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Medicine > Medicine 2 > Flashcards

Medicine 2 Flashcards

1
Q

What is the definition of arthritis?

A

Inflammation in the joints

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2
Q

Name 4 signs and symptoms of arthritis?

A
  • joint swelling: effusion / synovial thickening
  • pain
  • warmth
  • erythema
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3
Q

What is the definition of arthralgia?

A

Joint pain without swelling, redness or warmth

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4
Q

What is the definition of true syncope?

A

Loss of consciousness 2° to impaired cerebral perfusion

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5
Q

Name 4 general causes of true syncope.

A
  1. reflex mediated
  2. inadequate circulating volume
  3. obstruction to blood flow
  4. arrhythmia leading to sudden loss of CO
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6
Q

Name 4 types of reflex mediated syncope.

A
  1. vasovagal
  2. situational
  3. autonomic dysfunction
  4. postural hypotension
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7
Q

In what kinds of situations can you have “situational” reflex mediated syncope?

A
  • micturition
  • cough
  • carotid hypersensitivity
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8
Q

Name 5 causes of loss of consciousness that are NOT due to impaired cerebral perfusion.

A
  1. seizure
  2. hypoglycemia
  3. severe hypoxia or hypercarbia
  4. psychiatric
  5. head trauma
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9
Q

Name 4 causes of generalized edema driven by increased hydrostatic pressure / fluid overload.

A
  1. heart failure
  2. pregnancy
  3. drugs (e.g. CCBs)
  4. iatrogenic (too much IV fluids)
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10
Q

Name 3 causes of generalized edema driven by decreased oncotic pressure / hypoalbuminemia.

A
  1. liver cirrhosis
  2. nephrotic syndrome
  3. malnutrition
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10
Q

Name a cause of generalized edema driven by increased interstitial oncotic pressure.

A

Myxedema

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10
Q

Name a cause of generalized edema driven by increased capillary permeability.

A

Sepsis.

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11
Q

Name 4 hormonal causes of generalized edema.

A
  1. hypothyroidism
  2. exogenous steroids
  3. pregnancy
  4. estrogens
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12
Q

À St-Jean, où peut-on référer en physio périnéale?

A

À ActiSport ou chez Kinatex.

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13
Q

Name 5 systemic causes of sinus tachycardia.

A
  1. fever
  2. inflammation
  3. infection
  4. neoplasm
  5. autoimmune condition
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14
Q

Name 3 endocrine causes of sinus tachycardia.

A
  1. thyrotoxicosis
  2. pheochromocytoma
  3. hypoglycemia
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15
Q

Name 2 classes of drugs that can cause sinus tachycardia.

A
  1. stimulants
  2. anticholinergics
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16
Q

Name 3 psychiatric causes of sinus tachycardia.

A
  1. panick attacks
  2. GAD
  3. somatization
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17
Q

Name 4 causes of pathologic tachycardia.

A
  1. supraventricular tachycardia (SVT)
  2. a fib
  3. atrial flutter
  4. ventricular tachycardia
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18
Q

Name 2 causes of SVT (supraventricular tachycardia).

A
  1. reentrant SVT
  2. atrial tachycardia
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19
Q

What is the usual paper speed on an ECG?

A

25 mm/s

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20
Q

On an ECG, what does 1 small square (1 mm) represent on the horizontal axis?

A

40 msec

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21
Q

On an ECG, what does 1 large square (5 mm) represent on the horizontal axis?

A

200 msec

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22
Q

On an ECG, what does 1 small square (1 mm) represent on the vertical axis?

A

0.1 mV

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23
Q

On an ECG, what do 2 large squares (10 mm) represent on the vertical axis?

A

1 mV

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24
Q

What are the standard limb (bipolar) leads on a 12-lead ECG?

A

I, II, II, aVL, aVR, aVF.

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25
Q

What are the standard precordial (unipolar) leads on a 12-lead ECG?

A

V1-V6:
- V1-V2 (septal)
- V3-V4 (anterior)
- V5-V6 (lateral)

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26
Q

What are the additional leads you can ask for on an ECG?

A

Right-sided leads or posterior leads.

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27
Q

On an ECG, what leads represent the lateral wall?

A

I, aVL, V5, V6.

28
Q

On an ECG, what leads represent the inferior wall?

A

II, III, aVF.

29
Q

On an ECG, what leads represent the anterior wall?

A

V1-V4.

30
Q

What is the normal duration of the PR interval?

A

120 to 200 msec.

31
Q

What is the normal duration of the QRS interval?

A

< 120 msec.

32
Q

What is the normal duration of the P wave?

A

120 msec.

33
Q

What is the treatment effect of statins?

A

It lowers LDL by about 30-40%.

34
Q

What is the treatment effect of ezetimibe?

A

It lowers LDL by about 18%.

35
Q

Quels sont les 3 classes de médicaments pour la dyslipidémie?

A
  • les statines
  • l’ézétimibe
  • les inhibiteurs de la PCSK9 (PO ou injections SC, médicament d’exception)
36
Q

What is the treatment effect of PCSK9 inhibitors?

A

It lowers LDL-C by about 50%.

37
Q

Name 3 clinical signs of hyperlipidemia.

