physical diagnosis-16-landeen

Question 1

group of people who may not feel any discomfort from MI

Answer 1

diABETIES

Question 2

Most important factor in assessing ;ossible MI

Answer 2

History!

Question 3

Chest discomfort during MI versus angina

Answer 3

MI pain lacks any clear physical clinical cause like angina does

Question 4

most specific clinical manifestion indicating MI

Answer 4

Pain radiating to neck and arms

Question 5

1st sign of HF/ elevated venous pressure

Answer 5

non productive cough

Question 6

ass features of acute MI

Answer 6

unrelieved by nitro, duration symptoms grerater 30 min

Question 7

ass. features aortic stenosis

Answer 7

systolic murmor

Question 8

Ass. features pericarditis

Answer 8

relieved by sitting up and leaning forwards, pericardial frictio rub, sharp quality, and lasts hours to days

Question 9

Aortic dissection

Answer 9

abrupt onset terribble pain, knife like burning, location is ant chest radiating to back, ass with hypertension, marfan syndrome

Question 10

Spontaneous phnemothorax

Answer 10

smoking!

Question 11

esophogeal spasm

Answer 11

can be confused for angina

Question 12

patient sleeps with 6 pillows and preferes to sleep in a recliner, whats going on?

Answer 12

orthopnea, strongly suggests pul edema HF

Question 13

hepato pulmonary syndrome

Answer 13

common sign is platypnea, dyspnea is alleviated when laying down, worse while sdtanding

Question 14

syncope in medicated elderly

Answer 14

elderly exp syncope commonly especially when on many bp meds, make them hypotensive and pass out, alweays measure orthostatic vitals or can miss it.

Question 15

disorders in which hemoptysis is a common sign

Answer 15

PE, pulmonary edema, mitral stenosis, malignancies

Question 16

one of the common fiordt signs of HF/ increasedvenous pressure

Answer 16

non productive cough

Question 17

dry cough

Answer 17

common with PE, can produce a frothy pink sputum

Question 18

First thing to do when seeing patient for cardiac distress

Answer 18

ABC, airway brerathing circulation, then bp in both arms 1 leg

Question 19

pulsating uvula

Answer 19

aortic stenosis

Question 20

most comming sign in fundoscopic exam for peeps with diabetes, endocarditis, hypertension

Answer 20

roth spots

Question 21

Best art to measure jugular venous pressure (JVP)

Answer 21

inner carotid, cononected to right heart direct, outer ok not as good

Question 22

JVD def

Answer 22

engorgement of the IJ more than 5 cm above the sternal angle at 45 degrees

Question 23

how to measure JVP

Answer 23

Measured by adding 5 cm to the height of the observed jugular venous distention above the sternal angle of Louis at 45 degrees

Question 24

carotid pulses

Answer 24

use bell

Question 25

patients with a higher stroke volume (aortic regurgitation, arteriovenous fistula, hyperthyroidism, fever, or anemia findings from carotid pulse

Answer 25

inc frequency and intensity

Question 26

aortic stenosis findings with carotid pulse

Answer 26

pulse is delayed

Question 27

barrel chest

Answer 27

1:1 ratio, chronic lung disease

Question 28

pectus excavatum

Answer 28

excavated chest, sinks in funnel shape

Question 29

pectus carinatum

Answer 29

pigeon chest, protrude

Question 30

What are bruite suggestive of?

Answer 30

plaque accumulation

Question 31

aortic stenosis and bruits

Answer 31

aortic stenosis can radiate to caratid too, dont confuse

Question 32

common location pace maker

Answer 32

top left chest, can palpate small box, can get infected

Question 33

best way to detect pleural effusion

Answer 33

tactile fremitus and percussion

Question 34

lung crakles

Answer 34

suggests pulmonary edema, pneumonia or pleuritis.

Question 35

left ventricle apex beat

Answer 35

best heard left 5th space

Question 36

patient position for heart palp

Answer 36

patient in supine position at 30 degrees and enhanced by placing the patient in the left lateral decubitus

Question 37

PMI

Answer 37

Point of maximal impulse is less than 2 cm and it moves quickly away from the fingers. Size, amplitude and rate of force can be noted

Question 38

S1

Answer 38

MITRAL AND TRICUSPID VALVE CLOSURE

Question 39

S2

Answer 39

aortic and pulmonic valve closure

Question 40

ventricular systole

Answer 40

tween s1 s2

Question 41

ventricular dystole

Answer 41

tween s2 s1

Question 42

s3

Answer 42

Rapid filling phase of ventricular diastole. Can be normal and children and young adults. > 40 yrs: Heart failure, MR (mitral regurg), s3 is close to s2, comes right after s2

Question 43

s4

Answer 43

late ventricular diastole. | CAD, HTN, HF , can be normal in athletes, comes closer to s1 right b4

Question 44

systolic murmors

Answer 44

Mitral and Tricuspid Regurgitation, Aortic and Pulmonic Stenosis

Question 45

diastolic murmors

Answer 45

Aortic and Pulmonic Regurgitation, Mitral and Tricuspid Stenosis

Question 46

continuous murmors

Answer 46

patent ductus arteriosis

Question 47

grading systolic murmor

Answer 47

closer apex sound is to s2 or even in s2 more severeSystolic murmor is

Question 48

pericardial friction rub

Answer 48

100% specific for diagnosis acute pericarditis

Question 49

pericardial disease echo characteristic

Answer 49

ST elevation looks like inversted smily face not tombstone

Question 50

liver enlargement from ab palp

Answer 50

indicative of HF

Question 51

Hepatojugular reflux

Answer 51

licited by pressing on the liver and showing an increase in the jugular venous pressure

Question 52

spleen enlargemnt from ab palp

Answer 52

advanced HF

Question 53

ausc abs

Answer 53

Assess for abdominal aortic or renal artery bruit

Question 54

peripheral vasc disease

Answer 54

muscular atropy and lack of hair

Question 55

delayed pulses

Answer 55

diss/coarctation aorta

Question 56

clubbing advanced

Answer 56

>180 deg

Question 57

normal nail bed angle

Answer 57

160 deg

Question 58

early clubbing

Answer 58

180 deg flat