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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

Systemic symptoms :
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

Neuro symptoms:

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

61
Q

Common or concerning symptoms of the skin hair and nails

A

Hair loss, rashes, moles, changes in nails

62
Q

Health history, questions for the skin hair and nails

A

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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