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PCM > Midterm > Flashcards

Midterm Flashcards

1
Q

COMPREHENSIVE hx

A

New patients
Hospital admission patients
Consultations
Annual Physicals

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2
Q

quiet pt

A

open ended

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3
Q

talkative pt

A

Use direct questions to fill in the gaps or direct the encounter. Transitional statements and summarizing works well.

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4
Q

INCAPACITATED PATIENT

A

Seek information from other people, EMT, family members, old records.
Detailed physical exam is essential.

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5
Q

Confusing Patient

A

Use direct questioning.

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6
Q

most impt reason for dr selection

A

provider’s interpersonal skills

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7
Q

Para linguistics

A

Tone, Rhythm, Pace/rate, Vibrancy, Volume, Pauses/silence, Encouraging gestures/sounds/nodding

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8
Q

health

A

A state of complete physical, mental and social well being and not merely the absence of disease or infirmity.”

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9
Q

global health 3 criteria

A

for the poor

1) Equitable access (to both prevention and treatment services, rural and urban)
2) Affordability regardless of income
3) Sustainability of services through long term political and financial support

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10
Q

leading risk factor of health

A

poverty

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11
Q

best prevention

A

education

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12
Q

4 leading causes of death overall

A

1) Ischemic Heart Disease
2) Cerebrovascular Disease/stroke
3) COPD
4) Lower Respiratory Infections

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13
Q

4 leading causes of infectious disease death

A

LRI
diarrhea
HIV/AIDS
TB

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14
Q

top 3 single organism killers

A

HIV/AIDS
Tuberculosis
Malaria

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15
Q

leading killer of HIV+ pts

A

TB is a leading killer of HIV-positive people

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16
Q

ebola

A

Human to human transmission via direct contact with blood or body fluids from an infected person.

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17
Q

secondary lesion

A

evolve from primary skin lesions, either because of the natural history of the disorder (e.g., crusts in chicken pox) or because of scratching or infection.

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18
Q

vellus hair

terminal hair

A

vellus-peach fuzz

terminal-pubic

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19
Q

3 phases of hair growth

A

Catagen phase – transitional phase – 3%
Telogen phase – resting phase – 10-15%
Anagen phase – Growing phase – 85-90%

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20
Q

clubbing causes

A 
Congenital  
Chronic hypoxia
Heart disease
Lung cancer
Hepatic cirrhosis
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21
Q

nail pits

A

psoriosis

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22
Q

mees and beaus lines

A

chemo

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23
Q

mobility and turgor

A

Note ease with which it lifts up (mobility) and speed with which it returns to place (turgor).

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24
Q

extensor surface skin lesion

A

psoriosis

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25
Q

flexor surface

A

atopic dermatitis

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26
Q

Macule

A

vitiligo

flat less than 1cm

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27
Q

patch

A

cafe au lait

flat more than 1cm

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28
Q

papule

A

psoriosis

small raised lesion

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29
Q

plaque

A

large raised lesion

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30
Q

nodule

A

dermafibroma

firm, hard lesion, deeper than a papule, greater than 0.5 cm

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31
Q

cyst

A

nodule filled with material, liquid or semi-solid.

Often encapsulated.

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32
Q

vesicles

A

herpes
fluid filled lesions less than 1.0 cm.
Single or in clusters.

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33
Q

bulla

A

fluid filled lesion greater than 2.0 cm.

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34
Q

wheal

A

urticaria
superficial localized raised area of skin.
Blanche with pressure.

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35
Q

scale

A

Ichthyosis vulgaris

flaking of dead exfoliated epidermis.

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36
Q

crust

A

impetigo

dried residue of skin exudates such as serum, pus or blood.

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37
Q

fissure

A

tinea pedis

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38
Q

ulcer

A

deep epidermis loss

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39
Q

Lichenification

A

thickening of the epidermis and roughing of the skin surface often from rubbing or scratching.

40
Q

Excoriation

A

linear erosions caused by scratching.

41
Q

Koebner phenomena

A

skin trauma from scratching may cause new lesions spreading poisin ivy.

42
Q

KOH

A

fungus-hyphae

43
Q

tzanck

A

herpes (giant cells)

44
Q

oil mount

A

scabies

45
Q

BCC

A

80% of the skin cancers
Grow slowly, rarely metastasize
“rodent ulcer”
pearly white with talengitelisis

46
Q

SCC

A

Arise from the upper layer of the epidermis
Can metastasize
actinic keratoses

47
Q

left shift Neutrophil

A

more immature cells-May indicate Bacterial Infection, toxemia, hemorrhage, more acute problems

48
Q

right shift neutrophil

A

more mature cells Liver disease, megaloblastic anemia, iron def. disease, more chronic problems?

