Quiz 2 Adv Assessment Flashcards by Keisha Udorji

Characterisitics of Chronic Bronchitis

Recurrent cough & Increased sputum production
Exertional dyspnea
Digital clubbing
Dusky color to cyanotic (Blue Bloater)

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Characterisitics of Emphysema

Increased CO2 retention (PINK)
Purse Lip Breathing (PUFFER)
Orthopneic
Barrel Chest
Thin Appearance
Hyperresonance on Chest Percussion

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Normal chest percussion sound

Resonance

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Where are VESICULAR breath sounds heard?

Lower Lobes

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Where are BRONCHIAL breath sounds heard?

Upper Lobes

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What exam findings are noted with CONSOLIDATION?

Dullness to percussion
Increased tactile fremitus (have pt say 99)
Bronchial or tubular breath sounds, often with late inspiratory crackles that do not clear w/ cough
EGOPHONY: “eee” sounds like ah

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What exam findings are noted with PLEURAL INFLAMMATION?

Sharp, localized pain, worse w/ deep breath, movement, cough

Audible pleural friction rub (sounds like stepping in fresh snow)– heard on inspiration & expiration

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What physical exam findings are noted w/ AIR TRAPPING?

Hyperresonance
Decreased tactile fremitus
Wheeze (exp. first, insp. later)
Low diaphragms
Increased AP diameter

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Normal percussion sound for thorax

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Normal percussion sound for abdomen

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Abnormal percussion sounds for thorax and indications

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Abnormal percussion for abdomen and indications

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What is EGOPHONY and indications

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What is BRONCHPHONY and indications

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Difference between ACUTE cough?

< 3 weeks
Indicates: acute resp infection
Exacerbation of COPD
Asthma
Pneumonia
PE

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Difference between CHRONIC cough?

> 8 weeks
Indicates: Asthma
GERD
Pertussis, atypical pneumonia
ACE inhibitors (begins 1-2 weeks p starting med)
Chronic bronchitis
Bronchiectasis
Lung Ca

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What medications can cause a chronic cough?

Angiotensin-Converting Enzyme Inhibitors (ACEI)

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What microorganisms are associated with community acquired pneumonia (CAP)?

Strep pneumoniae
H. influenzae
Mycoplasma
Chlamydophila pneumonia

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What is the CURB 65 criteria?

Confusion of new-onset
Blood Urea nitrogen
Respiratory rate > 30
Age 65 or older

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What is the Centor criteria?

absence of Cough
Exudative tonsils
Anterior cervical adenopathy
Hx of fever 
Age

Score > 2 screen for Strep

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What does asymmetrical chest expansion indicate?

Pneumothorax

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Maculopapular rashes that are oval w/ Herald patch (Christmas tree) occurs mainly on the trunk

Pityriasis rosea

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Ringworm of the scalp

Tinea Capitis

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Ringworm of the body

Tinea Corporis

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Jock itch: Ringworm of the groin

Tinea cruris

Athlete's foot

Tinea pedis

Tinea of the hands

Tinea manuum

Pityriasis versicolor (caused by yeast)

Tinea versicolor

Onchymycosis: Toenail fungus

Tinea Unguium

Movement away from body

Abduction (Varus)

Movement toward the body

Adduction (VALGUS)

Test that indicates De Quervain's tenosynovitis from inflammation of the tendon at the base of the thumb. Pain w/ ulnar deviation

Finkelstein's test

Full wrist flexion for 60 sec (backward praying hands) + if tingling of median nerve indicates CTS

Phalen's test

Tap anterior wrist briskly. + if "pins & needles" sensation used to diagnosis carpal tunnel

Tinel's test

Painful condition that affects the ball of your foot most commonly between the 3rd & 4th toes may feel as if you are standing on a pebble

Morton's neuroma

Rotator cuff muscles

``` Supraspinatus (abduction) Infraspinatus (external rotation) Teres minor (external rotation) Subscapularis (internal rotation) ```

Apley scratch test

Hawkins shoulder test

What test is used to indicate rotator cuff tear? Tenderness is greater at the supraspinatus insertion

Empty can test

Test that indicates knee instability/ torn ligaments that prevent the femur from sliding posteriorly on the tibia and hyperextension of the knee & limits medial rotation of the femur when the foot is on the ground and the leg is flexed

Anterior drawer test (ACL)

The test that indicates knee instability/torn ligament of the ligament that prevents the femur from sliding anteriorly on the tibia particularly when the kee is flexed

Posterior drawer test (PCL)

Test conducted at 30-degree flexion suggests ACL damage

Lachman test

"Click" on manipulation of knee w/ rotation of ankle indicates injury to a medial meniscus tear. Passive flexion, varus stress & external rotation of the LLE

McMurray test (Medial/ lateral meniscus)

Apley's grinding test

Skin and nail appearance in hypothyroidism

Hand at or above the level of shoulder begins to be painful in lateral shoulder area Reach up into pantry/ closet = PAINFUL

Impingement syndrome

Lateral deltoid pain, weakness, loss of strength in external rotation or abduction usually disturbs sleep

Rotator cuff tear

Anterior shoulder pain, joint stiffness, measurable loss of movement in external rotation and abduction common in diabetes

Adhesive capsulitis (Frozen shoulder)

In a ring ( Bull's eye lesion-Lyme disease) - central clearing

Annular

Blisters > 1 cm w/ fluid (burn)

Bulla

Lesion occurring in a group w/o pattern (herpes)

Clustered

Multiple lesions blending together (psoriasis vulgarsis)

Confluent or Coalescent

Raised, encapsulated fluid-filled lesion

Cyst

Skin thickening usually found over pruritic or friction areas

Lichenification

Lesion distributed in streaks (poison ivy)

Linear

Flat non-palpable are of discoloration < 1 cm (freckle)

Macule

Solid lesion > 0.5 - 2 cm (> 2 cm tumor)

Nodule

Solid elevation < 0.5 cm (mole) | Smooth papule dome-shaped w/ central w/ white plug (molluscum contagiosum)

Papule

Flat, non-palpable area of skin discoloration larger that a macule (vitiligo)

Patch

< 1 cm (thrombocytopenia)

Petechiae

Elevated, variable shape > 1 cm (psoriasis)

Plaque

Flat, red-purple discoloration that does not blanch w/ pressure

Purpura

Vesicle like lesion w/ purulent content (impetigo)

Pustule

Netlike cluster

Reticular

Raised superficial lesions that flake w/ ease (dandruff)

Scale

generalized over body w/o specific pattern (rubella/ roseola)

Scattered

Clear filled (herpes)

Vesicle

Circumscribed area of skin edema (urticaria)

Wheal

Maculopapular butterfly rash (malar rash) thick scaly red rash on sun-exposed areas (discoid rash) Autoimmune photosensitivity

Systemic Lupus erythematosus (SLE)

Order of examination for ABDOMEN

Inspect Auscultate Percuss Palpate

Order of examination for Chest

Inspect Palpate Percuss Auscultate

Flat lung sounds on percussion indicate

Pleural effusion

Dull lungs sounds indicate

Pneumonia

Resonant lung sounds

Healthy lung

Hyperresonant lung sound

Emphysema, pneumothorax