PDx vocab, exam 1 Flashcards
1
Q
LOC: alert patient who opens eyes, focuses on you, responds fully and appropriately to stimuli
A
Alert
2
Q
LOC: pt must be shaken as if waking a sleeping person. Eyes open but responses are slow and somewhat confused. Requires you to force them to focus
A
obtunded
3
Q
LOC: pt is unarousable. eyes closed. no evident response to inner needs or external stimuli
A
coma
4
Q
LOC: pt responds to loud voices. Pt appears drowsy but opens eyes and responds to questions and then falls back to sleep. Focuses with effort, but not without encouragement
A
Lethargic
5
Q
LOC: Patient arouses from sleep only after painful stimuli. verbal responses are slow or absent. patient lapses into unresponsive state when the stimulus ceases
A
stupor
6
Q
What is the formula for BMI?
A
[(wt# x 700)/ht”]/ht”
7
Q
FACIES: small, round head, flattened nasal bridge, prominent epicanthl folds, small low-set ears, large tongue, (Also hypotonia, simian lines, MR)
A
Trisomy21 Down Syndrome
8
Q
What do you call it when a patient only has a single crease line on the palm of the hand?
A
Simian line
9
Q
FACIES: moon face, flushed cheeks, excessive hair growth
A
Cushings
10
Q
FACIES: warm, moist, soft, velvet skin. Thin hair, exophthalmos (also pretibial myedema)
A
Grave’s Dz
11
Q
FACIES: dry rough pale skin, course brittle hair, alopecia, thin brittle nails, thinning of lateral eyebrows, dull puffy face, edema, especially around the eyes
A
hypothyroid
12
Q
FACIES: elongated head, bony prominent forehead, enlarged soft tissures of mouth, nose, and ears, prominent jaw
A
acromegaly
13
Q
FACIES: dry skin, temporal wasting, dental caries
A
Anorexia
14
Q
What do FACIES actually mean?
A
You can draw conclusions about a patient’s underlying health condition based on just looking at them during your general survey.
15
Q
What pressure change constitutes orthostatic BP?
A
First reading taken in supine position. Second reading taken within 3 minutes of standing from supine position. Pressure in second reading is positive for orthostatic hypotension if the Systolic drops >20mmHg OR the Diastolic drops >10mmHg
16
Q
A pulse can be weak or bounding. These are examples of _____________
A
amplitude
17
Q
The diastolic flow of blood from the aorta into the left ventricle
A
Aortic regurgitation
18
Q
The silent interval that may be present b/t the systolic and diastolic BP’s. (Sound that disappears and reappears)
A
Ascultatory Gap
19
Q
A patient’s pulse has a decrease in amplitude during inspiration, alerting you that there is a decrease in cardiac output during inspiration
A
Paradoxical pulse
20
Q
What are some causes of paradoxical pulse?
A
pericardial tamponade, constrictive pericarditis, obstructive lung dz
21
Q
Unpredictable irregularity in breathing, may be shallow or deep and may stop for short periods
A
Ataxic (Biot’s breathing)
22
Q
periods of crescendo/decrescendo breathing between apneas
A
Cheyne-Stokes breathing
23
Q
When is the body’s temperature naturally cooler?
A
morning (higher in afternoon)
24
Q
1) clinical term for fever? 2) how high is the temp to be considered a fever?
A
pyrexia, 100.4
25
A fever higher than 106.0 is called___________
hyperpyrexia
26
Low temperature is called______________. It is any temp under_________degrees. Temp this low can be a sign of _____________.
hypothermia, 95 degrees, sepsis
27
What type of pain relates to tissue damage?
somatic pain (or nociceptive paint)
28
What type of pain relates to injury of the nervous system?
Neuropathic pain
29
What type of pain results from anxiety/depression, personality, or coping style?
Psychogenic pain
30
What type of pain occurs without an identifiable cause?
Idiopathic pain
31
What are the names of the glands that produce 1) sweat (no smell) 2) smelly sweat 3) oil?
1) eccrine 2) apocrine 3) sebacious
32
Holy cow, you've eaten a ton of carrots and your hands are orange. What is this?
Carotenia from excess carotin
33
When you lift a fold of skin on the back of a patient's hand and note the ease of which you can move that skin, you will be documenting what part of the skin assessment?
Mobility
34
When you've already pinched the skin on the back of a patient's hand and now you release it. You are looking at how effectively it will resume its shape. What are you looking at here?
Turgor
35
circumscribed flat discoloration <1cm
macule
36
circumscribed, flat discoloration, >1cm
patch
37
elevated skin lesion up to 1 cm
papule
38
elevated superficial lesion greater than 1 cm, formed by a confluence of papules
plaque
39
elevated, solid lesion more than 1 cm in diameter, deeper in dermis
nodule
40
fluid-filled blister, usually less than 1 cm
vesicle
41
large fluid-filled blister, greater than 1 cm
bullae
42
pus-filled vesicle
pustule
43
group papules or vesicles that resemble herpes
herpetiform lesion
44
elevated, circumscribed encapsulated lesion in dermis or subcutaneous layer filled with liquid of semisolid material
cyst
45
elevated, solid lesion may be clearly demarcated; deeper in dermis and greater than 2 cm
tumor
46
dead epidermal cells, white flakes of skin
scale
47
collection of dried serum or cellular debris (scab)
crust
48
area of thickened epidermis induced by scratching and rubbing
lichenification
49
focal loss of epidermis, does not penetrate below dermal epidermal junction
erosion
50
focal loss of epidermis and dermis
ulcer
51
linear ulcer, a "crack" in the skin
fissure
52
erosion caused by scratching, usually linear or circular
excoriation
53
a plug in a follicular orifice.
comedone (blackhead-open, whitehead-closed)
54
dilated superficial blood vessel
telangectasia
55
non-blanchable circumscribed deposit of blood 5mm or less in diameter
petechiae
56
circumscribed deposit of blood greater than 5mm
purpura
57
collection of pus surrounded by inflammation
abscess
58
hive or welt. raised, well-circumscribed lesion
wheal
59
thinning of skin surface and loss of markings
atrophy
60
discolored, fibrous tissue
scar
61
very thick and raised scar
keloid
62
the most common form of skin cancer (80%)
BCC
63
the 2nd most common form of skin cancer (16%)
SCC
64
least common, but most deadly form of skin cancer (4%)
melanoma
65
what are the ABC's of melanoma?
A--asymmetry B--borders C--color
| D--Diameter>6mm E--Elevation/enlargement
66
What type of hair is independent of androgens, its short, fine, and covers much of the body?
Vellus hair
67
What type of hair is thick, pigmented and found on head, beard, axilla, pubic areas? It's influenced by androgens.
Terminal hair
68
_______________ is the presence of terminal hair in a female with a male pattern on face chest or areolas.
Hirsutism
69
_____________ is the asymptomatic disease characterized by the onset of total hair loss in sharply defined round areas. Thought to be autoimmune
Alopecia areata
70
______________ is the 100% loss of scalp hair
Alopecia totalis
71
______________ is the 100% loss of hair everywhere
Alopecia universalis
72
What is the term for the production of finger/toenails?
Eponychium
73
You are looking at fingers that have enlarged, rounded distal phalanges. The nails are curved, hard, and thick. The angle made by the proximal nail fold and nail plate (Lovibond's angle) approaches or exceeds 180 degrees. This is _____________?
clubbing
74
The most common nail change found in psoriasis
Pitting
75
Separation of nail plate from nail bed
onycholysis
76
White spots, very common, possibly result from cuticle manipulation or other mild trauma
Leukonychia
77
white transverse lines at the time of acute illness
Mees Lines
78
Nail grooves appear after a very severe illness
Beau's lines
79
"spoon nails". can be a sign of Fe deficiency anemia. Nails become thin and lose convexity
koilonychia
80
White nail bed with only a thin zone of healthy pink at the distal end (a/w cirrhosis, CHF, DMII, old age)
Terry's Nails
81
painful bright red swelling of the proximal and/or lateral nailfold due to infection. When lanced, it produces purulent drainage
Paronychia
82
Fungal infection of nails that makes them very thick
Onychomaycosis
83
herpes infection of the finger
herpetic whitmore....(haha, see what I did there?)
84
What is the name of the screening tool used to monitor central vision loss?
Amsler grid
85
When you're legally blind, your best eye...even when corrected...is no better than 20/____? OR your field of vision is constricted so that you only see _____% of your visual field
20/200 or 20% of the field
86
impaired near vision found in older people
presbyopia
87
impaired far vision
myopia
88
double vision
diplopia
89
Patient has a lesion of the optic chiasm and cannot see laterally in either eye
bitemporal hemianopsia
90
Patient has a lesion of the optic tract and they cannot see anything on the left side out of either eye
left homonymous hemianopsia (vise versa on the right)
91
drooping of the upper eyelid
ptosis
92
lower lid is creeping up
reverse ptosis (bummer)
93
slightly raised, yellowish, well-circumscribed plaques that appear along the nasal portions of an eyelid (think lipid disorder)
xanthelasma
94
margin of lower lid turned outward, exposing palpebral conjunctiva
ectropion
95
inward turning of the eyelid margin, common in elderly
entropion
96
painless(usually) nodule caused by obstruction of Meibomian gland (no infection)
chalazion
97
painful, tender, red, infection of pilosebacious gland of Moll
sty/hordeolum
98
outward bulging of the eyes
exopthalmos
99
inflammation of the lacrimal sac, infection due to obstruction
dacryocystitis
100
harmless, yellowish triangular nodule in the bulbar conjunctiva on either side of the iris
just a little pinguecula.
101
triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea
pterygium
102
localized ocular redness from inflammation of the episcleral vessels
episcleritis
103
inflammation of the conjunctiva, most common eye disease
conjunctivitis
104
thin grayish-white arc near edge of the cornea suggestive of hyperlipoproteinemia
corneal arcus (Or arcus senilis when occurring in old age)
105
opacity in the crystalline lens. gradual painless loss of vision
cataract
106
constriction of pupils, iris contracted, heroin
miosis (pinpoint)
107
dilation of pupils, iris dilated, cocaine
mydriasis (blown)
108
pupil inequality of 0.5mm+.
anisocoria
109
What is the formal name for the corneal light reflex?
Hirschberg test
110
constriction of the left eye when light is shined in the right eye is called the _________________
consensual reflex
111
What is the Hirschberg Test looking for?
position and alignment of eyes
112
If you asked your patient to look strait ahead into your own eyes, and you observed a normal response in the left eye. But the patient's right eye deviated toward the patient's nose, what would you call this in your documentation?
Right esotropia
113
If you are looking for pupil reflexes and you shine a light on the left eye and neither eye responds, you'd document what?
Marcus Gunn pupils (sensory afferent defect...blindness of left eye)
114
Ptosis of upper lid and lateral deviation of the eye are almost always present in what?
oculomotor nerve (CNIII) paralysis
115
This reflex occurs when a person shifts their gaze from a far object to a near one and you see their pupils constrict
Accommodative reflex
116
This pupil is the "prostitute pupil" that will accommodate, but not respond. (Common in syphilis). Small irregular pupils that do not respond to light, but do accommodate to the near reaction
Argyll Robertson Pupil (problem with CNIII)
117
____________ stimulation will cause pupil dilation and elevation of the upper eyelid. (This response can also occur with cocaine and meth)
sympathetic stimulation
118
Your patient's left eye has a small pupil that reacts to light and near reaction, but does not dilate normally. You notice that the left side of their face is much drier than the right side. What do you suspect?
Horner syndrome
119
drugs like heroine and morphine will cause the constriction of pupils, this reaction is due to _________________ stimulation
parasympathetic stimulation
120
You shine your light in someones eye and there is little or no pupil constriction. This patient has no complaints about their vision, other than an transient blurred vision when focusing on a new object. When documenting this exam, how would you describe this pupil?
tonic pupil or Adie's pupil
121
You are checking the ocular movements of your patient's eyes. You notice a problem with the lateral gaze. What cranial nerve is this?
6-abducens (this is a problem with the lateral rectus)
122
Your patient cannot look strait down or down and toward their nose. Which cranial nerve is having a problem?
4--trochlear (this is a problem with the superior rectus)
123
any deviation from perfect ocular alignment is called _____________
strabismus
124
the affected eye is always turned in
esotropia
125
the affected eye is always turned out
exotropia
126
the affected eye is always turned up
hypertropia
127
the affected eye is always turned down
hypotropia
128
latent deviation of the eyes held straight by binocular fusion. (Patient normally has a conjugate gaze, but may see a deviation with fatigue)
phoria
129
what nerve helps you look down and in?
trochlear
130
what nerve helps you look laterally?
abducens
131
If you can't look any direction EXCEPT down and out....then you will be loved by no one. And also, there is a problem with your __________ nerve
oculomotor (III)
132
repetitive, rhythmic oscillations of one/both eyes
nystagmus
133
what part of your opthalmascope focuses light at different distances?
diopter
134
If you spin the diopter counter clock wise, you'll see red numerals. Assuming you have normal vision, if you bring your patient's eye into focus at -3. you can assume the patient is nearsighted? or farsighted?
near-sighted
135
impaired near vision, not associated with age
hyperopia
136
Looking at the optic nerve, you notice the disc takes up more than 1/2 the cup. What do you suspect?
chronic glaucoma
137
optic disc swelling due to elevated intracranial pressure
papilledema
138
creamy or yellowish lesions with well-defind hard borders (common w/ DM and htn)
hard exudates
139
"cotton-wool patches" seen commonly in htn or when there have been infarcted nerves
soft exudates
140
blood accumulated in the superficial nerve fiber layer of the retina. Indistinct borders
flame hemorrhages
141
ruptured microaneurysms in the deeper retina
blot and dot hemorrhages
142
blood has escaped into the potential space b/t the retina and the vitreous fluid
preretinal hemorrhage
143
this is seen in hypertensive retinopathy and is characterized by a seeming disappearance of a vein on either side of a nearby artery
AV nicking
144
What is the common otoscopic finding in patients with proliferative diabetic retinopathy?
neovascularization
145
yellowish round spots composed of undigested cellular debris
drusen
146
the presence of drusen and neovascularization within the macula are the hallmarks of _________________
wet age related mac degen
147
FACIES: decreased facial mobility, blunt expression and mask like face
Parkinson's
148
FACIES: periorbital edema, puffy pale face, swollen lips
nephrotic syndrome
149
ten sites for lymph nodes on head and neck
pre-auricular, post-auricular, occipital, superficial cervical, posterior cervical, cupraclavicular, deep cervical, tonsillar, submandibular, submental
150
what is the most active joint in the body?
temporomandibular joint
151
true/false, the lady in the pictures looks exceptionally happy to participate in her ENT exam..
Did you even look at the book? She is pissed.
152
that bony thingy in the hard palate
torus palatinus
153
loss of vermillion border
actinic cheilitis
154
black/red spots in mouth common in AIDS
karposi's sarcoma
155
sebaceous spots in the mouth
Fordyce spots
156
Measles spots in the mouth
Koplik's spots
157
hard deposits on ears caused by excess uric acid
tophis
158
On the posterior of your patient, toward the spine, the top of the horizontal fissures are typically at what vertebral level?
T3
159
subjective sensation of difficulty breathing
dyspnea. Seriously. you better get this one
160
musical respiratory sounds
wheezing
161
response to stimuli that irritates receptors in the larynx, trachea, or large bronchi
cough
162
coughing up blood from the lungs
hemoptysis
163
chest pain could be caused by what GENERAL systemic problems?
cardio, pulm, GI, MS, psych
164
Brownlee said the 5 "A's" of tobacco cessation would be on the test. Go:
```
Ask (do you smoke)
Advise (I love you sir, please stop smoking)
Assess (are you ready to quit)
Assist (set quit dates, make solid plan)
Arrange (follow up, support)
```
165
what are the 4 activities in correct order for EVERY pulm exam?
Inspect, palpate, percuss, ascultate
166
sunken chest is called
pectus excavatum
167
poking out Sigourney Weaver bony chest
pectus carinatum
168
fast, normal, or slow deep breathing (thanks, really narrows that one down). Common with metabolic acidosis
Kussmaul breathing
169
voice vibrations transmitted to the chest vall
fremitus
170
when is fremitus reduced?
fluid or air outside the lung
171
you're left handed, your right middle finger is your____________ and your left middle finger is your________________ when you are percussing
pleximeter, plexor
172
what are the percussion sounds?
resonance, hyperresonance, tympany, flat, dull,
173
How many sites are there to percuss and ascultate on the front of your patient in a resp exam? The back?
6 pairs of sites on the front, 7 pairs of sites on the back
174
while performing the ___________________ you notice a difference in position of the lower lung fields between inspiration and expiration. (could be paralyzed diaphragm, atelectasis, or pleural effusion)
diaphragmatic excursion
175
lung sound produced over most of the lungs. it is soft, and inspiratory sound lasts longer than expiratory sound
vesicular
176
Inspiratory and expiratory sounds are equal with no gap In between sounds
bronchovesicular
177
expiratory sounds last longer than inspiratory sounds (best heard over the manubrium)
bronchial
178
inspiratory and expiratory sounds are equal, but there is a gap in sound between them
tracheal
179
intermittent nonmusical brief sounds created when air is forced through respiratory passages that are narrowed by fluid, mucus, or pus. Frequently heard at the end of inspiration
crackles
180
continuous course whistling sound, due to narrowing in the respiratory tree and increased airflow velocities across these narrowed spaces
wheezes
181
high pitched wheeze that is primarily inspiratory, louder over the neck than chest and indicates partial obstruction of larynx or trachea
stridor
182
similar to wheeze though lower pitch with snore quality. suggestive of secretions in large airways
rhonchi
183
when vocal sounds are CLEAR and LOUD when you ascultate a patients chest and ask them to speak
bronchophony
184
easily distinguishable whispered words on respiratory exam
whispered pectoriloquy
185
Patient says "eeeeee" but you hear "aaaaaaa"
egophony
186
4 activities in correct order for the abdominal exam
inspection, auscultation, percussion, palpation
187
loss of appetite
anorexia
188
localized post-prandial epigastric discomfort
indigestion
189
inability to consume a normal size meal
early satiety
190
sense of retrosternal or epigastric burning with radiation to the neck a/w GERD
heartburn
191
3 mo h/o nonspecific upper abd discomfort of nausea. no structural abnormality
nonulcer dyspepsia
192
spasmodic movement of chest and diaphragm
retching
193
raising gastric contents w/o n/v or retching
regurgitation
194
forceful expulsion of gastric contents through mouth
vomiting
195
vomiting blood
hematemesis
196
pain with swallowing
odynophagia
197
difficulty swallowing
dysphagia
198
s/wk with lumpy hard stools
constipation
199
failure to pass stool or gas
obstipation
200
increased water content or stool volume
diarrhea
201
black tarry stool (GI bleed)
melena
202
red/maroon stool (low GI bleed)
hematochezia
203
greasy/oily stool (malabsorption vs pancreatic insufficiency)
steatorrhea
204
pain occurring in hollow organs when they distend stretch or contract in an unusual way. difficult to localize
visceral
205
pain that originates in the parietal perioneum, caused by inflammation, steading aching pain that's more difficult to localize, and more severe than visceral pain
parietal
206
pain that is experienced at a distant site that shares innervation with affected area
referred pain
207
veins that transport blood from digestive organs and spleen, pancreas, and gall-bladder to the liver
portal circulation
208
scarring of the liver (cirrhosis) or inflammation of the liver (hepatitis) can cause _________ because blood cannot easily flow through the liver
portal hypertension
209
weak-walled vessels that are prone to rupture and hemorrhage
varices
210
an abnormal layer of fibrovascular tissue or granulation tissue
pannus
211
the predominant percussion note over the abdomen
tympany
212
percussion note heard with ascites, organomegaly, or tumor
dullness
213
What spot will be tender or distended with splenomegaly?
Traube's space
214
for suspicion of pyelonephritis, you will percuss here_________________-
CVA-costovertebral angle
215
while palpating, your patient seems to be in pain, and their abdomen is rigid and board-like, you susect______________
guarding
216
while palpating, you push down on a tender area and release suddenly. The patient has more pain on the release. What is this called?
rebounding
217
abnormal accumulation of fluid in the abdomen
ascites
218
+ pain on extension of right thigh
psoas sign
219
pain on internal rotation of right thigh
obturator
220
pain in RLQ with palpation of LLQ
Rovsing's sign
221
Increased pain with coughing
Dunphy's sign
222
Area over the appendix that is acutely painful during appendicitis
McBurney's point
223
You think your patient has appendicitis, but their pain isn't in the normal location. Could this still be appendicitis? What explanation do you have for the different pain locations?
yes! could be retrocecal appendix, or pelvic appendix
224
Increased sensitivity to sensory stimuli such as pain or touch (ex: pt has exquisite pain from pinching a small superficial amt of skin)
cutaneous hyperesthesia (caused by inflammation of parietal pleura)
225
Move extended fingers of right under the costal margin, ask the patient to exhale and as they take a deep breath, advance the fingers under the costal margin.
A sharp increase in tenderness with a sudden stop in inspiratory effort is a positive sign.
(for cholecystitis)
Murphy's sign
