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differential dx > study guide > Flashcards

study guide Flashcards

1
Q

diaphoresis

A

sweating

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2
Q

McBurney’s point

A

lower quadrant tenderness (half way between the R ASIS and umbilicus, palpates legs straight, 11th thoracic n.), appendicitis

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3
Q

positive Kehr’s sign

A

sign of ruptured spleen, this test is done in supine with legs up and feel pain in tip of Left shoulder

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4
Q

signs of pre-eclampsia

A

HTN, unexpected wt gain during pregnancy

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5
Q

gallbladder referral

A

R shoulder

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6
Q

occult

A

obscure/hidden from view

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7
Q

best 1st questions:

A

are you having any limitations related to that?

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8
Q

one of the 4 key questions for screening

A

During the past month have you been feeling down, depressed, or hopeless?

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9
Q

one of the 4 key questions for screening

A

During the past month have you been bothered by little interest or pleasure in doing things?

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10
Q

one of the 4 key questions for screening

A

Do you ever feel unsafe at home or has anyone hit you or tried to injure you in any way?

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11
Q

one of the 4 key questions for screening

A

Are you currently pregnant or think you may become pregnant

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12
Q

Alcohol levels of dependency for men =

A

> 14/week, >4/sitting

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13
Q

Alcohol levels of dependency for women =

A

> 7/wk; >3/sitting

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14
Q

toxic level of caffeine

A

> 3 cups/day

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15
Q

possible reasons for significant wt gain

A

hypothyroid, congestive heart failure

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16
Q

possible reasons for significant wt loss

A

cancer, infection, hyperthyroid

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17
Q

relatives most interested in for family medical hx

A

1st degree = parents and siblings

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18
Q

pain description indicative of vascular

A

throbbing, pounding, pulsing

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19
Q

pain description indicative of neurogenic

A

sharp, crushing, burning, hot

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20
Q

pain description indicative of MSK

A

aching, sore, dull

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21
Q

pain description indicative of emotional

A

miserable, agonizing, torturing

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22
Q

pain description indicative of visceral

A

knifelike, boring, colicky, deep cramping, gnawing, comes in waves

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23
Q

colicky

A

GI discomfort usually form a hollow organ

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24
Q

what to ask if pt reports constant pain

A

do you have this pain now?

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25
Q

key ending question

A

are you having symptoms of any other kind that may or may not be related to your main problem?

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26
Q

pain referral C7

A

somatic pain from interscapular area

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27
Q

pain referral 10th rib

A

gallbladder (somatic and visceral)

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28
Q

somatic

A

pertaining to the body wall in contrast to viscera

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29
Q

pain referral to shoulder, midthoracic, low back

A

spleen

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30
Q

pain referral to chest

A

gallbladder

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31
Q

systemic pain patterns

A

likely constant, deep, boring, progressive, cyclic, less changeable, organ dependent, Bilateral symptoms, painless proximal weakness, fever

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32
Q

pelvic organ innervation

A

T10-11

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33
Q

malaise

A

vague feeling of discomfort, as feel on the onset of getting sick

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34
Q

fatigue

A

sense of tiredness >2 wks

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35
Q

normal wt gain during pregnancy

A

5 lbs/wk,

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36
Q

stridor

A

noisy breathing, specifically high-pitched crowing sound associated with croup, respiratory infection, and airway obstruction

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37
Q

tachypnea

A

RR > 20 b/min for an adult

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38
Q

chronic hypoxia

A

indicated by clubbing of the nails

39
Q

horner’s syndrome

A

caused by a lesion in the SNS, especially the cervical chain or central pathways, & characterized by drooping upper eyelid, pupillary contraction, absence of sweating, and receding eyeball

40
Q

pulmonary checklist is indicated for:

A

unresolved/atypical TOS with hx of CA, Horner’s Syndrome, pain in R/L shoulder girdle, thorax to T-L junction, medications impacting this system or hx of pulmonary dz

41
Q

vascular system checklist indicated for:

A

claudication (pain with exertion), pain in chest, neck, jaw, tooth, medications that impact vascular system, hx of cardiac/vascular problems

42
Q

indicates upper GI involvement

A

melena, heartburn/indigestion, food intolerance

43
Q

indicates lower GI involvement

A

incontinence, frank blood color, difficulty initiating defecation, caliber, diarrhea

44
Q

melena

A

black tarry stool

45
Q

can cause migraines

A

cheese, chocolate, nuts, red wine

46
Q

opioids

A

this drug has a risk of constipation

47
Q

GI system checklist indicated for:

A

long term use of: NSAIDs, corticosteroids, narcotics; pelvic pain, shoulder girdle pain, thorax, medications indicating GI, or hx of GI disorders

