Lecture 1 Flashcards
subjective data
what the pt tells you
objective data
what you detect during examination
standard precautions
all blood, body fluids, secretions, excretions (except sweat), non intact skin and mucous membranes may contain transmissible infectious agents.
universal precautions
A set of guidelines designed to prevent transmission of HIV, HBV ad other blood borne pathogens
Glasgow coma scale measures response to
eye opening, verbal responsiveness and motor response
LOC scale
alert, lethargic, obtunded, stupor and coma
mental retardation
small, rounded head, flattened nasal bridge, prominent epicanthal folds, small, low set, shell like ears, large tongue, hypotonia (decreased muscle tone), simian lines
Cushings disease
increase adrenal cortisol production, moon face, flushing of cheeks, excessive hair growth and abdominal striae
graves dx, hyperthyroidism
warm, moist, soft, velvety skin, thing hair, pretibial myxedema, hyperpigmentation, palpitations, anxiety
hypothyroidism
dry, rough, pale skin. course, brittle hair. alopecia, thing brittle nails and fatigue.
gigantism
increased growth hormone. elongated head, bony prominent forehead, enlarged soft tissues of the mouth, nose and ears.
anorexia nervosa
refusal to maintain minimum body weight, CV disorders, metabolic disorders, dry skin, dental caries, delayed gastric emptying, constipation, anemia, osteoporosis, and amenorrhea.
BMI stats
normal: 19-24
overweight: 25-29
obesity: greater then 30
undernourished: less then 19
auscultatory gap
a silent interval that may be present between the systolic and diastolic BPs, the sound disappears for awhile then reappears
orthostatic BP
take BP supine, then repeat 3 mins later standing. normal: systolic drops slightly/unchanged. diastolic rises slightly
orthostasis: systolic drops more then 30 and diastolic drops more then 10
aortic regurgitation
the diastolic flow of blood from the aorta into the left ventricle. Large, bounding pulses with increased stroke V
Paradoxical pulse
a decrease in the pulse’s amplitude on inspiration due to a pericardial tamponade, constrictive pericardiis and obstructive lung dx.
defined as a decrease in systolic BP more than 10 with inspiration signing fall in CO during inspiration
ataxic breathing (Biot’s breathing)
characterized by unpredictable irregularity. Breaths may be shallow or deep and stop for short periods
obstructive breathing
prolonged expiration because narrowed airways increase the resistance to air flow.
Cheyne-stokes breathing
periods of deep breathing alternate with periods of apnea.
oral temp compared to others
37/98.6 normal w/ diurnal variation
rectal is higher
axillary is lower
tympanic is higher
fever
pyrexia (greater than 100.4) and hyperpyrexia (greater than 106)
petechiae
small, round, red/brown lesions from hemorrhage into the skin and are present primarily in areas with high venous pressure. No blanching.
macule/papule
macule: small flat spot (bigger: patch)
papule: small raised lesion (bigger: plaque)
nodule
solid lesion more deeply rooted, palpable (bigger: tumor)
most common cancer in the US
skin
types of skin cancers
basal cell: 80% of skin cancers. shiny, rarely metastasize.
squamous cell: 16% of skin cancers, crusted/scaly, can metastasize
melanoma: 4% but with rapid spread
ABCDE for mole screening
A: asymmetry B: irregular borders C color variation/change D: big diameter E: elevation/enlargement
Two types of hair
Vellus: peace fuzz, independen of androgens, short, fine, non pigmented, covers most of body
Terminal: thick, pigmented, head/beard/axilla/pubic areas, influenced by androgens.
hirsutism
presence of terminal hairs in females with male like pattern
alopecia areata
a common asymptomatic dx characterized by the rapid onset of total hair loss in a sharply defined, usually round area.
eponychium
nail production
nail change found in psoriasis
pitting
onycholysis
separation of the nail plate from the nail bed
leukonychia
white spots, common finding, possibly result from cuticle manipulation or other mild traumas
Mees lines and Beau’es
white transverse lines t the time of acute illness;
nail grooves appear after a very serious illness
koilonychia
spoon nails, can be a sign of hypochromic anemia, abnormally thin nail that loses convexity.
terry’s nails
nail bed is white with only narrow zone of pink at the distal end
paronychia
painful, bright red swelling of the proximal and lateral nailfold due to infx (usually staph)
onychomycosis
clip the mail plate to relieve pain and expose subungal material for KOH examination.
