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Physical Diagnosis > Inspection Exam > Flashcards

Inspection Exam Flashcards

1
Q

BMI values

A

below 18.5 - underweight
18.5-24.9 - normal
25-29.9 - overweight
above 30 - obese

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2
Q

what is endomorph body type

A

large obese round

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3
Q

what is mesomorph body type

A

middle built muscle

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4
Q

what is ectomorph body type

A

small thin skinny

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5
Q

what is the characteristics of metabolic syndrome

A

large waist or central obesity

increase triglycerides

decrease HDL

increase blood pressure

elevating fasting blood sugar or insulin resistance

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6
Q

what is a flat lesion less than 1 cm

what is a flat lesion greater than 1 cm

A

macule

patch

ex. freckles, measles, flat moles

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7
Q

what is a solid raised lesion that is less than 1 cm

what is a solid raised lesion that is larger than 1 cm

A

papule

plaque

ex. lichen planus, warts, scabies

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8
Q

what is a solid lesion that is deeply root that is 1-2 cm

what is a solid lesion that is deeply rooted that is greater than 2 cm

A

nodule

tumor

ex. lipomas

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9
Q

what is a raised lesion that is filled with clear fluid that is less than 1 cm?

what is a raised lesion that is filled with clear fluid that is greater than 1 cm?

what is a raised lesion that is filled with pus?

A

vesicle
ex. herpes zoster, ckickenpox

bullae
ex. blister

pustule
ex. acne

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10
Q

what is edema in the upper epidermis referred as?

A

wheal

ex. insect bite or allergic reaction

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11
Q

what is permanent dilatation of superficial blood vessels in the skin called

A

telangiectasia

ex. crest syndrome

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12
Q

what are flakes or plates of the skin made up of desquamated layers of the stratum corneum

A

scales

ex. seborrheic dermatitis

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13
Q

what is drying of the plasma or exudate on the skin called

A

crust

ex. scab, abrasion, eczema

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14
Q

what are open areas of the skin where all the epidermis is lost

A

erosions

ex. varicella after rupture

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15
Q

what is thickening of the epidermis seen with exaggeration of normal skin lines due to chronic rubbing or scratching leading to thick leather skin

A

lichenification

ex. chronic dermatitis

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16
Q

what is traumatized skin that extends into the epidermis called

A

excoriations

ex. abrasions, scratches

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17
Q

what are linear cleavages of skin which extend into the dermis called

A

fissues

ex. athletes foot, cracks in corner of mouth

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18
Q

what is permanent fibrotic changes following damage to the dermis

A

scars

ex. healed wounds, surgical incision

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19
Q

what is exaggerated connective tissue response of injured skin that extends beyond the edges of the original wound

A

keloid

ex. surgery

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20
Q

what is chloasma

A

abnormal shaped brown spots or spot on the face

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21
Q

what presents as dark sports over the buccal mucosa, skin folds, and stretch marks

A

addisons disease

- hypocortisolism

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22
Q

what presents with purple stria on belly and extremities

A

cushings disease

- hypercortisolism

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23
Q

what is a condition is characterized by the skins destruction of pigment cells aka melanocytes which results in irregular white patches

A

vitilligo

  • affects all races
  • 10-30 years old
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24
Q

what flat macules are hyperpigmented and can have varying border shapes

A

cafe au lait spots

ex. mcune albright syndrome, fibrous dysplasia, neurofibromatosis (vonreckinghausens dz)

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25
Q

adrenal anatomy review each layer

A 
cortex (endocrine)
go fuck rob 
zona granulosa- salt 
zona fasiculata - sugar 
zona reticularis - secx

salt - mineral corticoids
ex. aldosterone

sugar - glucocorticoids
ex. cortisol

sex - hormone precursors
ex. DHEA and pregnenolone

medulla (neuroendocrine)
ex. adrenaline/epinephrine

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26
Q

what are features of hyperadrenalism

A

CUSHINGS DZ

weight gain 
truncal obesity
moon face 
buffalo hump 
hypertension 
dysglycemia 
frequent infections 
decrease immunity 
affects T4-->T3 conversion 
purple stria 
hirsuitism - face, back
head baldness 
depression
27
Q

what are the features of hypoadrenalism

A

ADDISONS DZ

low blood pressure 
dizziness 
weight loss 
no appetite 
hypoglycemia 
dehydration 
intolerance to cold 
fatigue and weakness 
pigmentation of skin
28
Q

what is the function of DHEA

A
  • sex hormone precursor
  • takes of estrogen production after menopause
  • anabolic hormone for proteins and fats
  • immune enhancer
  • improves insulin sensitivity
  • improves sleep

ANTI - AGING HORMONE

29
Q

what is the neuroendocrine function of the adrenals

A

fight and flight
norepinephrine
epinephrine/adrenaline

sympathetics 
increased BP, pulse
increase blood glucose 
dilates eyes
dilates bronchioles 
reduce GI secretions
30
Q

what is general adaption syndrome

A

hans selye - 3 stages

arousal - response to stress - fight or flight

  • rapid increase catecholamines
  • slow increase corticosteroids

adaption or resistance - continued release of corticosteroids - allows system to adapt to stress long after initial fight or flight response

