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Clincal Assessment > Male GU > Flashcards

Male GU Flashcards

1
Q

T/F men are more likely than women die or get injured at work

A

true

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2
Q

T/F men are less likely than women to attempt suicide ubt are more likely to suceed

A

true

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3
Q

T/F women over 75 have the highest rate of suicde

A

false, men

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4
Q

two categories of questions that concerning male gentalia

A

sexual function and screening for infection

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5
Q

sexual function questions of the male GU exam

A

how is your sex life

do you still have an interest in sex

do you have any concerns about getting an erections

do you have issues with the duration of intercourse (too long or too short)

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6
Q

infection questions to ask during the male GU exam

A

color, amount, presence of discharge

systemic signs of infection

penile lesions

scrotal lesions

painful erections or orgasm

Hx or risk factors for STI

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7
Q

two areas of erectile tissue in the penis

which of thse contain the urethra and form the glans

A

corpus spongiosum and corpus cavernosa

corpus spongiosum

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8
Q

prepuce

A

the fold of skin over the uncircumcised penis

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9
Q

smegma

A

the secretions that can be trapped in the prepuce

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10
Q

T/F the testes should always be smooth, without masses, and hard

A

false, they should be firm but not hard

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11
Q

tunica vaginalis

A

the serous membrane the covers the anterior and lateral parts of the testis

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12
Q

epididymis

A

the soft, comma shaped structure the functions as a reservior for storage, maturation, and transport of sperm

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13
Q

why would a herpes cause burning after urination rather than during

A

because the leasion might be on the meatus

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14
Q

hydrocele

A

accumulation of fluid in the tunica vaginalis

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15
Q

vas deferens

A

cord that passes through the external inguinal ring, down the spermatic cord, and into the tail of epididymis

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16
Q

signs of a vasectomy

A

a knot in the spermatic cord

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17
Q

landmarks of the groin

A

anterior superior iliac spine

pubic tubercle

inguinal ligament

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18
Q

where is the inguinal canal

what is in it

what is the internal and external opening

A

above and parallel to the inguinal ligament

the vas deferens

external/internal inguinal ring

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19
Q

inguinal hernia

A

a loop of bowel that has pushed through the inguinal canal

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20
Q

femoral hernia

A

a loop of bowel that pushes through the femoral canal

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21
Q

inspection of the penis notes

A

inspect all areas

if there is a discharge ask them to milk it

if there are painful lesions or nodule you will need to palpate them

educate uncircumsized men on hygiene

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22
Q

patient presents with a large scrotal mass or visable bulge in the inguinla area that disappears when they lay down

what does ithis indicate

what would you do if the mass remained

A

a hernia

auscultation with a stethoscope hearing bowel sounds = hernia

scrotal mass, shine a light behind the mass, if it glows red it probably not a hernia

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23
Q

at what age is testicular cancer most common

what is the prognosis

A

15-35

excellent with early detection

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24
Q

if there is a suspected hernia, what must be ruled out

A

an enlarged lymph node

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25
Q

two types of inguinal hernias

A

direct and indirect

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26
Q

how will direct inguinal hernias presnet

indirect

A

direct will rarely present in the scrotum

indirect will usually present in the scrotum

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27
Q

on inguinal exam there is a weakness in the inguinal ring during the cough

is that normal

A

yes

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28
Q

STI indicated by…

single painless chancre

single painful chancre

multiple painful chancre

A

syphilis

HSV

HSV or chancroid

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29
Q

EEP with direct inguinal hernia

A

less common, usualy in men over 40, rare in women

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30
Q

EEP indirect hernia

A

most common with any age, both sexes, and children

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31
Q

hypospadias

A

two urethral openings

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32
Q

peyronies disease

A

painful erections that can be indcated by nodules

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33
Q

phimosis

paraphimosis

A

the inability to pull the foreskin down the penis

the unability to pull the forskin up

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34
Q

signs of bowens disease

A

squamous cell carcinoma in situ that can be found on the penis, often looks benign

