Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FMPR and INDE > INDE > Flashcards

INDE Flashcards

1
Q

Why is melena black?

A

The iron in blood is oxidized as it passes through the bowels. Melena generally signifies an upper GI bleed whereas hematachezia generally signifies a lower GI bleed. According to wiipedia it takes ~14 hours for the oxidation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the difference between tendons and ligaments?

A

Ligaments attach bone to bone Tendons attach muscle to bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a bursa?

A

A flat pouch of synovial fluid that usually cushions joint movement, but can become inflammed and cause pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the main bursa to be aware of in the shoulder?

A

The subacromial bursa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the three main shoulder problems?

A

Pain Instablity Decreased range of motion (remember: referred pain possible…)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Important associated MSK symptoms

A

clicking (crepitus), stiffness, weakness, swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What’s the general flow of MSK exams?

A

Look Feel Move (flex, extend, abduct, adduct, internal and external rotation) Special Tests Neurovascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What structures are you feeling for in the shoulder?

A

Bony: clavicle, acromion, spine of scapula, medial border of scapula Muscles: teres minor, infraspinatus, supraspinatus, deltoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is shoulder impingement? What movements are painful?

A

compression of soft tissues between the acromion and the greater tuberosity of the humeral head. Elevation +/- internal rotation Pain when reaching overhead or behind the back Stiffness in the morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the special tests for shoulder impingement?

A

Painful arc (abduct arms, most painful between 70 and 120 degrees) Drop arm test ( examiner abducts arm up to shoulder level, then tells pt to smoothly lower arm. pain or ratcheting are positive) Hawkins Sign Neer’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the sulcus sign?

A

grab around the acromial clavicular joint, pull the arm down. a sulcus around the glenohumeral joint is indicative of joint laxity/instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Differentiate between features of OA and rotator cuff tear in the shoulder

A

OA: uncommon in shoulder, deep ache and stiffness, develops over years, bone-on-bone feeling limits ROM Rotator cuff tear: preceded by trauma or repetitive movement, painful with specific movements, can have associated impingement, pain/weakness limits ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common elbow complaints

A

fractures/dislocations medial and lateral epicondylitis (tennis and golfers elbow) Olecranon bursitis Inflammatory arthritis Instability Ulnar nerve injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the common flexor and extensor origin of the elbow (wrist?)?

A

Flexor: medial epicondyle Extensor: lateral epicondyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the common names for medial and lateral epicondylitis?

A

Medial: golfer’s elbow Lateral: tennis elbow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the active and passive provocation tests for lateral and medial epicondylitis?

A

Passively extend/flex the wrist and fingers (passive provocation) Have patient resist your attempt to flex or extend (active provocation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are healthy and unhealthy stool colors for neonates?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Broselow tape?

A

A pediatric tape measure with quick reference values on it (e.g. BP, HR, med dosages)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Can pyloric stenosis be palpated?

A

Yes- olive shaped. May also see a visible peristaltic wave after eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What will the DRE elicit in a child with acute appendicitis?

A

tenderness anteriorly and to the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is VACTERL and what is the clinical significance?

A

AKA VATER syndrome: a group of congenital anomalies that tend to occur together. The finding of one of these should prompt the clinician to evaluate the patient for the rest.

Vertebral

Anal atresia

Cardiac defects

Tracheo-

Esophageal

Renal

Limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is gastrochisis? What is omphalocele?

A

Both are congenital anomalies where the bowel protrudes through the anterior abdominal wall. They have different pathogenesis. Omphalocele has clear membrane around it and may contain liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the CAGE screen?

A

Have you ever felt you need to cut back

Has anyone annoyed you by criticizing your drinking

Have you ever felt guilty about drinking

Have you ever had to drink first thing in the morning to get rid of a hangover or steady your nerves (eye-opener)?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

GI history alarm symptoms

A

nocturnal symptoms

involuntary weight loss

intereference with daily functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the two phases of swallowing? Are they voluntary or involuntary? What is the difference between dysphagia and odynophagia?

A
  1. Transfer/oropharyngeal: voluntary
  2. Esophageal: involuntary

Dysphagia: difficulty swallowing

Odynophagia: pain swallowing (e.g. due to esophagitis)…feels like a razor blade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Dysphagia with regurgitation, choking and coughing would be suggestive of dysfunction in which phase of swallowing?

A

The oropharyngeal phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Dysphagia with solids but not liquids is suggestive of what? What are possible causes?

A

Something structural as opposed to a mobility issue.

