Readings Flashcards
WHO’s definition of “health promotion”
The process of enabling people to increase control over their health and its determinants, thereby improving their health
Methods of health promotion
Patient education
Identify risk factors
Routine screening tests
Head signs of systemic disease
Sunken cheeks
Wasting of temporal muscles
Flushing of face
Who first described goiters and when?
Asians 1500 BCE
Recognized that seaweed (iodine) in the diet helped make goiters small
MC endocrine cancer?
Thyroid
____ is the ___ leading site of new cancers in women
Thyroid
5th
What is the fastest increasing cancer occurring in both men and women?
Thyroid
85% of all head and neck cancers are linked to ____
Tobacco use
How many bones in entire skull? How many in face?
22
14 in face
Largest endocrine gland in the body
Thyroid
How many lymph nodes on each side of the neck?
75+
MC symptoms of the neck
Stiffness, mass
Midline neck masses tend to be:
Benign/congenital
Lateral neck masses tend to be:
Neoplastic
Lateral neck masses tend to be:
Neoplastic
Lateral upper neck masses may be mets from:
Head and neck tumors
Lateral lower neck masses may be mets from:
Breast and stomach tumors
MC cause of neck stiffness is:
Muscle sprain or strain
Hard thyroid gland:
Cancer or scarring
Softness/sponginess of thyroid:
Toxic goiter
Tenderness of thyroid:
Acute infections or hemorrhage
Bruit in thyroid gland
Toxic goiter
Bruit in thyroid gland
Toxic goiter
What is the MC cause of thyroid enlargement worldwide?
Iodine deficiency
Plummer’s disease
Single toxic nodule of thyroid
80-90% of thyroid cancers are what type(s)?
Papillary and follicular
What is the only thyroid cancer that develops from C cells?
Medullary
World’s leading preventable cause of blindness?
Trachoma (caused by Chlamydia trachomatis)
World’s leading preventable cause of blindness?
Trachoma (caused by Chlamydia trachomatis)
Why are many infants born with blue eyes?
At birth, there is little pigment in the iris
By what age does the iris complete pigmentation?
6 months
The lens is more ___ at birth than later in life
Spherical
Most infants are born _____ (myopic, hyperopic)?
Hyperopic (farsighted)
Arcus senilis
Infiltration of cholesterol deposits around the limbus of the cornea
Occurs in elderly patients
Hemianopsia
Loss of 1/2 a visual field
Quadrantanopsia
Field loss in one quadrant
“Pie in the sky”
Optokinetic nystagmus (OKN)
Rapid nystagmus that occurs when eyes try to fixate on a moving target (e.g. train station sign)
Strabismus
Deviated, crossed eye
Esotropia
Deviation of an eye nasally
Hypertropia
Deviation of an eye upward
Alternating tropia
Either eye deviates
Amblyopia
Loss of visual acuity secondary to suppression (only in children)
How long is amblyopia reversible?
Until retinas are fully developed (~7 yrs old)
Kearns-Sayre Syndrome
Genetic condition of progressive symmetric ptosis and weakness of EOMs
Lagophthalmos
Inability to close eyelids completely - thyroid disease secondary to orbital infiltration
Sturge-Weber syndrome
Congenital condition recognized by port wine stain (nevus flammeus) on one side of the face
Follows distribution of 1+ divisions of trigeminal nerve
____ have highest incidence of any malignant ocular tumor
Eyelids
95% of ocular malignancies are ____ (type)
Basal cell carcinoma
Icterus
Yellowish sclera d/t retention of bilirubin
Osteogenesis imperfecta
Bluish sclera
Hereditary disorder w/bone fragility
Scleromalacia perforans
Uncommon
Painless appearance of dehiscences in sclera
Scleromalacia perforans
Uncommon
Painless appearance of dehiscences in sclera
Kayser-Fleischer ring
Golden to greenish-brown ring near limbus of cornea superior and inferior
Sign of Wilson’s disease (disorder of copper metabolism)
Kayser-Fleischer ring
Golden to greenish-brown ring near limbus of cornea superior and inferior
Sign of Wilson’s disease (disorder of copper metabolism)
Munson’s sign
Way to detect keratoconus
Pt looks downward and cone-shaped cornea becomes obvious
Munson’s sign
Way to detect keratoconus
Pt looks downward and cone-shaped cornea becomes obvious
Anisocoria
Unequal pupil sizes
Argyll Robertson pupil
Prostitute’s eye - it will accommodate but doesn’t react
Neurosyphilis
Adie’s tonic pupil
dilated 3-6mm, constricts little in response to light/accommodation
Adie’s tonic pupil
dilated 3-6mm, constricts little in response to light/accommodation
Iris coloboma
Notch or gap in the iris
Keratic precipitates
“Muddy iris”
Deposition of inflammatory cells on corneal endothelium
“Candy cane” hyphema
