bloody diarrhea + skip lesions/string sign = dx?

Stress induced Bloody diarrhea + megacolon = dx?

A

Crohns

Ulcerative colitis

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55
Q

You listen for

bowel sounds known as _______ for at least _______ minutes

A

Aborborygmi

5 minutes

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56
Q

Increased GGT = dx?

A

Liver Corrhosis

“GGT = gotta get tipsy”

(Gamma glutamine transaminase)

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57
Q

Pt comes in with caput medusa or varicose veins. What ddx and organ are we considering?

A

Portal hypertension

Liver

“Vein problem = liver”

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58
Q

Transmission method of:
Hep a?
Hep b?
Hep c?

A

A) Oral/fecal

B) blood / needle / sex

C) blood / needle / sex / pregnancy

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59
Q

Strep infections begin in the mouth, spread to the ________(dx______), and eventually reach the _________ (dx_________)

A

Mouth -> kidney (Glomerulonephritis) -> heart (Carditis / SBE)

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60
Q

Upper tract infections (descend/ascend)

A

Descend

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61
Q

H.E.P. Stands for _____, ______, _______

What organ/tract is being affected by this?

A

Hypertension
Edema
Proteinuria

Upper tract descending kidney infections of the nephrons (ex: Proteinuria / casts / stones / FEVER)

(always has “neph-“ in its name)

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62
Q

Pt with sedentary lifestyle, Colicky painful urination, not relieved in any position. Dx?

A

Kidney stones

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63
Q

F.U.B. Stands for ?

What organ/tract does this relate to?

A

Frequency
Urgency
Burning

Lower tract ascending kidney infection
(Ex: std / e-coli / nitrates / NO fever)

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64
Q

Pt has increased fremitus because of (air/fluid) filled lungs. Percussion would be (hyperresonant / dull)?

3 potential ddx?

A

Fluid
“Fremitus feels fluids”

Dull percussion

Bacterial pneumonia / CHF / pulmonary edema
(L ventricle failing)

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65
Q

Pt comes in with air filled lungs.

fremitus would be (increased/decreased)?

Percussion would be (dull/hyperresonant)?

3 potential ddx?

A

Decreased fremitus

Hyperresonant percussion

COPD / emphysema / pneumothorax

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66
Q

What is it called when the lung is surrounded by fluid but none inside?

Would fremitus be increased or decreased?

A

Pleural effusion
(massive amounts: minor won’t affect fremitus)

Decreased fremitus

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67
Q

What does “stridor” sound like?

A

Pt coughs, followed by a high pitch inspiratory noise/crowing.

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68
Q

Prolonged expiration is associated with what lung disease?

Percussion / fremitus would be?

A

COPD

Dull percussion
Decreased fremitus

(Air filled)

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69
Q

What causes a friction rub being heard in the abdomen?

A

Enlarged viscera due to infection

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70
Q

What are the 3 adventitious sounds and what does it mean if you hear them?

A

Bronchophony (clearer sounding)
Egophony (ee sounds like aa)
Whisper pectoriloquy (heard louder)

= fluid filled lungs (ex/ lobar pneumonia)

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71
Q

“Pink puffer” = ?

A

Emphysema

72
Q

“Blue bloater” = ?

A

Chronic bronchitis

73
Q

A deep breathing pt in diabetic coma has what type of irregular breathe sound?

A

Kussmaul (air hunger)

74
Q

What type of irregular breathe sound is present if the pt has rhythmical apnea due to a brain lesions?

A

Cheyne stokes

75
Q

“Biot’s” breathe sound is present if _______ ________ affects the _________ causing irregular apnea

A

Intracranial pressure

Medulla

76
Q

Red current jelly sputum represents what specific type of pneumonia infection?

A

Klebsiella

friedlanders pneumonia?

77
Q

Which lung has 3 lobes?

You cannot see the (R/L) middle lobe of the lung on the (anterior / posterior) view.

A

R lung has 3 lobes

RML not seen on posterior view

78
Q

Which thoracic spinous process is located at the division between R & L upper / lower lobes of the lungs on the posterior side?

