Brainscape's Knowledge GenomeTM

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


See full index

Smmlws > Internal medicine propedeutics > Flashcards

Internal medicine propedeutics Flashcards

1
Q

fundamental skills of interview

A 
Active listening
empathy
Guided questions
Non verbal communication
Validation
reassurance
Partnering
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms characterisations 7 attributes:

A

Location
Quality
Quantity or severity
Timing, including onset, duration and frequency
Setting in which it occurs Aggravating and relieving factors
Associated manifestation

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

Review of symptoms

A 
General
Skin
Head, eye, ear, nose ,throat
Neck
Breast
Cardiovasc.
Peripheral vascular.
Genital
Musculoskel.
Pscyhiatric
Neurological
Hematological
Endocrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pulmo.

Vesicular sound

A

Insp>Exp
soft intensity
low pitch of expiratory
most part of lung

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

Bronchovesicular sound

A

Insp=exp
Medium/medium intens/pithc
1-2 intercostal space
Interscapular area

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

Bronchial

A

Exp>Insp
Loud/high
over manubrium

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

Trachial

A

Insp=exp
Very loud/high
over trachea

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

Crackles /rales

A

discontinuous

Chronic bronchitis, pneumonia, severe pulmonary edema

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

fine crackles

A

CHF, pneumonia, ateclectasis

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

wheezes and Rhonchi

A

Continuous
Wheeze: higher pitch
Asthma, COPD (isolated patches)
Rhonchi: COPD, cystic fibrosis, bronchiectasis, pneumonia

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

Flat sound

A

soft/high/short

large pleural effusion

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

Dull

A

Medium/medium/medium

Lobar pneumonia

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

Resonant

A

loud/low/long
Above diaphragm
Normal lung, simple chronic bronchitis

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

Chronic bronchitis

A 
Trachae midline 
Resonant
Normal breath Sound
Transmitted Voice normal
Adv. sound: none or wheezes,rhonchi, crackles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Left heart failure (early)

A 
Trachae midline
Resonant note
transmitted voice normal
Normal breath sound
Late inspiratory crackles in lower lung, possible wheezes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

consolidation

A 
trachae midline
Dull note
Bronchial breath sound
Transmitted voice Increased
Late inspiratory crackles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Atelectasis (lobar obstruction)

A 
Trachae may be shifted toward involved side
Dull note
Breath sound absent usually
Transmitted sound usually absent
adventitious sound none
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pleural Effusion

A 
Trachae maybe shifted away
Dull note
Breath sound decreased or absent
Transmitted voice decreased/absent
Advent. sound usually non/pleural rub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pneumothorax

A 
Trachae may be shifted away
Hyperresonant or tympanic
Breath sound decreased/abs
Transmitted voice decreased/abs
Possible pleural rub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

COPD

A 
Trachae Midline
Hyperresonant
breath s. Decr/abs
Transm. s. Decreas
Adv sound:none/ wheezes and rhonchi of chronic bronchitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

asthma

A

Midline trachea
Resonant to hyper resonant Note
Breath sound maybe obscured by wheezes
Adv sound: Wheezes, crackles

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

Dyspnea And Left Sided Heart Failure

A

Dyspnea may progress slowly, or suddenly as in acute pulmonary edema.

Exertion, lying down

Often cough, orthopnea,
paroxysmal nocturnal
dyspnea; sometimes wheezing

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

Dyspnea And Chronic Bronchitis

A

Chronic productive cough
followed by slowly progressive
dyspnea

Exertion, inhaled irritants, respiratory infections

Chronic productive cough,
recurrent respiratory
infections; wheezing may
develop

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

Dyspnea And COPD

A

Slowly progressive dyspnea;
relatively mild cough later

Exertion

Cough, with scant mucoid
sputum

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

Dyspnea And Asthma

A

Acute episodes, separated by
symptom-free periods. Nocturnal episodes common

Variable, including
allergens, irritants,
respiratory infections,
exercise, and emotion

Wheezing, cough, tightness
in chest

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

Dyspnea And Diffuse Interstitial Lung Diseases
(such as sarcoidosis, widespread
neoplasms, asbestosis, and
idiopathic pulmonary fibrosis)

A

Progressive dyspnea, which varies in its rate of development with the cause

Exertion

Often weakness, fatigue.
Cough less common than in
other lung diseases

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

Dyspnea And Pneumonia

A

An acute illness, timing varies
with the causative agent

Pleuritic pain, cough, sputum,
fever, though not necessarily
present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Dyspnea And Spontaneous Pneumothorax

A

Sudden onset of dyspnea

Pleuritic pain, cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Dyspnea And Acute Pulmonary Embolism

A

Sudden onset of dyspnea

Often none. Retrosternal
oppressive pain if the
occlusion is massive. Pleuritic
pain, cough, and hemoptysis
may follow an embolism if
pulmonary infarction ensues.
Symptoms of anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dyspnea And Anxiety With Hypertension

A

Episodic, often recurrent

More often occurs at rest
than after exercise. An
upsetting event may not be
evident.

