Neuro + abd beyonce

Question 2

1) Acute, unilateral loss of sensation should be concerning first and foremost for what?
2) What 3 symptoms can occur with some focal seizures or with atypical migraine?
3) What type of sensation loss is correlated heavily with advanced and uncontrolled diabetes?

Answer 2

1) Stroke
2) Numbness, tingling, and paresthesia
3) Distal, chronic, and bilateral

Question 3

1) Stroke is characterized by what kind of sensation loss?
2) What 2 conditions are associated with numbness, tingling, or paresthesia?

Answer 3

1) Acute, unilateral
2) Some focal seizures or with atypical migraine

Question 4

1) What can cause syncope? What is key?
2) Give examples of potential causes

Answer 4

1) Can be varied; details are key.
2) Vasovagal response, orthostatic hypotension, mechanical cardiac failure, arrhythmia, the (rare) central nervous cause, sudden PE, electrolyte imbalance, blood sugar imbalance, psychogenic cause

Question 5

List 8 potential causes of syncope

Answer 5

1) Vasovagal response
2) Orthostatic hypotension
3) Mechanical cardiac failure
4) Arrhythmia, the (rare) central nervous cause
5) Sudden PE
6) Electrolyte imbalance
7) Blood sugar imbalance
8) Psychogenic cause

Question 6

What is the mnemonic to remember the warning signs/ symptoms of a stroke? (according to AHA/ ASA)

Answer 6

FAST
1) Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
2) Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
3) Speech Difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
4) Time to call 9-1-: if someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately.
-Check the time so you’ll know when the first symptoms appeared

Question 7

1) Where is the biceps reflex?
2) How is it tested?

Answer 7

1) C5,C6
2) Elbow flexed, forearm pronated, thumb or finger over biceps tendon

Question 8

1) Where is the triceps reflex?
2) Where is the brachioradialis reflex?
2) How is the brachioradialis tested?

Answer 8

1) C6,C7
2) C5,C6
3) Rest hand on abdomen or lap, forearm slightly pronated, strike 1-2 in above the wrist

Question 9

1) Where are the quadriceps or patellar reflexes?
2) Where are the Achilles or ankle reflexes?
3) How are Achilles/ ankle reflexes tested?

Answer 9

1) L2 - L4
2) Primarily S1)
3) Dorsiflex the foot and strike

Question 10

1) What is the C2 dermatome?
2) What is the C3 dermatome?

Answer 10

1) Ear and upper neck
2) Bottom of neck and clavicle to shoulder both anterior and posterior

Question 11

What is the T10 dermatome?

Answer 11

Umbilical

Question 12

What is the L1 dermatome?

Answer 12

Inguinal (“bikini” line)

Question 13

What is the C6 dermatome?

Answer 13

Lateral forearm and distal lat bicep, plus thumb and pointer finger

Question 14

What is the C8 dermatome?

Answer 14

Medial arm and ring and little fingers + part of wrist

Question 15

1) What is the L4 dermatome?
2) What is the L5 dermatome?

Answer 15

1) Anterior knee and thigh from lateral to medial side going downward
2) Anterior shin from lateral to medial, plus ankle and big toe + toe next to it both anterior and posterior

Question 16

1) Colicky (comes and goes) pain located in the RUQ that radiates to the back is often ____________.
2) Constant burning and stabbing pain in the LUQ/epigastrium that cuts to the back is often ______________.
3) Colicky aching pain in the flank that radiates to the groin is often __________________.

Answer 16

1) gallbladder
2) pancreatitis
3) renal/ureteral calculus

Question 17

1) Pain that begins at the umbilicus and localizes later to the RLQ, becoming more intense, is often ______________.
2) Unilateral lower quadrant pain that is tearing and increasing in intensity can be __________________
3) Suprapubic pain with burning dysuria and frequency is often ______________.