48
Q

protuberant

A

swelling outward, bulging

49
Q

normal lymph node characteristics

A
50
Q

vesicular BS

A

heard over majority of lung, mainly hear inspiration

51
Q

bronchial BS

A

heard over trachea and bronchi, louder than vesicular

52
Q

Bronchovesicular BS

A

heard on posterior chest wall at level of scapula, equal inspiration and expicration

53
Q

examples pf adventitious sounds

A

crackels, wheezing

54
Q

S4

A

associated with long-standing HTN, additional sounds precedes S1

55
Q

S3

A

associated with ventricular failure, additional sound follows S2

56
Q

APTM

A

Aortic, Pulmonic, Tricuspid, Mitral breath sound sequence R to L head to toe

57
Q

Bell

A

used to hear Bruits over the aortic, carotid, femoral

58
Q

diaphragm of stethoscope

A

to listen for Digestion

59
Q

ascites

A

abnormal accumulation of fluid in the abdomen

60
Q

normal bowel sounds

A

clicks and gurgles (5-30 per min), listen up to 5 min to establish absence of sounds

61
Q

sequence of abdominal exam

A

INSPECT observe (symmetry) –> AUSCULTATE bowel sounds with diaphragm 4 quadrants –> assess inguinal nodes –> PERCUSS percussion of abdomen, painful area last –> PALPATE map the liver borders –> palpate organs (light up to 1/2 in, deep up to 1” varies with body types)

62
Q

6th vital sign

A

gait speed

63
Q

5 students

A

shape, size, site, spider angioma, surface

64
Q

5 teachers

A

temp, texture, tenderness, translumination, turgor (dehydration >4 sec)

65
Q

CAMPFIRE

A

Consistency, Appearance, Mobility, Pulsation, Fluctuation, Irreducibility, Regional lymph & Rash, Edges & Edema

66
Q

Melasma

A

mask of pregnancy, blotchy brown macules generally symetrical distrubution on checks and forhead

67
Q

sarcoidosis

A

dz affecting many organs developing granulomas (little tumors) made of cells from immune system

68
Q

scleroderma

A

autoimmune disorder, overproduction of abnormal collagen accumulating and scaring throughout the body

69
Q

liver flap

A

arms extended wrists extended, see beating of the wrist

70
Q

pt says “99” repetitively

A

when assessing for tactile fremitus

71
Q

petechiae/purpura

A

doesn?t blanch with pressure

72
Q

erythema

A

blanches with pressure

73
Q

spider angiomas

A

fiery red, radiating “legs” small up to 2mm (liver dz, pregnancy, estrogen therapy)

74
Q

cherry angiomas

A

fiery red, round smooth borders, up to 3 mm

75
Q

xanthomas

A

tumor composed of lipid foam cells

76
Q

risk factors for skin cancer

A

family hx, immunosuppression, prolonged sun exposure

77
Q

basal cell skin cancer characteristics

A

depressed center surrounded by raises, firm border

78
Q

squamous cell carcinoma characteristics

A

scaling, crusty nodules or plaques

79
Q

nail growth

A

average 3mm/month

80
Q

terry’s nail

A

Lunula (whate part of base of nail) more than 2/3 of the length –> found in pts with chrrhosis of the liver and hypoalbumnemia

81
Q

spoon nails

A

found in pts with iron deficiency

82
Q

psoriasis

A

pitting of the nail bed is found in 50% of this pt population

83
Q

mee’s lines

A

white transverse lines across the nail plate –> found in pts with renal failure, heart dz, pneumonia

84
Q

half-and-half nails

A

indicitive of chronic renal failure, the distal half of nail plate is darker colored

85
Q

clubbing

A

broadening of distal appendage with increased Lovibond’s angles related to hypoxia

86
Q

Beau’s lines

A

transverse lines, cracked looking across the nail plate result of severe systemic insult (high fever, infection, renal dz, hepatic dz)

87
Q

Murphy’s Sign

A

hook fingers abournd R anterior lower rib cage, pt inspires; exquisite tenderness = possible acute cholecystitis

88
Q

Murphy’s percussion

A

direct or indirect, ulnar surface of fist over kidney area; vibration reproduces pain

89
Q

Blumberg’s Sign

A

rebound tenderness; palpate deeply and slowly away from suspected area, remove quickly; pain experianced on side of inflammation

90
Q

pinch-an-inch test

A

alternative to Blumberg’s Sign

91
Q

Heel tap test

A

supine, tap heel, + if reproduces lower abdominal pain (L - diverticulitis, R - appendicitis)

92
Q

Hop test

A

unable and clutches abdomen

93
Q

indications for lymph node exam

A

visual lump, pain of lymph nodes, persistent illness, fever, inflammation, spinder bite, infection

94
Q

indications for CN screen

A

stroke, concussion, TBI, altered speech, sensory changes, ptosis, change in childs bx?

differential dx (1 decks)

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