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Physical Diagnosis Block III > Mental Status/Neurologic Exam/Pelvic/Peds/Geriatric > Flashcards

Mental Status/Neurologic Exam/Pelvic/Peds/Geriatric Flashcards

1
Q

Can evaluate this with the MMSE:

A

Cognitive Abilities

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2
Q

Ability to draw clock, A/O x4?

A

cognitive abilities

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3
Q

crying, depression, bipolar

A

Emotional Stability

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4
Q

repeating words, word salads, made-up words

A

Speech and language skills

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5
Q

Making up words just for yourself

A

Neologisms

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6
Q

Takes you 20 minutes to tell something very simple, round about way of explanation

A

Circumlocution

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7
Q

What are signs and symptoms of Wernickes?

A

Patient doesn’t realize they have a disorder, words don’t make sense together, nonsensical, neologisms, motor skills are perfect

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8
Q

What are the sign and symptoms of Brocas?

A

They know they have a problem, broken production of speech, takes them a long time, still in sensical words.

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9
Q

A/O x 4?

A

person, place, time, event

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10
Q

Limitation of the MMSE?

A

only checks cognitive abilities, ie. slowly progressing Dementia

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11
Q

5 areas tested on MMSE?

A

orientation (what times is it?), registration (3 words), attention and calculation (count backwards from 100 by 7), recall (3 words later), language (point to a pencil, what is this?)

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12
Q

Maximum score of the MMSE?

A

30 (24-26 are a positive screen)

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13
Q

Drawing 2 pentagrams test what?

A

Tests language (following directions)

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14
Q

Where is the motor cortex located?

A

Frontal Lobe

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15
Q

Where is proprioception processed?

A

Parietal Lobe

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16
Q

Postive Babinski sign shows a problem in which motor neuron?

A

Upper

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17
Q

Dysarthria

A

difficult or labored speech, listen for when testing Hypoglossal nerve (12)

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18
Q

Superficial reflex to evaluate T12, L1 and L2 spinal nerves

A

Cremasteric reflex in males

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19
Q

Superficial reflex to evaluate T8-T10 spinal nerves

A

upper abdominal reflex

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20
Q

Superficial reflex to evaluate T10-T12 spinal nerves

A

lower abdominal reflexes

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21
Q

Abnormal response to plantar reflex?

A

Babinski = dorsiflexing. Unless under 2 years of age

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22
Q

Where are you more likely to feel the 2 points as separate?

A

Finger tips easier than back

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23
Q

Sustained clonus is a sign of?

A

Upper Motor Neuron Disease

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24
Q

Difference between delirium and dementia?

A

Delerium can be acute, dementia cannot (is progressive). Delerium more perception, dementia more confusion.

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25
Q

Difference between Stupor or Lethargy?

A

Stupor responds to pain or verbal, where as lethargy respond appropriately when aroused. Stupor both slow to respond and doesn’t to 4 questions. Lethargy answers questions but slowly.

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26
Q

Absence of reflexes

A

Areflexia, may also indicate neuropathy

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27
Q

Total number of deliveries (not babies) after 20 weeks

A

Parity (twins are 1)

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28
Q

Total number of pregnancies (regardless of when, where, etc)

A

Gravida

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29
Q

Easily irritated or inflamed cervical tissue

A

Friable cervix

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30
Q

Chadwick’s sign

A

Bluish color in cervix which is a sign of increased vascularity, appears 8-12 weeks

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31
Q

Until which age do you measure head circumference?

A

2 years

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32
Q

At which age do you start taking BPs in kids?

A

3 years

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33
Q

At which age do you start testing vision?

A

3 years

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34
Q

At which age do you switch to BMI?

A

2 years

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35
Q

Screen for specific developmental milestones?

A

9, 18, 30 months

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36
Q

When should the posterior fontanelle close?

A

2 months

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37
Q

When should the anterior fontanelle close?

A

9-18 months

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38
Q

When should primitive reflexes be gone?

A

by 6 months

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39
Q

What is the cerebrum responsible for?

A

Higher order thinking (general movement, visceral functions, perception, behavior) Contains the frontal, parietal, occipital, temporal lobes.

40
Q

What is the cerebellum responsible for?

A

Works with the motor cortex (located in frontal lobe) and processes sensory info and sends it to cerebrum. Does fine muscle control, balance, posture.

41
Q

What does the frontal lobe do?

A

contains motor cortex, and is associated with voluntary skeletal movement and fine repetitive motor movements. Also, executive functions, thinking, planning. Contains prefrontal cortex.

42
Q

What kind of symptoms would you expect with someone with prefrontal cortex damage? Think Phineas Gage…

A

Can’t control behavior, has outbursts, is impulsive, lack of social norms.

43
Q

What does the parietal lobe do?

A

Perception - making sense of the world.Visual, gustatory, olfactory, auditory, proprioception.

44
Q

Which lobe is the primary vision center?

A

Occipital lobe

45
Q

Which lobe is responsible for the interpretation of sounds?

A

Temporal lobe

46
Q

If damage to Temporal lobe and Wernicke’s area, which symptom may you except from a patient?

A

Fluent aphasia. aka Sensory aphasia. Produce speech without grammatical error, but cannot comprehend (speaking russian)

47
Q

Name all the cranial nerves in order I-XII:

A

Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Acoustic (vestibulocochlear), Glossopharyngeal, Vagus, Spinal Accessory, Hypoglossal

48
Q

Which cranial nerves are classified as strictly sensory?

