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Quarter 2 > Phys Dx Exam 1 > Flashcards

Phys Dx Exam 1 Flashcards

1
Q

the 4 diagnostic tecniques

A

inspection, palpation, percussion, auscultation

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2
Q

standard vital signs

A

height, weight, temperature, pulse, respiration, blood pressure, +/- pulse ox

things I measure: pulse, respiration, BP

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3
Q

classified fever

A

> = 100.4

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4
Q

normal pulse

A

60-100

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5
Q

normal respiration

A

14-20/minute

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6
Q

“pulse pressure”

A

difference b/w systolic and diastolic.
narrow value= may represent shock, CHF, or trauma
wide value= valve problem of heart

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7
Q

prior to obtaining BP, no smoking, exercise, or caffeine for 30 minutes before

A

additional: cuff over brachial artery

ARM with brachial artery at the level of the heart

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8
Q

how much to inflate cuff with taking BP?

A

30 mmHg above expected systolic level

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9
Q

If you need to take BP again, how long do you wait?

A

15-30 minutes

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10
Q

Abnormal readings for Orthostatic BP

A

> 20 drop in systolic
10 drop in diastolic
20 increase in HR

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11
Q

How to take Orthostatic BP

A

lie down for 5 minutes

take each new reading within 3 minutes of position change

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12
Q

Layers of skin

A

Epidermis- barrier from environ, waterporof
Dermis- blood vessels, hair follicles, glands, nails
Subcutaneous (Hypodermis)- subC fat & connective tissue

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13
Q

Layers of Epidermis (top layer)

A 
Corneum- shedding dead skin
Lucidum- palmar/plantar
Granulosum- keratinization
Spinosum-spiny shaped cells. strength/flexibility
Basale- keratinocytes

Can Lenny Grab Something Big?

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14
Q

Cells within the Epidermis (top layer)

A

Keratinocytes, Melanocytes, Merkel cells, Langerhan cells

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15
Q

Layers of Dermis (middle layer w blood, vessels, nerves, hair follicles, glands)

A

Papillary dermis- loose network of collagen
Reticular dermis- densely packed layer of collagen
Ground substance

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16
Q

Layers of SubC (hypodermis) deepest layer

A

Fibroblasts, adipose, macrophages
SubC fat- deepest layer, collagen & fat cells, conserves hear
Contains larger vessels and nerves

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17
Q

Eccrine glands

A

cover most of body, abundant on palms, soles, and forehead
keep cool
No odor
Duct opens in PORE @ skin surface

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18
Q

Apocrine glands

A

concentrated in axillary and genital regions
Secretes into the SAC of hair follicles
releases thick odorless fluid, the odor is caused by bacteria that live on skin that break down apocrine secretions

Triggered by nervous system- stress, hormone, exercise, emotions

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19
Q

Vellous hairs

A

“V”ery tiny

short and fine (forehead)

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20
Q

Terminal hairs

A

long and thick (scalp/armpit)

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21
Q

Dermoscopy

A

transilluminating light with magnification- tool used to better see skin lesions

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22
Q

Morbilliform

A

“Measles like”

