Guided Readings Study Guide Flashcards
from Module 3 on
Identify the risk factors for Melanoma
- Ultraviolet (UV) Radiation Exposure
- Fair Skin
- Family History
- Personal History of Melanoma or Other Skin Cancers
- Multiple or Atypical Moles
- Immune Suppression
- Age
Define the ABCDE’s of Melanoma
A for asymmetry
B for irregular borders, especially ragged, notched, or blurred
C for variation or change in color, especially blue or black
D for diameter ≥6 mm or different from other moles, especially changing, itching, or bleeding
E for elevation or enlargement
Differentiate the different types of skin cancer. How would you identify each
a. Melanoma-rarest
only 4% of skin CA
b. Basal cell carcinoma
papule or nodule- waxy or pearly - may be shiny or red w/ a central induration
may be flat, hyperpigmented, border of the lesion appears rolled
solitary
sun exposed areas
c. Squamous cell carcinoma
usually solitary nodules
sun exposed areas/face
subjective- nonhealing lesion that continues to grow in size, tender, hx of actinic keratosis
objective- warty appearance, pink colored plaque, nodule, or papule w/ eroded surface
Describe a physical examination of the skin, hair, and nails (go step-by-step
watch the bates videos idk
a. Inspect and palpate skin for color, moisture, temperature, texture, mobility and turgor, lesions
b. Ask if they notice any changes in pigmentation or loss of pigmentation
c. Look for jaundice in sclera, mucous membranes use back of fingers to assess skin temperature
Describe a macule
a flat discoloration
<1cm
Describe a patch
A flat, discoloration that appears to be a collection of multiple, tiny pigment changes
> 1 cm in size
Describe a papule
Small, elevated firm lesion (example: wart, keratosis, nevi, lichen planus, insect bite)
< 1 cm in size
Describe a Nodule
Large, deep, and elevated firm lesion (examples: cyst, lipoma, fibroma)
> 1 cm in size
Describe a wheal
A raised lesion, related to an allergic reaction or hypersensitivity (extends a bit below the dermis)
1-10 cm in size
Appears most commonly on lateral neck, shoulders, abdomen, arms, and legs
Describe a plaque
A scaly, elevated, and well-circumscribed flat top lesion (erythematous to bright pink in color)
> 1 cm in size
Appears most commonly on knees and elbows
Describe a vesicle
A small, serous fluid filled lesion
<1 cm in size
Describe a bulla
A large, serous fluid filled lesion
> 1 cm in size
Describe a pustule
A small, elevated, circumscribed lesion filled with purulent fluid
<0.5-1 cm in size
IE a pimple
Identify the appropriate documentation for the skin assessment of lesions
a. Number- estimate totaly
b. Size- meaure w/ a rule in mm or CM
c. Shape
d. Color- be creative
e. Texture- palpate that thang
f. Location
g. Configuration- linear/straie, annular, nummular/discoid, target, bullseye etc
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with HERPES ZOSTER
Risk Factors for Herpes Zoster (Shingles):
Age: Most common in adults over 50.
Weakened immune system: Due to conditions like HIV, cancer, or immunosuppressive treatments.
Previous chickenpox: The virus remains dormant in the body and can reactivate as shingles.
Stress: Emotional or physical stress can trigger outbreaks.
Chronic illnesses: Such as diabetes, heart disease, or autoimmune diseases.
Subjective Information (Patient Presentation):
Pain or burning sensation: Often localized to a specific area, typically on one side of the body.
Tingling or itching: Common before the rash appears.
Fatigue: Feeling unwell or fatigued can precede the rash.
Signs/Symptoms:
Rash: Starts as red, blistering clusters, usually on the chest, back, or face, following a dermatome.
Pain: Sharp or burning pain often occurs along the path of the rash.
Fever and headache: Common during the acute phase.
Postherpetic neuralgia: Persistent pain after the rash heals, especially in older adults.