Blood breakdown products + fresh blood creating alternating red/white hyphema
“Candy cane” hyphema
Blood breakdown products + fresh blood creating alternating red/white hyphema
Optic pit
Congenital small depression located temporally in 75% of cases, yellow or gray
MC cause of blindness
Cataracts
Leading cause of blindness in Americans 20-75 yo
Diabetic retinopathy
Papilledema
Swelling of optic disc
Hollenhorst plaques
Cholesterol emboli found at bifurcation of retinal arteries
MC malignant tumor of retina and telltale sign
Retinoblastoma
Leukocoria (white pupil)
Head tilt may signal ___ weakness
EOM
MC cause of conductive hearing loss in 15-50 yo
Otosclerosis
MC cause of conductive hearing loss in 15-50 yo
Otosclerosis
Rhinitis medicamentosa
Nasal spray abuse
MC cause of anosmia
Nasal polyps
Anosmia
Loss of smell
Rhinitis medicamentosa
Rhinitis caused by nasal spray abuse
MC cause of anosmia
Nasal polyps
Anosmia
Loss of smell
Tophi
Deposits of uric acid crystals - appear as hard nodules in external ear
Tophi
Deposits of uric acid crystals - appear as hard nodules in external ear
Rhinophyma
Prominent hypertrophy of sebaceous glands of the nose
More than 90% of ____ patients have at least 1 oral manifestation of their disease
HIV
Pickwickian syndrome
Obstructive sleep apnea
Bruxism
Grinding of the teeth
Primary dentition - how many teeth and what ages does it occur?
20 teeth - 6 to 30 months old
Secondary dentition - how many teeth and what ages does it occur?
32 teeth - 6 to 22 years old
Largest salivary gland
Parotid
Ptyalism
Excessive salivation
Xerostomia
Dry mouth
Osler-Weber-Rendu syndrome
Multiple telangiecactic lesions on tongue and in GI tract
Peutz-Jeghers syndrome
Brown pigmentary changes on the lips
Fordyce’s spots
Small yellow papules on buccal mucus membrane
Angular cheilitis
Macerated, fissured lesions in corners of mouth
HIV pts
What kind of disease has had largest rise of any leading cause of death?
Lung disease
COPD is the ___ leading cause of death in the US over ____
3rd, stroke
T/F: COPD kills more men than women.
False
Uninfected sputum
Odorless, transparent, whitish-gray
Infected sputum
Purulent, yellow/green/red
MC cause of hemoptysis
Bronchitis
Dyspnea
Subjective sensation of SOB
Tachypnea
Objective finding of rapid breathing
Paroxysmal nocturnal dyspnea
Classic = run to the window for “air”
Upright position improves the pt
Platypnea
Rare symptom of difficulty breathing while sitting up
Trepopnea
Pt is more comfortable breathing while laying on one side
Trepopnea
Pt is more comfortable breathing while laying on one side
Wheezing
Abnormally high pitched noise from partially blocked airway
Usually expiration
Stridor
Harsh, noisy breathing usually a/w obstruction of a major bronchus
_____ are greater than 2-fold higher in asthmatic children than general population
Emotional disorders
Barrel chest
Increase in AP diameter
Flail chest
One chest wall moves paradoxically inward during inspiration
Pectus excavatum
Funnel chest
Depression of sternum
Pectus carinatum
Pigeon breast
Anterior protrusion of sternum
Kussmaul’s breathing
Increased depth of breathing a/w metabolic acidosis
Kussmaul’s breathing
Increased depth of breathing a/w metabolic acidosis
Bronchial breath sounds
Heard over manubrium
Loud, high pitched, expiratory phase is louder/longer
Bronchovesicular breath sounds
1st/2nd ICS (anterior), between scapulae posteriorly
Equal length phases
Bronchovesicular breath sounds
1st/2nd ICS (anterior), between scapulae posteriorly
Equal length phases
Vesicular breath sounds
Soft, low pitched, heard over most lung fields, longer inspiratory
Adventitious breath sounds
Abnormal
Crackles/rales
Short, discontinuous, nonmusical sounds heard mostly in inspiration
Wheezes
Continous, musical, high pitched sounds mostly in expiration
Rhonchi
Lower pitched, sonorous sounds
Pleural rubs
Grating sound, end of inspiration/beginning of expiration
Distant breath sounds
Term for “very soft” sounds
Who created guidelines for documentation and what years?
Centers for Medicare and Medicaid (CMS)
1995, 1997 (minor differences)
ICD codes - define and when were they estabilished
International Classification of Diseases - codes reported for insurance/billing
9 was released 1979
10 was released 2013
American Recovery and Reinvestment Act (ARRA)
Signed in 2009 by Obama to provide more $$$ for EMR development
HIPAA was enacted by who and in what year?
Congress in 1996
Types of pain scales
Simple descriptive, 0-10 scale, visual analog scale, face scale
Clubbing
Angle between normal nail base and finger (Lovibond’s) becomes > 180 degrees