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Unit 2 > POM > Flashcards

POM Flashcards

1
Q

steps of a physical exam

A

inspection, palpation, percussion and auscultation

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2
Q

Symptoms of Dyspnea

A

cough, chest tightness and wheezing due to respiratory muscle stretch and tension issues with oxygen delivery

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3
Q

hemoptysis

A

coughing up blood

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4
Q

major differences between adult and pediatric patients exams

A

peds- least to most invasive

  • you are dealing with the entire family so parents notice and appreciate your efforts
  • *parents understand was is normal and what is unusual in terms of their children’s behavior
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5
Q

ways to distract: infants, older infants, toddlers, and school age kids

A

infants- shiny things that aren’t visually complex

older infants- calculator, cell phone, peek-a-boo (object permanence)

toddlers- simple conversations (siblings, TV shows)

school age kids- conversations about school, activities, instruments they may play

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6
Q

how to get a good exam from a kid

A

do not touch them right away, use the parents for help, observe!, give them options

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7
Q

important peds elements for HPI, PMH, SH

A

HPI- activity, hydration

PMH- full term, mom’s prenatal care, complications, neonatal support, vaginal/C-section

SH- day care/school, siblings, smoke exposure, immunizations

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8
Q

milestones of development

A

motor, social, language

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9
Q

neural development is based on:

A

myelination and pruning (babies have more connections but they are ineffective)

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10
Q

3 key things about peds

A
  1. not interacting normally with caregiver is a measure for concern
  2. little kids do not fake illness
  3. fast breaking is bad
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11
Q

Newborns

A

M- primitive reflexes, fixing gaze, flexed posture

S/L- cries to communicate

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12
Q

2 months

A

M- smiles, less flexed, can hold head up with help from shoulders

S/L- coos (musical long vowels), smiles

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13
Q

4 months

A

M- hands to midline, rolls front to back

S/L- laughs, stops crying at parent’s voice

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14
Q

6 months

A

M- sits, unilateral reach, raking grasp

S/L- oral exploration, babbles (repetitive constants, stranger anxiety

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15
Q

9 months

A

M- crawls, cruises, walks along furniture, claps

S/L- says mama and dada, object permanence

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16
Q

12 months

A

M- independent steps

S/L- understand much, says 2 words, jargoning with gestures

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17
Q

2 years

A

M- walks up stairs holding one hand, scribbles

S/L- 10 words, names body part
**accident prone

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18
Q

3 years

A

M- pedals tricycle, walks up stairs alternating feet

S/L- parallel play, knows age and sex

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19
Q

4 years

A

M- hops on one foot, uses scissors and climbs well

S/L- tells a story, goes to toiley alone
*assume responsibility for dressing

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20
Q

SOB at night could be due to:

A

heart failure, asthma, sleep apnea

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21
Q

orthopnea

A

needing to elevate (uncomfortable breathing when supine)

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22
Q

paroxysmal nocturnal dyspnea

A

waking up unable to breathe

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23
Q

cardiomyopathy

A

weakening of the heart making it harder to pump blood

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24
Q

causes of breathlessness

A

asthma, COPD, interstitial lung disease

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25
Q

causes of common cough

A

post nasal drip, asthma, the combination of the two, chronic bronchitis and gastroesophageal reflux

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26
Q

exsanguination

A

bleeding to death

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27
Q

pectus carniatum

A

pigeon chest

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28
Q

pectus ecavatum

A

funnel chest

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29
Q

causes of barrel chest

A

emphysema due to hyperinflation and thus airway collapses on inhalation due to the loss of certain structures

30
Q

kyphosis

A

exaggerated curvature of the spine so chest loses space

31
Q

scoliosis

A

lateral deviation of the spine which can cause restrictive lung disease

32
Q

clubbed fingers

A

can indicate lung cancer and congenital heart diseases

33
Q

Cheyne strokes

A

respiratory center problem with periods of increased depth and apnea (CO accumulation causes overshooting of breathing then CO gets too low and patient will stop breathing)

34
Q

Kussmaul

A

rapid, deep and labored (compensate for metabolic acidosis)

35
Q

ataxic

A

damage to respiratory center

36
Q

tacile fremitus

A

palpable vibration fo the chest wall that results from speech or other verbalizations