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35
Q

typical cause of scrotal edema

will it transluminate

A

trauma or infection

no

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36
Q

indcations for a hydrocele

A

fiungers can get above the mass

it will transluminate

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37
Q

cryptochordism

increases risk for

A

undescended testicle

testicular cancer and infertility

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38
Q

acute orichitis causes

what might the patient say they do because of this

A

infection or trauma

they have to wear tight underwear to support the affected area

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39
Q

acute epididymitis causes

A

infection and trauma

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40
Q

T/F epididymal cysts tend to drain and smell bad

A

true

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41
Q

causes of scrotal varicocele

A

increase portal pressure, venous obstruction

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42
Q

two categories of questions concerning the anorectal exam

A

Lower GU

lowe GI

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43
Q

lower GI questions

A

change in bowel function

change in size, color, consistency of school

blood

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44
Q

GU questions

A

difficulty starting

normal amount of urine or caliber

nocturia

dysuria

blood discharge

trauma

pain or stiffness of the lowerback, hips, thighs

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45
Q

health promotion for the anorectal examn

A

testicle self examn

HPV vaccine

screen for rectal, prostate, colorectal cancer

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46
Q

important note for patients who engage in anal sex

A

top, bottom, or both

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47
Q

anal canal

A

the short segment at the end of the GI tract

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48
Q

where does the anal canal change to the rectum

A

the anorectal junction (pectinate line)

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49
Q

blood in the ejactulate is indicative to what

A

trauma or pathology at the prostate

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50
Q

where is the prostate in the rectum

A

the anterior rectal wall

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51
Q

screening for rectal cancer

A

proctoscopy

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52
Q

should the anorectal exam be painful

A

not unless there is a fissure or ulcer

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53
Q

notes for the male anorectal exam

A

the prostate is rubbery and nontender

try to go above the prostate to feel the seminal vescles

note color of anything on the gloves

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54
Q

limitation of the digital prostate exam

A

you can only palpate the posterior side of the prostate, lesions could be anywhere

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55
Q

shape of the prostate

A

heart shaped with a central sulcus with two lobes

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56
Q

what is important to discern when a patient presents with symptoms of prostate enlargement

A

if the prostate enlargement is normal or pathological

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57
Q

thrombosed hemorroid

treatment

A

a vein with a clot in it

small ones will go away, large ones you lance and express

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58
Q

age specific considerations for the neonatal assessment

A

exam happens in the presence of the patient

swaddle and then undress as necessary to do the exam

dim lights and rock newborn to encourage eye opening

observe feeding when possible

demonstrate calming measures to parents

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59
Q

first neonatl exam happens _____

comprehensive exam happens _____

A

immediately after birth

within 24 hours

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60
Q

neonatal assessment sequence

A

head and neck

heart and lungs

abdomen and GU

lower extremities

back

ears and mouth

neurologic

hips

eyes

skin

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61
Q

apgar test

categories

A
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62
Q

apgar appearance 0-2

A
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63
Q

apgar pulse0-2

A
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64
Q

apgar grimace 0-2

A
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65
Q

apgar activity 0-2

A
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66
Q

apgar scores respiration 0-2

A
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67
Q

1min apgar normal

some nervous system depression

severe depression

A

8-10

5-7

0-4

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68
Q

5 minute apgar normal

high risk for CNS or organ dysfunction

A

8-10

0-7

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69
Q

classification for preterm

late preterm

term

post term

A

<34 weks

34-36 wks

37-42 wks

>42 weeks

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70
Q

classification for extremely low birth weight

very low

low

normal

A

<1000g

<1500g

<2500

>= 2500

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71
Q

increased risk for preterm babies

short term

long term

A

CV and respiratory issues

neurodevelopment

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72
Q

increased risks for late preterm babies

A

prematurity related complications

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73
Q

increased risks for post term babies

A

perinatal mortality or morbidity such as asphyxia and meconium

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74
Q

complications for babies that are small for gestational age

A

asphyxia

meconium aspiration

hypoglycemia

polycythemia

hypothermia

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75
Q

complicatons for babies that are large for gestational age

A

dystocia

hypoglycemia

congeital anomalies

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76
Q

when is the best time to do a comprehensive neonatal exam

why

A

1-2 hours after a feeding, becuase that is when they should be most alert

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77
Q

four things to pay special attention to during the comprehensive neonatal exam

A

color, size, posture and movement, resipiration

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78
Q

how will a normal full term baby lie

A

a symmetric position with the limbs semiflexed and legs partially abducted at the hips

