Practice questions from DianNe's tutor Flashcards
During whisper test, which has a higher frequency, consonants or vowels?
Consonants
What is a cause of higher frequency loss?
Presbycusis
-common in elderly
What contributes to a normal whisper test and what is abnormal?
Repeating the correct initial sequence or at least 3 of 6
Abnormal: 4 of the 6 wrong
Pt has a positive Weber test on R side and a Rinne test shows BC > AC on the right side. What issue does this pt have?
Bone conduction loss on R side
Pt has positive Weber test on R side. Rinne test shows AC > BC. What issue does pt have?
A sensorineural loss on the L side
What does a Weber test do?
Lateralize sound
-need to follow up positive test with Rinne
A pt has a tonsil that is 65% the normal size. What grade is it?
3+ (>50% <75% - think of quarters making up a dollar)
Difference between bacterial and infectious mononucleosis tonsillitis?
Mono has posterior cervical and diffuse lymphadenopathy and fatigue/malaise
Bacterial has anterior and tonsilar lymphadenopathy and pain with swallowing
Pt comes in with pain R ear and flu like sxs. States she is having difficulty hearing. What caused this?
Otitis media due to obstruction of the Eustachian tube and fluid build up in middle ear
When pt sticks out tongue and it deviates to L. Cause?
CN12 lesion
-tongue deviates to the side of the lesion **lick your wounds
Picture of fucked up corner of mouth. Looks dry and cracked. What causes this?
Chelitis
Caused by B12 def, anemia/iron def, thrush
What are the steps in the cardiovascular exam?
Inspect
Palpate
Percuss
Auscultate
What is pigeon chest called?
Pectus carinatum
What shape chest does COPD pt have and how is it different than normal?
Barrel chest
Increased AP diameter
Where is the Point of Maximal Impulse (IMP) located?
4th-5th intercostal space at mid-clavicular line
What are 4 listening posts of the heart and location
Aortic - R 2nd
Pulmonary - L 2nd
Tricuspid - L 4th
Mitral - L 5th at midclavicular
Where are 3 places you can palpate to find a lower extremity pulse?
Popliteal pulse
Posterior tibial pulse
Dorsalis pedis pulse
Normal capillary refill time?
2 seconds
What is normal angle between nail and proximal nail fold?
180 degrees
Causes of clubbing?
Congenital heart dz
Interstitial lung dz
Lung CA
CF
What are some causes which would increase tactile fremitis?
Pneumonia,
Some causes which would decrease tactile fremitis?
COPD, pleural effusion, fibrosis, pneumothorax, infiltrating tumor
Explain how percussion would be done in a resp exam and what the 5 percussion notes are
Arms crossed in front of chest and percuss thorax on each side from apex to base
5 sounds: flat, dull, resonant, hyper resonant, tympmanic
What breath is equally heard in inspiration and expiration
Tracheal
-see diagram
Order of GI exam?
Inspect Auscultate Percuss Palpate *I Always Picture Penis* (you are welcome)
What is ecchymosis around umbilicus called and what is cause?
Cullen’s sign
Hemoperitoneum due to pancreatitis, ectopic prego
What does a high pitched tinkling sound indicate? Absent sounds indicate?
High pitch - early intestinal obstruction
Absent - intestinal perforation/ischemia/infarction
Normal gut sounds?
5-35 clicks or gurgles per minute
What are audible gut sounds called?
Borborygmi
What side stethoscope for auscultation of the GI and what are you listening for?
Bell
Looking for Bruits suggestive of vascular occlusive disease
Normal size of liver?
6-12 cm
Tests for appendicitis?
Rovsing’s sign, McBurney’s point, Heel strike, iliopsoas muscle test/obturator muscle test
What test can be done for pyelonephritis
Lloyd punch
