Health Assessment Flashcards
Hyperkalemia is associated with
acidosis
QT prolongation is associated with:
Toxic drug levels
Most indicative of Ectopic Pregnancy
Amenorrhea followed by spotting and sudden onset of lower quadrant pain
Which is not true about the 7 F’s of abdominal distention?
The fetus has NO effect on the abdominal distension
Which statements are true? (re:PVD)
Approximately 50% of patients of PVD are asymptomatic
African american, american indian, and mexican american population are at increased risk
Which statement is TRUE regarding leg pain?
a. Nerve damage can be a differential diagnosis for leg pain
Percussing fremitus on the posterior side is best felt in what intercostal space?
2nd
Where do you feel the PMI
5th intercostal space - lateral to the midclavicular line.
How do you check the ear of a 2.5 year old?
Pull auricle down and out
CO =
SV X HR
diaphramatic excursion distance is?
3-5 cm
Levine’s Sign
Patients will describe angina by clenching their fist and placing it over the sternum.
- A pt with heart failure has pink frothy sputum, what is the diagnosis?
pulmonary edema
What is mononucleosis caused by?
EBV
- What is the first sign of thrombophlebitis in 50% of patients
PE may be the first sign
an astute SRNA knows a thrill will be felt with which type of murmur?
Grade IV
What is located in the lower left quadrant of the abdomen?
sigmoid colon
diaphragm of the stethoscope is used to hear what sounds?
most murmurs
The bell of the stethoscope is used to hear what sound?
S3
Patient has blood clot — inflammed vein etc.
Thromobophlebitis
Sytolic murmurs fall between what heart sounds?
S1 and S2
Troponin I is unique to the heart because?
- Released in 1-3 hours after injury
- Peaks in 12-48 hours after injury
diagnostic of otitis media:
bulging tympanic membrane
day 3 post op. SOB, Tachy, O2 sat 85% differential dx:
PE
Correct documentation for normal pulses?
+2
Otitis externa presents as
sloughing
cute Otitis media is diagnosed when which of the following is present?
Otalgia, fluid in the middle ear, fever
Correct way to treat epistaxis?
Leaning forward and pinching anterior portion of nose for 15 minutes
A MUGA scan is typically used to:
Evaluated ejection fraction
Increased sodium could indicate?
Dehydration
S3 and S4 creates a cadence that resembles what?
Gallop of a horse
Abnormal to hear on S3?
33 year old male (>30)
Which of the following is a possible differential for eye redness
Scleritis
A Differential for peritonsillar abscess could also be what?
Epiglottitis
A patient has a painful tongue noted with white lesions that you are able to scrape off. This patient more than likely has what?
Oral candidiasis
Which of the following is an example of conductive hearing loss?
Otitis Media
Patient temp 102.2 leaning forward, dyspnea, sudden sore throat started 4 hours ago. Comes to the clinic
Escort to the ER
Diaphragmatic excursion is shortened by . choose two? (p. 201 in Rhoades)
Emphysema
Fractured rib
An age related loss of hearing that results from decreased hairy cell function and elasticity of the Tympanic Membrane
presbycusis
Which abdominal pain is not a red flag
Pain not associated with syncope
Trachea question choose 2
Small deviation to right is normal
Significant deviation can be atelectasis
Abdominal Assessment Order
Inspection- auscultation- percussion- palpation
A patient with ….. Grey-Turner’s, Hx of alcoholism
Pancreatitis
Cause of Otitis externa
cool tropical place???
Harsh, loud, systolic murmur heard over the 2nd right intercostal space with diminished, an early ejection click, diminished S2, crackles at the lung bases with LVHF..indicative of?
a. Aortic Stenosis
(Pulmonic is 3rd left ICS) “Remember SAD acronym Syncope, angina, dyspnea”
Tearing pain scenario question. Different bp on each arm, different pulse grades bilaterally.
Dissecting Aortic aneurysm
The assessment start:
when patient enters room
You percuss resonance in the lung, what is this indicative of?
A normal healthy lung
PMI >3 cm?
L ventricular Hypertrophy
Colicky pain that begins as periumbilical or epigastric pain and progresses to RLQ pain could be described as?
Appendicitis
Question about lung all is true except.
Left middle lobe
Scenario about diastolic murmur found at the 4th intercostal space? hx of rheumatic fever and another murmur (mitral stenosis); low pitched rumbling mid-diastolic murmur, heard at the left sternal border in the fourth interspace and increasing with inspiration (pg. 213) this is indicative of?
