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Clinical Pod Med Exam 1 > Podiatric H&P > Flashcards

Podiatric H&P Flashcards

1
Q

When should you ask ROS questions?

A

prior to past medical history

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2
Q

what age group should you consider asking pregnancy questions?

A

women age 12-50

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3
Q

what should you focus on when asking ROS questions for diabetes?

A

type, duration, last accucheck, last HbA1C, last time checked by family physician
*must have been seen my family doc within the last 6 months

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4
Q

what scale is pulse rated on?

A 
0/4- absent
1/4- weakly palpated
2/4- normal 
3/4- bounding
4/4- strongest, usually associated with thrill or bruit
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5
Q

what are bounding pulses associated with?

A

wide pulse pressure (>60mm Hg)

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6
Q

any delay in capillary fill time can be associated with what?

A

vasospasm or structural changes

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7
Q

what are some systemic diseases causing pitting edema?

A

congestive heart failure (protein-rich exudate)

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8
Q

what are some systemic diseases that cause non-pitting edema?

A

liver and kidney problems (lack of protein in exudate)

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9
Q

what are some important characteristics for determining the nutritional condition of the skin?

A
  1. hair growth
  2. temp
  3. turgor
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10
Q

what is turgor vs. mobility?

A

mobility- the ease with which skin is moved when it is liften
turgor- the speed with which the skin returns into place

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11
Q

identify this lesion: palpable, solid , measures .5-1cm

A

nodule

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12
Q

identify this lesion: non-palpable, <0.5 cm

A

macule

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13
Q

identify this lesion: palpable, solid (>1cm)

A

tumor

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14
Q

identify this lesion: palpable, solid (<0.5cm)

A

papule

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15
Q

identify this lesion: palpable, solid (>0.5cm flat, elevated surface formed by coalescence of papules)

A

plaque

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16
Q

identify this lesion: clear, fluid filled (>0.5cm)

A

bulla

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17
Q

Identify this lesion: cloudy, pus filled (>0.5cm)

A

abscess

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18
Q

Identify this lesion: clear, fluid filled (<0.5cm)

A

vesicle

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19
Q

identify this lesion: cloudy, pus filled (<0.5cm)

A

pustule

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20
Q

identify this lesion: non-palpable >0.5cm

A

patch

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21
Q

Name the two non-palpable lesions, and their size ranges.

A

macule (0.5cm)

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22
Q

Name the two palpable, solid lesions, and their size ranges.

A

papule 1cm

plaque >0.5cm flat, elevated surface formed by a coalescence of papules

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23
Q

Name the clear, fluid-filled lesions

A

vesicle 05cm

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24
Q

Name the cloudy, pus-filled lesions

A

pustule 0.5cm

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25
Q

Name some examples of secondary lesions.

A

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

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26
Q

what are teh 3 classification systems utilized for ulcers:

A
  1. Wagner’s- vascular surgery
  2. International Pressure Ulcer Advisory Panel (IPUAP)- wound care nursing
  3. University of Texam San Antonio (UTSA)
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27
Q

Describe the UTSA classification system for ulcers.

A 
#- refers to depth of ulcer 
letters- refers to ischemia/infection or both
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28
Q

Using the UTSA classification system, grade the depth of ulcers.

A

0- no break in skin
1- subcutaneous break
2- wound probes to tendon
3- wound probes to bone

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29
Q

Using the UTSA classification syste, grade the level of ischemia/infection.

A

A- no infection or ischemia
B- infection
C- ischemia
D- ischemia & infection

30
Q

muscle strength scale: normal strength

A

5/5

31
Q

movement against resistance, but less than normal

A

4/5

32
Q

movement against gravity, but not against added resistance

A

3/5

33
Q

movement at the joint, but not against gravity

A

2/5

34
Q

visible muscle movement, but no movement at the joint

A

1/5

35
Q

no muscle movement

A

0/5

36
Q

because the normal pod MSK exam occurs in the sitting position with the feet elevated (gravity eliminated), active movement of the foot and ankle against resistance implies what muscle strength?

