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NSG 6020 > Health Assessment Midterm > Flashcards

Health Assessment Midterm Flashcards

1
Q

Occlusion and inflammation of the salivary gland leads to

A

Sialadenitis

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2
Q

What is the most common neurologic problem caused by Lyme disease

A

A Bell’s palsy-like facial paralysis

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3
Q

Signs & symptoms of Hyperthyroidism

A

Nervousness, irritability, weight loss, tachycardia, heat intolerance, smooth/ silky skin, fine hair (with frequent loss), thin nails, loose stools

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4
Q

Signs and symptoms of Hypothyroidism

A

Periorbital edema, facial edema, bradycardia, weight gain, lethargy, cold intolerance, muscle weakness, coarse/ brittle hair, osteoporosis, constipation, menorrhagia, pitting edema of LE

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5
Q

Diagnostic test for CHF

A

Brain natriuretic peptide (BNP)

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6
Q

Differential Dx for chest pain

A

Pneumonia

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7
Q

Apply pressure downward & slightly upward on the liver. Up to 30 seconds of pressure. Watch for jugular vein distention. (If present, it should recede within seconds. Abnormal if JVD stays while you are pressing on the liver). This checks for right-sided heart failure

A

Hepatojugular Reflux

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8
Q

Most common valve abnormality in adults. Develops gradually. Decreased HR, faint pulse (Crescendo-decrescendo) systolic murmur. Radiates to the carotids. Heard @ 2nd ICS RSB

A

Aortic Stenosis (Systolic Murmur)

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9
Q

Most common in women w/ rheumatic heart disease. Atrial dilation & hypertrophy, thrombi formation from fibrillation (Rumbling decrescendo) diastolic murmur. Heard @ Apex, PMI, 5th ICS MC

A

Mitral Stenosis (Diastolic Murmur)

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10
Q

Seen in RHD, bacterial endocarditis, syphilis ( blowing decrescendo murmur in 3rd & 4th ICS) bounding peripheral pulses (Corrigan pulses). Heard @ 3rd & 4th ICS/ ERBs point

A

Aortic Regurgitation (Diastolic Murmur)

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11
Q

Caused by MVP, RHD, ineffective endocarditis, MI, Marfan syndrome (Loud holosystolic murmur at APEX) Left ventricular dilation/ hypertrophy, atrial dilation/fibrillation. Heard @ the Apex

A

Mitral Regurgitation (Systolic Murmur)

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12
Q

Lab test for myocardial damage

A

Troponin

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13
Q

Common cause of tricuspid regurgitation

A

Pulmonary HTN

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14
Q

Signs/ symptoms of right sided heart failure (“right = GI”)

A

JVD (normal< 4cm), enlarged spleen, enlarged liver causing anorexia, nausea and abdominal pain, LE edema

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15
Q

Signs/ symptoms of left sided heart failure (“left = lung”)

A

Crackles, cough, dyspnea, dullness to percussion, paroxysmal nocturnal dyspnea, orthopnea, non-productive cough & wheezing

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16
Q

MI, elevated BP, smoking, dyspnea w/ exertion lead to

A

Left-sided heart failure = decreased cardiac output

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17
Q

Most common causes of S4

A

Left ventricular hypertrophy (LVH), normal in some elderly, poorly controlled HTN, unstable angina

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18
Q

Most common causes of S3

A

CHF, pregnancy, possible thyrotoxicosis, possible normal for adolescent athletes, always abnormal if occurs > 35yo “Kentucky” - best heard at pulmonic area (AKA ventricular gallop or S3 gallop)

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19
Q

S3 ( Use Bell to hear)

A

“Kentucky” - best heard at the pulmonic area (AKA ventricular gallop or S3 gallop)

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20
Q

S4 ( Use Bell to hear)

A

Occurs late is diastole and best heard at apex with bell (Tennessee) (atrial gallop or atrial kick)

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21
Q

Closure of AV- mitral/ tricuspid (lub)
M =(mitral valve)
T= (tricuspid valve)
AV= (atrioventricular valves)

A

S1 = systole

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22
Q

Closure of semilunar - aortic/ pulmonic valves (dub)
A= (aortic)
P= (pulmonic)
S= (semilunar)

A

S2 = diastole

23
Q

Grading of murmurs

A

Grade I = Barely audible
Grade II = Audible but faint
Grade III = Moderately loud, easily heard (as loud as S1)
Grade IV = Loud, associated with a thrill
Grade V = Very loud, heard one corner of the stethoscope off the wall
Grade VI = Loudest heard w/o a stethoscope

24
Q

Occurs in severe anemia, dehydration & becomes louder when lying down

A

Physiologic Murmur

25
Q

Systolic murmurs (MR Peyton Manning AS MVP)

A 
MR Peyton Manning AS MVP
MR = mitral regurgitation ( radiates to axilla)
P/M = physiologic murmur
AS = aortic stenosis ( radiates to neck)
MVP = mitral valve prolapse
26
Q

DIastolic murmurs (ARMS)

