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Advanced Health Assessment > HEENT, Neuro, Musculoskeletal Diagnostic Reasoning > Flashcards

HEENT, Neuro, Musculoskeletal Diagnostic Reasoning Flashcards

1
Q

Acute vesicular eruption caused by the varicella zoster virus

A

Herpes zoster (shingles)

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2
Q

Identification of herpes zoster

A

Vesicular morphology
Grouped configuration
Dermatomal distribution

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3
Q

Subjective findings of herpes

A

Regional neuralgia and discomfort
Burning or intense pruritic
Malaise
Skin lesions that start as macules then develop into vesicles erupt and crust over

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4
Q

Objective findings of herpes zoster

A

Vesicular lesions ina dermatomal pattern
Regional lymphadenopathy
May becomes generalized in immunocompromised pts

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5
Q

The types of skin cancers :

A

Basal cell carcinoma
Squamous cell carcinoma
Melanoma

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6
Q

Comprises 80% of skin cancers
Grow slowly and rarely metastasize

A

Basal cell carcinoma

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7
Q

Comprises 16% of skin cancers
They can metastasize (3-7%) risk

A

Squamous cell carcinoma

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8
Q

Comprises 4% of skin cancers
Rapidly increasing in frequency and rapidly metastasizes

A

Melanoma

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9
Q

How to identify basal cell carcinoma

A

Papule or nodule morphology
Solitary configuration
Face or sun exposed skin

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10
Q

Subj findings of basal cell carcinoma

A

Non healing sore on face or sun exposed areas

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11
Q

Objective findings of basal cell carcinoma

A

Waxy “pearly” papule or nodule (or shiny red) with a central induration
Border of lesions appeared rolled
May be flat, hyperpigmented, and indistinct margins

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12
Q

Identification of squamous cell carcinoma

A

Nodule morphology
Solitary configuration
Face or sun exposed skin

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13
Q

Subjective findings of squamous cell carcinoma

A

Non healing lesion that continues to grow in size
Tenderness to lesion
History of actinic keratosis

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14
Q

Objective findings of squamous cell carcinoma

A

Warty appearance to lesion
Pink-colored plaque, nodule, or Papule with eroded surface
0.5-1.5 cm in size

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15
Q

ABCDE screening for Moles

A

Asymmetry
Border
Changes in color
Diameter
Elevation, enlargement, or evolution

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16
Q

Common or concerning symptoms of the head

A

Headache
History of head injury

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17
Q

Common or concerning symptoms of the eyes

A

Visual disturbances
Spots
Flashing lights
Use of corrective lenses
Pain
Redness
Excessive tearing
Diplopia

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18
Q

Common or concerning symptoms of the ears

A

Hearing loss
Tinnitus
Vertigo
Pain
Discharge

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19
Q

Common or concerning symptoms of the nose

A

Drainage
Congestion
Sneezing
Nose bleeds

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20
Q

Common or concerning symptoms of the oropharynx

A

Sore throat
Bleeding gums
Hoarseness

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21
Q

Common or concerning symptoms of the neck

A

Swollen glands
Goiter

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22
Q

Historical risk factors of sinusitis

A

Caused by S.pneumoniae
History of allergies, asthma, smoking

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23
Q

Subjective findings of sinusitis

A

Frontal headache
Malaise
Nasal discharge
Sore throat
Sinus ear pain:pressure
Congestion
Subjective fever

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24
Q

Objective findings of sinusitis

A

Sinus pain on palpitation
Fever
Inflamed nasal mucosa
Dull or inflamed TM
cervical lymphadenopathy
Nasal discharge

