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Physical Diagnosis > PD3- Final > Flashcards

PD3- Final Flashcards

1
Q

pain, temp, crude touch

A

lateral spinothalamic tract

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2
Q

light/fine touch

A

anterior spinothalamic, posterior column tracts

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3
Q

proprioception, vibratory sense, discriminative touch?

A

posterior column tract

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4
Q

motor pathways?

A

corticospinal tract

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5
Q

serial 7s test?

A

attention

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6
Q

illusions and hallucinations?

A

perception

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7
Q

MMSE- normal?

A

27-30

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8
Q

spell world backwards
months of year forwards/backwards
series of digits

A

attention

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9
Q

logic, relevance, organization, coherence

A

thought process

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10
Q

delusions, obsessions, compulsion, phobias

A

thought content

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11
Q

pose a simple problem

A

judgment

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12
Q

quantity/rate/rhythm/volume

A

speech

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13
Q

inability to speak or understand language; lesion in dominant cerebral hemisphere

A

aphasia

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14
Q

difficulty in articulation; lesions of tongue and palate

A

dysarthria

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15
Q

difficulty in phonation, lesions of palate and vocal cords

A

dysphonia

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16
Q

difficulty speaking/comprehending

A

dysphasia

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17
Q

ask pt to read, write, and name objects

A

language

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18
Q

must speak in loud voice, delayed response

A

lethargic

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19
Q

drowsy/somnolent, shake pt, cloudy

A

obtunded

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20
Q

marked reduction in mental and physical activity, vigorous stimuli needed

A

stupor

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21
Q

reflex to assess brainstem?

if that is abnormal move to? (pt is rarely conscious in this)

A

oculocephalic reflex

oculovestibular reflex

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22
Q

? can be the only Sx in a stroke

A

vertigo

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23
Q

wake up w/ HA or pain w/ valsalva

A

increased ICP

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24
Q

intermittent jabbing pain ?

A

trigeminal neuralgia

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25
Q

OCP, amlodipine, viagra, primary pulmonary htn ?

A

causes of HA

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26
Q

1 sided blindness?

A

optic neuritis

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27
Q

optic neuritis common sign in?

A

MS

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28
Q

pituitary tumor?

A

bitemporal hemianopsia

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29
Q

> 1mm difference in pupil size?

A

CN III compression

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30
Q

> 2 mm difference pupil size?

A

anisocoria

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31
Q

sluggish pupil résponse?

A

Adie’s tonic pupil

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32
Q

afferent input in affected eye, pupils fail to constrict fully

A

marcus gunn pupil

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33
Q

lyme dz, guillan barre, MS, ALS, tumors, syphilis, polio

A

palsies can be secondary to these

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34
Q

ALS, polio seen w/

A

hypoglossal damage

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35
Q

MCC cause of atrophy

A

lack of use

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36
Q

cerebellar function assesses? 4

A

motor, sensory, cerebellar, vestibular

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37
Q

prenatal pd?

A

1st 28 days of life

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38
Q

early child hood? middle?

A

1-4, 5-10

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39
Q

assess GA by scoring against ? and ?; name?

A

New Ballard or Dubowitz score, physical and neuro

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40
Q

developmental screening test - Denver II, PEDS, CDI; most used? measures ? not ?; can miss a ?

A

denver II, dev. attainment, intelligence, language delay

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41
Q

oral health start at ?

A

12 months

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42
Q

fever is ?

A

100.4

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43
Q

fever can be good bc?

A

body’s way of fighting

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44
Q

APGAR- acronym? 3 points scale- 1 point (0-2 scale) for each ?

A 
activity (muscle tone)- arms and legs flexed
pulse- <100
grimace- grimace
appearance- pink body/blue extremities
respiration- slow/irregular
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45
Q

newborn exam- first one in?

A

first 24 hours

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46
Q

apgar
1 min- resuscitate? depression? normal?
5 min- high risk? nl

A

1 min- 0-4, 5-7, 8-10

5 min- 0-7, 8-10

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47
Q

well child exam - do w/ in ?

A

2 days of birth

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48
Q

newborn most responsive ? after meals

A

1-2h

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49
Q

? exam last .. kids hate it

A

ear; do LESS invasive FIRST

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50
Q

stranger anxiety at ?

A

9-15 months

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51
Q

middle childhood - parents stay in exam through age?

A

11

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52
Q

length measurement

<2 yo.. take length ? position

A

supine

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53
Q

short stature consider ? and ? dz

A

endocrine, GI

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54
Q

weight infants directly on scale w/out ? toddlers ?

A

diaper

standing, w/ just undies

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55
Q

head circumference measured ?

A

first 2 yrs of life

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56
Q

newborn- 6 mo. - head is ? than chest; same size as chest at ?

A

2 cm larger; 6mo-2yrs

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57
Q

associated w/ macrocephaly? 4

A

macroencephaly, autism, hydrocephalus, fragile X

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58
Q

at birth bpm is?

age 2?

