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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
Q

Secondary findings (referring to lesions)

A

Arise from changes in primary lesions

Usually d/t exogenous factors- scratching, infection, rubbing, crusting, etc

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26
Q

Maccule

A

“Freckle”

<1cm, flat, circumscribed

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27
Q

Patch

A

> 1 cm, flat
hypo or hyper pigmented
“Cafe au lait” spot

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28
Q

Papule

A

<1 cm, palpable, RAISED, firm, circumscribed, firm, red/brown/or flesh colored
“Seborrheick Keratosis, SK, warty waxy stuck on appearance”

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29
Q

Plaque

A

Elevated, firm, palpable, >1cm

“Psoriasis”

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30
Q

Nodule

A

> 1.5 cm
Elevated, circumscribed. deeper & firmer than papule. can be compressible, soft, rubbery, or firm to palpation
“Epidermoid inclusion cyst”

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31
Q

Tumor

A

> 2 cm, a LARGE nodule

“Lipoma”

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32
Q

Wheel

A

irregular, comes and goes (transient), superficial edema

“Urticaria, mosquito bite”

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33
Q

Vesicle

A

< 1 cm, Fluid containing
well circums, usually clear fluid
“Chicken pox” “dew drops on rose petal”

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34
Q

Bulla

A

> 1 cm, fluid containing-serous fluid well circumscribed.

“Bullous Pemphigoid” fluid usually has a more yellow/fleshy color since it is serous fluid

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35
Q

Pustule

A

elevated, superficial, well circum. filled with Pus

“folliculitis”

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36
Q

Furuncle

A

infection of single hair
“Furry uncle” not to be confused with Funcle

S. Aureus
Aka a BOIL

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37
Q

Carbuncle

A

a car of furry uncles
infection of multiple hair
can form ABSCESS

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38
Q

Secondary lesions

A

crust, scale, fissure, erosion, ulcer, excoriation, atrophy, lichenification

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39
Q

Crust

A

dried serum, pus, or blood on the surface
Adherent
May include bacteria
“Impetigo- honey colored crusting”

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40
Q

Scale

A

Hyperkeratosis
buildup of the Stratum Corneum layer!!
“Psoriasis”
“silvery scale”

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41
Q

Fissure

A

linear, painful cleft in skin. from marked drying, skin thickening, loss of elasticity

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42
Q

Erosion

A

partial or sometimes complete loss of Epidermis
Moist, oozing, and/or crusted
“Pemphigus Foliaceus”

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43
Q

Ulcer

A

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
Q

Excoriation

A

exogenous injury to part of epidermis
can be linear or rounded
usually d/t scratching
“Neurotic excoriation”

45
Q

Atrophy (2 types)

A

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
Q

Lichenificaiton

A

thickening. increased visibility of skin markings

“Lichen simplex chronicus”

47
Q

Petechiae

A

deep red/purple lesions
< 0.5 cm
non blanchable

48
Q

Purpura

A

> 0.5 cm
round/irregular.
non blanchable
variable distribution

49
Q

Ecchymosis

A

“bruise”
fade to green, yellow, brown
irregular borders
represents blood outside of vessels d/t trauma or bleeding disorder

50
Q

Spider angioma

A

Blanchable
tiny, up to 2 cm
ppl with liver disease, otherwise healthy, pregnant

51
Q

Telangiectasias

A

Blanchable

52
Q

Hemangioma

A 
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
Q

Papulosquamous lesions

A

plaques & scales

Lichen Planus & Psoriasis

54
Q

Nodular

A

benign & malignant
Benign: moles (nevi), cherry angioma, epidermoise cyst
Malignant: SCC, BCC

55
Q

Vesiculobullous Lesions

A

Vesicles & bulla

Impetigo, Herpes, Pemphigus

56
Q

Maculopapuler

A

Viral exanthems
generalized, red, mac-pap rash
Drug Eruptions

57
Q

Clubbing

A

rounded, bulbous nail base
Spongy
associated w/ Lung disease
“Schamroth’s sign” no window b/w nails- positive clubbing sign

58
Q

Beau’s Lines

A

transverse depressions d/t trauma or acute severe illness

59
Q

Paronychia

A

inflammation of proximal lateral nail folds

ppl that bite nails/ skin around nails- becomes inflmaed

60
Q

Onychocryptosis

A

“Ingrown Toenail”

Nail grows into the dermis

61
Q

Terry’s Nails

A

“Ground glass” appearance
mostly white with a distal band of reddish brown
No Lunula

62
Q

Leukonychia

A

tiny white spots on nail d/t trauma

63
Q

Koilonychia “Spoon nail”