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25
Suspicion for bacterial sinusitis
Purilent discharge Facial pain Anosmia Symptoms lasting longer than 7-10 days Maxillary tooth pain Fever
26
Risk factors for acute otitis media
Commonly caused by strep pneumonia h.flu, or m.catarrhalis Common in children Preceded by viral illness
27
Subjective findings of AOM
unilateral ear pain Recent URI symptoms Diminished hearing acuity Irritable Subj fever
28
Obj findings of AOM
children pulling at ear Dull, bulging , inflamed , obscured cone of light, diminished mobility of tympanic membrane fever
29
Symptoms of bacterial conjunctivitis
Typically presents unilaterally and spreads manually Burning or gritty URI symptoms or none Mucopurulent, viscous Usually nonpalpable preauricular lymph nodes
30
Symptoms of viral conjunctivitis
Typically unilateral and spreads quickly bilateral Sensation of foreign body and/or gritty URI s:s Mucous-like discharge Palpable preauricular lymph nodes
31
Symptoms of allergic conjunctivitis
Bilateral No pain Hx recurrent allergy symptoms Water thin clear discharge Nonpalpable preauricular lymph nodes
32
Risk factors of corneal abrasion
Trauma or foreign body to eye History of dry eye
33
Subjective findings of corneal abrasion
Scratchy Pain Foreign body sensation Severe photophobia Excessive tearing Visual disturbances
34
Objective findings of corneal abrasion
Redness with cilliary flush Decreased visual acuity
35
Types of primary headaches
Tension Migraine Cluster
36
Causes of secondary headaches
Increased ICP uncontrolled HTN intracranial bleeding Stroke Malignancy
37
Risk factors for headaches
History of prior episodes Exposure to triggers: Stress Sleep alterations Food Alcohol Perfumes
38
Subjective findings for tension headaches
No fam history Pressing, nonpulsatile Wraps around the head Duration of pain 30min-7 days
39
Subjective findings of migraine headache
Family history 70-90% Pulsating quality Unilateral Pain duration 4-72 hours Symptoms include N/V, photophobia or phonophobia
40
Subjective findings for cluster headaches
Fam history in 20% Steady intense pain Unilateral, intense pain behind eye Duration 15min-3 hours Pain onset 1 hour into sleep S/s- lacrimation, conjunctival injection, congestion, ptosis
41
Subjective findings of migraines with aura
Feeling of dread or anxiety, fatigue, nervousness, excitement, GI, visual or olfactory alteration Dysfunction of cerebral or brain stem dysfunction Symptoms last >1 hour consider seizure
42
Consider diagnostic of headache is these s/s present (red flags)
Systemic symptoms or secondary headache risk factors Neurological s/s Onset - how it started Onset- age Previous headache history
43
Headache S(snoop) symptoms
Systemic symptoms : Fever Unexplained weight loss
44
Secondary headache risk factors
Malignancy Pregnancy HIV anti coagulation Hypertension Traumatic injury Alcoholism
45
Headache N (snoop) symptoms
Neuro symptoms: New focal deficits Nuchal rigidity Uncontrolled HTN papilledmea Cranial nerve dysfunction Abnormal motor dysfunction Signs of stroke
46
Headache o (snoop) symptoms
Sudden abrupt or split second onset Headache onset with exertion, sexual activity coughing or sneezing
47
Headache O (snoop) symptoms (age)
>50 <5
48
Headache P (snoop) symptoms
Any change in previous headache presentation (increase frequency, severity, time without headache) Change in clinical features of headache (Prolonged aura, new systemic symptoms)
49
Historical risk factors of OA
Increase age History of wear and tear to joints History of joint injury Effects hips, knees, hands, feet
50
Subjective findings of OA
Pain and stiffness in joints (asymmetrical) Worsens with rest Improved with moderate movement or activity
51
When to consider RA over OA
If complaint is symmetrical and or involves 3 or more metacarpophalangeal joints
52
Objective findings of OA
Bouchards nodes Herbedens nodes Joint effusion Clicking on ROM
53
Historic risk factors of carpal tunnel syndrome
History of overuse or repetitive movements Frequent computer use or painting
54
Subjective findings or carpal tunnel syndrome
Symptoms usually involve anterior wrist, first 3 digits, medial palm Pain, paresthesia, weakness Pain typically at night
55
Phalen’s sign
Pain, paresthesia, or numbness with wrists flexed for 60 seconds
56
Tinel’s sign
Pain, paresthesia, or numbness with tapping over the transverse carpal ligament
57
Examples of low back pain
Muscle, ligament, tendon strain Discogenic disorders Herniated disc Apophyseal joint arthritis Spinal stenosis Spondylolysis Scoliosis
58
Historical risk factors of mechanical low back pain
History of overuse and repetitive movements New physical activity or unusual exertion
59
Subjective findings of mechanical low back pain
Pain in buttocks, back, thigh Pain relieved when laying supine
60
Objective findings of mechanical back pain
Paravertebral spasms or tenderness Scoliosis Loss of natural lumbar lordosis No neuro signs or radiculopatgy
61
Common or concerning symptoms of the skin hair and nails
Hair loss, rashes, moles, changes in nails
62
Health history, questions for the skin hair and nails
Have you noticed any changes in your skin or hair? Have you noticed any moles that changed in size color shape or sensation? Have you noticed any new moles?

Advanced Health Assessment (8 decks)

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