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Intro to Clinical Medicine > ICM-2 > Flashcards

ICM-2 Flashcards

1
Q

Pulse pressure

A

Systolic - Diastolic

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2
Q

MAP

A
  • Diastolic + 1/3 (Systolic - Diastolic)

- Lowest MAP 50 mmHG

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3
Q

Blood pressure cuff techniques

A
  • 2.5 cm above ante-cubital
  • Position arm w/ brachial artery @ LVL with Heart
  • (+) 30 mmHG to where the pulse disappears
  • Taking pressure standing will give drop in systolic and rise in diastolic
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4
Q

BP Values

A
  • 160 / >100 = hypertension 2
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5
Q

Pulse rate values

A
  • Normal = 60 to 100 / min
  • Tachycardia = >100 /min
  • Bradycardia = < 60 /min
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6
Q

Pulse Rhythm

A
  • Regular irregular = premature atrial or ventricular contractions
  • Irregularly irregular = atrial fibrillation
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7
Q

Pulse volume

A
  • 0 = absent
  • 1 = diminished, barely palpable
  • 2 = normal
  • 3 = full or inreased
  • 4 = Pounding
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8
Q

Pulse character (contour/amplitude)

A
  • Pulsus alternans: alternating weak/strong = left ventricle failure
  • Pulsus bisferiens: 2 main peaks or 2 strong systolic bears (stop) mid systolic dip = aortic stenosis & regurgitation)
  • Pulsus Bigeminus: 2 beats in rapid sucession - normal beat + premature beat (pre-ventricluar contraction)
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9
Q

Pulse character (contour/amplitude)

A
  • Pulsus paradoxus: exaggeration of normal fall in amplitude during inspiration - Systolic BP drop = 12-15 mmHG (severe airway obstruction)
  • Water hammer: “collapsing pulse” greater amplitude, rapid rise, sudden descent = back flow through aortic valve
  • Pulsus differens = indicate stenosis on one side
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10
Q

Respiration

A
  • Normal values = 14-20 bPM
  • Bradypnea = slow breathing = disease in CNS or metabolic disorder
  • Tachypnea = Rapid/shallow greater than 24 bpm = restrictive lung disease or pleuritic chest pain
  • Hyperpnea = Rapid/deep = exercise/anxiety
  • Ataxic = rhythm random w/depression in bPM = midbrain damage
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11
Q

Swollen gums is indicative of?

A

-Hyperplasia (increase in number or size) due to antiepileptic drugs ex. phenytoin)

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12
Q

Where is the salivary duct (paotid) located on Buccal Mucosa?

A

-opposite the upper second pre-molar tooth on each side

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13
Q

Where are the lymph nodes located on Head/Neck?

A
  • Anterior Triangle (Base is mandible/Apex is jugular notch)
  • Posterior Triangle (Base is mid clavicle/Apex is Occipital bone)
  • Superficial group
  • Deep group
  • Supra-clavicular fossa
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14
Q

Lymphs in Anterior Triangle

A
  • Preauricular
  • Parotid
  • Tonsillar
  • Submandibular
  • Submental
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15
Q

Lymphs in Posterior Triangle

A
  • Post. auricular
  • Occipital
  • Supraclavicular
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16
Q

Virchow’s Nodes

A
  • Hard palpable non tender node in LEFT supraclavicular region
  • Diagnosis probable abdominal malignancy
17
Q

Thyrogloassal Cyst

A
  • Swellings in thyroid region move on swallowing.

- Move up on tongue protrusion

18
Q

Bruits

A
  • Heard in hypevascular gland

- Grave’s disease

19
Q

Palmar Arythema/Dupuytren’s contracture

A
  • Arythema: Swelling & redness on the exterior of the palm
  • Contracture: thickening of palmar apenerosis which causes the pinky to auto flex (node could appear)
  • Could be a sign of liver disease
  • Can be coupled with cirrhosis
20
Q

With ear Tenderness

A
  • Press Targus against external ear and pull up & down.

- Press over mastoid process = pain = middle ear infection

21
Q

Speculum exam

A
  1. Tilt head to opposite side of exam
  2. Pull ear upward, backward & slight away from head
  3. Hold otoscope like a pen (pinky against head)
22
Q

Tympanic membrane (ear drum)

A
  • Color: Pearly grey/white
  • Structures: Handle of malleus, jumbo, cone of light
  • Abnormal: redness, perforation of ear drum
23
Q

Tuning fork Tests

A
  • Air Conduction
  • Bone Conduction
  • Weber test: 512 KHZ fork and place on forehead and sound should be heard by both ears
  • Rinne Test: Compare AC with BC
  • Absolute bone test: Compare your BC with patient’s
24
Q

Properties of Nose

A
  • Middle meatus drains to maxillary sinus, Frontal & ethmodial
  • Superior meatus drains to posterior ethmodial & sphenodial sinuses
25
Q

General appearance of Skin color

A
  • Cyanotic (blueish low O2)
  • Jaundice (Yellowish blockage in hepatic)
  • Hyperpigmented (decrease/increase in melanin)
  • Pallid (Pale or dull)
  • Cherry red (Carbon monoxide)
26
Q

Olser’s nodes/Janeway lesions

A
  • Appear on toes or fingers
  • Mini hemorrhages (dark brown spots)
  • Caused by bacterial endocarditis
27
Q

Nail color

A
  • Leuconychia (whiteness under nail bed could be indicative of renal/liver failure)
  • Yellowish (Sepsis, Infective endocarditis, trauma)
  • Blueish (clubbing/cyanotic)
  • Koilonychia (concave nail bed = low iron anemia)
28
Q

Aetiology of clubbing

A
  • Abdominal: IBD, cirrhosis, celiac disease
  • Resp: Carcinoma bronchus, pulm tuberculosis, cystic fibrosis, asbestos
  • Cardiovascular: Chronic cyanosis, congenital heart disease
  • Clinical test: Schamroth’s sign missing diamond shape between index fingers
29
Q

Eyes abnormalities

A
  • Jaundice
  • Arcus senilus (blue opaque ring due to hypercholesteremia)
  • Anaemia (under eye lid)
  • Xanthelasma
30
Q

Mouth abnormalities

A
  • Fetor (Bad breath)
  • Angular stomatitis (Cracks/cuts on side of mouth can be due to vit/mineral def or fungal)
  • Tongue
  • Teeth
31
Q

Neck

A
  • JVP: can be measured by measuring from angle of manubrium to Jugular
  • Carotid
  • Thyroid
  • Lymph
32
Q

Chest inspection

A
  • Pulsations:
    1. Apical
    2. Chest wall
    3. Suprasternal
    4. Epigastric
33
Q

Apex Beat

A
  • Most inferior & lateral position
  • 1/2 inch medial to mid clavicle line left of 5th intercostal space
  • If cant hear LEAN pt. forward or turn pt. to left side
  • Sustained/Heaving = Aortic Stenois/hypertension
  • Hyperdynamic = Regurgitation/exercise
34
Q

Cardiac Murmurs

A
  • Systolic: Aortic/pulmonary stenosis (best heard with breath in expiration)
  • Diastolic: mitral/tricuspid stenosis/regurg (best heard with bell & breath held in expiration)
35
Q

Mitral area/Tricuspid

A
  • Tricuspid: immediately left of lower sternum (medial)

- Mitral: left of tricuspid (lateral)

36
Q

Aortic area/Pulmonary

A
  • Aortic: 2nd intercostal immediately right of sternum

- Pulmonary: 2nd intercostal immediately left of sternum

Intro to Clinical Medicine (2 decks)

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