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Physical Exam > Lecture 1 Reverse > Flashcards

Lecture 1 Reverse Flashcards

1
Q

98.6 F

A

What is normal oral temp?

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2
Q

97.6 Fleast accurate

A

What is normal axillary temp?

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3
Q

99.4 Fmost accurate

A

What is normal rectal temp?

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4
Q

99.6 F

A

What is normal ear temp? (aural)

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5
Q

2.54 cm = 1 in

A

How many cm in an inch?

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6
Q

2.2 lbs = 1 kg

A

How many pounds in a kg?

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7
Q

809097

A

What are normal systolic BP in 1, 5 & 10 years?

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8
Q

feel for vibrations

A

What is tactile fremitus?

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9
Q

whole head

A

Define calvarium

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10
Q

Stenson’s duct

A

Parotid duct

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11
Q

Warton’s duct

A

Submandibular duct

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12
Q

stroke - won’t appear on affected sidefacial droop

A

Why are nasolabial folds important?

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13
Q

upslanted in down’s syndrome

A

Why are palpebral fissures importan-t?

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14
Q

clinial syndromes or disorders w/ distinctive facial features

A

What are facies?

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15
Q
  1. Low set ears2. Macroglossia - big tongue3. Brush field spots on iris4. Flat nose5. Upslanted palpebral fissures 6. Larger epicanthal folds
A

What are the classic features of Down’s syndrome?

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16
Q

excess cortisolMoon facies1. Round face2. Facial flushin = plethoric3. inc. fact in cheeks4. Double chin

A

What are the classic features of Cushing’s?

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17
Q

usually happens in 1st trimester 1. Smooth philtrum2. Thin upper lip3. Microcephaly

A

What are the classic features of fetal alcohol syndrome?

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18
Q

usually from pituitary adenoma - excess GH1. Enlargement of hands, feet & head2. Frontal bossing - prominent forehead3. Palmar thickening4. Coarse features5. Prognathism - large protruding jaw

A

What are the classic features of acromegaly?

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19
Q

Paget’s disease

A

What is the DDx for acromegaly?

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20
Q
  1. Sjoren’s syndrome2. Mumps3. Chronic disease - DM, obesity, liver cirrhosis 4. Neoplasm - unilateral
A

What are the causes of parotid enlargement?

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21
Q

Graves - autoimmune hyperthyroidismenlarged thyroid

A

What disease is characteristic for exopthalmos?

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22
Q

only w/ lung CA, mediastinal, gastric CA

A

When is supraventricular LAD found?

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23
Q

Virchow’s node

A

With gastric CA, what is supraclavicular LAD called?

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24
Q
  1. More frequent/severe over 3 months2. Thunderclap3. New onset after 50 4. Fever, sweats, wt loss5. Known CA, HIV, pregnancy6. Recent head trauma7. Focal deficits, vision change, neck stiffness
A

What are the HA warning signs?

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25
Q

preeclampsia

A

Why is HA w/ pregnancy concerning?

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26
Q

Temporal/giant cell arteritisif untreated = blindness >50 y/o, autoimmune

A

A bounding, tender temporal artery is concerning for?

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27
Q
  1. Sx >7 days2. Fever3. Perulent nasal drainage4. Distinct facial pain5. Tenderness
A

What signs need to be present to diagnose bacterial sinusitis?

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28
Q

pneumothorax

A

When can the trachea be deviated?

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29
Q
  1. Pearly gray2. Non-injected/non-erythematous3. Intact
A

What does a normal TM look like?

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30
Q

in the earcaused by repeated exposures to cold waterex. surfers/divers

A

Who gets bony exotoses?

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31
Q

cerumen impactionuse mineral oil to get it out

A

What is the most common reason for conductive hearing loss?

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32
Q

Hardening of TM caused by recurrent infections

A

What is tympanosclerosis & what is it caused by?

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33
Q

Bulging erythematous No light reflexLoss of landmarks

A

What is seen w/ acute otitis media?

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34
Q

Infection of external auditory canal aka. swimmer’s ear most common = P. aeroginosa Pain w/ touchHurts to touch tragus May be so inflammed you can’t look at it Tx - earwick

A

What is otitis externa, findings & Tx?

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35
Q

Diabetics leads to erosino of inner ear

A

Who commonly gets fungal otitis externa?

