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Physical diagnosis Test 1 written > General survey and vital signs > Flashcards

General survey and vital signs Flashcards

1
Q

What are possible causes of fatigue?

A

-depression or anxiety
-Infections
-Endocrine
Heart failure, chronic lung disease, kindey or liver
- electrolyte imbalance, anemia, malignancies, nutrition, medications

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2
Q

What should you consider if there is localized weakness in a neuroanatomic pattern?

A
  • suggests mypopathy or neuropathy
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3
Q

What questions can you ask related to weight?

A
  • How is your weight compared to a year ago?

- Why do you think?

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4
Q

What do you observe in the general survey aspect of the PE?

A
  • sick or not sick
  • walks unassisted, w/ a limp
  • appears comfortable or distressed
  • appears well or ill
  • obese, thin, cachectic
  • well nourished or hydrated
  • appears older or younger than stated age
  • are they conscious/alert?
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5
Q

What is Cachexia?

A
  • weight and muscle loss
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6
Q

What are some signs of cardiorespiratory distress?

A
  • clutching chest or throat
  • diaphoresis
  • labored breathing, wheezing
  • coughing
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7
Q

What are some signs of pain?

A
  • stillness/guarding
  • unusual posture
  • grimacing
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8
Q

What are some signs of anxiety?

A
  • fidgety
  • poor eye contact
  • psychomotor slowing
  • flat affect
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9
Q

How do you check for pallor?

A

ask pt to look upward, gently draw down lower eyelid w/ you thumb

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10
Q

What could be causing pallor?

A

severe anemia.

Check: palpebral conjunctiva, nail beds, palmar skin

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11
Q

What is cyanosis and what tests must you f/u with if it is observed?

A
  • is bluish discoloration of the skin.

- must do pulse oximetry and other tests

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12
Q

What is juandice (icterus)?

A

yellowish pigmentation of tissues that contain elastin, bilirubin. best seen in fair and brown skin

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13
Q

What is carotonemia?

A

pt’s skin is yellow, sclera remains white

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14
Q

What should you be concerned about with moon face?

A

Cushings syndrome

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15
Q

What should you be concerned about with proptosis or exophthalmos?

A

Grave’s disease

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16
Q

What should you be concerned about if the pt is sitting in obvious postures to facilitate easier breathing (sitting up straight, leaning forward w/ arms braced, tripoding and drooling)?

A
  • L heart failure
  • COPD
  • epiglottitis

(perform a detailed heart/lung exam)

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17
Q

What must you evaluate if the pt has an abnormal gait?

A

nuerologic exam

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18
Q

What is the formula for BMI?

A

BMI=weight(lbs)*703/height2 (in2)

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19
Q

What are the vital signs?

A

BP, heart rate, respiratory rate, temperature, pain

20
Q

What is the difference between thigh and arm BP measurements?

A

thigh BP: systolic reading will be 10-40mmhg higher than the UE

21
Q

What must you do if a pt has a arrhythmia?

A

Get an EKG, and if it is stable, perform ambulatory monitoring

22
Q

What are four different ways temperature can be measured?

A
  • oral
  • axillary
  • Rectal
  • Aural
    (axillary least, rectal most accurate)
23
Q

What are some pulse patterns you may observe?

A
  • Regular: evenly spaced beats, may vary slightly w/ respiration
  • regularly irregular: regular pattern overall w/ “skipped” beats. (GET EKG if they have heart block)
  • Irregularly irregular - chaotic, no real pattern, difficult to measure accurately (Afib, get EKG)
24
Q

What are you observing when measuring respiration?

A
  • rate
  • rhythm
  • depth
  • effort of breathing
25
Q

What is tachypnea?

A

fast shallow breathing >20 breaths/min

26
Q

What is bradypnea?

A

breathing <10-12 breaths/minute

27
Q

What is Cheyen-Stokes?

A

-periods of deep breathing alternate with periods of apnea
(gradual increase/decrease w/ abpnea 10-30 seconds)
-Could suggest increasing intracranial pressure or brainstem injury- call 911

28
Q

What is Kussmaul’s?

A

tachypnea and hyperapnea (deep respirations)

29
Q

Why do you use the bell of the stethoscope to hear the karotkoff sounds when measuring BP?

A

Because the Karotkoff sounds are relatively low in pitch

30
Q

What is associated with and auscultatory gap?

A

arterial stiffness and atherosclerotic disease

31
Q

What is hyperpyrexia?

A

A temperature above 106 F or 41.1 C

32
Q

What is hypothermia?

A

Temp less then 35 C or 95 F rectally

33
Q

What can cause hyperpyrexia?

A

infection, trauma like surgery or crush injury, malignancy, blood disorder (acute hemolytic anemia), drug reactions and immune disorders

34
Q

What can cause hypothermia?

A
  • chief cause is exposure to cold

- could also be reduced movement in paralysis, interference w/ vasoconstriction and older age

35
Q

What should you be concerned about with cachexia?

A

Malignancy, until proven otherwise

36
Q

What can cause central cyanosis?

A

advanced lung disease, congential heart disease and hemoglobinopathies

37
Q

What should you be concerned about if you see jaundice?

A

Liver disease or excess hemolysis of RBC’s

38
Q

What should you be concerned about with pallor?

A

decreased RBC’s in anemia

decreased blood flow (fainting or arterial occlusion)

39
Q

What is the pulse pressure?

A

The difference between systolic and diastolic pressure

40
Q

What is systolic BP?

A

highest BP in the cycle, level at which you hear sounds of at least two consecutive beats

41
Q

What is diastolic BP?

A

lowest BP in the cycle, level at which sounds become muffled and dissapear

42
Q

What can happen if you do not recognize an auscultatory gap?

A
  • underestimation of systolic BP

- overestimation of diastolic BP

43
Q

If you have bradycardia what should you be concerned about?

A
  • sinus bradycardia
  • second-degree AV block
  • Complete heart block
44
Q

If you have tachycardia, what should you be concerned about?

A
  • sinus tachycardia
  • supraventricular tachycardia
  • atrial flutter
  • ventricular tachycardia
45
Q

What should you be concerned about w/ bradypnea?

A

uremia, alcohol, increased intracranial pressure, sedatives, opioids, cholinergic agents

46
Q

What should you be concerned about w/ tachypnea?

A

restrictive lung disease, pleuritic CP and elevated diaphragm

Physical diagnosis Test 1 written (7 decks)

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