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PDX Flashcards

1
Q

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

A

Nonmaleficence

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2
Q

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

A

Beneficence

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3
Q

Korotkoff Sounds

A

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

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4
Q

Blood pressure ranges

A

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

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5
Q

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

A

Orthostatic hypotension

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6
Q

Causes of Orthostatic Hypotension

A

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

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7
Q

Technique for orthostatic hypotension

A

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

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8
Q

Do you use the bell or diaphragm to measure ausculatory pressure

A

BELL

inflate 30 above

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9
Q

White coat hypertension

A

> 140/90

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10
Q

Pyrexia Fever temp

A

greater than 98.6

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11
Q

Hyperpyrexia fever temp

A

> 106 F

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12
Q

Hypothermia Fever Temp

A

< 95 F

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13
Q

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

A

BRADYPNEA

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14
Q

breathing with freq. sighs caused by hyperventilation syndrome

A

Sighing respiration

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15
Q

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

A

Tachypnea

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16
Q

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

A

Cheyne-Stokes breathing

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17
Q

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

A

Obstructive breathing

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18
Q

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

A

Hyperpnea

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19
Q

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

A

Kussmaul breathing

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20
Q

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

A

Ataxic breathing

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21
Q

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

A

Nociceptive Pain (somatic)

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22
Q

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

A

Neuropathic Pain

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23
Q

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

A

Central sensitization pain

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24
Q

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

A

Carotene

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25
Q

Short, fine, nonpigmented hair

A

Vellus

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26
Q

Coarser, thicker, conspicous, usually pigmented hair

A

Terminal

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27
Q

White free edge of nail plate

A

Lanula

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28
Q

Seal between proximal nail fold and nail plate

A

Cuticle

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29
Q

this type of sweat gland is everywhere and regulates body temp

A

ECCRINE

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30
Q

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

A

Apocrine

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31
Q

Sebaceous glands produce their fatty substance through

A

Hair follicles everywhere but palms and soles

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32
Q

red, swollen, and tender nail folds

A

Paronochia

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33
Q

enlarged nail free edge

A

Oncholysis

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34
Q

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

A

Terrys Nails

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35
Q

white spots on nails

A

Leukoychia

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36
Q

Traverse white bands on nails

A

Mees Lines

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37
Q

Transverse linear depressions on nails

A

Beaus Lines

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38
Q

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

A

Nail Clubbing

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39
Q

Difference between plaque and papule

A

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

40
Q

Difference between vesicle and bulla

A

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

41
Q

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

A

URTICARIA

42
Q

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

A

Wheal

43
Q

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

A

Purpura

44
Q

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

A

lichenification

45
Q

blanchable lesions

A

erythema
spider angioma
spider vein
cherry angioma

46
Q

non blanchable lesions

A

petechia/purpura
ecchymosis

47
Q

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

A

LATERAL SIDE

48
Q

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

A

sternal angle anteriorly and T4 spinous process posteriorly

49
Q

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

A

Pectus Excavatum

50
Q

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

A

Barrel Chest

51
Q

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

A

Dyspnea

52
Q

May show this breathing pattern while sleeping

A

Cheyne-Stokes Breathing

53
Q

diphragmatic excursion length usually

A

5-6cm

54
Q

Causes of when FREMITUS is decreased or absent:

A

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

55
Q

What increases fremitus

A

UNILATERAL pnemonia

56
Q

Abnormally high level for diphragmatic excursion is indicative of

A

Pleural effusion
high diaphragm from atelectasis
diaphragmatic paralysis

57
Q

Positive tests of egophony, whispered pectoriloquy, bronchophony indicate

A

pleural effisions and pneumonia

58
Q

discontinous, intermittent brief, like dots in time

A

CRACKLES

59
Q

Late Inspiratory Crackles

A

Interstital lung disease, early CHF

60
Q

Early Inspiratory Crackles

A

Chronic bronchitis, asthma

61
Q

Midinspiratory and expiratory crackles

A

Bronchiectasis

62
Q

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

A

Mediastinal Crunch
Hammans Sign

63
Q

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

A

WHEEZES

64
Q

airway is narrowed so much that wheezing cant be produced

A

Silent Chest
found in severe obstructive pulmonary

65
Q

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

A

Stridor

66
Q

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

A

Rhonchi

67
Q

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

A

ATRIA
Ventricles – systole

68
Q

What valves are open during DIASTOLE

A

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

69
Q

During SYSTOLE what valbes are closed

A

TRICUSPID and MITRAL = S1 sound lub

70
Q

The systolic murmur occurs between what

A

S1 and S2
ASsociated with ventricular ejection

71
Q

Diastolic murmurs occur between

A

S2 and S1
associated with ventricular relaxing and filling

72
Q

What sound is the atrial sound or atrial gallop

A

S4

73
Q

JVP reflects pressue in what part

A

RIGHT ATRIUM
elevated JVP – right side CHF

74
Q

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

A

APPENDICITIS

75
Q

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

A

Cholecytitis

76
Q

sloshing sound when patient moves from side to side

A

Succussion Splash

77
Q

this can be heard in patients with high blood pressure

A

BRUITS

if heard in systolic/diastole – arterial occulusion/insufficency

78
Q

Rebound tenderness suggests

A

Peritoneal inflammation that can come with appendicitis

79
Q

Positive iliopsoas and obturator test indicate what diagnostically

A

APPENDICTIS

80
Q

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

A

TENESMUS

81
Q

red blood in the stool

A

Hematochoezia

82
Q

black tarry stools

A

Melena

83
Q

Smooth large tender liver suggests

A

Inflammation
if NONtender = cirrhosis

84
Q

Kidney enlargement indicates

A

hydronephrosis, cysts and tumors
Bilateral enlargements – polycystic kidney disease

85
Q

Pyelonephritis is an infection of what

A

Kidney and ureters

86
Q

indicators of oropharyngeal dysphagia include

A

Drooling, naopharyngeal regurgitation and cough

87
Q

Odynophagia = pain on swallowing
Consider what

A

esophageal ulceration from radiation

88
Q

an increased hydrostatic pressure in cirrhosis can cause

A

ASCITES

89
Q

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

A

Abdominal Aortic aneurysm
pain may signal a rupture

90
Q

T5-9 Left

A

Stomach

91
Q

T7-T9 Left

A

Spleen/Pancreas

92
Q

T6/7-T9

A

Liver/Gallbladder

93
Q

T9-10

A

Small Intestine

94
Q

T10-L1

A

Kidney

95
Q

T10-T11 Right

A

Right Colon

96
Q

T12-L2 Left

A

Left Colon

PDX (2 decks)

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