HAP 4 Flashcards
1
Q
When can an “innocent murmur” be auscultated?
A
up to age 25
2
Q
What is a normal jugular vein finding?
A
see-saw pulse
3
Q
How do women present with an MI?
A
indigestion
4
Q
How do diabetics present with an MI?
A
nausea and vomiting
5
Q
What would cause rust/brown colored cough secretions?
A
TB
6
Q
What would cause green-colored cough secretions?
A
bacterial infection
7
Q
What would cause white/yellow colored cough secretions?
A
viral infection
8
Q
BP _______ during pregnancy and CO ________.
A
BP decreases
CO increases by 30-40%
9
Q
Increased BP during pregnancy is an abnormal sign related to ________.
A
preeclampsia - HR will increase as well and apical pulse will be higher and more lateral
10
Q
Normal HR for babies is between ______
A
100-180
11
Q
When kids have a heart rate under _____, we start compressions.
A
100bpm
12
Q
What are signs of heart failure in babies?
A
poor weight gain
resting tachycardia
clubbing
13
Q
CHF skin:
A
gray/cyanotic, cold, moist
14
Q
CHF lungs:
A
dyspnea, orthopnea, wheezes/crackles
15
Q
CHF pupils:
A
dilated
16
Q
CHF blood pressure:
A
decreased
17
Q
CHF patient demeanor
A
anxious, confused, fatigued
18
Q
CHF GI:
A
ascites, N/V
19
Q
CHF O2 Sat:
A
falling
20
Q
Which abnormal heart sound does CHF present with?
A
S3
21
Q
CHF spleen and liver:
A
enlarged
22
Q
CHF urine output:
A
decreased
23
Q
CHF leg presentation:
A
pitting edema
24
Q
When do bone epiphyses close?
A
20
25
What are broken bones in a child indicative of?
abuse - children's bones are very strong and not easily broken
26
When is scoliosis often diagnosed?
early in life
27
Pregnant women can develop which spinal irregularity?
lordosis
AND kyphosis
AND cervical flexion
AND waddling gait
28
Aging adults can develop which spinal irregularity?
kyphosis
29
Describe how we grade muscles:
```
0 - no muscle contraction
1 - slight muscle contraction
2 - full PROM
3 - full AROM against gravity
4 - full AROM against SOME resistance
5 - full AROM against FULL resistance (NORMAL)
```
30
From which joint do supination and pronation movement come from?
the elbow
31
Phalen's test is for _______ and is done for how long?
carpal tunnel
| 1 minute
32
Tinel's Sign is for _______
carpel tunnel
33
The bulge sign is for which joint?
knee
34
What is Lasegue's Test for?
herniated disks - also called the straight leg raise test
35
What is Ortolani's maneuver?
it checks for congenital hip dislocation in infants
36
What is Allis test?
it checks for hip dislocation
37
What is commonly dislocated in an infant during birth?
clavicle
38
What irregular spinal condition is normal in children?
lordosis with a pot belly
39
What irregular spinal condition is normal in adolescents
kyphosis due to poor posture
40
What test is done during adolescence to screen for scoliosis?
forward bend test
41
What is the Get Up and Go Test?
a test for aging adults where they get up from a chair, walk ten feet, walk back and sit down in ten seconds or less
42
Is rheumatoid arthritis or osteoarthritis inflammatory?
RHEUMATOID is INFLAMMATORY
43
Does rheumatoid arthritis or osteoarthritis feel better with joint movement throughout the day?
Rheumatoid
44
Does rheumatoid arthritis or osteoarthritis present with Heberden's nodes and Bouchard's nodes?
Osteoarthritis
45
Does rheumatoid arthritis or osteoarthritis cause ulnar deviation?
Rheumatoid
46
Does rheumatoid arthritis or osteoarthritis present with a fever?
Rheumatoid
47
Does rheumatoid arthritis or osteoarthritis feel worse with repetitive movement?
Osteoarthritis feels worse with repetitive movement
48
Symptoms from which arthritis hit the weight-bearing joints?
Osteoarthritis
49
Does rheumatoid arthritis or osteoarthritis present with degenerative changes?
Osteoarthritis
50
Where do Heberden's nodes present?
| Bouchard's?
H - distal
| B - proximal
51
What is the hallmark sign of Gout?
extreme big toe pain
52
What is a Tophi and when would you see one?
Tophi - round, pea-like deposits of URIC ACID in ear cartilage seen in GOUT
53
Where are the Montgomery glands located?
the areola
54
Where are the majority of breast masses found?
the tail of Spence
55
Where does 25% of lymphatic fluid go?
to the ipsilateral side
56
Lactation begins _____ days post-partum
1-3
57
What is witch's milk?
a normal finding in infants - enlarged breasts that secrete witch's milk due to estrogen crossing the placenta
58
Breast development usually begins between the ages of
8-10 (~2years before the onset of menses)
59
When should we start teaching a breast self-exam?
adolescence
60
What pattern is best to use to detect for breast cancer?
the vertical strip pattern
61
When should breast cancer screening begin?
annually beginning at age 45 at the latest
62
Who is at the highest risk of breast cancer?
those who have a 1st generation link (mother, sister, daughter)
63
What is retraction?
both breasts should move when the arms lift
64
Rank the 3 types of cancer for this exam in order of severity and give the age groups.