A

T3

79
Q

What is the inspiration:expiration ratio for:

Bronchial

A

1:3

80
Q

What is the inspiration:expiration ratio for:

Vesicular

A

3:1

81
Q

What is the inspiration:expiration ratio for:

Bronchovesicular

A

1:1

Tracheal = same

82
Q

Green sputum , night sweats, general chest pain

  • bacterial pneumonia
  • viral pneumonia
  • emphysema
A

Bacterial pneumonia

Green sputum = bacteria

83
Q

20 years of smoking, prolonged expiration

  • bacteria pneumonia
  • viral pneumonia
  • emphysema
A

Emphysema

Prolonged expiration = COPD

84
Q

20 year old male, rapid onset pinpoint chest pain after shoveling

  • MI
  • angina pectoris
  • pleurisy
A

Pleurisy

Pinpoint pain = Friction rub

85
Q

60 YoM has chest pain after shoveling

  • MI
  • pleurisy
  • emphysema
A

MI

86
Q

Dyspnea at night, swelling, & crackles suggest

  • MI
  • CHF
  • cor polmonale
A

CHF

Crackles = fluid

87
Q

Proteinuria, pyrexia, WBC Cast, & fat oval bodies

  • cystitis
  • glomerulonephritis
  • nephrosis
A

Nephrosis

(Pylonephritis=better since wbc cast but not option)

Nephrosis = both casts present

88
Q

Proteinuria, pyrexia, RBC Casts

  • cystitis
  • glomerulonephritis
  • nephrosis
A

Glomerulonephritis

(RBC casts = strep)

Strep: mouth -> Glomerulonephritis -> carditis)

89
Q

Proteinuria, edema, hypertension, & no convulsions

  • nephrotic syndromes
  • nephrotic syndromes
  • eclampsia
A

Nephrotic syndromes

No convulsions = pre eclampsia

90
Q

Elevated IgM, tenderness RUQ, & leukopenia

  • acute hepatitis
  • chronic hepatitis
  • cirrhosis
A

Acute hepatitis

IgM = acute / IgG = chronic

RUQ = liver

91
Q

Jaundice, boggy liver, & leukopenia

  • acute hepatitis
  • chronic hepatitis
  • cirrhosis
A

Chronic hepatitis

92
Q

Elevated GGT, alcoholism, & jaundice

  • acute hepatitis
  • chronic hepatitis
  • cirrhosis
A

Cirrhosis

93
Q

18,000 WBC doesn’t indicate

  • appendicitis
  • pancreatitis
  • nephritis
  • peritonitis
A

Nephritis

Other 3 are classic triad of rapid WBC INCREASE to ~18,000

94
Q

Numbness of hands/feet, excessive drinking

  • diabetes mellitus + pls
  • alcoholism + pls
A

Diabetes mellitus + posterolateral sclerosis

95
Q

20 yom with anxiety, diarrhea, excessive abdominal bloating

  • cholecystitis
  • gastritis
  • ulcerative colitis
  • peptic ulcer
A

Ulcerative colitis

Hla-b27
stress induced (anxiety)
96
Q

Which doesn’t cause PLS

  • diabetes mellitus
  • alcoholism
  • gastritis
  • cholecystitis
A

Cholecystitis

Pls = posterolateral sclerosis

97
Q

foreskin trapped behind glands of penis (turtle neck)

A

Paraphimosis

98
Q

Congenital defect on the ventral surface of penis causing dribbling on the floor

A

Hypospadius

Epispadias = dorsal surface

99
Q

HCG present in a male would cause concern for what?
palpate for what?
Palpate where?

A

Seminoma

Painless nodule

Testicles

100
Q

Crooked penis

A

Peyronnies

101
Q

Sustained erection 4+ hrs

What is the causes?

A

Priapism

  • CNS trauma / intracranial pressure
  • ED drugs
102
Q

Reddened, tender testicles with trans illumination posterior-superior

  • hydrocele
  • seminoma
  • epididymitis
  • scrotal hernia
A

Epididymitis

103
Q

“Bag of worms” testes

What organ are you concerned about?