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79
Q

T/F neonates should have spontaneous motor activity

A

treu

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80
Q

T/F flexed finges and slight tremors are abnormal for babies

A

false

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81
Q

T/F neonatal development is faster than at any other time

A

false, infancy is fastest

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82
Q

growth milestones for the infant

A

weight shuld have tripled, heigh should have increasd by 50% within the first year

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83
Q

describe the progression of neurlogical development in an infant

A

head before trunk

arms and legs before hands and fingers

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84
Q

congitive assessment of an infant

A

infants should know cause and effect

object permanence

use of tools

stronger anxiety

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85
Q

language assessment of the infant

A

infants should transition to cooing to squealing to babbling to saying 1-3 words by 1 yr old

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86
Q

what is the ballad score used for

A

to determine gestational age when te mom doesn’t know when the babies was concieved

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87
Q

social and emotional development of the infant

A

social tasks such as bonding, trust should be present

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88
Q

how does the structure of the PE differ in an infant

A

general
skin
head
thorax, lungs
heart
neck
breasts
abdomen
GU
musculoskeletal
nervous system
eyes
ears
mouth
nose
rectal

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89
Q

why are the Eyes, Ears, Mouth & Pharynx, Nose & Sinuses, Rectal done last in an infant PE

A

because you don’t want to make them mad earily

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90
Q

vital signs for infant exam

A

BP, pulse, respiration, temp, length, weight, head circumference

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91
Q

T/F weight should be taken with dirty diaper

A

false, it should be clean

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92
Q

normal BP at birth

1 month

6 months

A

70

85

90 systolic

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93
Q

normal RR infants

A

birth to 2 month (>60)

2-12 (>50)

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94
Q

implications of sustained infant HTN

A

renal artery disease

congenital renal disease

coarctation of the aorta

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95
Q

what indicates tachycardia in pulse

SVT

A

250bpm

>180 bpm

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96
Q

T/F fever can increase RR as much as 10resp/min/degree of fever

A

true

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97
Q

what might beindicated by very rapid, shallow breathing

A

cyanotic heart disease, right to left shunting, metabolic

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98
Q

tachypnea or increased respiratory effort indicateds what

A

pneumonia or bronchiolitis

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99
Q

nonpathological caues of fever

what constituites a fever in a neonate

A

swaddleing

anxiery

>100.4

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100
Q

testing for jaundice

A

press the skin, look for a yellowish tint indicative of jaundice

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101
Q

when a rectal exam be done on a neonate/infant

A

to check for imperforate anus

to assess rectal bleeding

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102
Q

erythema toxicum

A

a common condition usually statying 3-5 days after birth with small pustules on erythematous bases that usually resolves withinf 1-2 weeks

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103
Q

chronic conditions neurological, renal, cardiac, endocrine often manifest how

A

failure to thrive

104
Q

how will failure to thrive presents as it progresses

A

height will slow, then weight, then head circumference

105
Q

milliria rubra

treatment

A

blocked sweat glands in the face, scalp, diaper area

light clothing and decreased humidity

106
Q

pulsular melanosis

A

small fragile pustules that leave freckles behind

107
Q

milia

A

small white papules concentrated on nose, cheeks, forehead, chin that usually resilve within 1-2months

108
Q

benign birthmarks

A

eyelid patch

salmon patch

cafe aulait spots

mongolian spots

109
Q

biggest considerations for infant head assessment

A

symmetry, sutures, fontanelles

110
Q

symmetric abnormalities in infant head assessment

A

cephalohematoma (dones’t cross suture line)

caput succedaneum (crosses the stures line)

plagiocephaly

111
Q

how long does cephalohematoma take to resolved

caput

A

3 weeks

1-2 days

112
Q

what might cause plagiocephaly

A

something that causes the bbay lay their head to one side (injury to scm, lack of stimulation)