A

2/5

37
Q

early loss of strength will usually be seen in which muscle?

A

extensor digitorum brevis

*test by having patient dorsiflex the toes

38
Q

more severe loss of muscular strength will be seen in what motion?

A

ankle dorsiflexion

39
Q

MOST severe loss of muscular strength will be seen in what motion?

A

ankle plantar flexion

40
Q

sensation proceeds along which courses in the spinal cord?

A
  1. posterior column

2. lateral spinothalamic tract

41
Q

if a patient complains of “burning, cramping” pain- what tract is affected?

A

lateral spinothalamic tract- (aka small fiber tract)

42
Q

which tract is for sharp and dull pain (nociception), temp, crude touch?

A

lateral spinothalamic tract

43
Q

which tract is for position, vibration, and fine touch?

A

posterior column

44
Q

if a patient complains of “pins and needles or electric shock sensation”, which tract is affected?

A

posterior column

45
Q

what is considered a normal neurological exam with SWM?

A

at least 7/10 areas detected

46
Q

what is the normal distance for 2-point discrimination?

A

5-6mm

47
Q

an absent achilles reflex after what age is considered normal/

A

after 80 y/o

48
Q

what is the spinal root level for the knee reflex?

A

L2,3,4

49
Q

what is the spinal root level for the ankle reflex?

A

S1,2

50
Q

what are the 5 potential areas of problems if you don’t get a reflex?

A
  1. intact sensory nerve
  2. a functional synapse in the spinal cord
  3. an intact motor nerve fiber
  4. NMJ
  5. competent muscle
51
Q

true or false- deep reflex is not dependent upon higher levels of motor function in the brain and spinal cord.

A

true

52
Q

describe the scale for scoring a deep tendon reflex.

A

4/4- hyperactive, clonus –> indicates UMN lesion
3/4- brisker than average, may indicate disease
2/4- average, normal
1/4- somewhat diminished
0/4- no response –> indicates LMN disease, peripheral neuropathy

53
Q

what does a Babinskin response indicate?

A

(is a superficial reflex or plantar response, L4, L5, S1, S2) UMN disease- dorsiflexion of the great toe and fanning of the other toes

54
Q

if a patient is able to stand on their tiptoes but not on their heels, what dose this suggest?

A

peripheral neuropathy

55
Q

if a patient is able to stand on heels, but not tiptoes, suggests what?

A

spinal lesion

56
Q

what does the ability to hop in place with each foot indicate?

A

intact motor system in the legs, normal cerebellar function and good position sense

57
Q

what is the impression?

A

same as diagnosis

58
Q

if a child is born in the breech position (buttocks first), what problems are more associated with this?

A

greater chance of LE problems, especially hip dislocation with or without metatarsus adductus

59
Q

what is the APGAR score?

A 
(very intial exam of teh infant after birth)
A-appearance
P-pulse
G-grimace
A-activity
R-respirations
60
Q

what is the desirable APGAR score?

A

> 7

61
Q

when does a child develop hand preference?

A

age 2- a preference before then could signify a problem

62
Q

when can a child lift their head?

A

at 3 months

63
Q

when can a child control head position while sitting?

A

6 months

64
Q

when can a child begin to crawl?

A

6 months

65
Q

when can a child pull self to stand?

A

9 months

66
Q

when can a child walk?

A

14 months

67
Q

when can a child ascend staris with 2-hand support?

A

18 months

68
Q

when can a child run forward?

A

2 years

69
Q

when can a child pedal a tricycle?

A

3 years

70
Q

when can a child balance or hop on one foot?

A

4 years

71
Q

when can a child heel-toe walk?

A

5 years

72
Q

when can a child skip one foot at a time?

A

6 years

Clinical Pod Med Exam 1 (14 decks)

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