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Tutorials > Tutorials Written I > Flashcards

Tutorials Written I Flashcards

1
Q

innervation: lateral rectus and superior oblique

A

CN VI

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2
Q

innervation: superior medial and inferior rectus, inferior oblique

A

CN III

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3
Q

innervation: pupillary constriction, consenual response

A

CN II

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4
Q

how to find the optic disk

A

find and artery or vein branch point and follow the acute angle to the disk

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5
Q

blurred optic disk margins

A

increased intercranial pressure/papilledema

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6
Q

Rinne: air equal or worse than bone

A

conductive hearing loss

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7
Q

Rinne: air better than bone

A

sensorineural hearing loss

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8
Q

Weber: lateralizes to bad ear

A

conductive hearing loss

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9
Q

Weber: lateralizes to good ear

A

sensorineural hearing loss

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10
Q

Ddx ear pain

A

otitis externa or media, TMJ, temporal arteritis, zoster

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11
Q

tug test: extreme pain

A

otitis externa, swimmer’s ear! Treat with abx

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12
Q

cloudy, bulging or perforated ear drum

A

otitis media

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13
Q

Ddx pain swallowing, sore throat, voice change

A

viral or strep pharyngitis, mono, GERD, allergic rhinitis

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14
Q

Ddx slow explanding neck mass

A

thyroid nodule, goiter, malignany, lymphadenopathy, congetinal neck masses

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15
Q

hear a thyroid bruit?

A

hyperthyroidism secondary to Graves

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16
Q

tracheal deviation

A

in pneumothorax and lobar collapse (toward side of condition), or tumor or pleural effusion (away from conditions)

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17
Q

RLQ rebound tenderness, pain on percussion, rigidity and guarding

A

appendicitis

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18
Q

mildly enlarged, soft liver, enlarged spleen (5-15%)

A

hepatitis

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19
Q

Epigastric tendernessRUQ tenderness (if biliary)

A

peptic ulcers

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20
Q

abdominal tenderness, guarding (upper), distention. Diminished bowel sounds

A

pancreatitis

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21
Q

abdominal distenion, hyperactive bowel sounds (early), absent bowel sounds (late)

A

small bowel obstruction

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22
Q

localized tenderness, commonly LLQ (sigmoid colon)

A

diverticulitis

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23
Q

chest pain when lying supine or bent over

A

GERD

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24
Q

pain begins epigastric and then localizes RUQ

A

cholecystitis

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25
Q

normal bowel sounds

A

5-30 per minute

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26
Q

listen for renal bruits if

A

pt has history of hypertension

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27
Q

listen for iliac and femoral bruits if

A

pt has hx of peripheral arterial disease

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28
Q

causes of peritoneal inflammation

A

perforated stomach ulcer, perforated small or large intestine (ruptured appendix, perf from diverticulitis or obstructing cancer), ruptured gall bladder (from cholecystitis)

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29
Q

normal liver span

A

6-12 cm

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30
Q

conditions causing a small liver

A

advanced cirrhosis

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31
Q

conditions causing a large liver

A

hepatitis, hepatic congestion from R-side HF, liver cancer or metastatic liver disease

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32
Q

splenic percussion becomes dull on inspiration

A

enlarged spleen (you want tympanic throughout)

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33
Q

antalgic gait

A

when phase of gait is shortened on the injured side to alleviate pain

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34
Q

tenderness at the greater tubercle of the humerus, pain with abduction over 90 degrees

A

rotator cuff tendonitis

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35
Q

tenderness just lateral and inferior to the acromion

A

subacromial bursitis

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36
Q

pain and crepitus at the AC joint

A

acromioclavicular arthritis

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37
Q

tenderness at the insertion site or along the bicipital groove

A

tendonitis of the long head of the biceps

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38
Q

drop arm test

A

tear of supraspinatus (a rotator cuff muscle)

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39
Q

nodes at the PIP

A

bouchard’s nodes, osteo or rhumatoid arthritis

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40
Q

nodes at the DIP

A

heberden’s nodes, osteoarthritis

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41
Q

inguinal or groin pain that may radiate to knee, pain and limited internal rotation (15 degrees)

A

hip arthritis

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42
Q

lachman test (supine patient, knee bend thirty degrees, then move lower leg anteriorly)

A

ACL tear

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43
Q

tenderness when pressing patella to femur

A

patellofemoral syndrome

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44
Q

thompson test (squeeze grastocnemius)

A

check for ruptured achilles tendon

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45
Q

heel or foot pain in the morning, pain in plantar fascia when dorisflexed toes

A

plantar fascitis

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46
Q

straight leg raise

A

sciatica

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47
Q

assymetric chest wall movement

A

pneumothorax, atelectasis, lobar pneumonia, lung cancer

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48
Q

increased fremitus

A

consolidation

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49
Q

decreased fremitus

A

pleural effusion, pneumothorax

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50
Q

S1 is louder

A

apex (mitral area)

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51
Q

S2 is louder

A

base (AP area)

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52
Q

pt leans forward and exhales while you listen at the left sternal border

A

to appreciate aortic regurg murmur

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53
Q

normal JVD

A

1-3 cm above sternal angle, 6-8 cm above right atrium

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54
Q

listen to carotid with

A

diaphragm or bell

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55
Q

RV heave may mean

A

right ventricular hypertension

56
Q

6 dimensions of a murmur

A

LRQITS location, radiation, quality, intensity (1-5), timing and shape

57
Q

left lateral decubitus

A

use bell to hear mitral stenosis murmurs and gallops

58
Q

upper motor neuron lesion

A

increased tone, increased reflexes, clonus, upgoing plantar reflexes,

59
Q

lower motor neuron lesoin

A

atrophy, hypotonia, decreased reflexes, fasciculations (muscle twitching)