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36
Q

Fluid from ear

A

What is otorrhea?

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37
Q

Chronic inflammatory lesion on helix or antihelixMust Bx to rule out carcinoma

A

What is chondrodermatitis helicis?

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38
Q

High frequency hearing loss commonly caused by older agedmiss consonants & vowels

A

What is presbycusis?

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39
Q

Disorders of:1. Inner ear2. Brain3. CN VIII

A

What can cause sensorineural hearing loss?

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40
Q

Air conduction > bone conduction

A

What is a normal result for the Rinne test?

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41
Q

C - lateral to bad earS - lateral to good ear 8th CN impairment Obstruction lateralizes to blocked ear

A

Weber test - conductive vs. sensorineural loss?

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42
Q
  1. Cleanse2. Humidify3. Control temp of inspired air
A

What is the function of the nasal mucosa?

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43
Q

Cocaine or meth

A

What are common causes of nasal septum perforation?

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44
Q
  1. Congenital2. TraumaThey have problems w/ sleep apnea/anosmia
A

What are common causes of a deviated septum?

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45
Q

Woodruff’s plexus - posterior nose bleed difficulty breathing

A

What is an emergent nosebleed from?

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46
Q

Kiesselbach’s plexus - front nasal cavity

A

Where do nosebleeds commonly come from?

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47
Q

Recurrent allergies

A

What commonly causes nasal polyps?

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48
Q

“bumpy nose” from severe rosaciabenign

A

What is rhinophyma?

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49
Q

Artery, veins & nervesunder the dentin

A

What is contained in the pulp of a tooth?

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50
Q

Tastebuds in the back of the mouth

A

What are vallate papilla?

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51
Q

Tastebuds on the front of the tongue

A

What are fungiform papilla?

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52
Q

A benign midline lump under the tonguemay be mandibular or maxillary

A

What is torus palatinus?

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53
Q

CN XII

A

Which nerve causes the tongue to rise?

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54
Q

bifid

A

What is a snake-tongue looking uvula called?

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55
Q
  1. Fissured2. Geographic3. Hairy (tobacco use, poor hygiene, antibiotics, coffee)
A

What are the normal tongue variants?

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56
Q

Cancerous precursorpainless white patches on tongue/buccal mucosa

A

What is leukoplakia?

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57
Q

Oral candidiasispainfulscrapes off w/ red bleeding basecommon in immunocompromised/steroids

A

What is thrush?

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58
Q
  1. Leukemia if bleeding2. Chronic dilantin use3. Pregnancy
A

What are common causes of gingival hyperplasia?

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59
Q

infection of periapical region of toothtender lesion just adjacent to toothTx: I&D, abx

A

What is a periapical abscess?

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60
Q

Herpes type 8 purple vascular lesion in mouth

A

What is Kaposi’s sarcoma caused by?

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61
Q

cavities

A

What are dental caries?

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62
Q

HalitosisAbrasions on knuckles Negative gag reflexDentition in ill repairlook at back of throat for cuts

A

Bulimia

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63
Q
  1. Fever2. Malaise3. LAD4. Halitosis
A

S/S acute necrotixing ulcerative gingivitis

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64
Q
  1. Mono2. HIV3. Trauma4. Coagulopathy
A

What can cause petechiae on the hard palate?

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65
Q

Congenital syphilis

A

What causes Hutchinson’s teeth?

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66
Q

Smooth tongueDeficiency in:1. Riboflavin2. Niacin3. Folic acid4. Vitamin B125. Pyridoxine6. Iron7. Tx w/ chemo

A

Causes of atrophic glossitis

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67
Q

III

A

What CN opens the eye?

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68
Q

VII

A

What CN closes the eye?

69
Q

VI

A

What CN innervates the lateral rectus?

70
Q

IV

A

What CN innervates the superior oblique?

71
Q

CN II & III

A

What CNs are responsible for eye accommodation?

72
Q

20/200 vision

A

When is someone considered legally blind?

73
Q

dichromacymost common is red/greenaffects 1% of males issue w/ retinal conestested w/ ishihara cards

A

What is color blindness called?

74
Q

ishihara cards

A

How do you test for color blindness?

75
Q

3-5 mmopiates make pupils very small

A

What is a normal pupil size?