A

140bpm

~100bpm

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59
Q

palpate ? or auscultate heart

A

femoral arteries

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60
Q

respirations

  • newborns
  • early childhood
  • middle childhood
  • adult rate at ?
A

30-60/min newborns
20-40
15-25
age 15 yo

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61
Q

rr - during ? is more accurate

A

sleep (in newborns)

62
Q

observe RR for how long?

A

full 60s (so variable)

63
Q

rapid resp ? w/ grunting/nasal flaring/ acc muscle use = ? or ?

A

> 40/min, bronchiolitis, pneumonia

64
Q

temp- ? preferrable; ? if less than 2 months- insert ? mm

A

ear canal, rectal temp, 2-3mm (in anal sphincter)

65
Q

begin BP measurements at age?

A

2

66
Q

acrocyanosis on ? and ? normal; BIG PROBLEM if on ? or ?

skin NOT health determinant

A

face, digits

lips, mucous membranes

67
Q 
cutis marmorata ('marbled skin')
typically first few mo., worse when ?
A

infant is cold (immature nerve supply to superficial capillary bv)

68
Q

MC over butt/lumbar region; predominant in asians, mediterranean, african descent?

A

mongolian spots

69
Q

fine downy hair in PREMATURE that disappear in a few weeks

A

lanugo

70
Q

pinhead sized smooth white raised areas on nose, chin, forehead; erythema?

A

milia; NO erythema

71
Q

acne neonatorum- papules, pustules

  • from?
  • MC in ?
  • usually dev at ?
  • tx?
A

maternal estrogen
males
3 weeks but can present at birth
self limiting

72
Q

milaria rubra aka ?

  • scattered vesicles on ?
  • heat rash common on ?
  • obstructed sweat glands
A

prickly heat
erythematous base
face/trunk

73
Q

erythema toxic

  • erythematous macules with ?
  • scattered diffusely over ?
  • etiology? tx?
A 
central pinpoint vesicles
ENTIRE BODY (to diff from milaria rubra)
unknown, self limiting
74
Q

small vesiculopustures over BROWN macular BASE (to differentiate from milia)

A

pustular melanosis

75
Q

phys jaundice peaks on?

A

day 3/4

76
Q 
nevus flammeus (port wine stain)- persists ?; typically appear on ?, vascular birthmark consisting of superficial and deep dilated capillaries in skin
-Tx?
A

throughout life, face/extremities

topical/intralesional c/s

77
Q

skin exam of infants same as adult when?

A

after 1st year

78
Q

post font closes at ?

A

2 mo

79
Q

ant font closes at ?

A

4-26 mo

80
Q

asymmetry of cranial vault?

  • from lack of ? while sleeping
  • asymmetry from ?
A

plagiocephaly
tummy time (avoid sleeping on back)
-torticollis

81
Q

caput succedaneum

  • capillary distension/extravasation of blood from ?
  • usually resolve in ? w/o comp
  • scalp swelling extends across ? and over suture lines
  • caused by?
A
  • vaccuum effect of ROM
  • first few days
  • midline
  • pressure of presenting part of scalp against dilating cervix (tourniquet effect of cervix)
82
Q

cephalohematoma

  • tearing of ?
  • more common w/ ?
  • suspect ? if fx crosses midline
  • aka ? under scalp
A

veins
forceps/vaccuum delivery
skull fx
water balloon

83
Q

hydrocephaly, rickets, congenital syphilis: PE findings?

A

pliable/springy bones upon palpation

84
Q

percussion- RESONANT when ? or ?
location?
sign? aka ?

A

hydrocephalus, abscess
junction of frontal, parietal, and temporal bones
MacEwen’s sign, ‘cracked pot’

85
Q

GA appropriate?

A

10th-90th %ile

86
Q

LEADING preventable cause of mental and physical birth defects in US?

A

FAS

87
Q

special characteristics of FAS?

A

flattened cheekbones, indistinct filtrum, poor fine motor skills, lack of imagination/curiosity

88
Q

thick/coarse hair, LARGE tongue, ? hernias ?

A

congenital hypothyroidism, umbilical

89
Q

short neck, upward slanting eyes, ? crease, widely separated ?

A

simian, 1st and 2nd, DOWN syndrome

90
Q

infancy, lymphad?

childhood?

A

rare

more common- viruses

91
Q 
VA
blinks, may regard face
fixes on objects
coordinated eye movements
eyes converge, baby reaches
acuity around 20/50
A 
birth
1 month
2 months
3 months
12 months
92
Q

blinks in response to sudden, sharp sound

A

acoustic blink reflex

93
Q

infants only have ? sinuses

A

ethmoid

94
Q

sinuses
maxillar at age?
sphenoid?
frontal?

A

4
6
6-7

95
Q

thorax/lungs best to listen?

A

from front!

96
Q

central cyanosis ALWAYS?

A

abnormal

97
Q

high risk for SIDS?