1. cancer (30-80, up after 50)
2. benign breast disease (30-55, down after menopause)
3. fibroadenoma (15-30)
65
Which of the 3 types of cancer is irregular/ star-shaped?
cancer
66
What is the consistency of fibroadenoma?
firm/rubbery
67
What is the consistency of benign breast disease?
firm/rubbery
68
What is the consistency of cancer?
firm to stony hard
69
Which cancer has poorly defined margins?
cancer
70
Which of the three cancers usually appears in multiple places?
benign breast disease
71
Which cancer is fixed?
cancer
72
Which cancer is tender?
benign breast disease
73
Which cancer presents with retraction?
cancer
74
Which cancer grows cyclically?
benign breast disease
75
What are the 12 signs of breast cancer?
```
Growing vein
Red and hot
Invisible lump
New fluid
Dimpling
```
Pinching
Asymmetry
Nipple retraction
Hardening
Orange skin
Puckering
Erosion
76
Wet dreams are normal until what age?
12-13
77
Puberty manifests in what order for males?
1st testes enlargement
2nd hair
3rd penis size
78
Puberty manifests in what order for females?
1st breast enlargement
2nd pubic hair
3rd ovaries move into the pelvic cavity
4th period begins
79
Do female hormones decrease rapidly or gradually at menopause?
rapidly
80
To palpate for a hernia in males, we use what approach?
NAVEL
```
Nerve
Artery
Vein
Empty space
Lymph nodes
```
81
How should we teach Testicular Self Exam?
TSE
Timing - once a month
Shower - warm water relaxes the scrotum
Examine - check for and report changes immediately
82
What is Hypospadias?
opening of the urethra is on the underside of the penis instead of the tip
(hypo = less = under)
83
Whatis Epispadias?
opening of the urethra is on top of the penis instead of the tip
(Epi = uppy)
84
What is Priapism?
prolonged erection
85
What is Phimosis?
the foreskin of the penis can not be retracted
86
What is Paraphimosis?
the retracted foreskin of an uncircumcised male can not be returned back to its anatomical position
MEDICAL EMERGENCY
87
Which penis abnormality is a medical emergency?
paraphimosis
88
Where are the Skene and Bartholin glands located?
vagina
89
A PAP smear screens for which cancer?
cervical cancer
NOT for endometrial or ovarian
90
When should you NOT obtain a PAP smear?
during a woman's period/heavy discharge
91
The cervical exam is ______
bimanual
92
The cervical opening should be either _____ or _____.
nulliparous - little hole
| parous - little slit (after childbirth)
93
What are nabothian cysts?
benign growths that commonly appear on the cervix after childbirth
small, yellow retention cysts caused by cervical gland obstruction
94
How big is a normal cervix?
2.5 cm or 1 inch
95
Penile carcinoma presents as
warty growth with watery discharge
painless
on glans/inner lip of foreskin
96
STIs involving C. trachomatosa and gonorrhea often lead to ______
epididymitis
97
Testicular torsion is a surgical emergency whose hallmark sign is ________
sudden onset of severe pain and scrotal swelling
98
Chlamydia presents as
minimal or no S&S
| yellow/green discharge
99
Left untreated, chlamydia can lead to:
PID
100
Gonorrhea presents as
minimal or no S&S
| may have purulent discharge
101
Left untreated, gonorrhea can lead to:
PID
102
Syphilis often begins as
a small silvery papule that resolves spontaneously
secondary symptoms present as fever, rash, sore throat
103
Trichomoniasis presents as
malodorous discharge that worsens with period
the vagina has a strawberry appearance
Men have no S&S
104
Herpes presents as
pain, fever, and clusters of small blisters
infection lasts 7-10 days
virus remains dormant indefinitely
105
What is the most common STI?
HPV
106
How does HPV present subjectively?
painless warty growths that may go unnoticed
107
How does HPV present objectively?
cauliflower-like papules/patches
108
What is endometriosis?
benign growth of uterine tissue outside the uterus
causes pain and weird periods
109
What are ovarian cysts?
benign cysts in the ovaries that are asymptomatic
110
What causes cervical cancer?
HPV
111
What is the most common sign of cervical cancer?
abnormal bleeding between periods
112
What is the most common gynecological cancer?
endometrial cancer
113
Who usually gets endometrial cancer?
postmenopausal women, especially those taking estrogen
114
What is the hallmark sign of endometrial cancer?
abnormal bleeding, sometimes with watery discharge
115
Which gynecological cancer has the highest mortality rate?
ovarian cancer
116
What is the most common sign of ovarian cancer?
a feeling of fullness
| by the time we can feel it, it's usually too late
117
Describe 1st, 2nd, and 3rd-degree uterine prolapse
1st - prolapsed cervix remains in vagina
2nd - prolapsed cervix is introitus (at the vaginal opening)
3rd - cervix AND vagina drop outside introitus
118
The HPV vaccine covers what three conditions?
cervical cancer, anal cancer, and genital warts
119
What are the presumptive signs of pregnancy?
amenorrhea, breast tenderness, fatigue and increased urinary frequency
120
Who assesses the probable signs of pregnancy?
an examiner
121
What are two tests to determine positive pregnancy?
FHTs and cardiac activity on the ultrasound
122
When can a mother feel fetal movement?
between 18-20 weeks
| called "quickening"