37
Q

resonant vs dull percussion

A

resonant- normal due to air and tissue

dull-not normal indicating tumor, fluid

*hyperresonant- too much air, asthma, emphysema

38
Q

bronchial breath sounds

A

heard over the trachea and can mean abnormality if it is heard in another region

39
Q

ABCDE

A 
airway
breathing
circulation
disability
exposure
40
Q

signs of wellness

A

no caregiver concerns about level of activity
no changes in breathing patterns
no changes in intake or output
alter, interactive

41
Q

difference between peds and adult arrests

A

peds- respiratory
*kids compensate by working hard to breathe then tire out and fail

adults- cardiac

42
Q

lethargy

A

severe illness in children meaning abnormaly drowsy and unable to appropriately interact with their environment (inability to maintain alertness)

43
Q

irritability

A

can be a sign of severe illness that means inconsolable

44
Q

formula for normal systolic BP

A

70 + (2 x age)

45
Q

why is a fever a problem in peds?

A

immune system is just developing and they are prone to overwhelming infections

46
Q

HEADFIRST

A 
home
education
abuse
drugs
safety
friends
image
recreation
sexuality
threats
47
Q

egophany

A

increased resonance of voice sounds heard when auscultating the lungs due to fluid in lungs (enhanced transmission of sounds across fluid rather than air)

E–> A

48
Q

pectoriloquy

A

increased sound of whispered words when the lungs are heard through a stethoscope due to fluid (enhanced transmission of sounds through fluid as opposed to air)

49
Q

how to distinguish between an effusion and consolidation

A

tactile fremitus would be increased over a consolidation and decreased over a pleural effusion

  • E to A changes in consolidation
  • percussion is dull with an effusion
50
Q

asthma

A

SOB with exposure to strong odors, exercise or at night (triggers)
*cough, chest tightness, wheezing

51
Q

tests for asthma

A

PFTs (pulmonary function test and methacholine challenge test)

52
Q

Acute, subacute and chronic classification of cough

A

acute- less than 3 weeks
subacute- 3-8 weeks
chronic- greater than 8 weeks

53
Q

cough onsets (sudden and gradual)

A

sudden- upper airway infection (viral or bacterial)
environmental exposure to irritants

gradual- chronic infection like TB; chronic lung diseases like cancer

54
Q

platypnea

A

SOB that worsens when sitting down but is relieved when laying down

55
Q

normal breathing sounds (vesicular, bronchovesicular, bronchial)

A

vesicular- heard over most of the lung
bronchovesicular- heard over the upper lung zones
bronchial (tracheal)- heard over the trachea only

56
Q

wheezing is indicative of:

A

asthma, interstitial edema

57
Q

crackles are indicative of:

A

pulmonary edema, pneumonia

58
Q

types of Dyspnea

A 
on exertion
at rest
orthopnea
PND (sudden onset of SOB)
playpnea (SOB when upright)
59
Q

CHF

A

congestive heart failure
dyspnea, diaphoresis, juglar vein distesion, 3rd and 4th heart sounds (S3, S4), murmurs, peripheral edema

**EKG or ECHO

60
Q

COPD

A

dyspnea, chronic cough, sputum production, prolongation of expiration, intermittent wheezing and rhonchi
**CXR, PFTs

61
Q

what to inspect the abdomen for

A

masses, hernia, separation of muscles, skin characteristics, venous return patterns, symmetry, surface motion

62
Q

when does a baby start to smile and laugh

A

smile- 2 months

laugh- 4 months

63
Q

at what age does parallel play occur?

A

3 years

64
Q

where obstetrics and gynecology come from

A

ob- midwifery

gyn- surgery

65
Q

baby brain vs adult brain

A

baby brain is 25% of adult brain

66
Q

efficient bipedalism

A

walking and running- requires hip joints to be close together

67
Q

emmer and barley seeds

A

urinate on them everyday, if seeds germinate–> pregnant

barley (yellow) first- male
emmer (gray) first- female

none grow- not pregnant

68
Q

the Flexnor Report

A

standard protocol for medical education

69
Q

episiotomy

A

delivery with forceps

70
Q

meaning of “gyne” and “logica”

A

gyne- woman

logica- study

71
Q

J. Marion Sims

A

performed experiments on slaves

72
Q

gyn malignancies spread to

A

lymphatics

*gym malignancy spread can be determined by embryology

Unit 2 (3 decks)

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