76
Q
  1. Optic nerve disease/lesion - eyes react but don’t accommodate2. Argyll Robinson - Syphillis, hooker will accommodate you but not react to you3. CN III palsy - diabetes, lid lag & big pupil
A

What are the causes of afferent pupillary defect?

77
Q

Cause = syphillishooker will accommodate you but not react to you

A

What is seen with Argyll Robinson?

78
Q
  1. Cataracts2. Retinoblastoma - seen in newborn exam 3. Retinal detachment
A

What can cause an absent light reflex?

79
Q

L optic tract

A

Where is the lesion w/ R homonymous hemianopsia?

80
Q

Optic chiasmcommon w/ pituitary tumor

A

Where is the lesion w/ bitemporal hemianopsia?

81
Q

L optic radiation

A

Where is the lesion w/ homonymous R quandrantic defect?

82
Q

Eversion of eyelidcommon w/ old peoplecauses excessive tearing

A

What is ectropion?

83
Q

Inversion of eyelidcauses irritation of eye

A

What is entropion?

84
Q

Inflammation of the eyelidStaph/fungus/blockage of glands

A

What is blepharitis & common causes?

85
Q

Hypothyroidism

A

When is periorbital edema commonly seen?

86
Q

medical emergencyinvolves CN V - trigeminalinflammation of cornea leading to blindnessdendritic lesions on eye

A

What is Herpes Zoster ophthalmicus?

87
Q

styeStaph infection of meibomian glandcauses pain, irritationTx. - warm compresses, abx ointment

A

What is a hordeolum & common cause?

88
Q

A chronic granulomatous inflammation of the meibomian glandusually follows a hordeolumnot infectedTx - steroids/removal

A

What is a chalazion?

89
Q

lipid deposits around the eye

A

What is xanthelasma?

90
Q

bacterial infection of lacrimal saccommon in kidsTx - systemic abx

A

What is dacrocystitis?

91
Q
  1. Bacterial - usually Strep2. Viral - usually bilateral3. Allergic
A

What are the types of conjunctivitis?

92
Q

benign, well demarcated rupture of small vessels of scleracan be assoc. w/ HTN, coagulopathygoes away on its own

A

What is subconjunctival hemorrhage & what is it associated with?

93
Q

Medical emergency Ciliary injectionFrom autoimmune process - SLE, sarcoidosis, ankylosing spondylitisPain w/ eye mvmts & photophobia “cells in flare”

A

What is iritis?

94
Q

Medical emergencyPainful red eye w/ HA, N&VVision loss—Steamy corneafixed, dilated pupilciliary injectionTx - carbonic anhydrase, inhibitor IV, beta-blocker

A

What is acute glaucoma?

95
Q

Blood in anterior chamber of eye, usually from traumaTx - Drainage & f/u

A

What is hyphema?

96
Q

Benign overgrowth of the sclera Caused by sun, wind or dry air on bulbar conjunctiva

A

What is pinguecula?

97
Q

thickening of bulbar conjunctiva onto cornea causing visual disturbance

A

What is pterygium?

98
Q

Wilson’s diseasetoo much Cu2+autosomal recessive

A

What causes Kayser-Fleischer rings?

99
Q

aka senile arcus grayish hue around corneaif young - caused by hyperlipidemia

A

What is corneal arcus

100
Q

Macular degenerationyellowish spots on fundis exam, range in size, location & coalesce together

A

What are Drusens significant for?

101
Q

aka sternal anglepoint where 2nd rib attaches to sternum

A

Where is the angle of Louis?

102
Q

T4

A

Where does the trachea bifurcate into the L & R main stem bronchus?

103
Q

Funnel chestcan compress mediastinal structures

A

What is pectus excavatum?

104
Q

pigeon chest

A

What is pectus carinatum?

105
Q
  1. Abdominal2. SCM3. Trapezius
A

What are the accessory breathing muscles?

106
Q

interspaces & supraclavicular fossa

A

Where do you typically see retractions (breathing)?

107
Q

14-20/min

A

What is the normal breathing rate?

108
Q
  1. Voice too soft2. COPD3. Thick chest wall4. Pneumothorax
A

Dec/absent tactile fremitus?