A

Varicocele

Liver

104
Q

Painless nodule in testes that doesn’t trans illuminate

  • hydrocele
  • seminoma
  • epididymitis
  • scrotal hernia
A

Seminoma

105
Q

Non-tender mass that trans illuminates

  • hydrocele
  • seminoma
  • epididymitis
  • scrotal hernia
A

Hydrocele

106
Q

Borborygmi possible, no trans illumination and no palpable mass

  • hydrocele
  • seminoma
  • epididymitis
  • scrotal hernia
A

Scrotal hernia

107
Q

The median sulcus of the prostate is obliterated by?

  • chronic prostatitis
  • acute prostatitis
  • bph
  • cancer
A

BPH (benign prostatic hypertrophy)

Cancer = only OBSCURES median sulcus

108
Q

Painful ejaculation

  • chronic prostatitis
  • acute prostatitis
  • bph
  • cancer
A

Chronic prostatitis

109
Q

What dx do you find firm nontender nodules on Posterior lobes of prostate

  • chronic prostatitis
  • acute prostatitis
  • bph
  • cancer
A

Prostate cancer

110
Q

What dx do you find smooth nontender nodules on the lateral lobes of the prostate?

  • chronic prostatitis
  • acute prostatitis
  • bph
  • cancer
A

BPH

111
Q

_______ score has a score of 1-5 for severity of prostate cancer

A

Gleason

112
Q

________ test is a screening test for the prostate.

________ is a specific test for prostate cancer, but a _________ exam must be done first before this test.

A

PSA

Biopsy

Digital rectal exam

113
Q

M/c location for hernias to occur in Females

  • femoral
  • direct
  • indirect
A

Femoral

“Female Femoral”

(Can occur in males as well)

114
Q

M/c location for hernias to occur in Young males

  • femoral
  • direct
  • indirect
A

Indirect

115
Q

The (hiatal/inguinal) hernia is alleviated when laying down?

A

Inguinal

(Hiatal located above stomach, feels better when standing up since gravity helps pull it back down where it’s supposed to be)

116
Q

What chambers work harder?

  • ventricles
  • atrium
A

Ventricles

117
Q

S1 heart sound occurs on (systole/diastole) and is because of:

  • av valves relaxing
  • av valves shutting
  • semilunar valves relaxing
  • semilunar valves shutting
A

Ventricles contracting

AV valves SHUTTING
Semilunar OPEN

118
Q

ARMS & PRTS = ?

In reference to murmurs heard at (S1/S2) (systole/diastole) when ventricles are (relaxing/contracting)

A

Aortic
regurgitation
Mitral
Stenosis

Pulmonic
Regurgitation
Tricuspid
Stenosis

“She die in my arms & prts”
“Stenosis = stenosis”
“everything else = regurgitation”
(Ex/ insufficient - prolapse - incompetent)

S2 diastole
Ventricles relax

119
Q

Av valves consist of:

  • aortic
  • pulmonic
  • mitral
  • tricuspid
A

Mitral

tricuspid

120
Q

Semilunar valves consist of:

  • aortic
  • pulmonic
  • mitral
  • tricuspid
A

Aortic

Pulmonic

121
Q

Systolic murmur heard over apex

  • mitral stenosis
  • aortic regurgitation
  • mitral prolapse
  • pulmonic incompetence
A

Mitral prolapse (regurgitation)

Apex of heart = mitral valve

122
Q

Low pitched murmur on right side of sternum

  • aortic stenosis
  • aortic regurgitation
  • pulmonic insufficiency
  • pulmonic stenosis
A

Aortic stenosis

Low pitch = listening with bell = stenosis

123
Q

Left peristernal diastolic murmur

  • mitral regurgitation
  • tricuspid stenosis
  • mitral stenosis
  • pulmonic stenosis
A

Tricuspid stenosis

Left peristernal = tricuspid or pulmonic

124
Q

Click in late systolic in squatting position

  • mitral regurgitation
  • tricuspid stenosis
  • mitral stenosis
  • pulmonic stenosis
A

Mitral regurgitation

Remove diastolic murmurs
M/c murmur locations = mitral & aortic

125
Q

A split difficult to hear, heard over tricuspid

A

S1 (lub)

126
Q

Aortic valves shutting early

Heard durring (s1-4)?
Due to what?
A

Pathological S2 split (dub-dub)
(Always present)

Hypertension

127
Q

Where & when do you listen for a physiological s2 split?