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with SKIN CA
Risk Factors for Skin Cancer:
Ultraviolet (UV) radiation: Excessive sun exposure, especially with a history of sunburns.
Fair skin: Individuals with lighter skin, hair, and eyes are more susceptible.
Family history: A genetic predisposition to skin cancer, especially melanoma.
Age: Older adults are at higher risk, but skin cancer can occur at any age.
Previous skin cancer: A history of nonmelanoma skin cancer increases the risk of recurrence.
Immunosuppression: Conditions like HIV, organ transplantation, or use of immunosuppressive drugs.
Moles or atypical nevi: Having many moles or irregularly shaped moles increases the risk.
Subjective Information (Patient Presentation):
New or changing lesion: Patients may notice a new mole or a change in an existing one (size, shape, color).
Itching or tenderness: Sensation around a suspicious spot on the skin.
Bleeding or crusting: A mole or spot that bleeds, oozes, or develops a crust.
Signs/Symptoms:
Melanoma: Often presents as a new or changing mole with irregular borders, asymmetry, multiple colors, and a diameter greater than 6mm.
Basal cell carcinoma (BCC): Typically appears as a pearly, flesh-colored bump with small blood vessels or as a scaly, reddish patch.
Squamous cell carcinoma (SCC): Presents as a firm, red nodule or a flat, scaly lesion that may bleed or ulcerate.
Non-healing sores: Sores that don’t heal or heal but return.
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with Sinusitits
Risk Factors for Sinusitis:
Upper respiratory infections:
Allergies:
Nasal polyps:
commonly cause by S. Pneumoniae
Deviated septum:
Environmental factors:
Dental infections:
Subjective Information (Patient Presentation):
Nasal congestion:
Facial pain/pressure:
Headache:
Postnasal drip:
Fatigue: .
Signs/Symptoms:
Nasal discharge:
Fever:
Tooth pain:
Reduced smell/taste:
Tenderness:
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with conjunctivitis
Risk Factors for Conjunctivitis:
Exposure to viral or bacterial infections
Allergies (e.g., pollen, dust)
Contact lens wearers, especially with poor hygiene
Close contact with infected individuals (e.g., daycare, school)
Dry eye syndrome or underlying eye conditions
Environmental irritants (e.g., smoke, chemicals)
Weakened immune system (e.g., diabetes, HIV)
Subjective Information (Patient Presentation):
Redness in the eyes
Itchy, burning, or gritty sensation
Excessive tearing or watery eyes
Discharge from the eyes (watery, mucous, or pus-like)
Sensitivity to light (photophobia)
Blurred vision (due to discharge or irritation)
Signs/Symptoms:
Pink or red color in the white part of the eye
Swelling of the eyelids
Crusting of the eyelashes, especially upon waking up
Clear, watery, or thick discharge, depending on the cause (viral, bacterial, or allergic)
Eye irritation or a feeling of something being in the eye
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with corneal abrasions
Risk Factors for Corneal Abrasions:
Eye trauma
Contact lens use
Dry eyes
Environmental factors (e.g., wind, dust)
Previous eye injuries or surgeries
Subjective Information (Patient Presentation):
Eye pain or discomfort
Sensitivity to light
Feeling of something in the eye
Excessive tearing
Blurry vision
Signs/Symptoms:
Redness of the eye
Visible scratch on the cornea
Blurred vision
Pain with blinking
Mild eyelid swelling
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with AOM
Risk Factors for Acute Otitis Media (AOM):
Age (common in children, especially under 2 years old)
Upper respiratory infections (cold, flu)
Allergies
Exposure to secondhand smoke
Lack of breastfeeding
Pacifier use in infants
Frequent use of bottles while lying down
Family history of ear infections
Craniofacial abnormalities (e.g., cleft palate)
Subjective Information (Patient Presentation):
Ear pain or discomfort
Irritability or fussiness (especially in children)
Difficulty sleeping or lying down
Hearing difficulties
Tugging or pulling at the ear (in infants or toddlers)
Fever
Drainage from the ear (in some cases)
Signs/Symptoms:
Red, swollen eardrum
Decreased mobility of the eardrum on pneumatic otoscopy
Bulging tympanic membrane
Fever (typically low-grade)
Fluid or pus draining from the ear (if the eardrum ruptures)
Hearing loss (temporary)
Describe visual acuity screening using a Snellen Chart. What do the results means (i.e. 20/20, 20/30, 20/40, etc…).