red maculopapular lesions that become confluent on face and body

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23
Q

Diascopy

A

the test for blanching

apply pressure with hands or glass slide

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24
Q

ABCDE of Melanoma

A

Asymmetry, Borders, Color, Diameter, Evolution

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25
Secondary findings (referring to lesions)
Arise from changes in primary lesions | Usually d/t exogenous factors- scratching, infection, rubbing, crusting, etc
26
Maccule
"Freckle" | <1cm, flat, circumscribed
27
Patch
>1 cm, flat hypo or hyper pigmented "Cafe au lait" spot
28
Papule
<1 cm, palpable, RAISED, firm, circumscribed, firm, red/brown/or flesh colored "Seborrheick Keratosis, SK, warty waxy stuck on appearance"
29
Plaque
Elevated, firm, palpable, >1cm | "Psoriasis"
30
Nodule
>1.5 cm Elevated, circumscribed. deeper & firmer than papule. can be compressible, soft, rubbery, or firm to palpation "Epidermoid inclusion cyst"
31
Tumor
>2 cm, a LARGE nodule | "Lipoma"
32
Wheel
irregular, comes and goes (transient), superficial edema | "Urticaria, mosquito bite"
33
Vesicle
< 1 cm, Fluid containing well circums, usually clear fluid "Chicken pox" "dew drops on rose petal"
34
Bulla
>1 cm, fluid containing-serous fluid well circumscribed. | "Bullous Pemphigoid" fluid usually has a more yellow/fleshy color since it is serous fluid
35
Pustule
elevated, superficial, well circum. filled with Pus | "folliculitis"
36
Furuncle
infection of single hair "Furry uncle" not to be confused with Funcle S. Aureus Aka a BOIL
37
Carbuncle
a car of furry uncles infection of multiple hair can form ABSCESS
38
Secondary lesions
crust, scale, fissure, erosion, ulcer, excoriation, atrophy, lichenification
39
Crust
dried serum, pus, or blood on the surface Adherent May include bacteria "Impetigo- honey colored crusting"
40
Scale
Hyperkeratosis buildup of the Stratum Corneum layer!! "Psoriasis" "silvery scale"
41
Fissure
linear, painful cleft in skin. from marked drying, skin thickening, loss of elasticity
42
Erosion
partial or sometimes complete loss of Epidermis Moist, oozing, and/or crusted "Pemphigus Foliaceus"
43
Ulcer
Loss of at least the entire Epidermis PLUS superficial Dermis. may have loss of ENTIRE Dermis and some of the hypodermis "Venous stasis ulcer"
44
Excoriation
exogenous injury to part of epidermis can be linear or rounded usually d/t scratching "Neurotic excoriation"
45
Atrophy (2 types)
Epidermal: thinning of epidermis--> wrinkling and shiny appearance Dermal: los of dermal collagen/elastin leading to depression "striae/stretch marks d/t topical steroids"
46
Lichenificaiton
thickening. increased visibility of skin markings | "Lichen simplex chronicus"
47
Petechiae
deep red/purple lesions < 0.5 cm non blanchable
48
Purpura
> 0.5 cm round/irregular. non blanchable variable distribution
49
Ecchymosis
"bruise" fade to green, yellow, brown irregular borders represents blood outside of vessels d/t trauma or bleeding disorder
50
Spider angioma
Blanchable tiny, up to 2 cm ppl with liver disease, otherwise healthy, pregnant
51
Telangiectasias
Blanchable
52
Hemangioma
``` BIG RED SPOT ON BABY'S CHEEK Benign, vascular neoplasm Most common tumor of infancy Starts macular --> may get to plaque or nodule *spontaneously involute by age 5-10 ```
53
Papulosquamous lesions
plaques & scales | Lichen Planus & Psoriasis
54
Nodular
benign & malignant Benign: moles (nevi), cherry angioma, epidermoise cyst Malignant: SCC, BCC
55
Vesiculobullous Lesions
Vesicles & bulla | Impetigo, Herpes, Pemphigus
56
Maculopapuler
Viral exanthems generalized, red, mac-pap rash Drug Eruptions
57
Clubbing
rounded, bulbous nail base Spongy associated w/ Lung disease "Schamroth's sign" no window b/w nails- positive clubbing sign
58
Beau's Lines
transverse depressions d/t trauma or acute severe illness
59
Paronychia
inflammation of proximal lateral nail folds | ppl that bite nails/ skin around nails- becomes inflmaed
60
Onychocryptosis
"Ingrown Toenail" | Nail grows into the dermis
61
Terry's Nails
"Ground glass" appearance mostly white with a distal band of reddish brown No Lunula
62
Leukonychia
tiny white spots on nail d/t trauma
63
Koilonychia "Spoon nail"
concave | severe iron deficiency
64
Onycholysis