M/c in who?

A

Pulmonic during inspiration only

Athletes/children

128
Q

This is always pathological

  • s1 split
  • s2 split
  • s3
  • s4
A

S4

Atrial gallop

129
Q

Hear low pitched AV regurgitation at apex on a 47 yo pt.

  • atrial gallop
  • s2 split
  • ventricle gallop
  • pan-systolic murmur

Is this pathological or not?

A

Ventricle gallop = pathological 40+

Under 40 = physiological

130
Q

Very early diastolic high pitched murmur heard over pulmonic valve.

Caused by mitral (regurgitation/stenosis/prolapse/insufficiency)

A

Opening snap

Mitral stenosis

(Misdiagnosed as pulmonic valve abnormality)

131
Q

Stills murmur is heard in who?

A

Children

132
Q

What murmur is associated with PDA

A

Machinery murmur

Patent ductus arteriosis= opening between heart

133
Q

Fatigue is the 1st sign of what major problem?

A

Heart failure

“Failing to pump enough blood as needed”

134
Q

Cor pulmonale = ?

Caused by?

A

Right sided heart failure

Pulmonary hypertension
Right ventricular hypertrophy/failure

135
Q

Which side of Heart most commonly fails first?

  • R->L
  • L->R
A

L->R

136
Q

Left sided heart failure is known as?

Caused by?

Results in?

A

CHF

Systemic hypertension
Left ventricular hypertrophic / failure

137
Q

What is the first enzyme present in a MI?

1st hour?

2-3hours?

2-3 days?

A

Troponin

Ck-MB (cpk)

SGOT / AST

LDH

138
Q

_______ = feeling turbulence

_______ = hearing turbulence

(Blood flow)

A

Thrills

Bruits

139
Q

What do you use to evaluate heart chamber size / fluid?

Heart rythms?

A

Echocardiogram

EKG/ ECG

140
Q

Left ventricular failure causing amplitude to vary

  • bigeminal
  • paradoxical
  • Pulsus alterans
  • water hammer
A

Pulsus alterans

  • bigeminal: 2 beats -> pause (aortic stenosis)
  • paradoxical: amplitude decrease in inspiration (COPD)
  • water hammer: aortic regurgitation (jerky?)
141
Q

Bradycardia = ?

A

<60
(Athletes / hypothyroid)

> 100 = tachycardia
(Fever/shock)

142
Q

Pt comes in with bronze skin, what dx & organ are you considering?

Increase or decreased production?

A

Addisons

Kidneys: Adrenal cortex

Decreased adrenocorticoids

143
Q

Female comes in complaining about weight gain, you notice abnormal hair growth present on chin and a hump back. What dx?

What organ is affected? Increased/decreased secretion?

Primary or secondary more common?
(Syndrome/disease)

A

Cushing
(Buffalo hump / moon facies / hirstuism)

Kidneys: Adrenal cortex / increased adrenocorticoids

Cushing disease m/c (secondary)

“Sweet salt sex”

144
Q

Sympathetic storm/crisis occurring post CMT at t10-11. Dx?

T12-L1?

A

1) Pheochromocytoma
Aka neuroblastoma

(Kidneys)

2) Nephroblastoma (Wilms tumor)

145
Q

Decreased t3/t4
Increased tsh

Name if it is:
Primary?
Autoimmune?
Children?

A

Hypothyroidism

2) Myxedema / thyroiditis
3) Hashimoto
4) Cretinism

146
Q

Female pt weight gain, edema/swelling, dry skin, brittle hair

Dx?

A

Myxedema

Cushing s has moon facies swelling, myxedema has swelling around eye

147
Q

Pt with trouble gaining weight, anxiety, soft hair, moist skin.

What would you most likely find on lab work?

Dx?

A

Increased t3/t4

Graves’ disease / hyperthyroidism

148
Q

What 2 deficiencies can cause macrocytic normochromic anemia?