A

> 20s or <20s w/ Sx

98
Q

? easiest to palpate but do ? in infants

A

brachial, FEMORAL

99
Q

MC heart ban in infants?

A

PSVT and PAT

100
Q

infants- S3? S4?

A

normal, uncommon

101
Q

MC murmur in preschool?

adolescents?

A

still’s murmur

pulmonary flow

102
Q

infants:
bowel sounds?
liver extends 1-2 cm below?

A

HYPERactive

right costal margin

103
Q

male genital

  • urethral meatus and foreskin fully separate until?
  • 2/3 cryptoorchidism descend by ?
A

10 yo

12 months

104
Q

infant rectal- don’t check patency if ?

A

defecating normally

105
Q

at birth hands are ?

A

clenched

106
Q

most newborns are born ? (MS) and it will disappear at ~?

A

bowlegged, 18 months

107
Q

toeing in or out of foot disappears w/ ?

-if can’t be turned out on PE?

A

weight bearing

congenital abn

108
Q

absent reflexes/retention of reflex signals ?

A

dev abnormality

109
Q

rooting reflex goes away at

A

4 mo

110
Q

sucking reflex goes away at

A

3 yrs

111
Q

test CNXII w/ sucking/swallowing ability and tongue position w/ ?

A

pinch test

112
Q

if neuro exam abn, expand to include ? 3

A

sensory fxn
CN
less common primitive reflexes

113
Q

newborns ? are tactile regions

A

cheeks

114
Q

exploratory mouthing begins w/ grasping and stops around

A

6 months

115
Q

temp- more sensitive to ?

A

cold

116
Q

lack of realization of pain can be

A

congenital abn

117
Q

hearing- by D3 prefers ?

A

voices (over pure tones)

118
Q

vision- prefers to see ? at 3 months

A

faces

119
Q

VA is ? at 6 months

A

20/100

120
Q

intermodal perception- recognizes ? in mouth by ?

A

shapes, 1 month

121
Q

NORMAL: babinski positive until ?

A

2 yo

122
Q

palmar grasp goes away at

A

3 mo

123
Q

plantar grasp goes away at

A

1 yo

124
Q

moro reflex goes away at

A

6 mo (flexed legs, abducted arms, open hands)

125
Q

asymmetric tonic reflex from?

turn head to one side w/ jaw over shoulder- same side? other?

A

birth to 6 mo

arm & leg extends, other side flexes

126
Q

stepping reflex till 4w and reappears at ?

A

1-2 yo

127
Q

reflex from tapping on forehead? if blinking persists (ban)?

A

gabellar reflex

Myerson’s sign

128
Q

positive support reflex from ? to ?

A

3/4mo till thruout life

129
Q

turning of shoulder and trunk in direction of head; goes away at?

A

righting reflex, 4 mo

130
Q

when infants head pushed DOWN, legs drop down into FLEXION?

A

landau reflex aka SUPERMAN pose

131
Q

Gross Motor Skills
walk by?
run well by?
pedal tricycle/jump by?

A

15 mo
2 yrs
3 yrs

132
Q

eye exam begins at ?

refractive errors more common in?

A

3

middle childhood/adolescence

133
Q

assess mobility of TM w/ ?

A

pneumatic otoscope- use insufflator

134
Q

hearing

-under age 4? over 4?

A

whisper test, full acoustic screening

135
Q

mouth/pharynx

one tooth for ? between 6-26 mo; up to ?

A

each month, 20 primary teeth

136
Q

breast exam- onset ?, first sign of?

A

8-13 yo, puberty (male first sign of puberty: 9-13.5)

137
Q

liver size determined by ? spleen typically ?

A

percussion, palpable

138
Q

female- pubic hair before 7 =

A

precocious puberty

139
Q

MS early childhood

normal = increased? and decreased?

A

lumbar concavity, thoracic convexity

140
Q

neuro- ? not routinely tested in young children

A

DTR

141
Q

baby sleeping during day and awake at night - NORMAL; usually first ?

A

4-8 weeks; train w/ cycled lighting, feeding schedules, dec stimulation at night

142
Q

umbilical cord falls off at

A

2 weeks

143
Q

bathe babies ?

A

1x/week

144
Q

baby pooping

A

once every 5 days to 5 times a day

145
Q

face car seat BACKWARDS until ? or ?

A

1 yr or 20 lbs

146
Q

colic disappears at ?

A

3-4 months

147
Q

after 6 mo only use pacifier when? wean pacifier and stop altogether at ?

A

falling asleep, 10 months

148
Q

breast milk can store in freezer up to ? and in fridge?

A

3 mo, 48 hours

149
Q

honey dang if less than

A

2 yrs

150
Q

throw bottle away at ? NO NEED TO WEAN

A

9 months

151
Q

irregular/unequal pupils; weak/absent reaction to light? can be from?

A

argyll robertson pupil

neurosyphilis

Physical Diagnosis (4 decks)

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