113
Q

describe the course of normal jaundice

A

appears days 2-3

peaks day 5

disappears within the first week

114
Q

what causes molding of the infant skull

A

overlapping cranial bones as a result from being passed through the birth canal

115
Q

what level of bilirubin requires treatment

A

14-15 by day2 or 3

116
Q

depression of the anterior fontanelle suggests what

what about bulging

A

dehydration

hydrocephalus, increased ICP, neoplastic disease

117
Q

risk factors for early closing fontanelles

A

microcephaly

craniosynotosis

118
Q

conditions associated with delayed closing fontanelles

A

hypothyroid

megalocephaly

increased ICP

rickets

119
Q

an enlarged posterior fontanelle is indicative of what

A

congenital hypothyroidism

120
Q

which fontanelle is larger

which closes first

A

posterior is smaller and closes first

121
Q

craniossynotosis

A

when one of the sutures of the skull that fuses too early and causes the skull to shaped oddly

122
Q

considerations for the eye exam of an infant

A

newborns keep their eyes closed

attempting to open them makes them close they tighter

bright lights make them blink

use small, colorful toys

123
Q

T/F during the first 10 days an infants eys might be fixed

A

true

124
Q

T/F some infants will intermittently cross their eyes

A

true

125
Q

what to look for in the infant eye assessment

A

pupillary reactions

normal irises, conjuctiva

optic blink reflex

126
Q

opthalmoscopic exam for an infant

A

look for red reflex

optic disk should be lighter

may not see a fovea light reflex

look for retinal hemorrhages

127
Q

what might be indicated if an infant that doesn;t follow your face during alert periods

A

visual impairment

128
Q

whatmight be inidicated by an infant that cant open eyes

A

congential ptosis

129
Q

T/F subconjunctival hemorrhages are uncommon

A

false, they are common in neonates born vaginally

130
Q

T/F nystagmus is normal in the infant eye exam

A

true, but it should be gone by a few days or it may indicate CNS disease or poor vision

131
Q

alternating convergent and divergent strabismus beyond three months indicated what

A

ocular motor weakness

132
Q

visual milestones for infancy

birth

1 month

1.5-2 months

3 months

12 months

A

blinks, looks at face

fixes on objects

coordinating eye movement

eye converge

acuity around 20/50

133
Q

coloboma

A

defect in the iris

134
Q

brushfield’s spots

A

ring of white specks in the iris indicative of down syndrome but cna be normal

135
Q

dark light reflex is caused by what

white light reflex is caused by what

A

dark: cataracts, retinopathy
white: cataract, retinal detachment, chorioretinitis, retinoblastoma

136
Q

causes of retinal hemorrhages

A

severe anoxia

subdural hemotoma

subarachnoid hemorrhage

trauma

137
Q

what is the criteria for low set ears

A

if the auricle and pinna ears are below an imaginary line drawn from the inner and outer canthus of the eyes, the ears are low swt

138
Q

what prevents full otoscopic exam in a neonate

A

vernix in the ears

139
Q

acoustic blink relfex

A

babies will blink in response to a loud sound

140
Q

small, deformed, low set ears are indicative of what

A

congeital disease, specifically renal disease

141
Q

perinatal risk factors for hearing defects

A

<1500g weight at birth

anoxia

ototoxic meds

congenital infection

hyperbilirubinemia

meningitis

142
Q

assesment of the nose in an infant

A

test for patency

inspect septum

143
Q

choanal atresia

a simple fix

A

when the posterior openings of the nose aren’t open

pass a feeding tube through the nostril to the pposterior pharynx

144
Q

describe infant oral mucosa

A

edentulous, alveolar mucosa is smooth with finely serrated borders

145
Q

epsteins pearls

A

white or yellow rounded retention cysts located on the hard palate

146
Q

signs of thrush

A

white patches that are hard to wipe away and have a erythmoous base

147
Q

two conditions that will have a prominent protruding tongue

A

congenital hypothyroid

downs

148
Q

macroglossia is indicative of what

A

severe systemic conditions

149
Q

pattern of tooth eruption

A

1 tooth each month between 6 and 26 months up to 20 primary teeth

150
Q

infant neck assessment

A

palpate lymph nodes lying down for younger kids

assess for adiitional masses

check position of thyroid cartilage and trachea

check clavicles for newborns

151
Q

assessment of the thorax in an infant

A

expect a rounded thorax

note work of breathhing

should have very audilbe breath sounds

tactile fremitus

152
Q

T/F an infant should have similar breath sounds from the nose and stethoscope

A

true

153
Q

upper air way auscultation of an infant should beharsh and loud and symmetrc

A

true

154
Q

infant breath sounds should be louder higher and usually inspiratory should be louder