49
Q

hyperglycemia

A

DM

50
Q

hypoglycemia

A

pancreatic disease

51
Q

high bun:creatine

low bun: Creatine

A

prerenal-dehydration

renal issue

52
Q

AST>ALT

A

alchoholic hep

53
Q

ALT>AST

A

viral hep

54
Q

JNC-VII

A

pre=120-39/80-89
stage 1= 140-59/90-99
Start drugs
stage 2= >160/>100

55
Q

JNC-VIII

A

In general population, initiate pharmacologic tx when
BP is 150/90 or greater ; adults age 60 or older
BP is 140/90 or greater; adults younger 60 years

In patients with HTN and diabetes, initiate pharm tx when BP is 140/90 or greater*, regardless of age.

56
Q

orthostatic hypotension

A

Drop of >20mm systolic or >10mm diastolic

57
Q

BMI

A

18.5-24.9=normal
25-29.9=overweight
30-39=obese
>40= extreme obese

58
Q

most impt part of eye exam

A

visual acuity

59
Q

autophony

A

chronically open Eustachian Tube

60
Q

parts to see in ear

A

malleus, cone of light, incus, pars tensa and pars flaccida

61
Q

Nonmobile TM

A

fluid, mass, sclerosis

62
Q

Hypermobile TM:

A

ossicle bones disrupted

63
Q

conductive loss

A

BC>AC, external and middle ear, foreign body, ottits media, perforated eardrum, osteoclerosis

64
Q

sensoneurial loss

A

When the inner ear cochlear nerve is abnormal, this defines sensorineural hearing loss and both bone and air conduction is poor.

loud noise, inner ear infxn, tumors, aging

65
Q

Sudden vision loss

A

retinal detachment
vitreous hemmorage
CVA (stroke)

66
Q

gradual vision loss

A 
cataracts
glaucoma
HIV-CMV
Diabetes
macular degeneration
67
Q

presbyopia

A

aging vision- hard seeing close

68
Q

heterophoria

A

cross eye (bad eye moves in cover test)
2 types
esophoria-inward
exophoria-outward

69
Q

anterior chamber

A

bw cornea and iris

70
Q

post chamber

A

bw iris and lens

71
Q

homonymous hemianopsia

A

w/b w/b left to right

named for region you can’t see out of

72
Q

bitemporal hemianopsia

A

b/w w/b left to right

caused by pituitary tumor

73
Q

horizontal defect

A

top to bottom difference

74
Q

blephoritis

A

inflamed lid margins

75
Q

entropion

A

eyelid inwards

76
Q

ectropion

A

eyelid outward

77
Q

Bulbar conjunctiva

Palpebral conjunctiva

A

covers the anterior eye

lines the eyelids

78
Q

anisocoria

A

unequal pupils

79
Q

accomadation

A

near and far

80
Q

convergence

A

near coming closer

81
Q

fundus

A

Optic disc (blind spot) in middle of physiologic cup
Retina
Retinal vessels

82
Q

medial to lateral in eye

A

disc, macula, fovea

83
Q

Pinguecula

A

small nodule on the bulbar conjunctiva, does not cross over to the cornea.

84
Q

Pterygium

A

thickening of the bulbar conjunctiva which grows across the cornea.

85
Q

sty

A

infxn at margin of eyelid

86
Q

chalazion

A

painless nodule involving the meibomian gland

87
Q

bells palsy

A

CN 7

88
Q

conjunctivitis

A

bottom up

89
Q

ciliary injection

A

limbus to out;
corneal injury, iritis, glaucoma

inflammation of the radiating vessels around the limbus. Very painful, vision affected. Can be a ocular emergency.

90
Q

papilledema

A

disc is swollen with blurred margins. Physiologic cup is not visible. Increased intracranial pressure.

91
Q

Glaucomatous cupping

A

Increased intraocular pressure. Causes increased disc cupping. The physiologic cup is enlarged occupying more than half of the Disc’s diameter.

92
Q

HTN eye chnages

A

AV nicking-veins taper as artery crosses

copper wiring-thickened arteries

Cotton wool patches – infarcted nerve fibers.
Can also be seen in patients with diabetes.

93
Q

av nicking

A

veins taper as artery passes in HTN

94
Q

cotton wool patches

A

infarcted nerve fibers.

Can be seen in patients with HTN or diabetes.

95
Q

List things that factor in health determination

A
  • Income
  • Education
  • Knowledge of healthy behaviors
  • Social status
  • Sex
  • Genetic makeup
  • Access to health care
96
Q

Explain why we have multi-drug resistant and XDR tuberculosis.

A

Multi-drug resistant: Once diagnosed, insufficient means to follow through with full treatment, causing some of organism to become drug-resistant

  • Can be due to price, insufficient infection control, side effects of the medications
  • Complacency of government acknowledgement and response to disease itself (in wealthy and disease-endemic countries)

XDR: Extensively drug-resistant

PCM (2 decks)

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