A

Olfactory (smell), optic (sight), acoustic (hear)

49
Q

Which cranial nerves are classified as motor?

A

Oculomotor (eye moves), Trochlear (eye moves), Abducens (eye moves), Facial (face moves), Spinal Accessory (turn head, shrug) , Hypoglossal (tongue moves)

50
Q

Which cranial nerves are both motor and sensory?

A

Trigeminal (jaw moves and eye and face feels), Facial (mostly motor), Glossopharyngeal (swallowing and gag reflex), Vagus (peristalsis, heart and senses behind ear)

51
Q

Which spinal tract carry info from the external environment?

A

Ascending tract

52
Q

Which spinal tract conveys impulses to various muscle groups, control muscle tone, posture and precise movements?

A

Descending tract

53
Q

What structures receive info for the various dermatomes?

A

the sensory and motor fibers of the sensory nerves

54
Q

A patient is believed to have a motor neuron disorder and is symptomatic on the contralateral (opposite) side. Which Type?

A

Upper Motor Neuron above the brainstem. (if below the brainstem then same side)

55
Q

A cervix that points anteriorly is positioned how?

A

Retroverted

56
Q

A cervix that points posteriorly is positioned?

A

Anteverted

57
Q

If the cervix appears pale, that could be a sign that the patient is?

A

anemic

58
Q

What type of pressure is applied when inserting the spec?

A

downward

59
Q

Swelling, redness, or tenderness of the labia majora may indicate;

A

infection of the Bartholin’s glands.

60
Q

Friable cervix

A

red patchy ares, granular areas, and white patches that could indicate cervicitis, infection or carcinoma

61
Q

The normal texture of the vaginal walls in a premenopausal women

A

Rugae

62
Q

When can a cystocele or rectocele be visible on pelvic exam?

A

when the patient “bears down”

63
Q

After 2 attempts in 2 positions to feel for the fundus of the uterus, and you didn’t, you could assume the uterus is in which position?

A

midline

64
Q

If unable to palpate adnexa on vaginal bimanual exam, when should you try to locate them again?

A

During the rectovaginal exam

65
Q

An uterus palpable during the rectovaginal exam is in what position?

A

retroverted

66
Q

A woman who has been pregnant more than once

A

multigravida

67
Q

uterine descent

A

when the cervix itself protrudes out of the vaginal opening

68
Q

inside out vagina

A

vaginal prolapse

69
Q

Why are young women more likely to get HPV?

A

Because transition zone is still ectropic (not turned in) and is an area of actively growing cells and prone to become cancerous

70
Q

Cervical motion tenderness

A

pain elicited when the cervix is manipulated. Suggests inflammatory process or ectopic pregnancy

71
Q

5 components of pediatric exam?

A

nutritional, elimination, development, immunization, sleep

72
Q

4 things you check on a newborn visit:

A

weight, heart, jaundice, metabolic screen

73
Q

Amount of days babies take to regain birthweight:

A

10-14 days

74
Q

Muscle tone of a “floppy baby”:

A

hypotonic

75
Q

Muscle tone of a baby whose legs are hard to spread agart?

A

Hypertonic

76
Q

Rooting reflex

A

stroke perioral skin at the corners of the mouth

77
Q

Palmar grasp

A

baby will flex all fingers to grab on

78
Q

Plantar grasp

A

Toes curl around

79
Q

Moro (startle) reflex

A

arms with abduct and extend, hands open, legs flexed

80
Q

Placing/Stepping reflex

A

sole touch ground and hip and knee will flex upward and other foot will step forward

81
Q

Truncal Incarvation (galant’s reflex)

A

in prone position, spine will curve to stroked side

82
Q

Asymmetric tonic neck reflex

A

turn head to the side and arm and leg from that side will extend and the opposite side will flex

83
Q

Cephalohematoma

A

within periosteum of bone and cannot cross the midline. Does not involved blood. Usually result of birth trauma, usually benign.

84
Q

Caput succedaneum

A

can cross the midline

85
Q

frontal bossing

A

premature closing of suture lines

86
Q

Anticipatory guidance

A

educating parents on the development and growth of their child.

87
Q

Hemangiomas are usually resolved within

A

1 year

88
Q

Flat, blue, or gray skin markings near the buttocks, back, and shoulders

A

Mongolian spots

89
Q

esotropia

A

one eye looks in

90
Q

exotropia

A

one eye looks out

91
Q

hypertropia

A

looks up

92
Q

hypotropia

A

looks down

93
Q

IADLs

A

instrumental activities of daily living - higher level of functioning: telephoning, shopping, cooking, finances, taking meds. Poor scores on IADLs indicate independence is eroding and may need more help or move to a home

94
Q

ADLs

A

basic activities required of adults to be independent - arising, continence, dressing, eating, etc.

95
Q

Functional Assessment

A

takes 45 minutes, includes comprehensive history, physical exam, and social assessment

96
Q

Hippocratic facies

A

the face of someone who is chronically ill (hollowing of the cheeks, loss of muscle tone)

97
Q

What are the 3 things associated with the alcohol stigmata?

A

palmar erythema, gynecomastia in males, and testicular atrophy in males

Physical Diagnosis Block III (2 decks)

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