A

yes to bth

155
Q

apnea in an infant

might indicate what

A

cessation of breathin for 20 seconds often accompanied with tachycardia

respiratory, CNS, cardiopulmonary disease, high risk for sids

156
Q

nasal flaring indicates what

A

effort from URI or pneumoia

157
Q

causes of acute stridor in an infant

A

laryngotracheobronchitis, epiglottis, bacterial trachiatis, foreign bodies, hemangioma

158
Q

assymetrical chest movement indicates what

diminished breath sounds indicates what

A

space occupying lesion

congenital diaphragmatic hernia

159
Q

wheezes = ____

crackles = ____

A

asthma or bronchiolitis

pneumonia or bronchiolitis

160
Q

abnormal respiratory effort and ausculataion iindicates what

A

pneumonia

161
Q

T/F tachypnea is commonly found in pneumonia

A

true

162
Q

hoover’s sign

A

paradoxical seesaw movement between the chest and abdomen commn with LRI (bronchiolitis, pneumonia)

163
Q

T/F URIs are no typically serious in infants

A

true

164
Q

assesment of the heart in an infant

A

inspection for cyanosis, pulse ox

palpate for PMI, abnormal precordial movement, peripheral puses

auscultation

165
Q

T/F S1 and S2 are commonly dull in an infant

A

false, they are normally crisp and normally separate

166
Q

notable findings on infant auscultation

A

sinus arrhytmia

skipped beats

murmurs

extra heart sounds

167
Q

what causes enlarged breasts in males and females

A

maternal estrogen

168
Q

infant abdominal assessment

A

inspect the umbilical cord

auscultation

percussion of the liver and spleen

169
Q

increased frequency or pitch of bowel sounds indicates what

A

gastroenteritis

170
Q

small mass in the right upper quadrant or epigastrum indicates

A

pyloric stenosis

171
Q

enlarged heart or tender liver in an infant indicates

A

heart failure or storage disese

172
Q

abdominal masses common to infants

A

hydropnephrosis

urethral obstrucion

intussussception

turmors

173
Q

potential causes of hepatomegaly in a new born

A

hepatitis

storage diseaes

vasucular congestion

biliary obstructuin

174
Q

cuaes of splenomegaly in newborns

A

infection

hemolytic anemia

inflammatory autoimmune diseases

portal HTN

175
Q

infant male GU assessment

A

penis should be straight

testes should be palpable in teh scrotum

scrotum should have rugae by 40 weeks

scrotal edema may be present due to maternal estrogen

176
Q

hypospadias

A

urtherla orfice on the ventral surface of the glans or the shft of the pens

177
Q

cryptorchidsm

A

undescended testicle

178
Q

what indcates an infant hydrocele

A

nonreducible, transluminated mass that overlies the spermatic cord and testes that usually resolves in 18 months

179
Q

inguinal hernia indications

A

reducible, non-translumiunable mass separate from the testes

180
Q

T/F maternal estrogen will make female infant genitalia prominent

A

true

181
Q

notable inspection points for the infant female GU exam

A

size of the clitoris

color and size of labia

lesions on genitalia

assess hymen

look for labial adhesions

182
Q

important features of the MS exam on an infant from hands to hips

A

clenched hands (palmar reflex)

check for clavical fractures

check for patches or pits indicative of spina bifida

ortolani, barlow for hipdysplasia

183
Q

important infant MS features in the legs and feet

A

legs should be bowlegged and be equal legnth

toe in/out shiuld correct in the second year

feet turned in at birth

feet seem flat due to plantar fat pad

184
Q

what is the most common severe congenital deformity

A

club foot (talipes equinovarus

185
Q

important features of the neuro exam on infants

A

mental status (crys, responds to pain)

gross and fine motor function meeting milestones

muscle tone

cry

DTRs

primitive reflex (suck, root, grasp)