  • glucose tolerance
  • increase BP, thyroid hormone, and sex hormone

exhaustion - burned out adrenals

31
Q

what is pregnenolone steal

A

adrenal hormones are produced from cholesterol

cholesterol –> pregnenolone is the first step in making hormones

STRESS HORMONES (CORTISOL) ARE PRODUCED AT EXPENSE OF SEX HORMONES

results in adrenal exhaustion

32
Q

what is stage 1 and stage 3 of adrenal exhaustion or fatigue

A

stage 1

  • increase ACTH
  • increase cortisol stim.
  • increase cortisol
  • pregnenolone steal
  • decrease DHEA
  • increase night time cortisol

stage 3

  • increase ACTH
  • increase cortisol stim.
  • decrease cortisol
  • pregnenolone steal
  • decrease DHEA
  • decrease night time cortisol
33
Q

what condition is vitligo associated with

A

pernicious anemia
graves - hyperthyroidism
addisons - low cortisol

34
Q

what condition is cafe au lait spots associated with

A

mccune albright syndrome (fibrous dysplasia)

neurofibromatosis (von reckinghausens disease)

35
Q

what is the difference in clinical presentation of mccune albright syndrome and von reckinghausens disease

A

mccune albright

  • fibrous dysplasia
  • cafe au lait sponts - irregular borders - coast of maine
  • precocious puberty

von reckinghausens disease

  • neurofibromatosis
  • cafe au lait spots - regular borders - coast of california
  • systemic nodules
36
Q

what does cyanosis or acrocyanosis suggest

A

CHF
pneumonia

acrocyanosis - lips, nose, hands, feet

37
Q

what are the features of acromegaly

A 
excess GH 
pituitary tumor MC 
weight gain 
hirsuitism 
enlargement of hands, feet, and facial bones 
thickening of skin 
joint pains
38
Q

describe the varying types of tremors

A

rhythmic oscillations

  • fine - 6 or more per sec
  • coarse - less than 6
  • static - resting
  • intention - action
39
Q

what are essential involuntary movements

A

hands, head, voice
increase with action or intention
hereditary, drugs, alcohol

40
Q

describe choreiform and the different types

A

rapid jerking motions
restlessness appearance
repetitive, jerky, dancelike, uncontrolled

ex. syndenhams or huntingtons chorea

41
Q

describe athetosis involuntary movement

A

slow, writhing, snake like motions

42
Q

what is koilonychia

seen in what condition

A

spoon shaped nails
concave nails

plummer vinson syndrome, IDA, hemochromatosis

43
Q

what is clubbing

seen in what condition

A

convexity nails

Lung cancer, hypertrophic pulmonary osteoarthropathy, cardiac failure, hepatic cirrhosis

44
Q

what is schamroths sign

seen in what condition

A

pushing dorsal side of two fingers together - nails should touch and have small window

indicates clubbing
- lung or heart failure

45
Q

what are lindsays nails

seen in what condition

A

half and half nails
proximal portion white
distal portion pink

renal failure

46
Q

what are mees lines

A

transverse white bands
parallel to lunula
single or multiple on each nail
same position on each nail

arsenic poisoning
renal failure
hodgkins
pneumonia

47
Q

what are terry nails

seen in what condition

A

white bands
lunula covered by white band up to 1 -2 mm from the distal border of the nail

hepatic cirrhosis
CHF
rheumatoid arthritis

48
Q

what are beau lines

seen in what condition

A

transverse depression across nail plate

severe infection 
myocardial infarction 
hypotension 
shock 
immunosuppresive therapy 
severe zinc deficiency
49
Q

what is oncholysis

seen in what condition

A

separation of the distal nail

psoraiasis
trauma
thyroid disorders

50
Q

pitting nails are seen in what condition

A

psoriasis - MC
eczema
alopecia areata

51
Q

splinter hemorrhages are seen in what condition

A

subacute bacterial endocarditis
trauma
SLE
rheumatoid

52
Q

what is paronychia

seen in what condition

A

infection of the cuticle

trauma is initial event

53
Q

what is antalgic gait

A

gait performed to avoid or minimize pain in the back, hip, or limb

54
Q

what is ataxic sensory gait

what is it also called

A

tabetic gait

broad base stance
watches the ground
slaps feet down

55
Q

what is hemiplegic gait

what is it also called

A

circumduction gait

leg extened
foot movement from pelvic tilting
arm adducted

56
Q

what is propulsion gait

what is it also called

A

festination gait

torso flexed forward, arms rigid, no arm swing, bent at the hips
small steps
hesitation on starting and stopping

PARKINSONS

57
Q

what is steppage gait

A

throws foot forward from hip and slaps foot down
anterior crural muscle deficit
cant dorsiflex the foot

POLIOMYELITIS

58
Q

what kind of gait is seen in parkinsons

A

propulsion gait

festination gait

59
Q

what kind of gait is seen in poliomyelitis

A

steppage gait

60
Q

what is staggering gait

what is it also called

A

reeling gait

cerebellar ataxia

MS and alcohol

61
Q

what is scissors gait

what is it also called

A

spastic gait

spastic paralysis to adductors 
excessive adduction of leg in swing 
plantar flexion of ankle 
flexion of the knee 
adduction and IR at the hip

MS

62
Q

what type of gait is seen in MS

A

staggering (reeling)
and
scissors (spastic)

63
Q

what is waddling gait

A

weak pelvic muscles

pregnancy and muscular dystrophy

64
Q

what is tredelenburg gait

A

hip drops during gait

weak gluteus or hip pathology

Physical Diagnosis (18 decks)

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