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LECOM H&P S2 > test 1 overall > Flashcards

test 1 overall Flashcards

1
Q

what are the 4 principles of physical exam

A

inspection, palpation, percussion, auscultation

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2
Q

what principle of physical exam typically occurs first

A

inspection

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3
Q

what principle of physical exam typically occurs last

A

auscultation

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4
Q

what arteries should be auscultated prior to palpating the neck

A

carotid

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5
Q

what are some aspects that go along with inspection

A

general appearance, state of nutrition, body habits, gross symmetry, posture and gait, speech

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6
Q

what side should you general approach the patient from

A

right

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7
Q

what are some examples of airborne-infectious agents

A

TB, varicella

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8
Q

what are the required equipment items for an exam

A

stethoscope, otoscope, ophthalmoscope, penlight, reflex hammer, tuning fork (128hz), safety pins, tape measure, pocket acuity card

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9
Q

define sensitivity

A

frequency of a positive result of a test or technique in individuals with a disease or condition

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10
Q

define specificity

A

frequency of a negative result of a test or technique in individuals without a disease or condition

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11
Q

what does aniso- mean

A

unequal

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12
Q

what does idio- mean

A

separate, distinct

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13
Q

what does lith mean

A

stone

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14
Q

when does the physical exam usually begin

A

after the history has been documented

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15
Q

what type of mask is necessary with airborne precautions

A

N-95 or equivalent respiratory mask

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16
Q

what does the suffix -gnosis mean

A

recognition

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17
Q

what does the suffix -dynia mean

A

pain

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18
Q

what is the most common cancer in the world

A

basal cell carcinoma

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19
Q

what layer of the skin are keratinocytes in

A

epidermis

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20
Q

what layer of the skin are melanocytes in

A

epidermis

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21
Q

what layer of the skin are fibroblasts in

A

dermis

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22
Q

define primary lesions

A

first to appear and are due to disease or abnormal state

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23
Q

what techniques are required for the skin exam

A

inspection and palpation

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24
Q

what aspects are required for proper inspection of the skin

A

ensure adequate lighting, proper exposure, review appropriate draping

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25
Q

what are the general principles of the skin exam

A

color, moisture, turgor, texture

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26
Q

what are the A-E of assessment of pigmented lesions

A

asymmetry of shape, border irregularity, color variation, diameter >6mm, evolving

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27
Q

what should be evaluated on the seated patient for skin exam

A

fair, fingernails, skin of face/neck/back

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28
Q

what type of cancer is responsible for most skin cancer deaths

A

melanoma

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29
Q

what are the main symptoms of disease of the skin, hair and nails

A

rash or skin lesion, changes in skin color, itching, changes in hair, changes in nails

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30
Q

what i the only equipment necessary for the examination of the skin

A

penlight

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31
Q

what are mee’s bands historically associated with

A

chronic arsenic poisoning

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32
Q

what type of nails has the proximal portion of the nail bed is whitish, whereas the distal part is red or pink

A

lindsay’s nails

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33
Q

what diseases are commonly associated with lindsay’s nails

A

chronic renal disease and azotemia

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34
Q

what type of nails are white nail beds to within 1-2 mm of the distal border of the nail

A

terry’s nails

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35
Q

what type of nail is a dystrophic state in which the nail plate thins and cuplike depression develops

