General Diagnosis Flashcards
What are the components of the health history?
Chief Complaint
Past health history
Personal/Social History
ROS
What is OPQRST?
Attributes of a symptom Onset Palliative/Provoking Quality Radiation/Referral Site/Setting/Severity Timing
What are key questions to ask during the past health history?
Serious illnesses Previous injuries Hospitalizations Surgeries Medication Allergies
What are the major disorders you’re looking for in the family health history?
Cardiovascular disease
Diabetes
Stroke
Cancer
Key questions in the personal/social history?
Marital status Occupation Diet Exercise Bowel/Urinary patterns Sleep Alcohol, Tobacco, and Drug use Stress
Components of CAGE?
Cutting down
Annoyed by others criticism
Guilty feelings
Eye openers
What is normal oral temp?
98.6F
What is normal Rectal/Tympanic temp?
99.6F
What is normal Axilla temp?
97.6F
What is generally considered a normal range for temperature?
96-99.5F
What is a normal adult pulse?
60-100
What is a normal newborn pulse?
120-160
What is a normal elderly pulse?
70-80
What is a normal adult respiratory rate?
14-18
What is a normal newborn respiratory rate?
44
What is considered normal blood pressure range?
90-120/60-80
What are Korotkoff Sounds?
Low pitched sounds produced by turbulent blood flow in arteries
What can a difference of 10-15mmHg indicate?
Arterial occlusion on the side of decreased pressure
True or False: Blood pressure readings are generally 20% lower in the lower extremities?
False. They are 20% higher.
What does Barre-Lieou test and how is it performed?
VBI
Patient is seated while the patient rotates the head maximally from side to side
What does DeKleyn’s test and how is it performed?
VBI
Patient supine, the patient rotates and then extends the head off the table then turns to each side for 15-45 seconds
What does Hallpike test and how is it performed?
VBI
Patient supine with head extended off the table, examiner brings the head into extension, rotation, and lateral flexion
What does Hautant’s test for and how is it performed?
VBI
Patient seated, arm are extended forward to shoulder level with the hands supinated. Maintain position for a few seconds. Patient then closes the eyes, rotates, and hyper extends the neck to one side. Repeat on the opposite side
What does Underberg test and how is it performed?
VBI
Patient stands with eyes open, arms at side, feet close together. They close eyes, supinate hands, then extend and rotate the head to one side. Once in that position they march in place
What is Adie’s Pupil?
Sluggish pupillary reaction that is unilateral, caused by parasympathetic lesion of CN3
What is anisocoria?
Unequal pupil size
What is Argyll Robertson?
Bilaterally small and irregular pupils that accommodate but do not react to light
What condition is Argyll Robertson commonly seen with?
Syphilis
What is Arroyo Sign? What condition is it commonly seen with?
Sluggish pupillary reaction due to hypo-adrenalism
Addison’s Disease
What are cataracts?
Opacities in the lens, commonly seen with diabetes and in the elderly. Also has an absent red light reflex
What is a chalazion?
Infection of the meibomian gland, causing a nodule which points inside the lid
What does pale conjunctive indicate?
Anemia
What is corneal arcus?
Grayish opaque ring around the cornea
What is ectropion?
Lid turned outward
What is exophthalmosis?
Lid lag/failure to cover the eyeball
What can exophtalmosis indicate when it’s bilateral? Unilateral?
Graves’ Disease
Tumor
What pathology of the eye is crescent sign commonly seen with?
Glaucoma
What is a hordeolum also known as?
A sty
What are the symptoms of Horner’s Syndrome?
Ptosis, Miosis, and Anhydrosis on the same side
What pathology will show with cotton wool exudates, flame hemorrhages, and copper wire deformity?
Hypertensive retinopathy
What pathology is associated with internal opthalmoplegia?
Multiple sclerosis
What pathology is iritis commonly seen with?
Ankylosing spondylitis
What is mydriasis?
Dilated and fixed pupils (seen with anti cholinergic drugs)
What is a pinquecula?
A yellowish triangular nodule in the bulbar conjunctiva that indicates aging
What pathology is associated with blue sclera?
Osteogenesis imperfecta
What does emmetropia mean?
Normal vision
What is the clinical term for nearsighted?
Myopia
What is the clinical term for farsighted?
Hyperopia
What CN’s does direct light reflex test?
2 and 3
What CN’s does consensual light reflex test?
2 and 3
What CN’s does Accommodation test?
2 and 3
What CN’s are tested by the cardinal fields of gaze?
3, 4, and 6
Acoustic neuroma affects which cranial nerve?
8
What type of pathology is acute mastoiditis?
Bacterial infection
What is the clinical name for swimmer’s ear?
Acute Otitis Externa
What symptoms characterize Meniere’s Disease?
Recurrent prostrating vertigo, sensory hearing loss, tinnitus, and a feeling of fullness in the ear
What is persbycussis?
Sensorineural hearing loss that occurs in people as they age and they may be affected by genetic or acquired factors
Which part of the ear is affected by Otitis Media?
Middle ear
What finding does a lateralization to the involved ear during a Weber test indicate?
Conductive hearing loss
What results are “normal” for Rinne Test?
Acoustic conduction > Bone conduction
What finding does a lateralization to the uninvolved ear during a Weber test indicate?
Sensorineural hearing loss
What is the clinical term for red sores at the corner of the mouth caused by Riboflavin deficiency?
Cheilosis or Angular Stomatitis
A deficiency of what compound(s) cause the tongue to appear smooth and glossy?
B12 or iron
What is the clinical term for thick white fungal patches on the tongue that can easily be scraped off?
Candidiasis or Thrush
What type of lesion is leukoplakia?