A

ARMS
AR = aortic regurgitation
MS = mitral stenosis

27
Q

JNC- 8 Guidelines

A

Implement lifestyle modifications
BP goal
Anyone w/ DM or CKD < 140/90
No DM or CKD < 150/90

28
Q

JNC-8 Guidelines (MEDS)

A

Non AA= thiazide or ACEI/ ARB or CCB alone or in combo
AA = thiazide or CCB alone or in combo
CKD = ACEI or ARB alone or in combo w/ other class

29
Q

CENTOR critieria

A 
Absence of cough
Tonsillar exudate
Anterior cervical adenopathy
Hx of fever 
Age
Score > 2 screen for strep
30
Q

Sudden onset of floaters associated with looking through a curtain sensation w/ sudden flashes of light (photopsia)

A

Retinal Detachment

31
Q

Acute onset of severe eye pain with redness & vision changes. Accompanied by headache, N/V, halos around lights & decreased vision. Cornea appears cloudy. Funduscopic exam reveals cupping of optic nerve

A

Acute Angle Closure Glaucoma (Opthalmological emergency)

32
Q

Gradual onset increased IOP greater than 22. Presents with a gradual change in peripheral vision

A

Open Angle Glaucoma

33
Q

Gradual or sudden loss of central vision in one or both eyes. Straight lines become distorted or curved (scotoma)

A

Macular degeneration

34
Q

Causes by EBV. Symptoms (3F’s & an L) fever, fatigue, pharyngitis, lymphadenopathy sore throat, enlarged posterior cervical nodes, peak ages 15-24

A

Mononucleosis

35
Q

Chronic inflammation of meibomian gland, painless nodule with gradual onset. Tx I &D or corticosteroid injections

A

Chalazion

36
Q

Acute onset swollen, red and warm abscess on the eyelid may spontaneously rupture & drain purulent exudate. Caused by staph. Tx w/ hot compresses & erythromycin

A

Hordeoleum (stye)

37
Q 
Confusion of new onset
Blood urea nitrogen > 19
Respiratory rate > 30
Blood pressure diastolic < 90 or systolic < 60
Age 65 or older
A

CURB 65 (Pneumonia)

38
Q

PPD x Years =

A

Packs per year

39
Q

COPD: FEV1/ FVC < 70

A

Mild > 80
Moderate < 50
Severe < 30

40
Q

Increased tactile fremitus

A

Indicates consolidation

41
Q

Functional murmurs

A

Are due to increased blood flow. Normal in children @ 2nd- 3rd L ICS. Will disappear with sitting

42
Q

Risk factors for pulmonary emboli

A

Hx of A-fib, pregnancy, recent travel, smoking, prolonged inactivity, birth control, estrogen therapy, surgery, cancer, long bone fx

43
Q

Midsternal chest pain, numbness/ tingling left jaw, pain provoked by eating heavy meals or exercise. Pain or discomfort at rest. Women present w/ fatigue, sleep disturbance, anxiety, dyspnea, weakness, back pain, nausea & syncope

A

ACS (acute coronary syndrome)= STEMI, NSTEMI & unstable angina

44
Q

What type of pain can you reproduce?

A

Muscloskeletal pain

45
Q

Three factors that can cause thrombus formation (Virchow Triad)

A

Vessel wall injury
Blood flow abnormalities
Altered blood constituents leading to hypercoagulability

46
Q

Alveolar damage from loss of elastic recoil lungs, chronic cough (2 yrs), chronic sputum production, SOB worse w/ exertion, barrel chest, weight loss, hyperresonance upon precision, tactile fremitus & egophony are decreased, hyperinflation w/ CXR. (* pack per year smoker*)

A

COPD

47
Q

Thrombi developed from stasis, trauma, inflammation or coagulation. Gradual onset of swelling in LE after prolonged sitting, painful, red, warm, swollen extremity. (If PE abrupt onset CP, dyspnea, dizziness or syncope. + Homan’s sign

A

Deep vein thrombosis (DVT)

48
Q

Narrowing or occlusion of medium to larger arteries in LE

A

Arterial insufficiency

49
Q

Worsening pain on ambulation instantly relived by rest (claudication- angina of calf muscles). Thin skin, hairless toes, thick toenails/ discolored, decreased or absent dorsal pedal pulse

A

Peripheral artery disease (PAD)

50
Q

What crescendo- decrescendo murmur presents in older patients with syncope, angina & dyspnea (SAD), or calcified valve? These murmurs radiate to the carotids

A

Aortic Stenosis

51
Q

What holosystolic murmur presents in a patient with Hx of Rheumatic fever? This murmur radiates to the axilla.

A

Mitral regurgitation

52
Q

What holosystolic murmur presents in patients with Hx of intervenous drug abuse (IVDA)?

A

Tricuspid Regurgitation

53
Q

What murmur has an opening snap sound and presents in a patient with Hx of Rheumatic fever?

A

Mitral Stenosis

54
Q

What murmur presents in young women w/ psychiatric Hx ( anxious or depressed)? Has a mid-systolic click. Can be caused by myxomatous valve disease

A

Mitral valve prolapse

NSG 6020 (4 decks)

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