60
Q

Power/strength 0

A

absent motor strenth

61
Q

power/strength 1

A

trace: slight contraction detected

62
Q

power/strength 2

A

weak: movement with gravity eliminated

63
Q

power/strength 3

A

fair: movement against gravity

64
Q

power/strength 4

A

good: movement against gravity with some resistance

65
Q

power/strength 5

A

normal: movement against gravity with full resistance

66
Q

normal tendon reflexes

67
Q

biceps nerve levels

68
Q

brachioradialis nerve levels

69
Q

tricep nerve levels

70
Q

patellar nerve levels

71
Q

ankle nerve levels

72
Q

plantar nerve levels

73
Q

upgoing (extensor) plantar response

A

upper motor neuron lesion

74
Q

how close should you be to evaluate a lesion

A

closer than 20 cm

75
Q

arcal distribution

A

head, hands and feet

76
Q

dermatomal distribution

A

along dermatomes: herpes zoster

77
Q

intertriginous distribution

A

in axilla, perineum, under breasts, under skin folds

78
Q

ABCDE of melanoma

A

asymmetry, border irregularity, color variegation, diameter > 6mm, evolution

79
Q

clubbing is associated with 6

A

interstitial lung disease, lung cancer (esp large cell), mesthelioma, subacute bacterial endocarditis, Crohn’s, primary biliary cirrhosis

80
Q

phimosis

A

inability to retract prepuce, normal in kids under 4

81
Q

peyronie’s disease

A

fibrous plaque on corpus cavernosum gives penis a sharp curve

82
Q

tender prostate

A

acute or chronic prostatitis

83
Q

firm prostate

A

Normal or BPH: feels like thenar eminence of stretched hand

84
Q

hard prostate

A

cancer or stones (scar), feels like a knuckle

85
Q

soft prostate

A

hypogonadism, feels like an earlobe

86
Q

boggy prostate

A

abscess, feels like blown out cheeks

87
Q

discrete nodular prostate

A

BPH or cancer

88
Q

3 of the 10 most common cancers in men are

A

GU: prostate, bladder, kidney

89
Q

normal BMI

90
Q

obese BMI

91
Q

fever in C and F

A

37.7 or 99.9

92
Q

drinking hot beverages

A

increase oral temp by .9 C for fifteen minutes

93
Q

drinking cold beverages

A

decrease oral temp by .3-1.2 C for 15 minutes

94
Q

tachypnea and temperature

A

can lower temp by .5 C for every 10 breaths above normal

95
Q

present with a weak thready pulse

A

hypervolemia, hypertension

96
Q

present with a bounding pulse, wide pulse pressure

A

hyperthyroidism

97
Q

normal HR

A

Between 50/60 and 100

98
Q

Pressure difference in both arms should be less than

A

10-15 mmHg

99
Q

proper cuff: length of bladder is

A

80% of arm circumference, width is 40%

100
Q

BP asymmetry

A

coarctation of aorta, aortic dissection, external compression of arterial flow

101
Q

prehypertension

A

120-139/80-89

102
Q

stage I HTN

A

140-159/90-99

103
Q

stage II HTN

104
Q

orthostasis definition

A

drop of 20 systolic or 10 diastolic within three minutes of standing

105
Q

conductive hearing defects

A

cerumen impaction, typmanic membrane diseases, middle ear disorders

106
Q

visual acuity, top and bottom number

A

top is where patient can read charge from, bottom is normal person

107
Q

diminished light transillumination in mouth

A

indicates sinus congestion

108
Q

expiration is prolonged in

A

obstructive ventilatory diseases such as asthma and emphysema

109
Q

pt with inferior MI may complain of

110
Q

acute ischemia or MI in elderly may present as

A

delirium, reduced cognition, waxing and waning levels of consciousness

111
Q

pt with subacute bacterial endocarditis may appear

A

fatigued, with evidence of weight loss

112
Q

apical impulse is typically found

A

midclavicular line at fifth intercostal space

113
Q

aortic area

A

right second intercostal

114
Q

pulmonic area

A

left second intercostal

115
Q

mitral area

A

cardiac apex

116
Q

tricupsid area

A

left lower sternal border

117
Q

S1 marks

A

beginning of systole (closure of M and T)

118
Q

S2 marks

A

onset of diastole (relaxation, AP close)

119
Q

aortic regurg murmur occurs

A

left sternal border/apex in diastole

120
Q

carotid v. IJV

A

IJV: not palpable, flutters, varies with respiration. Carotid: palpable, up and down, does not vary

121
Q

hyperdynamic PMI

A

hyperthyroid, anemia, beriberi, infection states.

122
Q

normally split on inspiration

123
Q

S3 represents

A

sound of passive filling into dilated venricle

124
Q

S4 represents

A

active filling into stiff ventricle

125
Q

involuntary guarding may indicate

A

peritoneal irritation

126
Q

inspiration causing pain enough to halt it while pressing RUQ

A

murphy’s sign: cholecystitis

127
Q

tenderness at lateral epicondyle

A

tennis elbow

128
Q

tenderness at medial epicondyle

A

golfer’s elbow

129
Q

pain at the base of the thumb commonly occurs in

A

osteoarthritis

130
Q

atrophy of the thenar eminence

A

advanced carpal tunnel

131
Q

Tinnel’s sign

A

percussion over carpal tunnel makes pain/tingling over medial nerve distribution

132
Q

Phalen’s test

A

maximal wrist flexion for one minute causes pain or numbness

133
Q

test of trapezius/SCM

134
Q

symmetrical uvula

135
Q

anatomical snuffbox pain

A

scaphoid fracture, osteoarthritis, tenosynovitis

Tutorials (3 decks)

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