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Diagnostics > Test 2 > Flashcards

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
Q

Salter-Harris Classification - Type II

A

A-bove, into the metaphysis

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26
Q

Salter-Harris Classification - Type III

A

L-ower, into the epiphysis

27
Q

Salter-Harris Classification - Type IV

A

T-hrough
E-verything

through both the metaphysis and epiphysis

28
Q

Salter-Harris Classification - Type V

A

R-ammed, epiphysis rammed into metaphysis leaving no physis space

29
Q

What is the eFAST?

A

extended focused abdominal scan for trauma

check chest and abdomen in trauma patients

30
Q

Barcode sign

A

“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
Q

Linear Probe

A

depth 9cm, more surface ultrasound views

arteries, veins, soft tissues, testicles

32
Q

Curve Linear Probe

A

depth 30cm, can see organs

liver, gallbladder, uterus

33
Q

Phased Array Probe

A

depth 35cm

heart, lungs, pleura, abdomen

34
Q

ABCDE of assessing skin

A

Asymmetry

Border Irregularities

Color variegation (multiple shades)

Diameter >6mm

Evolution (changing in size, shape, color)

35
Q

Melanoma

A

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
Q

Basal Cell Carcinoma

A

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
Q

Squamous Cell Carcinoma

A

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
Q

Merkel Cell Carcinoma

A

Affects older adults with light skin

rapidly growing, painless, firm nodule

blue/reddish nodule on head and neck region

39
Q

Superficial Shave Biopsy

A

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
Q

Deep Shave Biopsy

A

includes epidermis and some dermis

more often for basal cell and squamous cell biopsy

41
Q

Punch Biopsy

A

Better cosmetic result than shave

for lesions involving the dermis, can close with stitches

42
Q

Impetigo

A

“school sores”

Pain: itchy
Color: yellow pus-filled vesicles
Configuration: leaky pus/fluid
Location: mouth and face (child)

43
Q

Dermatitis

A

Pain: itchy
Color: pink to red
Configuration: rash-like
Location: moist area

44
Q

Eczema

A

Pain: itchy
Color: red, swollen
Configuration: weeping, crusting patches
Location: elbows and face

45
Q

Actinic Keratosis

A

Pain: none
Color: red, pink, light, dark, tan
Configuration: thick scales with crust
Location: anywhere there is skin exposure

46
Q

Psoriasis

A

Pain: itchy
Color: red
Configuration: scaly patches and plaques
Location: elbows, knees, palms, scalp

47
Q

Scarlatina

A

sandpaper-like skin, starts on trunk and spreads to extremities lasts 4-5 days

from strep.A

strawberry like tongue

48
Q

Roseola

A

6th disease from HHV6 or HHV7

high fever followed by macules and papule on trunk that spread to extremities lasting 1-2 days

49
Q

5th Disease

A

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
Q

What is the CAGE tool?

A

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
Q

Suicide Screening Tool

A
  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
Q

PHQ-9 Tool

A
  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
Q

Herpes Zoster

A

Pain: painful
Color: yellow fluid filled blisters
Configuration: blisters
Location: on dermatomes

54
Q

Acute Viral Rhinosinusitis

A

Fever for 24-48hrs

Possible purulent drainage and congestion

No itching (pruritis)

Lasting <10 days with bilateral sinus pain

red and swollen mucosa

55
Q

Acute Bacterial Rhinosinusitis

A

Fever for more than 48hrs

Unilateral sinus pain and purulent drainage

No itching (pruritis)

Lasting >10 days

red and purulent nasal mucosa

56
Q

Allergic Rhinitis

A

Typically afebrile with clear drainage and nasal congestion

Seasonal allergens trigger

57
Q

Nonallergic Rhinitis

A

Typically afebrile with clear drainage and nasal congestion. No sinus pain

Perennial (all the time, not seasonal) allergens trigger

58
Q

Strep Differential

A

abrupt onset

painful swallowing and fever/chills and fatigue

NODES ANTERIOR swollen

59
Q

Mono Differential

A

(Epstein Barr Virus)

abrupt or gradual onset

painful swallowing and fever/chills and fatigue

POSTERIOR nodes swollen

60
Q

Viral Infection Differential

A

gradual onset

painful swallowing, nasal congestion, post nasal drip, cough, and fatigue

sometimes fever

BOGGY NODES

61
Q

Postnasal (allergies?) Differential

A

gradual onset

painful swallowing, nasal congestion, post nasal drip, cough

No fatigue or fever

BOGGY NODES

62
Q

Primary Headaches

A

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
Q

Secondary Headaches

A

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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