Internal Med - LE 2 Old Reviewer COPY Flashcards by Frankie Aguinot

Visual acuity is expressed as two (2) numbers in which the first number represents:

C. distance of the patient from the chart

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1Legal blindness is defined by the IRS as test corrected visual acuity of:

A. 20/200

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True about Myopia:

D. distant objects require a diverging lens in front of the eyes

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Causes of transient or sudden visual loss include the ff. except:

D. Macular degeneration – chronic type of visual loss (insidious)

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The most common primary tumor of the eye is:

D. Melanoma

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Ptosis (drooping of the eyelid) can be caused by the following except:

A. Myasthenia gravis

B.Old age

C. Sympathetic nerve damage

D. Hyperthyroidism;

D. Hyperthyroidism

Explanation:

A. Myasthenia gravis - autoimmune neuromuscular disease that causes weakness in the skeletal muscles

B.Old age

C. Sympathetic nerve damage - Horner’s syndrome

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Small irregular pupils that do not react to light but react to near effort is termed:

C. Argyll – Robertson pupil

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Slightly raised yellowish circumscribed plaques in the skin along the nasal portions:

a. Chalazion
b. Episcleritis
c. Pinguecula
d. Sty or Hordeolum
e. Xanthalesma

Xanthalesma

Explanation:

Chalazion -Chronic inflammatory lesion involving the meibomian gland

Episcleritis - Non-infectious inflammation of the superficial tissue of the sclera

Pinguecula - Yellowish triangular nodule in the bulbar conjunctiva

Sty or Hordeolum - Painful tender red infection around the hair follicle of the eye lashes

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Non-infectious inflammation of the superficial tissue of the sclera

a. Chalazion
b. Episcleritis
c. Pinguecula
d. Sty or Hordeolum
e. Xanthalesma

B. Episcleritis

Explanation:

Chalazion -Chronic inflammatory lesion involving the meibomian gland

Pinguecula - Yellowish triangular nodule in the bulbar conjunctiva

Sty or Hordeolum - Painful tender red infection around the hair follicle of the eye lashes

Xanthalesma - Slightly raised yellowish circumscribed plaques in the skin along the nasal portions

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Chronic inflammatory lesion involving the meibomian gland

a. Chalazion
b. Episcleritis
c. Pinguecula
d. Sty or Hordeolum
e. Xanthalesma

a. Chalazion

Explanation:

Episcleritis - Non-infectious inflammation of the superficial tissue of the sclera

Pinguecula - Yellowish triangular nodule in the bulbar conjunctiva

Sty or Hordeolum - Painful tender red infection around the hair follicle of the eye lashes

Xanthalesma - Slightly raised yellowish circumscribed plaques in the skin along the nasal portions

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Painful tender red infection around the hair follicle of the eye lashes

a. Chalazion
b. Episcleritis
c. Pinguecula
d. Sty or Hordeolum
e. Xanthalesma

d. Sty or Hordeolum

Explanation:

Chalazion -Chronic inflammatory lesion involving the meibomian gland

Episcleritis - Non-infectious inflammation of the superficial tissue of the sclera

Pinguecula - Yellowish triangular nodule in the bulbar conjunctiva

Xanthalesma - Slightly raised yellowish circumscribed plaques in the skin along the nasal portions

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Yellowish triangular nodule in the bulbar conjunctiva

a. Chalazion
b. Episcleritis
c. Pinguecula
d. Sty or Hordeolum
e. Xanthalesma

c. Pinguecula

Explanation:

Chalazion -Chronic inflammatory lesion involving the meibomian gland

Episcleritis - Non-infectious inflammation of the superficial tissue of the sclera

Sty or Hordeolum - Painful tender red infection around the hair follicle of the eye lashes

Xanthalesma - Slightly raised yellowish circumscribed plaques in the skin along the nasal portions

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Grayish –white opacity at the edge of the cornea that may accompany normal aging:

a. Arcus Senilis or corneal arcus
b. Cataract
c. Corneal infection
d. Corneal scar
e. Pinguecula