A

concave

severe iron deficiency

64
Q

Onycholysis

A

painless separation

65
Q

Onychomycosis

A

fungal infection

66
Q

Nail pitting

A

small punctate depressions
caused by nail matrix inflammation
Seen w Psoriasis

67
Q

Cushing Syndrome

A

increased cortisol

“Moon face” (meaning round face) w/ red cheeks. excessive hair growth may be present in mustache, sideburn, chin

68
Q

Nephrotic syndrome

A 
Slit- like eyes in morning
excess albumin excretion which causes swollen face and often pale 
Sodium &amp; Water retention
-Periorbital edema
-Puffy pale face
-Lips may be swollen
69
Q

Myxedema

A

-Hair dry, coarse, sparse
-Lateral eyebrows thin
-periorbital edema
-puffy dull face w/dry skin
DULL PUFFY
Loss lateral 1/3 eyebrows
Hypothyroidism

70
Q

Parotid gland enlargement

A

may be assoc w/ Obesity, DM, Cirrhosis
Gradual unilateral suggestive of neoplasm
Acute enlargement-mumps

71
Q

Parkinson’s

A

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
Q

Bell’s Palsy

A

idiopathic facial nerve paralysis CN 7

73
Q

Giant Cell Temporitis (Arteritis) associated with

A

Polymyalgia Rheumatica- inflammatory condition mostly in older adults
This can cause Temporal Arteritis
Concern: blindness & stroke

74
Q

Anisocoria

A

pupils are unequal size

75
Q

Near far accomodation

A

10 cm away and >6 feet away

76
Q

Ptosis

A

CN 3 problem

77
Q

Incomplete closure of eye

A

CN 7 problem

78
Q

Chalazion

A

Nontender blockage of Meibomian (sebacous gland) points INSIDE lid

79
Q

Hordeolum (Stye)

A 
tender, red infection.
usually S. aureus
can be inner or outer lid
inner- blocked meibomian gland
outer- obstructed eyelash or tear gland
80
Q

Dacryocystitis

A

lacrimal sac inflammation
infection/inflammation
Swelling b/w base of nose and eye

81
Q

Exophthalmos

A

seen in Grave’s Disease (Hyperthyroidism)

82
Q

Hypothyroidism

A

loss of lateral 1/3 eyebrows

83
Q

Episcleritis

A 
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
Q

Subconjunctival hemorrhage

A

hx of cough, sneeze, straining
Asymptomatic, self limited
can reassure pts that it will go away on own
Consider blood thinners

85
Q

Hyphema

A

big deal
Grossly visible blood in anterior chamber!
visoion threatening- refer~

86
Q

Eye puncture

A

puncture wound with hemorrage and asymmetric, non reactive DILATED pupil

87
Q

Cataract

A

clouding of lens
Painless progressive vision loss
Best seen with split lamp
Risk factors: age, smoking, DM, steroid, EtOH

88
Q

Diabetic Retinopathy

A

HARD exudates
well defined borders
HTN and DM

89
Q

Glaucoma (increased pressure)

A

with cupping

increased pressure results in backward depression

90
Q

Detached retina

A

shadow over vision

91
Q

Papilledema

A 
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
Q

Bitemporal Hemianopsia

A

Optic Chiasm injury

tunnel vision

93
Q

Cover uncover

A

testing for Strabismus
*must treat early to prevent vision loss- eye exercises and patching
surgery may be needed

94
Q

Anterior chamber depth

A

testing for increased intraocular pressure (i.e. glaucoma)

Crescent shadow is abnormal

95
Q

Corneal Reflex

A

cotton swab on cornea

Cranial nerve 5 (sensory) and 7 (motor)

96
Q

Weber

A

will lateralize to BAD ear

97
Q

BC >AC

A

conductive hearing loss

98
Q

Pneumatic Otoscopy

A

testing TM mobility
little puff of air- normal is that TM moves inward

abnormal- no TM movement
i.e. effusion

99
Q

Serous effusion with air bubbles

A

viral URI or barotrauma
eustachian tube involved
fullness in ear, popping

100
Q

Bullous myringitis

A

painful
hemorrhagic vesicles
commonly conductive hearing loss during infection

101
Q

otitis externa

A

swimmers ear

infection of external auditory canal

102
Q

Septal hematoma

A 
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
Q

Leukoplakia

A

Potensh Premalignant

Inability to remove white area

104
Q

Torus palantinus

A

Lana

benign, midline mass in hard palate

105
Q

Herberden’s

A

Osteroarthritis
DIP joins

“HOD”

106
Q

Bouchard’s

A

Rheumatoid Arthritis
PIP joins

“BIRP”

Quarter 2 (16 decks)

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