Tricuspid Stenosis
Pt leans forward for ease of breathing, drools, palpation of larynx indicates pain. The pt probably has:
Epiglottitis
Pt experiences chest pain while doing lawn work but the pain is relieved when he stops
Angina Pectoris
Tachyarrhymias causes all except?
sick sinus syndrome
Question about mainstem bronchi?
Bifurcates at level of sternal angle
What is found in the RLQ?
cecum
What is found in the LLQ?
sigmoid colon
Bacterial Pharyngitis/ tonsillitis cause is associated with
Strep Group B
What are the precordial chest leads?
V1, V2, V3, V4, V5, V6
Preoperative anemia screening
Not for low risk procedures like cataracts
Pierre Robin syndrome associated with
Difficult Airway
ASA preanesthesia evaluation for cataract extraction:
Day of surgery
Day prior to surgery
Familistic cultures:
value the
family over the individual
healthcare decision making and problem solving are executed by the family
Radial pain of the right wrist, Limited ROM, swelling, Locking sensation
De Quervain’s Tendonitis
12 lead EKG to read
3rd degree HB
EKG (V2-6 STEMI)
Anterior MI with lateral involvement
generalized anxiety disorder lasts
6 months or longer
24yo: Lack of sleep, nightmares, irritable; Mugged at gun-point
PTSD
Test for Herniated Disk → 32 year old was lifting heavy boxes and had numbness/tingling down the leg afterwards?
Straight leg test
Tall P wave is related to (PPulmonale)
R atrial enlargement
Most common injured muscles for rotator cuff?
Supraspinitous
Which meds increase risk of systemic erythematous lupus? Pick 2
Oral contraceptives
hydralazine
Which hormone is not released from anterior pituitary?
Oxytocin
Routine labs lead to unnecessary downstream testing, cancellation of surgery, increases in patient anxiety and cost. What does it NOT contribute to?
Increased burden on insurance company
What is are S&S of RA:
RA antigen, morning stiffness, ANA (+)
A football player with injury to L knee and MRI shows a fracture, what does he have?
A ligamentous injury
Tendons connect
Muscle to bone
Long paragraph about a patient went camping and was around Ticks?
Lymes disease
Murmur between s1-s2
Systolic murmur
Patient Ripping / crushing chest pain- widening pulse pressure:
Aortic aneurysm.
Which patient at risk for closed angle glaucoma
EAST Asians
Which patient at risk for open angle glaucoma
Hispanics
Group with strong external boundary and outsiders must work hard to earn trust
High context
Ethinic cultures may associate illness with and treat illness with??
Spiritual associations with disease
Take herbs
Patient is sad and appears depressed, what was her diagnosis?
depression
Patient had murmur at 2nd intercostal space LSB and came in with angina and dyspnea for lap chole
Aortic stenosis.
Pink frothy sputum
Pulmonary edema
PMI is found
Lateral to the midclavicular- 5th intercostal space
PMI greater than 3cm =
Left ventricular hypertrophy
What is seen with RA
Morning stiffness, +RA antigen and ANA
Poor anesthesia student jumping from one topic to the other
Flight of Ideas
First sign of thrombophlebitis
PE
who is most likely to be at greater risk for fibromyalgia?
25 yr old female
Cardiac muscle issues with II, III, AVF and 60% SA node and 90% AV node
RCA
Football player with pain between 3rd and 4th intermetatarsal
Morton’s neuroma
The diaphragm of the stethoscope is used for
Most murmurs
The bell of the stethoscope is used for
S3
Not a red flag with neck pain
Intermittent pain
Fluid filled cyst adjacent to tendon?
Ganglion cyst
2nd heart sound is
Closure of aortic/pulmonic valves
Poor R wave progression may be a normal variation in
young people (particularly young women??
An astute SRNA knows a thrill will be felt with which type of murmur?
Grade IV
What produces the S2 sound?
Closure of the aortic and pulmonic valves
Group that has strong external boundaries so it is hard for outsiders to get in
High context
Barrel chest with flattened diaphragm on the lateral CXR is indicative of?
a. COPD
Occupational lifetime dose of radiation is?
a.
Age x 10 mSV
Where should you place your dosimeter during fluoroscopy? See arm exam.
a. outside of collar
Where is the tip of a properly placed central line?
a.
SVC proximal to the right atrium
The annual occupational effective dose of whole-body exposure is?
a. 50 mSV
Which one of the following indicates poor inspiratory effort?
a. < 9 posterior ribs visible
Which of the following provides the best safety from ionized radiation?
a. Distance
X-ray taken in PA position, how is this image viewed?
a. Erect face to face
There is 100 mLs of pleural fluid, which CXR will show this?
a. A lateral view
What can only be viewed with a lateral CXR?
a. The retrocardiac space
