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Clinical Medicine I > Physical Diagnosis 2 > Flashcards

Physical Diagnosis 2 Flashcards

1
Q

Tracheal deviation causes

A
  1. large pleural effusion,
  2. large PTX
  3. Mass
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2
Q

Cheyne Stokes Breathing

A
  1. Gradualing increasing and decreasing resps w/ periods of apnea
  2. HF, uremia, drugs, brain damage
  3. can be normal in sleeping children/elderly
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3
Q

Kussmaul Breathing

A

Hyperventlation

Metabolic acidosis

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4
Q

Biots breathing

A

irregular, unpredictable, intermittent apnea

Respiratory depression, brain damage

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5
Q

Causes of limited chest excursion

A
  1. pleural fibrosis
  2. pleural effusion
  3. lobar pneumonia
  4. pain/splinting
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6
Q

What increases tactile fremitus?

A

Pneumonia/consolidation.

Everything else decreases

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7
Q

Hyper resonance

A

Very loud, low pitch, long duration.

COPD, PTX

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8
Q

Resonant

A

loud, low pitch, long duration

Chronic bronchitis

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9
Q

Tympanic

A

Loud, high pitch, moderate duration.

Large PTX

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10
Q

Dull

A

medium, moderate pitch, moderate duration.

Pneumonia, pleural effusion

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11
Q

Flat

A

soft, high pitch, short duration

pleural effusion

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12
Q

Tracheal breath sounds

A

Insp = Exp, loud, high pitch

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13
Q

Bronchial breath sounds

A

insp < exp, loud, high pitch

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14
Q

Bronchovesicular breath sounds

A

insp = exp, moderately loud, moderate pitch

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15
Q

vesicular breath soulnds

A

insp > exp, soft, low pitch

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16
Q

Positive egophony or bronchophony indicates…

A

lung consolidation or collapse, pneumonia, atelectasis, tumors

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17
Q

Crackles indicate…

A

bronchitis, pulmonary fibrosis, CHF

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18
Q

rhonchi indicates…

A

secretions in large airways… chronic bronchitis

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19
Q

wheeze indicates

A

airflow through narrow bronchi… asthma, COPD, chronic bronchitis, bronchus obstruction

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20
Q

Pleural friction rub indicates…

A

recent URI, pneumonia

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21
Q

Mediastical crunch

A

Hamman’s sign. Crackles in sync w/ heartbeat seen w/ mediastinal emphysema

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22
Q

Percussion: dull

Breath Sounds: bronchial, crackles

+ bronchophony, egophony, whispered pectoriloquy

increased tactile fremitus

A

Pneumonia

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23
Q

Percussion: dull to flat

Breath sounds: decreased or absent

Decreased voice sounds

Decreased tactile fremitus

A

Pleural effusion

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24
Q

Percussion: hyperresonant or tympanic

Breath sounds: decreased, possible pleural rub

Voice sounds: decreased

Fremitus: decreased

A

Pneumo

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25
Q

percussion: diffusely hyperresonant

breath sounds: decreased

voice sounds: decreased

fremitus: decreased

increased AP diameter

A

COPD

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26
Q

percussion: resonant, diffusely hyperresonant

breath sounds: wheeze, crackles

voice sounds: decreased

fremitus: decreased

accessory muscle use:

A

asthma

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27
Q

percussion: resonant

breath sounds: vesicular, crackles, wheezes, rhonchi

voice sounds: normal

fremitus: normal

A

chronic bronchitis

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28
Q

Ejection click:

A

valve disease, dilated aorta/pulm a.