How It Works:
Positioning: The patient stands or sits 20 feet away from the Snellen Chart.
Testing: One eye is tested at a time while the other is covered with an eye patch or occluder. The patient is asked to read the letters on the chart starting from the largest at the top and moving down to the smaller letters.
Scoring: The patient’s ability to read the smallest line of letters determines their visual acuity score.
Interpreting Results (e.g., 20/20, 20/30, 20/40):
20/20: This is considered “normal” vision. It means the patient can see at 20 feet what a person with normal vision can see at 20 feet.
20/30: This means the patient can see at 20 feet what someone with normal vision can see at 30 feet. In other words, the patient’s vision is slightly worse than average.
20/40: The patient can see at 20 feet what someone with normal vision can see at 40 feet. This is often the minimum requirement for driving in many places.
Describe the correct use of an ophthalmoscope
An ophthalmoscope is a medical instrument used to examine the interior of the eye, including the retina, optic disc, macula, and blood vessels
Describe the correct use of an otoscope
instrument used to examine the ear canal and tympanic membrane (eardrum). It is essential for diagnosing ear conditions like infections, impacted earwax, and other abnormalities in the ear.
Describe how to perform the Weber test and what does it test for?
The Weber test is a quick and simple hearing test used to evaluate lateralization (whether the sound is heard in one ear more than the other) and to help differentiate between types of hearing loss (conductive vs. sensorineural).
make the sound and put it on the pts forehead
Normal Hearing: Equal hearing in both ears.
Conductive Loss: Louder sound in the affected ear.
Sensorineural Loss: Louder sound in the unaffected ear.
Describe how to perform the Rinne test and what does it test for?
Strike the tuning fork: Tap a 512 Hz tuning fork on your palm to make it vibrate.
Bone conduction: Place the base of the vibrating tuning fork against the patient’s mastoid bone (behind the ear).
Air conduction: When the patient no longer hears the sound through the bone, move the tuning fork to in front of the ear canal (about 1-2 cm away) and ask if they can still hear the sound.
Compare the sounds:
Normal hearing or sensorineural loss: The patient hears the sound longer through air conduction (AC > BC).
Conductive hearing loss: The patient hears the sound longer through bone conduction (BC > AC).
Describe the technique for palpating sinuses
Frontal Sinuses:
Place your thumbs just above the eyebrows, under the brow ridge.
Apply gentle pressure and ask the patient if they feel any tenderness.
Compare both sides for any differences in tenderness or swelling.
Maxillary Sinuses:
Place your thumbs on the bony part of the upper cheeks, just below the cheekbones.
Apply gentle pressure and ask the patient if they feel any discomfort or tenderness.
Again, compare both sides for consistency.
there should be no pain
Describe the correct evaluation of a lymph node
Inspect: Look for any swelling or redness.
Palpate: Use your fingers to gently feel the node.
Check size (should be less than 1 cm).
Assess shape (should be round or oval).
Feel for firmness (soft is normal, hard could be concerning).
Check if the node is moveable (moveable is usually benign).
Feel for tenderness (tender may indicate infection).
Record the Location: Note where the swollen node is (e.g., neck, armpit).
Assess for Symptoms: Ask about fever, weight loss, or pain, which could indicate infection or illness.