Sighing, lightheadedness,
numbness or tingling of the
hands and feet, palpitations,
chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Main Problems Causing Dyspnea

A 
Left-Sided Heart Failure
(left ventricular failure or
mitral stenosis)
Chronic Bronchitis
Chronic Obstructive Pulmonary
Disease (COPD)
Asthma
Diffuse Interstitial Lung Diseases
(such as sarcoidosis, widespread neoplasms, asbestosis, and
idiopathic pulmonary fibrosis)
Pneumonia
Spontaneous Pneumothorax
Acute Pulmonary Embolism30
Anxiety With Hyperventilation
32
Q

S1-S2 you can find

A

murmurs of aortic and mitral regurgitation; pericardial friction rubs

33
Q

S3-S4 murmurs of

A

Mitral Stenosis

34
Q

Heart Auscultation points

A 
Right 2nd intercostal space-aortic
Left 2nd Intercostal-Pulmonic
Left Sternal Border - right ventricular area
Apex- left ventricular 
Epigastric/ subxiphoid
35
Q

S1 Accentuated

A

Tachycardia ,short PR int ,states of high cardiac output; mitral stenosis, anemia, exercise

36
Q

S1 Diminished

A

1st degree heart block
reduced left ventricular contractility, immobile mitral valve as in mitral regurgitation
in heart failure
coronary heart disease

37
Q

Systolic click

A

Mitral valce prolapse

38
Q

S2 Accentuated in Right second intercostal. space

A

Systemic Hypertension, dilated aortic root

39
Q

S2 Diminished or Absent

A

Immobile aortic valve

Calcific aortic stenosis

40
Q

P2 Accentuated

A

Pulmonary hypertension, dilated pulmonary artery, atrial septal defect

41
Q

P2 diminished or absent

A

Aging, pulmonic stenosis

42
Q

opening snap

A

Mitral Stenosis

43
Q

S3

A

Physiologic in children and young adults, Volume overload of ventricle, as in mitral regurgitation / HF

44
Q

S4

A

Excellent physical conditioning (athletes), Resistance to ventricular filling because of decreased compliance, left ventricular hypertrophy from pressure overload: hypertensive heart disease or aortic stenosis

45
Q

Varying S1

A

complete heart block
total irregular rhythm
Afib

46
Q

Split S1

A

Lower left sternal border
If audible, tricuspid component
RBBB, and premature ventricular contractions

47
Q

S1 variations:

A 
Normal
Accentuated
Diminished
Varying
Split
48
Q

S2 variations:

A

Physiologic Splitting
Pathological splitting
Fixed Splitting
Paradoxical or Reversed splitting

49
Q

Identifying murmurs

A 
Timing
Shape
Location
Radiation
Pitch
Quality
Intensity
50
Q

Shape of sound of murmur

A

Crescendo - decrescendo
Plateau
Crescendo
Decrescendo

51
Q

Patient Turned Left during auscultation for

A

low pitched sounds

Left sided s3,diastolic murmur pf mitral stenosis

52
Q

patient sit, lean forward auscultation on left sternal border , breath held after exhale for

A

diastolic decrescendo murmur of aortic regurgitation

53
Q

Systolic murmurs

A

Mid systolic
Pan systolic
Late systolic

54
Q

Diastolic murmurs

A

early diastolic
Middiastolic and presystolic

Continuous murmurs:
Patent ductus arteriosus,
Pericardial friction rub,
Veneous hum

55
Q

Mitral Valve Stenosis Diagnosing

A 
Orthopnea
(bell-low pitch sound)
Crescendo murmur
Accentuated S1
Middiastolic and Presystolic (opening snap before s1)
56
Q

Mitral Insufficiency Diagnosing

regurgitation/incompetence

A 
(diaphragm-high pitch sound)
Plateau murmur
Diminished S1
S3
Pathological splitting
57
Q