Pre-cancerous
When does acromegaly typically begin?
Middle age
When does gigantism present?
Prior to skeletal maturation
What is the most common cause of hyperthyroidism?
Grave’s disease
What is the most common cause of hypothyroidism?
Hashimoto’s
What are some classic symptoms of hyperthyroidism?
Weight loss with increased appetite Irritable/nervous Heat intolerant Moist skin Fine hair Possible neck swelling due to goiter
What are some classic symptoms of hypothyroidism?
Weight gain with decreased appetite Depression, weakness, and fatigue Intolerance to cold Coarse, dry hair, and skin Loss of lateral 1/3 of eyebrows
What pathologies are associated with barrel chest?
COPD and cystic fibrosis
What is Biot’s Breathing?
Groups of quick shallow inspirations, followed by irregular periods of apnea with no pattern
What is Cheyne Stokes Respiration?
Breathing characterized by alternation periods of apnea and hyperpnea
What is Kussmaul’s Breathing?
First rapid and shallow but as the metabolic acidosis worsens, breathing gradually becomes deep, slow, labored, and gasping
What pathology are splinter hemorrhages commonly seen with?
Strep organisms
What is paronychia?
Inflammation of the nail fold near the the cuticle
What is Kiolonychia and what can it indicate?
Spoon nail
Iron deficiency anemia
What does it indicate if vibration is increased during tactile fremitus?
Pneumonia
What does is indicate if tactile fremitus is decreased with air?
Emphysema or pneumothorax
What pathologies are associated with hyperresonant lung percussion?
Emphysema or pneumothorax
What pathologies are associated with dull lung percussion?
Pneumonia or atelectasis
What is the clinical term for small clicking, bubbling, or rattling sounds in the lung?
Rates
What is the clinical term for breath sounds that resemble snoring?
Ronchi
What is the clinical term for a wheeze-like sound heard upon aspiration?
Strider
What is the clinical term for a high pitched sound produced on exhalation?
Wheeze
What do rales indicate?
Bronchitis
What do ronchi indicate?
Bronchiectasis
What do wheezes indicate?
Asthma in young people
Emphysema in old people
What are some signs of lobar pneumonia?
Productive (rusty brown) cough for about 10 days and fever
What are some symptoms of Friedlander’s Pneumonia?
Productive red jelly sputum cause by Klebsiella pneumonia
What patient population is most likely to experience Pneumocystis Carinii?
AIDS patients
What causes tuberculosis?
Mycobacterium tuberculosis
What are the symptoms of pleurisy?
Stabbing chest pain worsened by respiration. Dry non-productive cough. Decreased excursion and fremitus. Dull with percussion.
What is a pneumothorax?
A ruptured lung causing air to be trapped in the pleural space
What is atelectasis?
Collapse of the lung that’s usually the result of bronchial obstruction due to a mucous plug
What is the clinical term for the destruction of elastic pulmonary connective tissue that results in permanent dilation of the alveolar air sacs?
Emphysema
What causes emphysema?
Alpha 1 anti-trypsin deficiency
What population is most heavily affected by sarcoidosis?
African Americans
Where does hodgkin’s commonly spread to?
The spleen
What does a bounding pulse indicate?
Exercise, anxiety, fever, or hyperparathyroidism
What does a weak or th ready pulse indicate?
Hypovolemia
Aortic stenosis
Congestive Heart Failure
What does a pulse with alternating amplitudes indicate?
Left ventricular failure
What does pulses bisferiens indicate?
Aortic regurgitation or aortic stenosis
What does a paradoxical pulse indicate?
COPD
Bronchial asthma
Emphysema
Pericardial effusion
What causes a water hammer pulse?
Aortic insufficiency
What occurs at S1?
Closure of AV valves (mitral and tricuspid)
What occurs at S2?
Closure of semilunar valves (pulmonary and aortic)
What does S3 indicate?
Normal in children, young adults, and athletes, but over 40 it can indicate CHF
What does S4 indicate?
Stiff ventricular myocardium, normal in children, young adults, and athletes
What does a low pitch murmur indicate?
Stenosis
What part of the stethoscope is best suited for auscultating valve stenosis?
Bell
What does a high pitched murmur indicate?
Regurgitation
What part of the stethoscope is best suited for auscultation of regurgitation?
Diaphragm
What is the heart murmur mnemonic?
ARMS & PRTS
What comprises the tetralogy of Fallot?
Dextraposition of the aorta
Right ventricular hypertrophy
Interventricular septal defect
Pulmonic stenosis
What is the most common cause of Left Sided Heart Failure?
Hypertension
What is the most common cause of right sided heart failure?
Left sided heart failure
What is the P wave?
Normal atrial depolarization
What is the QRS complex?
Depolarization of the ventricles and repolarization of the atria
What is the T wave?
Repolarization of the ventricles
What is the U wave?
Repolarization of the papillary muscles
What is Mallory Weiss Syndrome?
Coughing, tearing esophageal blood vessels, and hematemesis with palmar rash due to bile salts
What is Wernicke’s Korsakoff Syndrome?
Thiamin deficiency from alcoholism that leads to dementia
What is the term for Thiamin deficiency without alcoholism?
Beri Beri
What causes increases in direct/conjugated bilirubin?
Duct obstruction, hepatic disease, and pancreatic cancer
What causes an increase in indirect or unconjugated bilirubin?
Hemolytic disease, drugs, and spleen disorders
How is Hep A transmitted?
Fecal/oral
How is Hep B transmitted?
Dirty needles and sexual contact
How is Hep C transmitted?
Blood transfusions
What type of Hepatitis is most likely to become liver cancer?
Hep B
What organ most commonly refers pain to the right shoulder?
Gallbladder
