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OPP III Exam 1 > Review V > Flashcards

Review V Flashcards

1
Q

spinal facilitation

A

nociceptive input

  • CNS has decreased firing threshold
  • these neurons fire more quickly
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2
Q

pathologic murmur

A 
holosystolic or diastolic
grade 3 or higher
harsh
increased intensity with standing
max intensity ULSB

echo - definitive diagnosis

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3
Q

feeding difficulty with infant

A

first sign of CHF

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4
Q

liver enlargement/ascites

A

CHF

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5
Q

wide fixed split S2

A

atrial septal defect

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6
Q

URSB

A

aortic valve clicks

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7
Q

ULSB

A

pulmonary valve clicks

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8
Q

LLSB

A

ventricular septal defects

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9
Q

apex

A

aortic and mitral valve clicks

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10
Q

venous hum

A

grade 1 to 6 continuous murmur
accentuated in diastole

whining, roaring, or whirring quality

heard over low anterior neck lateral to SCM
louder on right

resolves or changes when patient is supine

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11
Q

still murmur

A

grade 1 to 3 early systolic murmur
low to medium pitch - vibratory/musical

best heart lower left sternal border

loudest with patient supine

decreases with patient supine

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12
Q

ventricular septal defect

A

loud holosystolic murmur at LLSB for small defect

thrill at LLSB, split S2, grade 2-5, grade 1 or 2 mid-diastolic rumble - for medium or large defects

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13
Q

atrial septal defect

A

grade 2 or 3 systolic ejection murmur
-best heart ULSB
wide flixed split S2
absent thrill

may have grade 1 or 2 diatolic flow rumble at LLSB

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14
Q

patent ductus arteriosus

A

continuous grade 1 to 5 in ULSB

  • crescendo in systole and decrescendo into diastole
  • normal S1 - buried S2
  • thrill or hyperdynamic left ventricular impulse may be present
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15
Q

tetralogy of fallot

A 
central cyanosis, clubbing nail beds
grade 3 or 4 long systolc ejection murmur at ULSB
-may have holosytolic murmur at LLSB
-systolic thrill at ULSB
-increased S1 and single S2
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16
Q

coarctation of aorta

A

systolic ejection murmur best heard over interscapular region
=normal S1 and S2
-decreased or delayed femoral pulse
-increased left ventricular impulse

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17
Q

seven S’s

A

of innocent murmurs

  • sensitive - changes with childs position
  • short duration
  • single
  • small
  • soft
  • sweet - not harsh
  • systolic
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18
Q

most common innocent murmur

A

still murmur

  • characteristic to LLSB - musical or vibratory quality
  • vibrations of left outflow tract
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19
Q

chest radiography and ECG

A

rarely assist diagnosis of heart murmur

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20
Q

phonocardiography

A

good for distinguishing between innocent and pathologic murmurs

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21
Q

diagnosis of innocent murmur

A

1 absence of abnormal physical exam findings
2 negative ROS
3 history negative for features that increase risk of structural heart disease
4 auscultatory features of innocent murmurs

criteria for children older than 1 year

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22
Q

newborns

A

higher risk of having serious structural heart disease that presents as asymptomatic murmur

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23
Q

cardiac viscerosomatics

A

Sympathetics - T1-5

Parasympathetics - OA

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24
Q

pulmonary viscerosomatics

A

sympathetics T2-6

parasympathetics OA

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25
Q

urology consult

A

larger than 5mm stone or multiple stones

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26
Q

Tx for acute pyelonephritis

A

fluoroquinolones

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27
Q

nocturnal enuresis

A

bedwetting

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28
Q

always going to bathroom

A

recurrent cystitis

29
Q

gold standard

A

spiral CT

30
Q

bladder symapthetics

A

T10-L2

31
Q

kidney sympathetics

A

T10-11

32
Q

ureter sympathetics

A

T10-L1

33
Q

green discharge

A

gonorrhea

34
Q

cheesy discharge

A

candida

35
Q

acute pyelonephritis

A

bacterial infection of renal pelvis and kidney

  • young adult women
  • FLANK PAIN universal

diagnosis - positive urinalysis

common - E. coli

36
Q

beta lactam

A

resistance in cystitis and acute pyelonephritis

37
Q

risk factors for acute pyelonephritis

A

sexual intercourse 3x per week

new sex partner

38
Q

uncomplicated acute pyelonephritis

A

without structural or functional GU tract

39
Q

CVA tenderness, flank pain, requency, urgency, fever, nausea, vomiting

A

acute pyelonephritis

may not have fever

40
Q

leukocyte esterase

A

positive in urinalysis for acute pyelonephritis

41
Q

antibiotics for acute pyelonephritis

A

fluoroquinolones

or ciprofloxacin

should improve 48-72 hours

42
Q

nephrolithiasis

A

kidney stones
-stone on radiograph - not uric acid though

cramping, abdominal and flank pain intermittent, hematuria, N/V, malaise, fever, chills

43
Q

referral to neurologist for kidney stone

A

more than one stone, larger than 5mm stone, hydronephrosis, pregnant

44
Q

Tx for nephrolithiasis

A

oral hydration and pain management

-10mm or less - antispasmodics - CCBs and alpha blockers - relax smooth m of ureters

45
Q

carbonic anhydrase inhibitors

A

calcium phosphate stone formation

46
Q

acidic urine

A

uric acid, cystine, calcium oxalate stones

47
Q

alkaline urine

A

calcium phosphate and struvite (Mg) stones

48
Q

pregnant women

A

likely calcium phosphate stones

second and third trimester - higher urine pH

49
Q

recurrent infections

A

struvite stones

50
Q

Oxalobacter formigens

A

ingestion can decrease urinary oxalate levels

51
Q

obesity

A

dehydration and proinflammatory

52
Q

fructose

A

incresed kidney stone risk

53
Q

alkalinize urine

A

fruit and veggies

citrate

54
Q

acidify urine

A

cranberry juice and betaine

55
Q

UTIs

A

msot common bacterial infection in women

frequency and dysuria

suprapuhic tenderness

E. coli

56
Q

suprapubic tenderness

A

acute uncomplicated cystitis

57
Q

phone diagnosis for UTI

A

works!

58
Q

nitrites and leukocyte esterase on urinalysis

A

-acute uncomplicated cystitis

59
Q

Tx for acute uncomplicated cystitis

A

nitrofurantoin

fosfomycin

60
Q

inhalation

A

kidneys move inferiorly along psoas

61
Q

sympathetics to kidney

A

decreased GFR

-decreased urine output

62
Q

sympathetics to ureter

A

decreased peristalsis

T10-L2

psoas spasm

63
Q

urination

A

relax external sphincter
decreased sympathetic tone

increased parasymapthetics to internal sphincter
-S2-4

viscerosomatic reflex - warmth, muscle spasm, tenderness, moisture

64
Q

HTN

A

SD at C2, T2, T6

65
Q

ANG II

A

constric afferent and efferent

prostaglandins vasodilated afferent - NSAIDs affect this
-hypoperfusion over time

66
Q

fatigue

A

with renal disease

67
Q

emotional stress

A

decreased urine production and output

vasoconstriction

68
Q

OMT and nephrolithiasis

A

decreased sympathetic tone - allow stone passage

69
Q

OMT and cystitis

A

improve motion of bladder and supporting structures

OPP III Exam 1 (7 decks)

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