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29
Q

systolic click

A

mitral valve prolapse, mid-systolic

30
Q

JVP measures….. and evaluates…

A

right atrium pressure, heart failure

31
Q

Key areas of auscultation:

A

Aortic: 2ICS, RSB

Pulmonic: 2ICS, LSB

Tricuspid: 4, 5 ICS, LSB

Mitral: 5th ICS, MCL (apex)

32
Q

Accentuated S1 indicates:

A

tachy, fever, HTN, anemia, mitral stenosis, hyperthyroidism

33
Q

Soft S1 indicates:

A

weak contraction–thick chest wall, emphysematous lung

34
Q

Physiologic splitting of S2 is caused by…

A

lower right sided pressure during inspiration

35
Q

Wide pathologic splitting of S2…

A

during inspiration.

pulmonic stenosis, mitral regurg, r. bundle branch block

36
Q

Fixed pathologic splitting of S2

A

no changes during respiration

ASD, r. vent. failure

37
Q

Paradoxcal splitting of S2

A

left bundle branch block

38
Q

S3…

A

ventricular gallop, early diastole, rapid distension of ventricular walls. heard w/ bell at apex

heart failure, anemia, volume overload of ventricle, decreased myocardial contractility

39
Q

S4

A

atrial gallop, heard w/ bell at apex. resistance to ventricular filling

HTD, CAD, AS, cardiomyopathy.

40
Q

Pan/holo murmurs:

A

systolic tricuspid and mitral valve regurgitation

41
Q

Crescendo-decrescendo murmurs:

A

systolic aortic stenosis

42
Q

Midsystolic murmur:

A

ASD

43
Q

Early diastolic, decrescendo

A

Aortic regurgitation

44
Q

Mddiastolic murmur, decrescendo

A

Mitral and tricuspid stenosis

45
Q

opening snap and diastolic rumble…

A

mitral stenosis

46
Q

machinery like murmur

A

patent ductus arteriosus

47
Q

Effect of standing or valsalva strain:

A
  1. decreased volume in LV, decreased venous return to heart.
  2. decreased BP, pulmonary vascular resistance
  3. most murmurs decrease, HCM increases, prolapse of MV increases
48
Q

Effect of squatting or valsalva release

A
  1. increased volume in LV, increased venous return.
  2. Increased BP, PVR
  3. decreased HCM, decreased prolapse of MV, increased intensity of other murmors
49
Q

Increased JVP (> 8cm)

A

heart failure, pulmonary HTN, increased vasc. tone, pericardial tamponade

50
Q

Decreased JVP

A

blood loss, decreased vasc. tone

51
Q

Allen test

A

assess patency of ulnar artery

52
Q

Homan sign

A

calf pain on passive dorsiflexion of foot.

can indcate DT

53
Q

soft papules and plaques in anogenital region…

A

condyloma acuminata

54
Q

painful vesicles and ulcers on erythematous base…

A

genital herpes

55
Q

painless papule that erodes into a painless ulcer.

A

syphilitic chancre

56
Q

dysuria and urethral discharge, inclammed meatus

A

urethritis due to gonoccocal, or trachomatis

57
Q

fibrosis in tunica albuginea. painful penile curvature, ED

A

peyronie’s disease

58
Q

firm nodule or ulcer that doesn’t heal. nontender. +/- inguinal adeonopathy

A

carcinoma of penis

59
Q

soft bag of worms, developed slowly, collapse if elevated scrotum while supine

A

varicocele. infertility association

60
Q

swelling that transilluminates

A

Hydrocele

61
Q

painless mass above testis, smaller than hydrocele

A

spermatocele

62
Q

+Prehn’s sign (elevation provides releif

Fever/chills

hemi scrotal swelling

A

acute epididymitis

63
Q

testicular tenderness and swelling

complication of mumps and epididymitis

A

acute orchitis

64
Q

acute onset of scrotal pain

after trauma, vigorous activity

pain on palpation

absent cremasteric reflex

A

testicular torsion

65
Q

Bright red bleading w/ defecation

A

internal hemorrhoid

66
Q

tender, swollen, bluish mass at anal margin

A

external hemorrhoid

67
Q

perianal erythema, palpable mass

can lead to anorectal fistula

A

anorectal abscess

68
Q

firm, nodular mass

blood per rectum

A

rectal carcinoma

69
Q

uti sxs, fever, chills

tender prostate

perineal or abdominal pain

A

acute prostatitis

70
Q

recurrent UTI, normal prostate exam

A

chronic prostatitis

71
Q

enlarged, firm nodule

irrecular contour

obstructive voiding sxs

A

carcinoma of prostate

Clinical Medicine I (25 decks)

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