A
  1. xanthelasma
  2. xanthoma
  3. arcus cornealis
38
Q

What is a xanthoma?

A

Xanthomas are depositions of yellowish cholesterol-rich material that can appear on the skin anywhere on the body.

39
Q

What is a xanthelasma?

A

It is the most common type of xanthoma. It appears on or by the corners of the eyelids, close to the nose.

40
Q

What is arcus cornealis?

A

The deposition of lipids on the cornea, around the iris. It forms an arc and can eventually form a ring around the iris.

41
Q

What are the high-risk ethnicities for dyslipidemia?

A

South Asians and Indigenous peoples.

42
Q

What are the atherogenic particles?

A
  • VLDL
  • IDL
  • LDL
  • lipoprotein A
43
Q

What is ApoB?

A

Each atherogenic particle contains one molecule of ApoB. Serum ApoB reflects the total number of particles and may be useful in assessing cardiovascular risk.

44
Q

What is important to remember to rule out in acute upper abdominal pain?

A

Thoracic sources:
- MI
- pneumonia
- dissecting aneurysm

45
Q

Describe the Brief Geriatric Screen using the “5 M’s Framework”.

A

Mind
Mobility
Medications
Multimorbidity
Matters most

46
Q

What to explore in the “Mind” part of the 5 M’s Framework (brief geriatric screen)? (4 things)

A
  • dementia
  • delirium
  • depression
  • chronic pain
47
Q

What to explore in the “Mobility” part of the 5 M’s Framework (brief geriatric screen)? (5 things)

A
  • impaired gait / balance
  • exercise
  • vision
  • home safety assessment
  • Ca++ and vitamin D
48
Q

What to explore in the “Medications” part of the 5 M’s Framework (brief geriatric screen)? (3 things)

A
  • polypharmacy
  • deprescribing
  • adherence
49
Q

Name 3 important things to check in “general and vital signs” section of geriatric physical exam.

A
  • weight loss
  • height
  • orthostatic vitals
50
Q

Name 5 important things to check in head and neck exam in the elderly.

A
  • visual acuity
  • whisper test (hearing screen)
  • dentition
  • lymphadenopathy
  • neck masses
51
Q

Name 5 important things to check in extremities in a geriatric physical exam.

A
  • arterial insufficiency
  • venous insufficiency
  • edema
  • ulcers
  • diminished peripheral pulses
52
Q

Name 3 important things to check in the dermatologic exam in the elderly.

A
  • premalignant/malignant lesions (sun-exposed areas)
  • pressure injuries
  • foot wounds
53
Q

Name 5 parts of the gait assessment in the elderly.

A
  • Romberg for balance
  • sit-to-stand test

Consider additional balance tests:
- pull-back test
- forward reach
- tandem stance and gait

54
Q

Name 3 importants parts of the neurological exam in the elderly.

A
  • signs of parkinsonism
  • tremor
  • cerebellar testing
55
Q

What is anisocytosis?

A

RBCs with increased variability in size (increased RDW).

56
Q

What is poikilocytosis?

A

Increased proportion of RBCs of abnormal shape.

57
Q

Name 4 causes of poikilocytosis.

A
  • iron-deficiency anemia
  • hemoglobinopathies
  • severe B12 deficiency
  • burns
58
Q

In which condition do you see spherocytes?

A

In immune hemolytic anemia.

59
Q

What is a discocyte?

A

Biconcave disc (normal RBC).

60
Q

What is a spherocyte?

A

A spheroidal RBC, due to membrane defect or loss of membrane.

61
Q

Romberg’s test is a test for what?

A

Balance

62
Q

What premise is Romberg’s test based on?

A

It is based on the premise that a person requires at least 2 of the 3 following senses to maintain balance while standing:
-proprioception
-vestibular function
-vision

63
Q

How do you perform Romberg’s test?

A

The patient stands with feet together, eyes open and hands by the sides.
The patient closes the eyes while the examiner observes x 1 minute.

64
Q

What is a positive Romberg’s test?

A

Romberg test is + when the patient loses balance with their eyes closed. Loss of balance can be defined as increased body swaying, foot movement in the direction of the fall, or falling.

65
Q

What is the clinical significance of a positive Romberg’s test?

A

It denotes sensory ataxia as the cause of postural imbalance.

66
Q

What is the sit-to-stand test?

A

The chair is placed against the wall to prevent it from moving.The patient is seated in the chair. Arms are crossed at the wrists and held against the chest.
The patient sits and stands as many times as possible in 30 seconds.

67
Q

What is the pull back test?

A

The patient is standing up, feet shoulder width apart. The examiner is behind the patient and pulls the patient off balance from the back (needs to be able to catch the patient if they fall!)
If the patient needs more than 2 steps to catch their balance, it is suggestive of parkinsonism.

68
Q

Au Québec, quel est le temps d’écran recommandé pour les enfants moins de 2 ans?

A

Aucun temps d’écran.

69
Q

Au Québec, quel est le temps d’écran recommandé pour les enfants entre 2 et 5 ans?

A

Moins d’une heure par jour, supervisé.

70
Q

Au Québec, quel est le temps d’écran recommandé pour les jeunes de 6 à 17 ans?

A

Maximum 2 heures par jour.

Medicine (3 decks)

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