PDX

Question 1

do no harm, never want to give a patient information that you dont is true, dont avoid relevant topics

Answer 1

Nonmaleficence

Question 2

Your actions need to be motivated by what is in the patients best interest

Answer 2

Beneficence

Question 3

Korotkoff Sounds

Answer 3

Normally patients blood flow through an artery produces no audible sounds
When a pressure cuff is applied and inflated above the systolic pressure in the artery the collapse stops flow and also produces no audible sounds
as the pressure in the cuff is reduced, the external pressure surrounding the artery becomes less than systolic allowing blood to rush into the artery and produce korotkoff sounds

Question 4

Blood pressure ranges

Answer 4

Normal: <120 / <80
Prehypertension: 120-139/ 80-89
Hypertension 1: 140-159 / 90-99
Hypertension 2: >=160 / >=100

Question 5

A fall in systolic pressure of 20mmHg or more after standing, especially when accompanied by symptoms and tachycardia
Diastolic fall of > 10

Answer 5

Orthostatic hypotension

Question 6

Causes of Orthostatic Hypotension

Answer 6

Drugs, moderare or severe blood loss
prolonged bed rest
diseases of the ANS

Question 7

Technique for orthostatic hypotension

Answer 7

Measure BP/HR with patient supine after patient is resting up to ten min, wait 3 min
Repeat measurements with patient standing

Question 8

Do you use the bell or diaphragm to measure ausculatory pressure

Answer 8

BELL

inflate 30 above

Question 9

White coat hypertension

Answer 9

> 140/90

Question 10

Pyrexia Fever temp

Answer 10

greater than 98.6

Question 11

Hyperpyrexia fever temp

Answer 11

> 106 F

Question 12

Hypothermia Fever Temp

Answer 12

< 95 F

Question 13

slowed breathing, caused by diabetic coma, drugs, and increased intracranial pressure

Answer 13

BRADYPNEA

Question 14

breathing with freq. sighs caused by hyperventilation syndrome

Answer 14

Sighing respiration

Question 15

rapid shallow breathing caused by restrictive lung disease, pleuritic chest pain, and elevated diaphragm

Answer 15

Tachypnea

Question 16

periods of deep breathing (hyperpnea) followed by periods of apnea (no breathing), may be in children and elederly while sleeping, alo caused by heart failure, uremia, drugs and brain damage

Answer 16

Cheyne-Stokes breathing

Question 17

prolonged expiration b/c narrowed airways, increased resistance to airflow, caused by asthma, chronic bronchitis and COPD

Answer 17

Obstructive breathing

Question 18

hyperventilation = rapid deep breathing, caused by exercise, anxiety, and metabolic acidosis

Answer 18

Hyperpnea

Question 19

= always deep breathing, but can be fast, normal or sloq

Answer 19

Kussmaul breathing

Question 20

(biots breating) = unpredicatble irregularity – may be shallow or deep and stop for short periods, caused by respiratory depression and brain damage

Answer 20

Ataxic breathing

Question 21

= pain is linked to tissue damage to the skin, musculoskeltal system or viscera but the sensory system is intact

Answer 21

Nociceptive Pain (somatic)

Question 22

= is a direct consequence of a lesion or disease affecting the esomatosensory system

Answer 22

Neuropathic Pain

Question 23

= there is alteration of central nervous system processing of sensation, leading to amplification of pain signals

Answer 23

Central sensitization pain

Question 24

This pigment is golden yellow in subcutaneous fat and heavily keratinzed areas (palms/soles)

Answer 24

Carotene

Question 25

Short, fine, nonpigmented hair

Answer 25

Vellus

Question 26

Coarser, thicker, conspicous, usually pigmented hair

Answer 26

Terminal

Question 27

White free edge of nail plate

Answer 27

Lanula

Question 28

Seal between proximal nail fold and nail plate

Answer 28

Cuticle

Question 29

this type of sweat gland is everywhere and regulates body temp

Answer 29

ECCRINE

Question 30

This type of sweat gland is found in the axillary and genital areas, stress stench comes from bacterial decomposition

Answer 30

Apocrine

Question 31

Sebaceous glands produce their fatty substance through

Answer 31

Hair follicles everywhere but palms and soles

Question 32

red, swollen, and tender nail folds

Answer 32

Paronochia

Question 33

enlarged nail free edge

Answer 33

Oncholysis

Question 34

ground glass appearance, distal band of reddish brown, obliteration of lunula (nails)

Answer 34

Terrys Nails

Question 35

white spots on nails

Answer 35

Leukoychia

Question 36

Traverse white bands on nails

Answer 36

Mees Lines

Question 37

Transverse linear depressions on nails

Answer 37

Beaus Lines

Question 38

bulbous swelling of the soft tissue at the nail base, with loss of the normal angle between the nail and proximal nail fold vasodilation congenital heart disease

Answer 38

Nail Clubbing

Question 39

Difference between plaque and papule

Answer 39

Both are elevated superficial lesions Plaque = 1cm or larger Papule = 1cm or lesss

Question 40

Difference between vesicle and bulla

Answer 40

Both are fluid filled cavities Vesicle is 1cm or less Bulla is 1cm or more

Question 41

AKA hives, a raised, itchy wheal that is usually a sign of an allergic reaction

Answer 41

URTICARIA

Question 42

somewhat irregular, relatively transient, superficial area of localized skin edema

Answer 42

Wheal

Question 43

red or purple disclorations on the skin that do not blanch on applying pressure

Answer 43

Purpura

Question 44

visible and palpable leathery induration and thickening of the epidermis , often from chronic rubbing