What does each one lead to?

A

B12 -> PLS (posterolateral sclerosis)

B9 -> neural tube defects

149
Q

Which of the following would result in decreased ferritin levels?

  • b12 uptake deficiency
  • thalassemia
  • sickle cell
  • chronic hemorrhage

What type of anemia is this called?

A

Chronic hemorrhage: gi/bone disorders/period

(iron deficiency or aplastic causes as well)

Microcytic hypochromic anemia

150
Q

M/c cause of anemia in:

USA?

World?

Neonates?

A

Iron deficiency

Thalassemia

Physiological

151
Q

What anemia causes jaundice

A

Hemolytic

Normocytic normochromic

152
Q

What anemia can cause AVN of femoral head?

A

Sickle cell

Aka poikylocytosis

153
Q

Multiple myeloma has what type of protein in urine?

A

Bence Jones (Proteinuria)

154
Q

What organ do you consider malfunctioning if protein is present in urine?

What are two pathological exceptions that cause Proteinuria?

A

Kidneys (nephrons disease)

Multiple myeloma (MM)

Muscular dystrophy (MD)

155
Q

What are you concerned about if pt has painless hematuria?

A

Cancer

156
Q

What immunoglobulin is present in acute infections?

Chronic?

A

IgM - acute

IgG - chronic

157
Q

Which is not a ddx for Black color urine?

  • ochronosis
  • liver disorder
  • lead poisoning
  • end stage malaria
A

Liver disorder = yellow urine

158
Q

Which immunoglobulin is only found in trace amounts?

A

IgD

159
Q

Which immunoglobulin is found in breast milk?

Which protects baby in utero?

A

IgA

IgG

160
Q

Immunoglobulin that is present from allergies?

A

IgE

161
Q

GUAIAC is a stool test testing for what type of bleed?

A

Occult / upper gi

162
Q

Biliary obstruction would result in what color stool?

A

Clay / grey / pale

163
Q

What organs are you considering if pt presents with floating stool?

A

GB / pancreas / malabsorption of fat

Steatorrhea

164
Q

Would be elevated with blastic bone metastasis

  • alkaline phosphatase
  • acid phosphatase
  • A/G ratio
  • APA
A

Acid phosphatase

Increased with any bone growth good or bad

165
Q

What type of special study is used to identify the agent of infection?

A

Cultures = confirm agent

Ex/ stool - sputum - blood cultures

166
Q

Ultrasound is used to see what?

A

“Belly & vessels”

Abdominal organs / blood vessels / baby etc

167
Q

Fat soluble vitamins?

Most toxic one?

Secreted the fastest?

A

A (most toxic)
D
E
K (secreted the fastest)

168
Q

What vitamins are Antioxidants?

A 
A
C
E
Selenium
Zinc

“Acesz”

169
Q

2nd m/c reason for vitamin deficiency

A

Malabsorption

170
Q

Why vitamin is for cns?

Pns?

A

B1 - thiamine = cns

B6 - pyridoxine = pns

171
Q

Beri beri / wernicke-kaskoff is a deficiency of what?

Commonly do to what?

A

Thiamine (b1)

Alcoholics

172
Q

What vitamin is a diuretic that helps with pms?

A

Pyridoxine (b6)

173
Q

What Vitamin deficiency causes pallegra?

What are symptoms?

A 
B3 niacin
(pruritic/itchy when deficient/excess/taken)

4 D’s: dementia / diarrhea / dermatitis / death

174
Q

What deficiency is common with vegans?

A

B12 - cyanocobalamin

175
Q

Difference between vitamin k1 / k2

A

K1: clotting cascade
(Don’t give on blood thinner)

K2: bone mineralization
(Pt osteoporotic? Can give on blood thinner)

176
Q

What are the two most useful vitamins for everything?

A

Zinc

EPA (omega 3)

177
Q

What post viral symptoms are present after:

Guillian barre / pityrasis roseacea / Reye’s syndrome / west Nile

A

Chronic fatigue

Fibromyalgia

HA

T: Part 2 Boards (2 decks)

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