Aortic Stenosis Diagnosis

A 
(diaphragm to R 2nd interc)
Delayed carotid pulse(upstroke)
Midsystolic murmur(diamond sh)(Cresc.Decres. murmur)
Valsava maneuver, murmur decrease
Splitting of S2 , decreased A2
S4
58
Q

Aortic Insufficiency Diagnosis

A 
Bounding upstroke
(carotid and radial art)
sit,lean position, exhale hold breath, left sternal border:
soft Decrescendo diastolic murmur
(Early diastolic m.)
59
Q

circulatory failure

A 
Numbness and tingling in the hands and feet
Cold hand and feet
Swelling in the feet ankles, and legs
Memory loss and difficulty in concentrating
Digestive issue
Fatigue
Joint and muscle cramping
Skin color change
Ulcers on leg and foot
Varicose vein
60
Q

Physical examination of Large Vessels : Jugular Vein

A

jugular venous pressure(JVP)
Measure vertical distance between the highest point and sternal angle
This is usually from 3 4 cm. Elevated JVP means right sided heart failure,
while Decreased JVP means hypovolemia from
dehydration or GI bleeding.

61
Q

Physical examination of Large Vessels : Carotid Pulse

A

the amplitude and the contour of the carotid upstroke
Pulsus Alternans
Paradoxical Pulse
Listen for Bruits

62
Q

Peripheral Vascular System

A

Brachial art, radial art, subclavian art
Abdomen for Aortic aneurysm (palpable in elderly)
Femoral, Pedal Arteries and Popliteal arteries are palpable

63
Q

Oral temp
Rectal temp
Axial temp
tympanic

A

oral 37 Celsius
rectal 37.5
axial 36
tympanic around 37.5

64
Q

Types of fever

A 
Subfebrility :doesn't exceed 38
Continuous: Incremental (chills), decremental (sweating)
Biphasic: (viral) 
Remittent:remain greater than 37
Intermittent: lowest value below 37
Septic:remittent+intermittent
65
Q

White blood cells (WBCs)

A 
4500-10,000 cells/uL
Low (leukopenia):
autoimmune disorder, bone
marrow problem, cancer, or
certain medication
High:
infection or inflammation, immune system disorder, bone
marrow disease, or certain
medication
66
Q

Red blood cells (RBCs)

A 
male 4.5-5.9 million cells/uL,
female: 4.1-5.1 millions cells/uL
Low: anemia
High: erythrocytosis (high
red blood cell count),
polycythemia ver a, heart
disease
67
Q

Hemoglobin (Hb or Hgb)

A

male: 14-17.5 g/dL

women 12.3-15.3 g/dL

68
Q

Hematocrit

A

male: 41.5-50.4%
female: 36.9-44.6%

69
Q

Mean Corpuscular Volume (MCV)

A

80-96 score

70
Q

Platelets

A 
150,000-450,000 platelets/uL
Lower (thrombocytopenia)
or higher (thrombocytosis):
sign of underlying medical
condition, or side effect
from medication.
71
Q

Neutrophil

A 
54-62%
I: Neutrophilia, acute bacterial infection, acute stress, pregnancy, chronic leukemia
D:  Neutropenia lack of neutrophil production in
bone marrow, aplastic
anemia, severe or bacterial
or viral infection , recent
chemotherapy or radiation
therapy.
72
Q

Lymphocyte

A 
25-30%
I: Lymphoma, chronic
bacterial infection, hepatitis,
multiple myeloma, viral
infection (mumps, mononucleosis, measles,
lymphatic leukemia
D: Bone marrow damage
due chemotherapy or
radiation treatment, HIV,
tuberculosis, or hepatitis
infection, leukemia, severe
infection such as sepsis,
autoimmune disorder lupus, rheumatoid arthritis
73
Q

Monocyte

A

0-9%
I:Chronic inflammatory
disease such as inflammatory bowel disease, parasitic or viral infection ,bacterial infection in your heart, collagen vascular
disease such (lupus, vasculitis, or rheumatoid arthritis), certain types of leukemia

74
Q

Eosinophil

A 
1-3%
I:eosinophilia which can be
caused by allergic disorder,
parasite, tumor and GI disorder, skin inflammation
(eczema or dermatitis),
inflammatory disorder
(inflammatory bowel disease
or celiac disease), or cancers
75
Q

Basophil

A

1%
I:Serious food allergy,
inflammation, leukemia

Smmlws (4 decks)

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