  • esophageal ring (concentric..e.g. Schatzki ring) or web (eccentric)
  • esophageal stricture
  • esophageal cancer
  • mediastinal compression (e.g. enlarged hilar node, goiter)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

differentiate poor appetite and early satiety

A
  • don’t feel like eating vs. getting full early
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

nausea and vomiting that improves when fasting suggests what kind of etiology

A

something GI related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How to assess for volume depletion?

A
  • urine output
  • mentation
  • postural Sx
  • cap refill
  • skin tugor
  • JVP
  • peripheral pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Hematemesis or coffee ground emesis suggests bleeding from which anatomic part of the GI tract? What is the differential?

A

Proximal to the ligament of Trietz:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What can turn stool black?

A
  • iron
  • peptobismol
  • blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Differentiate visceral and parietal pain

A

Visceral

  • the visceral peritoneum is poorly innervated so pain is vague, often localized to midline, restless pain with variable quality (ache, burn, cramp)

Parietal

  • the parietal peritoneum is well innervated. The pain is consistent and severe, exacerabted by movement so pt is v. still
34
Q

What color is bilious vomit?

A

green OR bright yellow

“beware of the child who vomits green”

35
Q

Define obstipation

A

Obstipation: failure to pass gas or stool

vs. constipation is less than 3 BM/day–>week

36
Q

Diarrhea that is completely improved with fasting suggests what kind of underlying cause? Small volume diarrhea is more likely _____ whereas large volume diarrhea is more likely____

A

osmotic

small volume = colonic

large volume = small bowel

37
Q

What the particle size limit between droplet and airborne precautions? What are examples of pathogens that fit into each category (including contact)?

A

Droplet: >5 um (diptheria, pertussis, influenza

Airborne: <5 um (these droplets can be suspended in the air for a long time…TB, SARS, chickenpox)

Contact: MRSA, C. diff

38
Q

What percentage of adults carry C. diff? What general steps to take with suspected C. diff associated disease?

A

<2%

Initiate contact precautions. Test for C. diff. Review antibiotics and discontinue unless clearly indicated. Commence PO vancomycin +/- metronidazole

39
Q

What to exposure risks to ask about with diarrhea?

A
  • water supply
  • travel/camping/cruises
  • contacts sick?
  • food sources, refrigeration
  • animal contact
  • swimming pools?
  • daycare
  • hospitals/nursing homes..
40
Q

Qualitative vs. quantitative fit testing

A

Qualitative: ability to smell/taste substances

Quantitative: measure penetration of particles

41
Q

What are the fours stages of clubbing?

A
  1. Increased flutuance of nail bed
  2. Loss of angle between nail and nail bed (Shamroth’s sign)
  3. increased curvaure longitudinally and transversally
  4. Drumstick appearance
42
Q

What might the following indicates:

  • enlarged beefy tongue
  • angular stomatitis
A
  • B12 or folate deficiency

iron deficiency anemia

43
Q

If patient has tense abdomen during exam, how to overcome this?

A

Flex the legs

44
Q

Castell’s sign vs. Traube’s space

A

Traube’s space you expect to be resonant all the time

Castell’s sign is positive if you hear dullness on inspiration

45
Q

How to differentiate and enlarged left kidney and the spleen?

A

The spleen has notches and, cannot palpate the upper border and moves inferomedially on inspiration

The kidney has no notches, the upper border cannot be palpated and moves inferiorly on inspiration

46
Q

When would you see rebound tenderness?

A

with peritonitis, most commonly appendicitis

47
Q

What are the obturator and psoas signs?

A
48
Q

What history points would differentiate dysphagia from the following causes:

  • GERD
  • Schatzki ring
  • EoE
  • CA
  • motility dysfunction
A
49
Q

Why ascultate the liver? Why auscultate the spleen?

A

You could hear a bruit (e.g cancer) or a rub ( e.g. perihepatitis in Fitz-Hugh-Curtis syndrome). May hear a splenic rub i fyou have a splenic infarct

50
Q

What is the difference between irreducible and incarcerated hernia?

A

Irreducible means that it can’t be manually reduced, incarcerated means it has been strangulated (circulation cut off).

Need to listen for bowel sounds to help determine whether incarcerated and to r/o bowel obstruction from hernia.

51
Q

What is a Blumer’s shelf?

A

A finding on DRE- metastasis to the pouch of douglas

52
Q

Cullen sign

A

blue coloration around umbilicus from retroperitoneal bleeding

Grey Turner sign ecchymoses on flanks from massive retroperitoneal bleeding

53
Q

What are differences between direct and indirect hernias based on what happens when the patient stands and lies down?

A

Indirect: takes a while to reach it’s full size when standing, doesn’t reduce immediately upon laying down. more likely to strangulate.