Answer 17

1) appendicitis
2) ectopic pregnancy
3) cystitis

Question 18

1) Left lower quadrant pain with bloody stools in the elderly is often ______________
2) Burning pain in the epigastrium without radiation is often ________________ and sometimes ________________

Answer 18

1) diverticulitis
2) gastritis and sometimes MI (watch out)

Question 19

1) Difficulty swallowing, painful swallowing can indicate what two things?
2) Vomiting blood is indicative of what?
3) “Coffee ground consistency” of vomitus is often what?

Answer 19

1) GERD, Cancer
2) Cancer, esophageal varices, Malory Weis tear
3) Digested blood

Question 20

1) Define hematochezia
2) Dark-tarry stool (melena) is often what? What part of the GI is this?

Answer 20

1) Blood in stool
2) Slow and chronic bleed; probably will be lower GI, but occasionally slow “upper GI”

Question 21

1) Bright red blood on TP is often what?
2) Bright red blood filling the toilet can be what two things?

Answer 21

1) Hemorrhoids
2) Inflammatory bowel disease, cancer

Question 22

1) What can jaundice indicate?
2) What can recurrent diarrhea indicate?

Answer 22

1) Liver dysfunction
2) Inflammatory bowel disease, irritable bowel syndrome, c. difficile, malabsorption, medicines (antibiotics)

Question 23

1) What can recurrent vomiting indicate?
2) What can recurrent constipation indicate?

Answer 23

1) Ulcer, gastritis, GERD
2) Irritable bowel syndrome, hypothyroid, anticholinergic meds

Question 24

1) Dark stool can indicate what?
2) What about pencil thin stool?
3) What about gray and soft stools?

Answer 24

1) Lower GI bleed
2) Colon cancer
3) Pancreatic cancer

Question 25

1) What can bloody urine indicate?
2) What 3 things can dark urine indicate?
3) What can pain with fever, chills, sweats, shakes indicate? Give examples

Answer 25

1) Bladder cancer
2) Renal disease, hematuria, rhabdomyolysis
3) Infectious process: Pyelonephritis, appy, intraabdominal abscess, possible perforation

Question 26

List 10 red flags for the abdominal region

Answer 26

1) Pain (many different kinds can be red flags)
2) Difficulty swallowing, painful swallowing
3) Vomiting blood
4) Blood in the stool (hematochezia)
5) Jaundice
6) Recurrent vomiting, diarrhea, or constipation
7) Change in stool consistency or color
8) Bloody urine
9) Dark urine
10) Pain with fever, chills, sweats, shakes

Question 27

What are the risk factors for abdominal aortic aneurysm?

Answer 27

Male, over 65, a smoker
*and having 1st degree relative with hx of AAA repair

Question 28

1) Define guarding
2) What must guarding be in order to count?

Answer 28

1) A voluntary contraction of the abdominal wall, often accompanied by a grimace that may diminish when the patient is distracted.
2) Severe

Question 29

1) Define rigidity. What causes it?
2) Define rebound tenderness
3) How do you assess rebound tenderness? When is the maneuver positive? What should you then do?

Answer 29

1) An involuntary reflex contraction of the abdominal wall from peritoneal inflammation that persists over several examinations.
2) Rebound tenderness refers to pain expressed by the patient after the examiner presses down on an area of tenderness and suddenly removes the hand.
3) Ask the patient “Which hurts more, when I press or let go?” Press down with your fingers firmly and slowly, then withdraw your hand quickly.
-The maneuver is positive if withdrawal produces pain.
-Percuss gently to check for percussion tenderness.

Question 30

What are the 3 signs of peritonitis?

Answer 30

1) Guarding
2) Rigidity
3) Rebound tenderness

Question 31

1) What do the 3 signs of peritonitis say about its likelihood?
2) What causes peritonitis?
3) Give 4 examples of these causes

Answer 31

1) Double the likelihood of peritonitis
2) Disease that has spread to inflame the peritoneum
3) Appendicitis (esp. if ruptured), advanced cholecystitis, perforated bowel wall, abscess