ICM

Question 1

Name 2 good indicators of Acute Bacterial Sinusitis

Answer 1

• unilateral maxillary sinus tenderness

- pain in teeth for 10 days or longer

Question 2

Why do you palpate high for carotid pulse?

Answer 2

Because if palpate on carotid sinus = faintness/diziness and decrease HR

Question 3

What would “functional testing” of neuro exam entail?

Answer 3

e.g. standing on toes or rising from chair w/o using arms

Question 4

Grading strength scale (esp 2 and 3)

Answer 4

Can only grade as 4- or 4+
0 = paralysis
2 = can move with elimination of gravity
3 = can move against gravity but not against resistance
4 = full ROM against moderate resistance

Question 5

spinothalmics

Answer 5

basically sensory perception of touch, pain, temperature

Question 6

how to test CN V sensory? CN V motor?

Answer 6

fine touch wisp of cotton for sensory. Bite down masseter contraction for motor

Question 7

how to test CN VII, upper and lower

Answer 7

upper = raise eyebrows and resist opening
lower = frown/smile/puff cheeks

Question 8

Grading scale for reflexes

Answer 8

2+ is normal (1+ is hypoactive and 3+ is hyperactive without “clonus”)

Question 9

positive Babinkski reflex indicates what finding? What are some causes for positive Babinski?

Answer 9

positive finding = brain or spinal cord lesion

causes = ALS, stroke, cord injury, brain tumor

Question 10

What does pronator drift test for?

Answer 10

upper motor neuron disease

Question 11

What is antalgic gait?

Answer 11

shortened stance phase to avoid pain in hip or leg

Question 12

What does heel-on-shin test for?

Answer 12

cerebellar function

Question 13

A 24 yo healthy woman has severe R ear pain and drainage. What do you suspect? What do you examine ear for?

Answer 13

suspect: Otitis externa

Examine for: canal inflammation and drainage

Question 14

A 3 yo girl has runny nose, coughing, left ear pain and keeps tugging at her ear. What do you suspect? Look for?

Answer 14

Tugging = pressure changes from viral otitis media with effusion

look for exam findings of bacterial acute otitis media

Question 15

AOM v. OME. 2 best exam findings for AOM?

Answer 15

AOM = acute otitis media = BACTERIAL
OME = otitis media = VIRAL syndrome with congestion

2 best signs for AOM = bugling and cloudy (“dullness”) TM

Question 16

(3) ways to distinguish Actue bacterial sinuisitis from viral upper respiratory syndrome

Answer 16

• unilateral maxillary sinus tenderness
• -pain in maxillary teeth for 10 days or longer
• thick, yellow nasal drainage (not improved with decongestants)

Question 17

Diagnostic purpose of examining carotid arteries

Answer 17

for patients at risk of stroke

Question 18

Why is (left) supraclavicular lymphadenopathy worrisome?

Answer 18

could be a sign of tumor (neoplasm or malignancy”

Question 19

Where are superficial cervical v. deep cervical lymph nodes related to SCM?

Answer 19

superficial nodes = over and in front of SCM

deep cervical = within/behind SCM

Question 20

reason for patient holding breath while auscultating over carotid arteries

Answer 20

eliminate distracting breath sounds