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Test 2 Flashcards

1
Q

Increased density causes what type of X-ray

A

decreased penetration of the X-ray

UNDEREXPOSED, more white, RADIOPAQUE

-metal, barium, bone

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2
Q

Decreased density causes what type of X-ray

A

increased penetration of the xray, “burns it black”

more exposed, more black, RADIOLUCENT - air, fat, blood

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3
Q

4 views of xray

A

AP
PA
Lateral
Oplique

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4
Q

Typical CXR views

A

PA and Lateral

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5
Q

Typical Abdomen xray views

A

Flat and upright

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6
Q

Typical Extremity xray views

A

PA/AP, Lateral, Oblique

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7
Q

Why get more views on xray?

A

increases the sensitivity and increases chance of finding problem

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8
Q

> 10 ribs showing on xray

A

hyperinflation

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9
Q

if heart > 1/2 total width of chest

A

consider pericardial effusion, cardiomypathy, CHF

pediatrics are normally 1/2 size of chest

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10
Q

silhouette sign

A

loss of borders and landmarks on chest xray that indicated pneumonia

increased density occurs with infiltrates

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11
Q

How many lobes of right lung

A

3 - upper middle lower

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12
Q

How many lobes of the left lung

A

2 lobes - upper and lower

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13
Q

Where will Right Lower Lobe PNA present

A

consolidation with obscure the right hemidiaphragm

lateral view- infiltrated appear posterior to heart and obscure thoracic spine

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14
Q

Where will right middle lobe PNA present

A

right heart border will disappear and right hemidiaphragm is preserved

lateral- sits on the heart

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15
Q

Where will right upper lobe PNA present

A

right heart border will disappear

lateral view- infiltrates anterior to heart

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16
Q

Differential diagnosis for unilateral pleural effusion

A

Pneumonia
Pulmonary emboli
Neoplasm
Pancreatitis

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17
Q

Differential diagnosis for bilateral pleural effusion

A 
CHF
Collagen Vascular Disease
Hypothyroid
Fluid Overload
Hypoproteinemia
Nephrotic Syndrome
Cirrhosis
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18
Q

Right verses Left pleural effusion

A 
Right = cardiac
Left = pancreatitis
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19
Q

CXR signs of hyperinflation (COPD)