109
Q
  1. Inspiratory sounds longer than expiratory2. Soft intensity3. Low pitch4. Heard over most healthy lung fields
A

Describe vesicular lung sounds

110
Q
  1. Insp = exp 2. Intermediate intensity3. Intermediate pitch4. Heard over 1st & 2nd interspaces anteriorly & btwn scapula posteriorly
A

Describe bronchovesicular lung sounds

111
Q
  1. Exp slightly longer than insp2. Loud3. High pitched (tubular)4. Heard over manubrium
A

Describe bronchial breath sounds

112
Q
  1. Insp = exp2. Very loud3. High pitched (tubular)4. Heard over trachea in neck
A

Describe tracheal breath sounds

113
Q
  1. Obesity2. Thick chest wall3. Shallow breaths4. Pathology
A

Dec. intensity of normal lung sounds?

114
Q

aka ralesBrief discontinuous sounds, most often at end of inspiration

A

Describe crackles

115
Q

Can have snoring or gurgling qualityIndicate secretions in large airways

A

Describe rhonchi

116
Q

Musical sounds created when air flows rapidly through bronchi that are narrowed significantlyHeard in expiration & sometimes inspiration

A

Describe wheezes

117
Q

Wheeze heard primarily during insp & mainly over large airways can be sign of airway obstruction

A

Describe stridor

118
Q

Related to inflammation of pleural surfacesCoarse grating sound timed w/ lung mvmtEvidence of local inflammation

A

Describe pleural rub

119
Q

when fluid or air pushes lung away from chest wall

A

When are transmitted voice sounds dec?

120
Q

consolidationcommon w/ PNA, atelectasis or tumors

A

When is bronchophony heard?

121
Q

nothing

A

What is usually heard w/ whispered pectoriloquy?

122
Q

consolidationex. PNA

A

When is egophony heard?

123
Q
  1. Vesicular sounds2. Distant spoken words3. Spoken e = e4. Distant whispered words5. Distant tactile fremitus6. Resonant percussion7. RR 14-20
A

Normal lung

124
Q
  1. Boncho/vesicular breath sounds2. Inc. spoken words3. Egophony4. Inc. whispered words5. Inc. tactile fremitus6. Dull percussion7. Inc. RR
A

Consolidated lung

125
Q

Inc afterloadInc. regurg murmurs 1. Aortic regurg2. Mitral regurg3. VSD4. Delayed MVPDec. gotward flowing murmurs1. Aortic stenosis2. HOCM

A

Effect of handgrip maneuver on murmurs

126
Q
  1. Inc. venous return (inc. preload)2. Inc. stroke volume3. Inc. murmur of AS, PS, TR4. Delays murmur of MVP
A

Effect of squatting maneuver on murmurs

127
Q
  1. Dec. venous return (dec. preload)2. Dec. stroke volume3. Dec. murmur of AS, PS, TR
A

Effect of valsalva maneuver on mumurs

128
Q

decubitus position

A

Where are mitral murmurs best heard?

129
Q
  1. Early diastolic2. High-pitched3. Blowing4. Decrescendo 5. Best heard at 2nd RICS6. Inc. w/ leaning forward & holding breath in full expiration7. Inc. w/ handgrip maneuver
A

Describe aortic regurg murmur

130
Q
  1. Early diastolic2. High-pitched3. Blowing4. Decrescendo5. Best heard at 2-3 LICS6. Inc. w/ handgrip maneuver
A

Describe pulmonary regurg murmur

131
Q
  1. Mid-diastolic 2. Rumbling3. PMI inc. in L decubitus position4. Crescendo assoc w/ opening snap
A

Describe mitral stenosis murmur

132
Q
  1. Mid-diastolic2. Rumbling3. May inc. w/ inspiration4. Wide splitting of S1
A

Describe Tricuspid stenosis murmur

133
Q
  1. Mid systolic2. Crescendo-decrescendo3. Usually harsh but can be musical 4. Best heard at 2nd RICS5. May radiate to carotids 6. Dec. w/ standing or valsalva maneuvers or handgrip maneuver
A

Describe aortic stenosis murmur

134
Q
  1. Mid systolic2. Crescendo-decrescendo3. Harsh4. Best heard at 2nd LICS 5.May radiate to L neck6. May cause wide S2 splitting
A