186
Q

CN II assesment for infants

CNIII

A

face tracking

check for optic blink reflex

187
Q

CN III, IV, VI assesment for infants

CN V

CN VII

A

face tracking

root/suck

facial expressions

188
Q

CN VIII assessment for infants

CN IX, X

XI

XIII

A

acoustic blink

swallowing

symettry of shoulders

coordination of sucking

189
Q

physical develpment slows by how much after infancy

A

1/2 the previous rate

190
Q

gross motor skills 1-4 years

A

walk by 15 months

run well by 2

ride tricycle by 3

jump 3-4

191
Q

fine motor milestones between 1-4

A

18 month scribbles freely

2yrs imitates lines

3yrs draws and copies circles

192
Q

language milestones between 1-4

A

18 months 10-20 words

2 yrs 2-3 word sentances

3 yrs has convesations, asks why, sings songs

4 yrs complex sentances but lack of logical thought

193
Q

social and emotional development 104 yrs

A

strive for independence

temper tantrums

don’t ask them if they want to do something

194
Q

child development 5-10 years general

A

goal directed exploration of the world

increases physical and cognitive abilities (trial and error)

195
Q

child development 5-10 years physical

A

grow at a steady, slower rate

strength and coorindation increases

children with disabilities will find their limitations

196
Q

child development 5-10 years cognitive and language development

A

more able to used logic

little understanding of consequences

learning done mainly from environment

language becomes more complex

197
Q

child development 5-10 years social and emotional development

A

progressively more independent

critical time for self esteem

moral and value systems mature but remain relatively simply

198
Q

important respiratory ROS for middle childhood

A

otitis media

recurrent UTIs

bronchitis

cough

croup

pneumonia

wheezing

199
Q

important CV ROS for middle childhood

A

fatiguabilty or syncope

200
Q

important GU ROS for middle childhood

A

UTIs

hematuria

dysuria

frequency

oliguria

unexplained fever

201
Q

important CNS ROS for middle childhood

A

seizures

tics

202
Q

important GI ROS for middle childhood

A

diarrhea/constipation

food intolerances

203
Q

three stages of adolescents

A

early, middle, late

204
Q

when does adolescent physical development start for girls

boys

when does it stop

A

10 for girls, 11 for boys

stops 14 for girls, 16 for boys

205
Q

congitive development in adolescence

A

progression from formal reasoning to logical and abstraction

increased morality

206
Q

social and emotionald development during adolescents

A

increase influence of friends and peers

struggles for identity

207
Q

what is the goal of providing confidentiality to an adolescent patient

A

to encourage them to talk to their parents not keep their secrets

208
Q

important points for early childhood

A

avoid physcial struggle

be aware of stranger anxiety

209
Q

middle childhood exam considerations

A

usually modest so give provacy

generally cooperative

get to know the kid

210
Q

tips for examining young children

A

get at the childs eye level

examine patient teddy bear first then the child

let the child do some of the exam

have the child hold your hand and help you

211
Q

tipps for examining young children

A

use a reassuring voice

let the child touch and see the exam tools

examine child in the parents lap

let them take a break

make a game of it

don’t ask permission

212
Q

when do you stop measuring head circumference

A

after 2

213
Q

T/F BP should increase through out child hood

A

treu

214
Q

what are common causes for high blood pressure in children

A

improper BP cuff

primary HTN, renal disease, dug use

215
Q

major factors effecting pulse

A

illness, emotion, exercise

216
Q

what constitutes tachypnea in a child

A

>1yr >40breaths/minute

217
Q

things to look for on the head exam for older kids

A

shape, symmetry, abnormal facies

218
Q

eye exam for older kids

A

red reflex

disconjugate gaze/eom

visual acuity

219
Q

T/F adolescents should get a visual acuity test annually

A

true

220
Q

why are ears difficult to evaluate in older kids

A

because they aren’t very sensitive

221
Q

when would acoustic screening be warranted for a kid older than 4

A

those who have failed screening or have delayed speech

222
Q

common diagnosis of the ear in kids

A

acute otitis media

middle ear effusion

otitis externa

223
Q

mucous membranes in allergic rhinitis

A

pale and boggy

224
Q

causes of purulent rhinitis in kids

A

viral infections, sinusitis

225
Q

foul smelling purulent unilateral discharge inducates what

A

foreign body in the nose

226
Q

signs of sinusitis in kids

A

purulent rhinorrhea that is generally unilateral and includes headache, sore throat, sinus pain