Direct: opposite

54
Q

What are the geriatric giants (x10)?

A
  • Vision and hearing
  • Malnutrition
  • Falls
  • Urinary incontinence
  • Bowel function
  • Depression
  • Chronic pain
  • Memory loss
  • Iatrogenesis
  • drug and alcohol abuse
55
Q

What are ADLs and iADLs

A

ADL: dressing, eating, toileting, ambulating, transferring, bathing, personal hygiene

iADL: shopping, cleaning, medication management, food prep, transportation

56
Q

What are frontal release signs?

A

Frontal release signs are primitive reflexes traditionally held to be a sign of disorders that affect the frontal lobes. The appearance of such signs reflects the area of brain dysfunction rather than a specific disorder which may be diffuse such as a dementia, or localised such as a tumor. (WIkipedia)

57
Q

Differentiate shoulder impingement and OA pain

A

Shoulder impingement: shoulder elevation +/- internal rotation (pain reaching overhead, behind the back

OA: uncommon, deep ache, diminished ROM (abduction and EXternal rotation)

58
Q

Normal carrying angle of elbow

A

valgus

59
Q

What are the phases of gait?

A

Stance (heel—> flat foot–> push off) and swing

60
Q

Genu recurvatum can be associated with what?

A

quadricepts weakening

61
Q

What is a Lisfranc fracture?

A

4th tarsal-metatarsal fracture

62
Q

What would give you hallux rigidus?

A

bone spurs or degenerative changes at the 1s MTP joint

63
Q

differentiate trigger finger and dupuytren’s

A

Trigger: the tendon is swollen and doesnt slide through the sheath

Dupuytren;s: the palmar aponeurosis

64
Q

What nerve damage would decrease ability to oppose?

A

median…probably ulnar too, but median is in the notes

65
Q

What is de quervain’s tenosynovitis?

A

irritated tenosynovium of extensor pollicis brevis, abductor pollicis longus (1st extensor compartment)

66
Q

What is a sufficient view for C-spine xray?

A

C1- C7/T1 junction

67
Q

What is normal mouth opening width?

A

At least three finger breadths

68
Q

What spinal level is the spine of the scapula?

A

T4

69
Q

What are the Jendrassik maneouvres?

A

Running interference on the brain…for upper limb have them clench teeth, for lower limb have them clasp hands in front of sternum and pull

70
Q

What is the main focusing power of the eye?

A

The corner (35-35 diopters)

The lens adds (20 diopters)

71
Q

Which eye do you use first for:

  • visual acuity
  • pupillary exam (direct, consensual, near, swinging flashlight)
  • eye movements
  • visual field testing (confrontational)
  • opthalmoscopy
A
  • visual acuity: right eye
  • pupillary exam: right eye
  • eye movements (no glasses) (start the H by moving from the centre to the left
  • confrontational testing: start with the left eye
  • opthalmoscopy: right eye
72
Q

Define bipolar hemianopia and homonymous hemianopia

A

Bipolar hemanopia: loss of half of the field of vision in each eye (e.g. both lose temporal)

Homonymous hemianopia: loss of the same half of visual field (e.g. right temporal, left nasal)

73
Q

What do you exam with an opthalmoscope and what do you examine with a slit-lamp?

A

Slit-lamp: conjunctiva, cornea, anterior chamber, iris, lens

Opthalmoscope: optic nerve, macula, retina

74
Q

What kind of correction do you use on the opthalmoscope for myopes and hyperopes?

A

Myopes: negative

Hyperopes: positive

75
Q

What is the mean intraocular pressure?

A

16 mmHg +/- 2.5

76
Q

What is presbyopia?

A

Diminished accomodation due to aging

77
Q

What is 20/20 vs. 20/50 vision?

A

tested/normal eye…so for 20/50 the tested eye can see at 20ft what the normal eye can see at 50 ft

78
Q

What is a contraindication to pupillary dilation?

A

Narrow iridocroneal angle–> can get angle closure glaucoma

79
Q

What are the 4 common causes of loss of vision in the elderly? What are the classic symptoms of each?

A

macular degenation: central scotoma (hole in central field of vision)

Diabetic retinopathy: floaters

Cataracts: monocular diplopia

Glaucoma

80
Q

What are the components of the MMSE? When can’t it be used?

A

**not useful in delirum

Orientation: time and place

Registration: remember 3 words

Attention: spell WORLD forward and backwards

Recall: 3 words given earlier

Language and praxis: naming objects, repetition of sentence, 3 stage command, read and follow instruction

Visual construction: copy diagram

FMPR and INDE (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions