phys dx Flashcards by Leslie Ryan

BP over 140/90

BP under 90/60

HTN

hypotension

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vesicle: elevated serous filled cavity .5 cm that follows a unilateral thoracic dermatome

herpes zoster

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silver scales on extensor surfaces

psoriasis

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butterfly rash

sle

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pos dedlyns, or vertebrobasilar artery functional maneuver indicate

pos: vertigo, blurred vision, nausea, syncope, nystagmus
Indicates: vertebrobasilar artery circ compromise

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bilateral ptosis is ___ unilateral is _____

bilat: myasthenia gravis
unilat: horners (loss of cervical symp + miosis, anhydrosis), CN III lesion

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iritis/uveitis

early stage AS (and retirees)

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pailledema

increased ICP

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AV nicking, silver wire arterioles, widened light reflex

arteriosclerosis

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flame hemorrhages, cotton wool spots, narrow light reflex

HTN

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yellow, hard, waxy exudates, neovascularization, micro aneurysm, absent red light reflex

diabetes

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external ear conditions

otitis externa

air conduction loss

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middle ear conditions

otitis media
otosclerosis
meniere’s

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inner ear conditions

menier's
labyrinthtis
vertigo
acoustic neuroma
ototoxicity

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tactile fremitus INCREASED with ____ and DECR with ___

pneumonia

emphysema

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dull chest percussion

pneumonia, atelectasis, pleurisy

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resonant chest percussion

normal, bronchitis

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hyperresonant chest percussion

emphysema, pneumothorax

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dull percussion, increased TF
rales/crackles
productive cough 10 days
rust sputum

lobar pneumonia

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low grade fever, night sweat, prod cough
yellow/green sputum
apices of lung, crackles in upper lobe
tine/mantoux test
mycobacterium \_\_\_

dull percussion, dec TF
dry non prod cough, dec res excursion
friction rub, dec breath sounds
+ schep

pleurisy

dec chest expansion
dec TF, hyperres, dec breaths sounds
unilat darkening of chest

pneumothorax

tracheal shift away from lesion

mucous plug
dec TF, dull perc, dec/no breath sounds
dec chest expansion
increased density on xray

atelectasis

tracheal shift towards lesion

dec TF, hyperres perc, dec breath sounds
prolonged expiration, EXPIRATORY wheeze
20-30y smoking
bilat darkened lung field, narrowed compressed heart, horizontal ribs, flattened diaphragm

emphysema

LT hx of smoking, non prod coughing > 30 days | afebrile***, dyspnea, weight loss, fingernail clubbing

bronchogenic CA

from phys activity, worse with activity, pain incr with deep breath

costochondritis | tietze syndrome

granuloma nodules, appears in lungs and lymph nodes african american bilateral hilar lymphadenopathy

sarcoidosis

``` young cause male 20-30 fever, night sweat, weight loss, pruritus, enlarged spleen two lumps above clavicle reed sternberg cell unilat hilar lymphad ```

hodgkins

cardiomegaly, jugular venous pulsations/distension | billet leg swelling, pitting edema, difficulty breathing

right sided HF | **common cause of LSHF, for pulmonale

comes on with exertion | relived by vasodilator under tongue

angina pectoris, coronary vasospasm | prinzmetal comes on with rest

comes on with rest, severe substernal chest pn, refer to left arm labored breathing, atherosclerosis inc CPK, SGOT, LDH test with electrocardiogram, echocardiogram, refer to cardio

pain refer to right shoulder, tip of right scap

gallbladder

overweight female, RUQ pn cause is cholelithiasis n/v, eating a large fatty meal

cholecystitis, choledocholithiasis | test: us, oral cholecystogram, murphy sign

epigastric pn thru t10-12 like a knife grey turner cullen sign inc amylase and lipase

pancreatitis chronic: alcoholism acute: 911 emergency

protrusion of stomach above diaphragm with LUQ | esophagitis, dyspepsia, worse after large meal and when lying down

hiatal hernia

upward reflux of acid contents of stomach into esops caused by sliding hiatal hernia worse with lying down, after meal, valsalva, bearing down -xray, upper gi series

reflux esophagitis

EBV, young adults flu symptoms, young downey cells in blood monospot, herterophile, paul bunnel

mono | can adjust

RLQ pn, chronic diarrhea B12 malabsorption cobble stone distal ileum and colon

regional ileitis/chron's | -dx with sigmoidoscopy

colon, rectum, left side | bloody diarrhea and fever, can lead to sacroliliitis

UC --> enteropathic arthropathy | dx with sigmoidoscopy

BP radiating into groin, writing pain inc BUN, uric acid, creatinine clearance, KUB, UA staghorn calculi

nephrolithiasis

icily from Muti | wbc casts

pyelonephritis

ecoli in females n gonorrhea in males nitrates in urine

urethritis

noninfectious bladder inflame causes burning, painful, freq urination with incontinence suprapubic and lbp

cystitis

nipple retraction, bleeding, orange peel, dimpling (pages of breast) mets to axilla lytic to bone case hx lumpectomy

breast ca | 2nd mcc ca death women

post lobe is hard, nodular, painless, enlarged | mets to lumbar spine via batsons plexus

prostatic ca

pain appears while walking and disappears after rest

intermittent claudication

tenderness, edema, pain in calf

dvt

blockage of artery in lung difficulty breathing, chest pain on inspiration, palpitations flying and prolonged bed rest

pulmonary embolism