painless separation
65
Onychomycosis
fungal infection
66
Nail pitting
small punctate depressions caused by nail matrix inflammation Seen w Psoriasis
67
Cushing Syndrome
increased cortisol | "Moon face" (meaning round face) w/ red cheeks. excessive hair growth may be present in mustache, sideburn, chin
68
Nephrotic syndrome
``` Slit- like eyes in morning excess albumin excretion which causes swollen face and often pale Sodium & Water retention -Periorbital edema -Puffy pale face -Lips may be swollen ```
69
Myxedema
-Hair dry, coarse, sparse -Lateral eyebrows thin -periorbital edema -puffy dull face w/dry skin DULL PUFFY Loss lateral 1/3 eyebrows Hypothyroidism
70
Parotid gland enlargement
may be assoc w/ Obesity, DM, Cirrhosis Gradual unilateral suggestive of neoplasm Acute enlargement-mumps
71
Parkinson's
decreased facial mobility and "Masklike" faces Decreased blinking and characteristic stare Pt seems to peer upward towards observer bc neck & upper trunk flex forward Facial skin oily, drooling may occur
72
Bell's Palsy
idiopathic facial nerve paralysis CN 7
73
Giant Cell Temporitis (Arteritis) associated with
Polymyalgia Rheumatica- inflammatory condition mostly in older adults This can cause Temporal Arteritis Concern: blindness & stroke
74
Anisocoria
pupils are unequal size
75
Near far accomodation
10 cm away and >6 feet away
76
Ptosis
CN 3 problem
77
Incomplete closure of eye
CN 7 problem
78
Chalazion
Nontender blockage of Meibomian (sebacous gland) points INSIDE lid
79
Hordeolum (Stye)
``` tender, red infection. usually S. aureus can be inner or outer lid inner- blocked meibomian gland outer- obstructed eyelash or tear gland ```
80
Dacryocystitis
lacrimal sac inflammation infection/inflammation Swelling b/w base of nose and eye
81
Exophthalmos
seen in Grave's Disease (Hyperthyroidism)
82
Hypothyroidism
loss of lateral 1/3 eyebrows
83
Episcleritis
``` localized ocular inflammation of episcleral vessels central nodule with radiation of vessels *usually self limiting- benign "work of art" bunch of tiny vessels may be assoc. w/autoimmune ```
84
Subconjunctival hemorrhage
hx of cough, sneeze, straining Asymptomatic, self limited can reassure pts that it will go away on own Consider blood thinners
85
Hyphema
big deal Grossly visible blood in anterior chamber! visoion threatening- refer~
86
Eye puncture
puncture wound with hemorrage and asymmetric, non reactive DILATED pupil
87
Cataract
clouding of lens Painless progressive vision loss Best seen with split lamp Risk factors: age, smoking, DM, steroid, EtOH
88
Diabetic Retinopathy
HARD exudates well defined borders HTN and DM
89
Glaucoma (increased pressure)
with cupping | increased pressure results in backward depression
90
Detached retina
shadow over vision
91
Papilledema
``` Optic disc swelling caused by increased intracranial pressure No clear border Fuzzy borders Pt sx: severe HA, nausea, vomiting Emergency: could be stroke, tumor, etc. ```
92
Bitemporal Hemianopsia
Optic Chiasm injury | tunnel vision
93
Cover uncover
testing for Strabismus *must treat early to prevent vision loss- eye exercises and patching surgery may be needed
94
Anterior chamber depth
testing for increased intraocular pressure (i.e. glaucoma) | Crescent shadow is abnormal
95
Corneal Reflex
cotton swab on cornea | Cranial nerve 5 (sensory) and 7 (motor)
96
Weber
will lateralize to BAD ear
97
BC >AC
conductive hearing loss
98
Pneumatic Otoscopy
testing TM mobility little puff of air- normal is that TM moves inward abnormal- no TM movement i.e. effusion
99
Serous effusion with air bubbles
viral URI or barotrauma eustachian tube involved fullness in ear, popping
100
Bullous myringitis
painful hemorrhagic vesicles commonly conductive hearing loss during infection
101
otitis externa
swimmers ear | infection of external auditory canal
102
Septal hematoma
``` seen following trauma more common in ped patients nasal obstruction, pain, tenderness Soft, tender swelling MUST R/O SEPTAL HEMATOMA IN ALL NASAL TRAUMA AND DOCUMENT ```
103
Leukoplakia
Potensh Premalignant | Inability to remove white area
104
Torus palantinus
Lana | benign, midline mass in hard palate
105
Herberden's
Osteroarthritis DIP joins "HOD"
106
Bouchard's
Rheumatoid Arthritis PIP joins "BIRP"

Quarter 2 (16 decks)

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