Answer 44

lichenification

Question 45

blanchable lesions

Answer 45

erythema spider angioma spider vein cherry angioma

Question 46

non blanchable lesions

Answer 46

petechia/purpura ecchymosis

Question 47

Which side of the chest wall is best to hear all the lobes of the lungs

Answer 47

LATERAL SIDE

Question 48

Tracheal Position the trachea bifurcates into its mainstem bronchi at the levels of:

Answer 48

sternal angle anteriorly and T4 spinous process posteriorly

Question 49

funnel chest is characterized by a depression in the lower portion of the sternum, compression of the heart and great vessels may cause murmurs

Answer 49

Pectus Excavatum

Question 50

this chest has an increased anteroposterior diameter This shape is normal during infancy and often accompanies normal aging and COPD

Answer 50

Barrel Chest

Question 51

nonpainful uncomfortable awareness of breathing that is inappropriate to the level of exertion (SOB)

Answer 51

Dyspnea

Question 52

May show this breathing pattern while sleeping

Answer 52

Cheyne-Stokes Breathing

Question 53

diphragmatic excursion length usually

Answer 53

5-6cm

Question 54

Causes of when FREMITUS is decreased or absent:

Answer 54

Very thick chest wall Obstructed bronchus COPD seperation of the pleural surfaces by fluid (pleural effusion) neoplasms

Question 55

What increases fremitus

Answer 55

UNILATERAL pnemonia

Question 56

Abnormally high level for diphragmatic excursion is indicative of

Answer 56

Pleural effusion high diaphragm from atelectasis diaphragmatic paralysis

Question 57

Positive tests of egophony, whispered pectoriloquy, bronchophony indicate

Answer 57

pleural effisions and pneumonia

Question 58

discontinous, intermittent brief, like dots in time

Answer 58

CRACKLES

Question 59

Late Inspiratory Crackles

Answer 59

Interstital lung disease, early CHF

Question 60

Early Inspiratory Crackles

Answer 60

Chronic bronchitis, asthma

Question 61

Midinspiratory and expiratory crackles

Answer 61

Bronchiectasis

Question 62

precordial crackles synchronous with heartbeat, not respiration Best heard in left lateral position due to mediastinal emphysema

Answer 62

Mediastinal Crunch Hammans Sign

Question 63

Continous, relatively high-pitched with hissing or shrill quality Musical, often audible at mouth and through chest wall Narrow airways, astma, COPD, chronic bronchitis, CHF

Answer 63

WHEEZES

Question 64

airway is narrowed so much that wheezing cant be produced

Answer 64

Silent Chest found in severe obstructive pulmonary

Question 65

Wheeze is entirely or predominantly inspiratory Partial obstruction of larynx or trachea

Answer 65

Stridor

Question 66

Continous, musical, low-pitched with snoring quality Secretions in large airways

Answer 66

Rhonchi

Question 67

During diastole there is contraction of and during systole there is contraction of

Answer 67

ATRIA Ventricles -- systole

Question 68

What valves are open during DIASTOLE

Answer 68

TRICUSPID and MITRAL valves (aortic and pulmonic are closed = S2)

Question 69

During SYSTOLE what valbes are closed

Answer 69

TRICUSPID and MITRAL = S1 sound lub

Question 70

The systolic murmur occurs between what

Answer 70

S1 and S2 ASsociated with ventricular ejection

Question 71

Diastolic murmurs occur between

Answer 71

S2 and S1 associated with ventricular relaxing and filling

Question 72

What sound is the atrial sound or atrial gallop

Answer 72

S4

Question 73

JVP reflects pressue in what part

Answer 73

RIGHT ATRIUM elevated JVP -- right side CHF

Question 74

Positive Rovsings Palpation of the LLQ increases the pain felt in the RLQ

Answer 74

APPENDICITIS

Question 75

Positive murphys sign indicates Patient places hand below right anterior costal margin midclavicular and the patient is told to inspire

Answer 75

Cholecytitis

Question 76

sloshing sound when patient moves from side to side

Answer 76

Succussion Splash

Question 77

this can be heard in patients with high blood pressure

Answer 77

BRUITS | if heard in systolic/diastole -- arterial occulusion/insufficency

Question 78

Rebound tenderness suggests

Answer 78

Peritoneal inflammation that can come with appendicitis

Question 79

Positive iliopsoas and obturator test indicate what diagnostically

Answer 79

APPENDICTIS

Question 80

during bowel movements, an intense urge with straining but little or no result

Answer 80

TENESMUS

Question 81

red blood in the stool

Answer 81

Hematochoezia

Question 82

black tarry stools

Answer 82

Melena

Question 83

Smooth large tender liver suggests

Answer 83

Inflammation if NONtender = cirrhosis

Question 84

Kidney enlargement indicates

Answer 84

hydronephrosis, cysts and tumors Bilateral enlargements -- polycystic kidney disease

Question 85

Pyelonephritis is an infection of what

Answer 85

Kidney and ureters

Question 86

indicators of oropharyngeal dysphagia include

Answer 86

Drooling, naopharyngeal regurgitation and cough

Question 87

Odynophagia = pain on swallowing Consider what

Answer 87

esophageal ulceration from radiation

Question 88

an increased hydrostatic pressure in cirrhosis can cause

Answer 88

ASCITES

Question 89

a periumblical or upper abdominal mass with expansile pulsations that are 3cm or more wide would suggest

Answer 89

Abdominal Aortic aneurysm pain may signal a rupture

Question 90

T5-9 Left

Answer 90

Stomach

Question 91

T7-T9 Left

Answer 91

Spleen/Pancreas

Question 92

T6/7-T9

Answer 92

Liver/Gallbladder

Question 93

T9-10

Answer 93

Small Intestine

Question 94

T10-L1

Answer 94

Kidney

Question 95

T10-T11 Right

Answer 95

Right Colon

Question 96

T12-L2 Left

Answer 96

Left Colon