Identify the anatomic location of the lymph nodes of the head and neck
a. Identify the anatomic location of the lymph nodes of the head and neck
b. Posterior auricular
c. Occipital
d. Superficial cervical
e. Deep cervical
f. Posterior cervical
g. Supraclavicular
h. Preauricular
i. Parotid
j. Tonsillar
k. Submental
l. Submandibular
Describe the grading of tonsils.
1- hidden w/in tonsil pillars NORMAL
2- extend pillars NORMAL
3- beyond pillars ABNORMAL
4- tonsils extend to midline- ABNORMAL- there’s prob an infection
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with
OSTEOARTHRITIS
i. Risk factors:
1. Increased age
2. History of wear and tear to joints
3. History of joint injury
ii. Subjective
1. Effects larger joints like hips and knees
2. Effects smaller joints like hands and feet
3. Pain and stiffness in joints (asymmetrical)
4. Worsens with rest
5. Improves with mod activity and movement
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with
MECHANICAL LOWER BACK PAIN
i. Risk factors
1. History of overuse
2. History of repetitive movements
3. History of new physical activity or unusual exertion
4. No major trauma, uncontrolled HTN, infection or malignancy
ii. Subjective
1. Pain in back, buttocks, thigh
2. Pain relieved when laying supine
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with
CARPAL TUNNEL
i. Risk factors:
1. History of overuse
2. Repetitive movements
3. Pregnancy
4. Frequent computer use
5. Painting
ii. Subjective:
1. Symptoms affecting the anterior writst, first three digits, medial palm
2. Pain, paraesthesia, and weakness (relieved by shaking hand)
3. Pain is experienced at night (early symptom)
red flags for lower back pain
pretty sure numbness is bad- = nerve involvement
Describe how to perform Tinel Sign and Phalen Sign. What is a positive result and what does it mean?
a. Tinel: tapping over the transverse carpal ligament, signs of carpal tunnel syndrome
b. Phalen- wrist flexion for 60 seconds, pain anestheisa or paresthesia positive = carpal tunnel syndrome
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with
migraine headaches
i. Risk factors:
1. History of prior headache episodes
2. Exposure to common triggers
a. Stress
b. Sleep alterations
c. Food
d. Alcohol
e. Perfumes
ii. Subjective
1. Pulsating quality
2. Unilateral
3. Pain 4-72 hours
4. Nausea, vomiting, photophobia
5. Phonophobia
6. Aura:
a. Feeling of dread or anxiety, fatigue, nervousness, excitement, GI, visual or olfactory alteration
b. Dysfunction of cerebral or brain stem dysfunction
c. Aura lasting >1hour seizure activity
7. Without aura
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with
cluster headaches
i. Risk factors
1. 20% fam history
ii. Subjective
1. Steady, intense pain
2. Unilateral
3. Intense pain behind one eye
4. 15min-3 hours
5. Ipsilateral autonomic signs
a. Lacrimation
b. Conjunctival injection
c. Ptosis
d. congestion
Describe the risk factors and subjective information (patient presentation and signs/symptoms) of a patient with
tension headaches
i. Risk factors
1. No family history
ii. Subjective
1. Pressing, non pulsatile pain
2. Wraps around the head
3. Pain lasts 30 min-7 days
Tell me all the cranial nerves and if they are sensory or motor
Olfactory-sensory
Optic- sensory
Occulomotor- motor
Trochlear- motor
Trigeminal- both
Abducens- motor
Facial-both
Auditory- sensory
Glossopharyngeal- both
Vagus- both
Spinal Accessory- motor
Hypoglossal- motor
Oh Oh Oh To Touch And Feel A Girls Vagina And Hymen
Some Say Marry Money But My Brother Says Big Boobs Matter More
CN 1- name and how to test
olfactory- sniff sniff
CN2- name and how to test
optic
Test visual acuity with Snellen eye chart or hand-held card; inspect fundi; screen visual fields by confrontation
2 and 3 tested together
CN3- name and how to test
Occulomotor
Inspect size and shape of pupils; test reactions to light and near response
2 and 3 tested together