Describe pulmonic stenosis murmur

135
Q
  1. Late systole2. May be preceded by clicks3. Best heard over the apex w/ the diaphragm
A

Describe Mitral valve prolapse murmur

136
Q

Uncommon except in presence of mitral valve prolapse

A

Describe tricuspid valve prolapse murmur

137
Q
  1. 4th LSB2. Inc. w/ respiration (Varcalios sign)
A

Describe a tricuspid/insufficinecy/regurgitation murmur

138
Q
  1. Apex in L lateral decubitus position2. High pitched3. No change w/ respiration4. May radiate to axilla
A

Describe mitral regurg murmur

139
Q
  1. L 3-4 ICS along sternal border2. Inc. w/ handgrip maneuver
A

Describe WSD murmur

140
Q
  1. Still’s murmur2. Physiologic systolic ejection murmur3. Cervical venous hum
A

What are innocent mumurs in kids?

141
Q
  1. Pansystolic murmurs2. Diastolic murmurs3. Loud murmurs (>3/6)4. Other evidence of heart disease, SOB, fatigue, failure to thrive, cyanosis, pulse defecits
A

Red flags of pathologic murmurs?

142
Q
  1. Pregnancy2. Anemia3. Thyroid conditions4. Exercise
A

What are innocent murmurs in adults?

143
Q

Pericarditisleathery raspy soundBest hear w/ Pt leaning forward at end of expiration

A

When are friction rubs heard?

144
Q

1+ slight, disappears rapidly 2mm2+ disappears in 10-15 sec 4mm3+ noticeably deep, >1 min swollen 6mm4+ deep pit, lasts 2-5min, gross swlling 8mm

A

Grading Pitting Edema

145
Q
  1. Redial mastectomy w/ node resection2. Tumor blockage3. Inflammation4. Fibrosis
A

What are some common causes of lymphedema?

146
Q
  1. Snake bites2. Afib3. IE4. Pelvic fracture5. Aneurysm6. Arterial dissections7. Fat embolism8. Trauma
A

Common causes of acute arterial occlusion?

147
Q
  1. Prolonged capillary refill2. Loss of hair3. Thinning of skin4. Shiny skin5. Dependent rubor6. Painful ulcers
A

Skin changes w/ chronic arterial insuffiency

148
Q

Right

A

Which kidney is lower?

149
Q
  1. Pancreas2. Kidneys3, Ureters4, Aorta5. Vena cava
A

Retroperitoneal organs?

150
Q

Weakening of linea alba so have bump when you crunch

A

What is diastasis recti?

151
Q
  1. Gastroenteritis2. Hunger3. Early obstruction
A

When would you have inc. bowel sounds?

152
Q
  1. Peritonitis2. Adynamic ileus3. Late obstruction
A

When would you have dec. bowel sounds?

153
Q

full - dull

A

What sound is expected w/ percussion over the bladder?

154
Q

dull

A

What sound is expected w/ percussion over the liver

155
Q

empty - tympanicfull - full

A

What sound is expected w/ percussion over the stomach?

156
Q

dull

A

What sound is expected w/ percussion over the spleen?

157
Q

dull

A

What sound is expected w/ percussion over most of the abdomen if the Pt is very constipated?

158
Q

Pyelonephritiscould also be MSK

A

What does a +CVA tenderness suggest?

159
Q
  1. Poorly localized periumbilical pain2. Then RLQ pain aggravated by mvmt/cough Palpate at McBurney’s point
A

What Sx would a Pt have w/ acute appendicitis?

160
Q

Pain on other side of palpation

A

What is Rovsing’s sign?

161
Q

appendicitis

A

What does a + psoas sign suggest?

162
Q

cholecystitispress on gall bladder & inspiratory arrest

A

What does a + Murphy’s sign suggest?

163
Q

ascites

A

What does shifting dullness test for?

164
Q

Pain in L shoulder from splenic rupture

A

What is Kehr’s sign?

165
Q

stomach goes through gastroesophageal junction into the thorax most commonly sliding hernia

A

What is a hiatal hernia?

166
Q

herniated disc

A

What is a herniated nucleus pulposus?

167
Q

weakness or disruption of the linea alba w/ protrusion of peritoneal contents

A

What is an epigastric hernia?

168
Q

ulnar side

A

What side of the hand do epitrochlear lymph nodes drain?

Physical Exam (6 decks)

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