Arcus Senilis or corneal arcus

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Superficial grayish – white opacity in the cornea secondary to an old injury or to an inflammation

a. Arcus Senilis or corneal arcus
b. Cataract
c. Corneal infection
d. Corneal scar
e. Pinguecula

d. Corneal scar

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Opacity of the lens seen through the pupil

a. Arcus Senilis or corneal arcus
b. Cataract
c. Corneal infection
d. Corneal scar
e. Pinguecula

b. Cataract

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Presents with ciliary injection and dilatation of deeper blood vessels

a. Arcus Senilis or corneal arcus
b. Cataract
c. Corneal infection
d. Corneal scar
e. Pinguecula

c. Corneal infection

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Triangular thickening of the bulbar conjunctiva

a. Arcus Senilis or corneal arcus
b. Cataract
c. Corneal infection
d. Corneal scar
e. Pinguecula

e. Pinguecula

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Lesion with the optic nerve:

Blind eye

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Lesion on the optic chiasm:

Bitemporal hemianopsia

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Lesion in the optic tract:

Homonymous hemianopsia

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Partial lesion to the optic radiation:

homonymous upper quadrantic defect

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Occlusion of the branch of a central retinal artery:

horizontal [altitudinal] defect

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Innervated by the abducens nerve:

E. Cranial nerve VI; LR6 = lateral rectus

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Innervates the upward and downward mov’t of the right eye:

inferior rectus

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Mediates the upward and outward mov’t of the right eye:

superior rectus

Innervated by the trochlear nerve:

superior oblique; SO4

Mediates the upward and inward mov’t of the right eye:

inferior oblique

To straighten and visualize the ear canal, you should pull the auricle:

upward and backward

In using the otoscope, it is recommended that the available speculum size used is the:

largest

In trying to distinguish the type of hearing loss, you make use a tuning fork with the following frequency:

512-1024 Hz

Distortion of sounds that impair theunderstanding of words are often present as the upper tones of words and are disproportionately lost is consistent with: a. conductive loss b. sensorineural loss

sensorineural loss

A noisy env’t may seem to improve hearing: a. conductive loss b. sensorineural loss

conductive loss

Patient’s own voice tends to be loud, has trouble hearing his/her own voice: a. conductive loss b. sensorineural loss

sensorineural loss

The onset is most often in childhood and young adulthood: a. conductive loss b. sensorineural loss

conductive loss

Hearing problem is not visible during the examination of the ear canal and ear drum: a. conductive loss b. sensorineural loss

sensorineural loss

1In performing the Weber test , sound lateralizes to the good ear: a. conductive loss b. sensorineural loss

sensorineural loss

In performing the Weber test , sound lateralizes to the impaired ear: a. conductive loss b. sensorineural loss

conductive loss

In performing the Rinne’s test , bone conduction is longer than or equal to Air conduction: a. conductive loss b. sensorineural loss

conductive loss

In Rinne’s test , air conduction lasts longer than bone conduction: a. conductive loss b. sensorineural loss

sensorineural loss

Causes include otitis media, otosclerosis and immobilized eardrum: a. conductive loss b. sensorineural loss

conductive loss

Recurrent and painful vesicular eruption of the lip and surrounding skin:

herpes simplex

Firm and button-like lesion that ulcerates and may become crusted:

[syphilitic] chancre

Diffused non-pitting, tense swelling of the dermis and subcutaneous tx of the lip:

angioedema

….softening of the angles of the mouth :

angular cheilitis

A lesion may appear as scaly plaque or as an ulcer or a nodular lesion:

carcinoma of the lip

Normal sebaceous glands that appear as small yellowish spots in the buccal mucosa:

Fordyce Spots

Small white specks that resemble grains of salt on a red background:

Koplik’s spots [measles]

A midline bony growth in the hard palate:

torus palatinus

Flat or raised purplish lesions seen among patients with AIDS:

Kaposis sarcoma

Grayish exudate or pseudomembrane that is present in the uvula, pharynx and tongue:

Diptheria

Decreased facial mobility, blunt expression resulting in a mask-like expression increased blinking and a characteristic stare:

Parkinson’s dse

Round moon face with red cheeks, excessive hair growth:

cushing’s syndrome

Dull and puffy face particularly pronounced around the eyes, hair and eyebrows, coarse and thin and dry:

myxedema [hypothyroidism]

Face is edematous often pale swelling usually occurs first around the eyes in the morning:

nephrotic syndrome

Head is elongated with bony prominence of the forehead, nose and lower jaw features of your generally….:

acromegaly

Most common cause of headache that is describe as recurring and associated with nausea vomiting and other neurologic dysfunctions:

migraine

An example of a male dominated cause of headache is:

coital headache

The most common symptom accompanying severe migraine is:

nausea [up to 70%]

In this type of migraine syndrome no focal neurologic disturbance precedes the recurrent headache:

common migraine

A dramatic episode of this type of migraine begins with total blindness accompanied by mixtures of vertigo ataxia, arthria and perioral paresthesia:

basilar migraine

Carotid artery involvement usually in this type of migraine, that is commonly precipitated by dental trauma:

facial migraine

In this type of migraine the most common premonitory symptoms are visual arising from the dysfunction of occipital lobe neurons:

classic migraine

This episodic type of vascular headache is characterized by one to three short lived attacks of periorbital pain per day over a period of 4-8 wks followed by…. :

cluster headache

Direction of associated nystagmus can either be unidirectional or bidirectional:

central vertigo

Visual fixation inhibits nystagmus and vertigo:

peripheral vertigo

Severity of vertigo is often mild:

central vertigo

Tinnitus and/or deafness is usually absent in:

central vertigo

Vertical or purely torsional nystagmus is never present in:

peripheral vertigo [in central vertigo daw kasi pwede rotational pwedeng vertical ang hilo. Eh ang peri almost always rotational daw.]

Duration of symptoms maybe chronic:

central vertigo

Common causes include neuronitis, trauma and toxins:

peripheral vertigo

Purely horizontal nystagmus w/o torsional component is uncommon:

peripheral vertigo

Most commonly involve in sinusitis:

maxillary

Acute sinusitis:

less than 4 wks

CT scan for chronic sinusitis is the radiographic

study of choice

Strep pneumonia in

acute otitis media

Most common identifiable cause in acute pharyngitis:

rhinovirus

Swimming in contaminated water commonly caused

by Pseudomonas

Chief symptom of chronic suppurative otitis media:

painless oral discharge [candida]

The distinguishing feature between anterior tonsilar abscess:

earache or otalgia

Retropharyngeal abscess can only be demonstrated by:

palpation

The most common presenting symptom among patients with nasal disorder?:

obstruction

Allergic rhinitis: bilateral unilateral

bilateral

Foreign body and nasopharyngeal carcinoma: bilateral unilateral

unilateral

Unilateral watery nasal discharge should alert you regarding the possibility

of CSF leak

The most common cause of epistaxis localized is:

idiopathic [80%]

Hallucinatory swelling disorder is usually associated with the ff except:

CNS tumors-usually have anosmia

Nasal regurgitation of fluid and food maybe due to which condition:

[palate problems] paralyzed soft palate

Sinuses in the human body that are not evaluable during PE:

sphenoid and ethmoid

A negative transillumination test suggests:

both thickened epithelium or sinus end or sinus congestion

Involvement of the frontal sinus would result in proptosis in what direction:

inferior and lateral

Involvement of the ethmoid sinus would result in proptosis what direction:

lateral

Involvement of the maxillary sinus would result in proptosis in what direction:

superior

Large non tender and non-suppurating nodes from tertiary syphilitic granuloma :

gumma

Enlargement of a single node in the left supraclavicular group signify malignancy in the upper aerodigestive tract:

Virchow’s node

Suppurative lymph node enlargement forming sinuses with bright red hue due to:

Actinomycoses

Multiple large non tender nodes caused by bovine strains of tubercle bacilli:

Scrofula [TB of the lymph node]