A

koilonychia

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36
Q

what is pitting of the nails commonly associated with

A

psoriasis and psoriatic arthropathy

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37
Q

what are the 3 specific criteria for a dermatologic diagnosis

A

morphologic characteristics, configuration and distribution

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38
Q

what are some examples of macules

A

freckles, moles

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39
Q

what are some examples of patches

A

vitiligo, cafe au lait spots

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40
Q

what type of lesion is a wart

A

papule

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41
Q

what type of lesion is a erythema nodosum

A

nodule

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42
Q

what type of lesion is psoriasis

A

plaque

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43
Q

what type of lesion is seborrheic keratosis

A

plaque

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44
Q

what type of lesion is a blister

A

vesicle or bulla

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45
Q

what type of lesion is acne

A

pustule

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46
Q

what type of lesion is a blackhead

A

comedo

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47
Q

what type of lesion is scabies

A

burrow

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48
Q

what are the characteristics of telangiectasia

A

fine, irregular dilated blood vessels

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49
Q

what type of lesion is disc-shaped without central clearing

A

discoiid

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50
Q

what type of lesion is a circle within a circle; bull-s eye lesion

A

iris

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51
Q

what type of melanoma is seen most commonly in the geriatric population

A

lentigo maligna melanoma

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52
Q

what 3 things should you always remember with eye exam

A

check vision, shine a light on the pupils, check ocular motility

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53
Q

what cranial nerve innervates the superior oblique

A

CN 4

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54
Q

what cranial nerve innervates lateral rectus

A

CN 6

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55
Q

what is the medical term for improper alignment of the eye

A

strabismus

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56
Q

how many degrees should the visual fields test go temporally

A

100-110 degrees

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57
Q

how many degrees should the visual fields test go nasal and upward as well as downward

A

nasal and upward is 60; downward is 70

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58
Q

what occurs if there is unilateral visual field loss

A

it is unilateral in front of the chiasm

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59
Q

what occurs if there is bilateral visual field loss

A

it occurs behind the chasm

60
Q

what is the treatment for blepharitis

A

steroids, doxycycline, azithromycin, erythromycin, baby shampoo

61
Q

what is the definition of a sty

A

inflamed around the hair follicle, often infections

62
Q

what causes a chalazion

A

inflamed, clogged meibomian gland

63
Q

what are the symptoms of the eye with allergic conjunctivitis

A

clear drainage, itch

64
Q

what is the secretion of the eye with bacterial conjunctivitis

A

mucous

65
Q

what is the secretion with viral conjunctivitis

A

clear

66
Q

what is given at birth to prevent conjunctivitis in the newborn

A

erythromycin

67
Q

what is inflammation of the connective tissue between the conjunctive and sclera

A

episcleritis

68
Q

what is another name for nearsidedness

A

myopia

69
Q

what is another name for far-sightedness

A

hyperopia

70
Q

what type of lens is used for myopia

A

minus lenses

71
Q

what type of lens is used for farsightedness

A

plus lens

72
Q

what can cause unilateral painful loss of vision

A

angle closure glaucoma, optic neuritis, temporal arteritis, trauma

73
Q

who does optic neuritis typically occur in

A

women under 45 years old

74
Q

what condition with 50% of individuals who have optic neuritis develop

A

MS

75
Q

when should you avoid using neosynephrine for eye dilation

A

pregnant, recent heart attack or stroke, shortness of breath

76
Q

what can be used for reversing dilation

A

pilocarpine 1%

77
Q

what is the red reflex used to test for

A

retinoblastoma

78
Q

at what size are pupils considered large

A

greater than 5mm

79
Q

at what size are pupils considered small

A

less than 3 mm

80
Q

what is the term for pupil size inequality

A

anisocoria

81
Q

how far away should the physician hold their finger from the patient when checking extra ocular movements

A

15-18 inches

82
Q

define accommodation

A

near focusing of the eye

83
Q

how far away should the examiner be from the patient when testing visual fields by confrontation

A

3 feet

84
Q

what is the red free filter on the fundoscopic exam used for

A

green light that visualizes vessels and hemorrhages

85
Q

what is the cobalt filter used for in the fundoycopic exam

A

evaluate for corneal abrasions, lesions or foreign objects after fluorescein staining

86
Q

what is the action of the medial rectus

A

adduction

87
Q

what is the action of the inferior rectus

A

depression, extorsion, adduction

88
Q

what is the action of the superior rectus

A

elevation, intorsion, adduction

89
Q

where do synapses of they eye occur

A

lateral geniculate body

90
Q

when does the near reflex occur

A

when the subject looks at a nearby target

91
Q

what are the 3 parts of the near reflex

A

Accommodation, convergence, and pupillary constriciton

92
Q

what does diplopia result from

A

faulty alignment of the eyes

93
Q

what causes the twitching symptom in the eye

A

fibrillation of orbiculares oculi

94
Q

where is the blind spot of the ye located

A

approximately 15-20 degrees temporal to central fixation, corresponding to the optic nerve head

95
Q

what is the term for a defect in both temporal fields

A

bitemporal hemianopsia

96
Q

what is the term for deviation of an eye nasally

A

esotropia

97
Q

what is the term for chronic inflammation of the eyelid margins

A

blepharitis

98
Q

what is the term used to describe the inflammation of the lower lacrimal passage (usually seen in infants or older individuals)

