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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
Q

Suspicion for bacterial sinusitis

A

Purilent discharge
Facial pain
Anosmia
Symptoms lasting longer than 7-10 days
Maxillary tooth pain
Fever

26
Q

Risk factors for acute otitis media

A

Commonly caused by strep pneumonia h.flu, or m.catarrhalis
Common in children
Preceded by viral illness

27
Q

Subjective findings of AOM

A

unilateral ear pain
Recent URI symptoms
Diminished hearing acuity
Irritable
Subj fever

28
Q

Obj findings of AOM

A

children pulling at ear
Dull, bulging , inflamed , obscured cone of light, diminished mobility of tympanic membrane
fever

29
Q

Symptoms of bacterial conjunctivitis

A

Typically presents unilaterally and spreads manually
Burning or gritty
URI symptoms or none
Mucopurulent, viscous
Usually nonpalpable preauricular lymph nodes

30
Q

Symptoms of viral conjunctivitis

A

Typically unilateral and spreads quickly bilateral
Sensation of foreign body and/or gritty
URI s:s
Mucous-like discharge
Palpable preauricular lymph nodes

31
Q

Symptoms of allergic conjunctivitis

A

Bilateral
No pain
Hx recurrent allergy symptoms
Water thin clear discharge
Nonpalpable preauricular lymph nodes

32
Q

Risk factors of corneal abrasion

A

Trauma or foreign body to eye
History of dry eye

33
Q

Subjective findings of corneal abrasion

A

Scratchy
Pain
Foreign body sensation
Severe photophobia
Excessive tearing
Visual disturbances

34
Q

Objective findings of corneal abrasion

A

Redness with cilliary flush
Decreased visual acuity

35
Q

Types of primary headaches

A

Tension
Migraine
Cluster

36
Q

Causes of secondary headaches

A

Increased ICP
uncontrolled HTN
intracranial bleeding
Stroke
Malignancy

37
Q

Risk factors for headaches

A

History of prior episodes
Exposure to triggers:
Stress
Sleep alterations
Food
Alcohol
Perfumes

38
Q

Subjective findings for tension headaches

A

No fam history
Pressing, nonpulsatile
Wraps around the head
Duration of pain 30min-7 days

39
Q

Subjective findings of migraine headache

A

Family history 70-90%
Pulsating quality
Unilateral
Pain duration 4-72 hours
Symptoms include N/V, photophobia or phonophobia

40
Q

Subjective findings for cluster headaches

A

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
Q

Subjective findings of migraines with aura

A

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
Q

Consider diagnostic of headache is these s/s present (red flags)

A

Systemic symptoms or secondary headache risk factors
Neurological s/s
Onset - how it started
Onset- age
Previous headache history

43
Q

Headache S(snoop) symptoms

A

Fever
Unexplained weight loss

44
Q

Secondary headache risk factors

A

Malignancy
Pregnancy
HIV
anti coagulation
Hypertension
Traumatic injury
Alcoholism

45
Q

Headache N (snoop) symptoms

A

New focal deficits
Nuchal rigidity
Uncontrolled HTN
papilledmea
Cranial nerve dysfunction
Abnormal motor dysfunction
Signs of stroke

46
Q

Headache o (snoop) symptoms

A

Sudden abrupt or split second onset
Headache onset with exertion, sexual activity coughing or sneezing

47
Q

Headache O (snoop) symptoms (age)

A

> 50
<5

48
Q

Headache P (snoop) symptoms

A

Any change in previous headache presentation (increase frequency, severity, time without headache)
Change in clinical features of headache
(Prolonged aura, new systemic symptoms)

49
Q

Historical risk factors of OA

A

Increase age
History of wear and tear to joints
History of joint injury
Effects hips, knees, hands, feet

50
Q

Subjective findings of OA

A

Pain and stiffness in joints (asymmetrical)
Worsens with rest
Improved with moderate movement or activity

51
Q

When to consider RA over OA

A

If complaint is symmetrical and or involves 3 or more metacarpophalangeal joints

52
Q

Objective findings of OA

A

Bouchards nodes
Herbedens nodes
Joint effusion
Clicking on ROM

53
Q

Historic risk factors of carpal tunnel syndrome

A

History of overuse or repetitive movements
Frequent computer use or painting

54
Q

Subjective findings or carpal tunnel syndrome

A

Symptoms usually involve anterior wrist, first 3 digits, medial palm
Pain, paresthesia, weakness
Pain typically at night

55
Q

Phalen’s sign

A

Pain, paresthesia, or numbness with wrists flexed for 60 seconds

56
Q

Tinel’s sign

A

Pain, paresthesia, or numbness with tapping over the transverse carpal ligament

57
Q

Examples of low back pain

A

Muscle, ligament, tendon strain
Discogenic disorders
Herniated disc
Apophyseal joint arthritis
Spinal stenosis
Spondylolysis
Scoliosis

58
Q

Historical risk factors of mechanical low back pain

A

History of overuse and repetitive movements
New physical activity or unusual exertion

59
Q

Subjective findings of mechanical low back pain

A

Pain in buttocks, back, thigh
Pain relieved when laying supine

60
Q

Objective findings of mechanical back pain

A

Paravertebral spasms or tenderness
Scoliosis
Loss of natural lumbar lordosis
No neuro signs or radiculopatgy

Advanced Health Assessment (7 decks)

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