A

flat diaphragm
>10 ribs visible
Increased AP diameter on a lateral xray

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20
Q

Haustral Marking

A

Indicative of large bowel obstruction, more peripheral located

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21
Q

Valvulae Conniventes

A

Look like stacked coins

Indicative of small bowel obstruction, more central

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22
Q

Metaphysis

A

Permanent bone

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23
Q

Epiphysis

A

The growth plate

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24
Q

Salter-Harris Classification - Type I

A

S-traight across, through the physis

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25
Salter-Harris Classification - Type II
A-bove, into the metaphysis
26
Salter-Harris Classification - Type III
L-ower, into the epiphysis
27
Salter-Harris Classification - Type IV
T-hrough E-verything through both the metaphysis and epiphysis
28
Salter-Harris Classification - Type V
R-ammed, epiphysis rammed into metaphysis leaving no physis space
29
What is the eFAST?
extended focused abdominal scan for trauma check chest and abdomen in trauma patients
30
Barcode sign
“barcode sign” indicates absent lung sliding on ultrasound and suggests the presence of pneumothorax at this interspace A seashore sign is normal and means absent pneumo
31
Linear Probe
depth 9cm, more surface ultrasound views arteries, veins, soft tissues, testicles
32
Curve Linear Probe
depth 30cm, can see organs liver, gallbladder, uterus
33
Phased Array Probe
depth 35cm heart, lungs, pleura, abdomen
34
ABCDE of assessing skin
Asymmetry Border Irregularities Color variegation (multiple shades) Diameter >6mm Evolution (changing in size, shape, color)
35
Melanoma
Most serious form of skin cancer HIGH RISK: - white males >50 - family or personal history - total nevus count >25 - one or more atypical nevi - young adult sun exposure with blistering - tanning beds - immunocompromised - red hair phenotype
36
Basal Cell Carcinoma
Locally invasive and destructive. Increased risk for developing subsequent lesion Most common in white caucasians. Usually on the face pink or flesh colored, shiny/translucent, rolled border papule, can be ulcerated
37
Squamous Cell Carcinoma
2nd most common skin cancer behind BCC Risk Factors: - whites - 45-75 yrs old - high UV sun exposure Can resemble aktinic keratosis- looks like a papule or plaque that can be smooth, hyperkeratotic, or ulcerative lesion. Most commonly on the neck and face
38
Merkel Cell Carcinoma
Affects older adults with light skin rapidly growing, painless, firm nodule blue/reddish nodule on head and neck region
39
Superficial Shave Biopsy
used for lesions of the epidermis and/or superficial dermis -seborrheic keratosis, actinic keratosis, skin tags, warts, basal cell or squamous cell carcinoma NEVER FOR MELANOMA or pigmented lesion
40
Deep Shave Biopsy
includes epidermis and some dermis more often for basal cell and squamous cell biopsy
41
Punch Biopsy
Better cosmetic result than shave for lesions involving the dermis, can close with stitches
42
Impetigo
"school sores" Pain: itchy Color: yellow pus-filled vesicles Configuration: leaky pus/fluid Location: mouth and face (child)
43
Dermatitis
Pain: itchy Color: pink to red Configuration: rash-like Location: moist area
44
Eczema
Pain: itchy Color: red, swollen Configuration: weeping, crusting patches Location: elbows and face
45
Actinic Keratosis
Pain: none Color: red, pink, light, dark, tan Configuration: thick scales with crust Location: anywhere there is skin exposure
46
Psoriasis
Pain: itchy Color: red Configuration: scaly patches and plaques Location: elbows, knees, palms, scalp
47
Scarlatina
sandpaper-like skin, starts on trunk and spreads to extremities lasts 4-5 days from strep.A strawberry like tongue
48
Roseola
6th disease from HHV6 or HHV7 high fever followed by macules and papule on trunk that spread to extremities lasting 1-2 days
49
5th Disease
Parovirus B19 erythematous molar rash with circumoral pallor (slapped cheek rash) acute arthritis in adults by time rash shows up, patient is no longer infectious
50
What is the CAGE tool?
Used to assess potential problem with alcohol abuse 1. Have you ever felt you needed to C-ut down on your drinking? 2. Have people A-nnoyed you by criticizing your drinking? 3. Have you ever felt G-uilty about drinking? 4. Have you ever felt you needed a drink first thing in the morning (E-ye opener) to steady your nerves or to get rid of a hangover?
51
Suicide Screening Tool
1. In the past few weeks, have you wished you were dead? 2. In the past few weeks, have you felt that you or your family would be better off if you were dead? 3. In the past week, have you been having thoughts about killing yourself? 4. Have you ever tried to kill yourself? ___________________________________ 5. Are you having thoughts of killing yourself right now? “Yes”to question #5 = acute positive screen (imminent risk identified). Patient requires a STAT safety/full mental health evaluation. Patient cannot leave until evaluated for safety “No”to question #5 = non-acute positive screen(potential risk identified). Patient requires a brief suicide safety assessment to determine if a full mental health evaluation is needed. Patient cannot leave until evaluated for safety.
52
PHQ-9 Tool
1. Patient completes PHQ-9 Quick Depression Assessment 2. If there are at least 4 checks in the shaded section (including Questions #1 and #2), consider a depressive disorder. Add score to determine severity. Consider Major Depressive Disorder - if there are at least 5 checks in the shaded section (one of which corresponds to Question #1 or #2) increased score = increased severity of depression
53
Herpes Zoster
Pain: painful Color: yellow fluid filled blisters Configuration: blisters Location: on dermatomes
54
Acute Viral Rhinosinusitis
Fever for 24-48hrs Possible purulent drainage and congestion No itching (pruritis) Lasting <10 days with bilateral sinus pain red and swollen mucosa
55
Acute Bacterial Rhinosinusitis
Fever for more than 48hrs Unilateral sinus pain and purulent drainage No itching (pruritis) Lasting >10 days red and purulent nasal mucosa
56
Allergic Rhinitis
Typically afebrile with clear drainage and nasal congestion Seasonal allergens trigger
57
Nonallergic Rhinitis
Typically afebrile with clear drainage and nasal congestion. No sinus pain Perennial (all the time, not seasonal) allergens trigger
58
Strep Differential
abrupt onset painful swallowing and fever/chills and fatigue NODES ANTERIOR swollen
59
Mono Differential
(Epstein Barr Virus) abrupt or gradual onset painful swallowing and fever/chills and fatigue POSTERIOR nodes swollen
60
Viral Infection Differential
gradual onset painful swallowing, nasal congestion, post nasal drip, cough, and fatigue sometimes fever BOGGY NODES
61
Postnasal (allergies?) Differential
gradual onset painful swallowing, nasal congestion, post nasal drip, cough No fatigue or fever BOGGY NODES
62
Primary Headaches
caused by overactivity or problems with pain sensitive structures in the head - Cluster (awakens you in sleep, unilateral eye) - Tension (band across head) - Migraine (w/ or w/o aura) - pulsing sensation unilateral, sensitive to light and smells, nausea and vomiting common -Cough headaches, Exercise headaches, sex headaches, alcohol (red wine), foods (w/nitrates), changes to sleep, poor posture, skipped meals, stress
63
Secondary Headaches
a symptom of a disease that activates the pain sensors in the head - sinusitis - aneurysm - tumor - concussion - dehydration - glaucoma etc etc

Diagnostics (4 decks)

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