227
Q

development of sinuses

A

maxillary age 4

sphenoid age 6

frontal age 6-7

228
Q

mouth exam for kkids

A

make it a game

check teeth for decay and carries

malcocclusion(overbite)

tongue

position, size, symmetry of tonsils

halitosis

229
Q

typical causes of swollen lymph nodes in kids

A

viral or bacterial infections

230
Q

how does croup sound on auscultation

A

prolonged inspiration accompanied with stridor, cough, rhonchi

231
Q

auscultation of asthma in kids

A

prolonged expiration with coughing, wheezing, increased work of breathing

232
Q

how to check for coarctation of the aorta

A

measure BP in both arms or one leg at a time

233
Q

stills murmur

A

a benign murmur usually found between 2 and 8 increased with supine position, fever, anemia

234
Q

what causes venous hum in kids

A

turbulence in the jugular veins

235
Q

three benign murmurs found in childhood

A

stills

venous hum

carotid bruitis

236
Q

pathological murmurs found in childhood

A

Aortic stenosis, mitral valve disease

237
Q

what does stills murmur sound like

where is it found

A

grade I or II, musical, vibratory, early and midsystolic murmur

mid to lower left sternal border frequently carotid bruits

238
Q

how does venous hum sound

where it is usualyl heard

A

soft, hollow, continuous

uunderclavicke

239
Q

how does a carotid bruit sound in kids

where is it heard

A

early or midsystolic whoosh

usually louder on the left, made btter by carotic compressuion

240
Q

describre a pulmonary heart murmur

where is it heard

A

grade I-II/VI soft, non harsh, ejection in timiming

Upper left sternal border

241
Q

notes for the abdominal exam in kids

A

toddlers have a protuberant abdomen

check for apendicitis if there is acute abdominal pain

palpate liver, spleen, kidneys

percussion is more tympanic

242
Q

male GU exam for kids

A

check for descended testes

inguinal canal for hernia

243
Q

painful testicle in kids indicates what

A

epididymitis

orchitis

torsion

244
Q

female GU for kids

A

vaginal discharge

adhesions

rashes

abrasions

trauma

lesions

hymenal variations

vaginal bleeding

245
Q

first sign of female puberty

other signs

A

breast buds

hymen changes secondary to estrogen

wider hips

beginning of height spurt

246
Q

delayed pubery might indicate what

A

turners

anorexia

chronic disease

247
Q

what is the first reliable sign of puberty in males

A

increased size of testes, more pubic hair, larger penis

248
Q

causes of delayed puberty in boys (no sign of puberty before 14)

A

constitutional delay

249
Q

MS exam for kids

A

observe child walking, standing, touch toes, rise from a chair, run, pick up objects, duckwalk, squat, jump

250
Q

nursmaids elbow

A

subluxation of the raidal head due to a tugging injury

251
Q

lower extremity conditions for the MS exam in kids

A

bowleggedness (usually disappears by 18 months)

knock knees 3-4 years to 9-10

toe in walk may incrase up to age 4 and disappear around 10

assess for leg length

trendelenburg for hip disease

252
Q

T/F most scoliosis is idiopathic

A

trye

253
Q

adams test

A

bend foward with knees straight, looks for scoliosis

254
Q

T/F scoliosis in young children is abnormal, older children is not uncommon

A

true

255
Q

plumb line test for scoliosis

A

attach a string to C7 and see if the line extends to the gluteal crease

256
Q

neuro exam for kids

A

primitive reflexes should be gone

check cranial nerves

257
Q

gait, strength, coordination assesment during the kids neuroexam

A

look for asymmetries, weakness, undue tripping, heel to toe walk, hopping and jumping

hand preference usualyl determined by 2

differentiate ortho from neuro gait abnormailities

Clincal Assessment (3 decks)

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