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CMS200 > Practical Exam-Findings > Flashcards

Practical Exam-Findings Flashcards

(48 cards)

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1
Q

What would BMI and Bp show for NAFLD?

A

BMI: ↑ (central adiposity)
Bp: ↑ due to IR, systemic inflammation + obesity

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2
Q

What would external eye exam show in NAFLD?

A

Jaundice
Pallor (if liver disease leads to anemia)

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3
Q

What would a skin exam show in NAFLD (4)?

A
  1. Spider angiomas
  2. Signs of portal hypertension → edema, ascites, caput medusae
  3. Palmar erythema
  4. Jaundice (eyes + skin)
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4
Q

What would liver percussion + palpation show in NAFLD?

A
  1. Hepatomegaly → larger than 12 cm mid-clavicular or 8 cm mid-sternal
  2. Firmness indicating cirrhosis on palpation
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5
Q

What would a spleen percussion + palpation show in NAFLD?

A

Splenomegaly → due to portal HTN associated w/ liver fibrosis

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6
Q

Test for ascites in NAFLD?

A

Ascites due to portal HTN + fluid retention

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7
Q

What would Bp, HR, RR, and WC show in obesity?

A
  1. Bp → HTN
  2. HR → ↑ due to ↑ physiologic demands, potential artherosclerosis
  3. RR → ↑ due to ↑ physiologic demands
  4. WC → ↑
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8
Q

What would a skin exam show in obesity (6)?

A
  1. Acanthuses Nigerians (IR)
  2. Striae (stretch marks)
  3. Acrochordons (skin tags associated w/ IR)
  4. Edema
  5. Xanthoma
  6. Central adiposity
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9
Q

Would would an external eye exam show in obesity?

A

xanthoma

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10
Q

What would a liver percussion + palpation show in obesity?

A

Hepatomegaly (due to NAFLD – comorbidity)

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11
Q

What would a heart auscultation show in obesity?

A

Extra sounds (S3+ S4) due to CV comorbidities

Stenosis + regurgitation due to CV comorbidities

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12
Q

What would a test for ascites show in obesity?

A

Fluid accumulation due to comorbidities

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13
Q

What would a peripheral edema exam show in obesity?

A

Edema due to comorbidities such as CHF, venous insuffiency

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14
Q

What would a BP be in someone with diabetes?

A

elevated - HTN

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15
Q

What would a skin exam show in someone with diabetes (7)?

A
  1. Acanthoses nigricans (IR)
  2. Eruptive xanthomas
  3. Central adiposity/ weight gain
  4. Diabetic dermopathy
  5. Skin tags (IR)

On the feet..
- ulcers
- pre-ulcerative callus/ corn

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16
Q

What would ophthalmoscopic exam show on diabetes (4)?

A

Diabetic retinopathy:
- micro aneurysms: small swellings attached to vessels
-flame hemorrhages
-hard exudates
-neovascularization

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17
Q

What would a peripheral pulses exam show in diabetes?

A

Diminished pulses due to PAD (atherosclerosis) or diabetic neuropathy (poor circulation due to nerve damage that control vessel constriction/ dilation)

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18
Q

What would a sensory exam should is diabetes (Ipswich touch test, soft touch, vibration, pain)

A

Vibration: absence
Ipswich touch test: absence of light touch on 2 or more sites out of 6 = + for diabetic neuropathy
Soft touch, pain: absence

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19
Q

What would a positive external rotation lag test mean?

A

Supraspinatus + infraspinatus tear

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20
Q

What would a positive internal rotation lag test mean?

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A

Subscapularis tear

21
Q

What would a positive painful arc test mean?

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A

pain btwn 60-120 → supraspinatus impingement OR rotator cuff tendonitis/ tear

22
Q

What would a positive drop-arm test mean?

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A

Supraspinatus tear

23
Q

What would Bp, HR, temp + W:H show in hypothyroidism?

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A

Bp: Diastolic hypertension
HR: Bradycardia
Temp: slightly lower body temperature
W:H: Weight gain (5lbs)

24
Q

What would a skin exam show in hypothyroidsim (4)?