A

dacrocystitis

99
Q

what is the condition that is painless scleral condition characterized by the appearance of one or more dehiscences in the sclera in the absence of inflammatory changes

A

scleromalacia perforans

100
Q

what is most likely occurring if there is a whitish ring at the perimeter of the cornea

A

arcus senilis

101
Q

what is an acquired abnormality of the shape of the cornea

A

keratoconus

102
Q

what is another name for pupillary enlargement

A

mydriasis

103
Q

what instrument can be used for the quantitative assessment of intraocular pressure

A

schiotz tonometer

104
Q

what is the position of the ear to view in adult

A

up and back and out

105
Q

what is the position of the ear to view in kid

A

down, back and out

106
Q

whats the cause of sensory-neural hearing loss

A

damage to CN VIII

107
Q

what is sound conducted to CN VII via the ear canal, TM and auricular bones

A

air conduction

108
Q

what is sound conducted to CN VII via the cranial bones

A

bone conduction

109
Q

what does low frequency sound transmit through best

A

solids

110
Q

what doe high frequency sound transmit through best

A

air

111
Q

what is rinne test used for

A

determine if it is conductive loss

112
Q

what is weber test used for

A

determine if it is neurosensory loss

113
Q

what happens if the weber test is heard better in the bad ear

A

conduction loss or distraction

114
Q

what happens if the weber test is heard better in the good ear

A

likely neurosensory loss

115
Q

what can cause otitis externa

A

staph/strep, fungal, pseudomonas

116
Q

what is another name for otitis externa

A

swimmers ear

117
Q

what does the external ear consist of

A

pinna and external auditory canal

118
Q

what are the parts of the tympanic membrane

A

pars flaccid and pars tensa

119
Q

what meatus does the nasolacrimal duct empty into

A

inferior meatus

120
Q

what openings does the middle meatus contain

A

frontal, maxillary and anterior ethmoid sinuses

121
Q

where does the posterior ethmoid sinus drain

A

superior meatus

122
Q

where is the local pain for the maxillary sinus

A

behind ear, cheek, nose, upper teeth, upper lip

123
Q

where is referred pain for the maxillary sinus

A

teeth, retrobulbar

124
Q

where is the local pain for the ethmoid sinus

A

periorbital, retronasal, retrobulbar

125
Q

where is the referred pain for the ethmoid sinus

A

occipital, upper cervical

126
Q

where is the local pain for the frontal sinus

A

supraorbital, frontal

127
Q

where is the referred pain for the frontal sinus

A

bitemporal and occipital headache

128
Q

what are the functions of the pharynx

A

enable swallowing, enable speech, provide an airway

129
Q

what is another name for hoarseness

A

dysphonia

130
Q

what is the condition in which the dorsum of the tongue has a smooth, localized red areas, denuded of filiform papillae, surrounded by well-defined, raised yellowish-white margins and normal filiform papillae

A

geographic tongue

131
Q

what is the most common endocrine cancer

A

thyroid cancer

132
Q

what does the lacrimal apparatus consist of

A

lacrimal gland, accessory tear glands, canaliculi, tear sac, and nasolacrimal duct

133
Q

what is the most common cause of blindness

A

cataracts

134
Q

where is sweetness detected

A

tip of the tongue

135
Q

where is saltiness sensed

A

at the lateral margins of the tongue

136
Q

where is sourness and bitterness perceived

A

posterior aspect of the tongue

137
Q

what are the boundaries of the anterior triangle

A

SCM, mandible, midline

138
Q

what are the boundaries of the posterior triangle of the neck

A

SCM, traps, clavicle

139
Q

use the _____ to auscultate the carotid arteries

A

bell

140
Q

what is the normal size of a lymph node

A

typically <1cm

141
Q

how does the patient lie for a brudzinski’s sign test

A

supine

142
Q

what is a positive brudzinski’s sign

A

patient has flexion of hips and knees with motion of neck

143
Q

how does the patient lie for a kerning’s sign

A

supine

144
Q

what is a positive kerning’s sign

A

patient has associated pain and resistance to motion

145
Q

what part of your fingers do you use for palpating lymph nodes

A

pads of fingertips

LECOM H&P S2 (2 decks)

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