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A
  1. Lateral 1/3 eyebrow thinning
  2. Puffy face/ eyelids
  3. Skin pallor or yellowing (carotenemia)
  4. Dry skin
25
What would a hair + nail exam show in hypothyroidism?
THin brittle nails Thinning hair/ alopecia
26
What would a thyroid exam show in hypothyroidism (4)?
Goitre, bogginess, nodules, tenderness
27
What would DTRs show in hypothyroidism?
Delayed DTRs (grade 1)
28
What would Bp,HR, RR + temp show in non-organic fatigue?
Bp: mild hypotension HR: tachycardia RR: tachypnea Temp: low grade fever or lower than baseline *looking to rule out infection as a cause of fatigue*
29
What would an oropharyngeal exam show in non-organic fatigue?
Non-exudative pharyngitis - erythematous posterior pharynx - grade tonsils to see if swollen *Looking to rule out infection as a cause of fatigue*
30
Cervical + Axillary Lymph node exam for non-organic fatigue?
Lymphadenopathy Tender lymph nodes *looking to rule out infection as a cause of fatigue*
31
What would an oropharyngeal exam show in insomnia? (rule out 3 conditions)
Use either tonsil grading to see if tonsils enlarged - grade 3 + 4 have higher risk of obstruction thus insomnia Or mallampati score class 3 + 4 have higher risk of OSA Also assess posterior pharynx: - erythema → evidence of post nasal drip - ulceration, enamel erosion, cobble stoning → evidence of GERD
32
Nose (external/ internal) + sinus exam for insomnia?
External: - asses for deviated septum → any asymmetry Internal: - swollen turbinates → rhinitis, allergies, obstruction, -mucous - can lead to post nasal drip -polyps, redness of mucous → sinusitis Sinus: - if tender → increase suspicion of post nasal drip
33
Neck circumference in insomnia?
≤ 40cm increases risk of OSA
34
Lung auscultation in insomnia?
If HF → Fluid/ crackles
35
Heart auscultation in insomnia?
if HF → Extra heart sounds (S3), regurgitation
36
Abdominal palpation exam in insomnia?
if IBS → palpation may be sensitive/ tender to touch if GERD → epigastric pain on palpation
37
What would BP show in PAD?
hypertension
38
What would a skin exam show for PAD? (5)
1. Cold cool skin 2. Presence of foot ulcers, ulcers between toes (kissing ulcers) 3. Discolouration (gangrene) 4. Rubor 5. Distal hair loss + hair loss on toes
39
What would hair + nail exam show for PAD?
Hair: hair loss on toes + distal ankles Nails: Dystrophic nail changes → discolouration, hypertrophic nails, splinter hemorrhages
40
What would a peripheral pulses exam for in PAD?
All will be diminished (carotid, radial, femoral, posterior tibial, dorsalis pedis)
41
What would auscultation of bruits show in PAD?
if bruits detected → Stenosis/ atherosclerosis (PAD)
42
What would a sensory exam (soft touch, vibration, pain, show in PAD?
may be absent due to PAD w/ neuropathy (PAD reduces blood flow can damage nerves)
43
What would BP, HR + RR show in anemia?
BP: Hypotension HR: Tachycardia RR: Tachypnea
44
What would a skin exam show in anemia?
Pallor: face, skin, palmar, palmar creases (IDA), pallor on tongue - icterus (hemolytic) - petechia (aplastic anemia, IDA) - purpura (aplastic anemia) - bruising
45
What would a hair + nail exam show in anemia?
Hair: course, dry hair + evidence of hair loss Nails: Koiloncyhia (spooning), brittle nails, nail bed pallor (IDA)
46
What would a nutritional status exam show in anemia?
-Pallor conjunctiva + rim (anterior) - pallor on nail beds - pallor on palms - pallor on oral mucosa + tongue (IDA)
47
What would BP, Temp, HR + RR show in an UTI?
BP: hypotension (if shock) Temp: fever HR: Tachycardia RR: tachypnea
48
Abdominal palpation for UTI?
Pain/ tenderness may be felt in lower quad on bladder

CMS200 (3 decks)

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