Workbook5 Flashcards by Deanna Volking

Primary Headaches

No identifiable underlying cause

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Secondary Headaches

Arise from other conditions

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If headache is severe and of sudden onset

Subarachnoid hemorrhage or meningitis

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Episodic headaches that peak over several hours

Migraine and Tension

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New and persisting, progressively severe headaches raise concern of…

Tumor, abscess, mass lesions

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Unilateral headaches found in…

Migraine and cluster headaches

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Tension headaches found in…

Temporal areas

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Cluster headaches found in

Retro-orbital areas

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Associated symptoms of nausea and vomiting associated with…

Migraines, brain tumors, subarachnoid hemorrhage

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Feelings of euphoria, food cravings, fatigue, or dizziness, aura, change in vision, numbness/weakness in arm or leg associated with…

Migraines

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If coughing/sneezing/head position worsens headache it could be…

Pain from brain tumor, acute sinusitis

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Pts. with chronic daily headaches taking symptomatic meds 2+ days per week might have…

Medication overuse

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Hyperopia

Farsightedness (Difficulty seeing close up)

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Presbyopia

Aging vision (impaired near vision)

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Myopia

Nearsightedness (problems with distance)

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Unilateral visual loss that is painless might suggest…

Vitreous hemorrhage from diabetes or trauma, macular degeneration, retinal detachment, retinal vein occlusion, or central retinal artery occlusion

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Unilateral visual loss that is painful might suggest…

Corneal ulcer, uveitis, traumatic hyphema, acute glaucoma, optic neuritis from MS

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Sudden and painless bilateral visual loss caused by…

Medications that change refraction (i.e. cholinergics, anticholinergics, and steroids)

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Sudden and painful bilateral visual loss caused by…

Chemical or radiation exposures

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Gradual bilateral visual loss caused by…

Cataracts, macular degeneration

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Slow central visual loss caused by…

Nuclear cataract, macular degeneration

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Peripheral visual loss caused by…

Advanced open-angle glaucoma

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One-sided visual loss caused by…

Hemainopsia, quadrantic defects

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Visual field moving specks/strands suggest…

Vitreous floaters

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Visual field fixed defects suggest...

Lesions in the retina or visual pathways

Flashing lights in visual field suggest...

Detachment of vitreous from retina...should have prompt eye consultation

Diplopa arises from...

Lesion in brainstem/cerebellum, weakness/paralysis of extraocular muscles

Horizontal diplopia due to palsy from CN...

III or VI

Vertial diplopia from palsy of CN...

III or IV

Diplopia in one eye with the other eye closed suggests...

Cornea/lens issue

Hearing loss due to...

Congenital, single gene mutations

Conductive hearing loss due to...

Problems in external or middle ear

Sensorinerual loss due to...

Problems in inner ear, cochlear nerve, connections to the brain

Having trouble understanding speech, complaining that others mumble, and noisy environments makes it worse suggests...

Sensorineural loss

Noisy environments help hearing suggests...

Conductive loss

Otitis externa

Pain in external ear

Otitis media

Pain in inner ear

Ear pain associated with other symptoms of respiratory infection/referred from mouth/throat/neck suggests...

Otitis media

Soft wax discharge, debris from inflammation, rash in ear canal suggests...

Otitis media

Tinnitus

Percieved sound with no external stimulus

Tinnitus + hearing loss + vertigo suggests...

Meniere's disease

Vertigo suggests problem in these places:

Labrynths of inner ear, peripheral lesions of CN VIII, or lesions in central pathways/nuclei in brain

Best way to ask about vertigo:

do you have feelings of being pulled to the ground or off to one side?

Rhinorrhea

Drainage from the nose

Causes of rhinorrhea

Viral infections, allergic rhinitis (hay fever), vasomort rhinitis

Rhinitis medicamentosa

Drainage from nose worsened by excessive use of decongestants

Symtoms of acute bacterial sinusitis

Symptoms appearing agter a URI, pain bending forward, maxillary toothache, tenderness over sinuses

Drugs that cause stuffiness

Oral contraceptives, alcohol, reserpine, guanethidine

Nasal congestion limited to one side suggests...

Deviated septum, foreign body, tumor

Epistaxis

Bleeding from the nose

Causes of epistaxis

Trauma, inflammation, drying, crusting, tumors, foreign bodies

Fever, pharyngeal exudates, anterior lymphdenopathy, especially in the absence of cough suggests...

Streptococcal pharyngitis (strep throat)

Sore tongue results from...

Local lesions, systemic illness

Bleeding gums caused by...

Gingivitis

Causes of chronic hoarsness

Smoking, allergy, voice abuse, hypothyroidism, chronic infections i.e. tuberculosis, tumors

Enlarged, tender lymph nodes accompany:

Pharyngitis

Intolerance to cold, decreased sweating suggests:

Hypothyroidism

Palpitations and involuntary weight loss suggests:

Hyperthyroidism

Fine hair accompanies:

Hyperthyroidism

Coarse hair accompanies:

Hypothyroidism

Redness and scaling of scalp may indicate:

Seborrheic dermatitis, psoriasis

Enlarged skull indicates

Hydrocephalus or Paget's disease of bone

Hirsutism

Excessive facial hair

Hirsutism caused by

Polycystic ovary syndrome

Vision of 20/200 means...

At twenty feet, the patient can read print that a person with normal vision could read at 200 ft (larger second number = worse vision)

Legally blind

20/200 or less in better eye, corrected

Temporal hemianopsia

Pt can't see temporal sides

Homonymous hemanopsia

Temporal defect in visual field of one eye, nasal defect in the other eye

Enlarged blind spot in:

Glaucoma, optic neuritis, papilledema

Inward/outward deviation of eyes or abnormal protrusion seen in

Graves' disease, ocular tumors

Eyebrow scaliness seen in

Seborrheic dermatitis

Lateral sparseness of eyebrows seen in:

Hypothyroidsim

Upstarting palepbral fissures seen in:

Downs syndrome

Red inflamed lid margins:

Blepharitis

Excessive tearing from increased production of tears seen in:

Conjunctival inflammation, corneal irritation

Excessive tearing due to impaired draininge of tears seen in:

Ectropion, Nasolacrimal duct obstruction

Jaundice

Yellow sclera

Miosis

Constriction of the puplis

Mydriasis

Dilation of pupils

Aniscoria

Pupillary inequality of .5 mm or less (benign if reactions are normal)

Asymmetry of corneal reflex suggests:

Deviation from normal ocular alignment

A fine, rhythmic, oscillation of the eyes

Nystagmus

Abnormal proturstion of eyeball

Proptosis or Exophthalmos

Proptosis caused by:

Hyperhyroidism

Poor convergence seen in:

Hyperthyroidism

Reasons for dilating the eyes:

Head injury, coma, suspicion of narrow angle glaucoma

Absence of a red reflex suggests:

Opicaity of lens (cataract), detached retina, or retinoblastoma in children

Swelling of optic disc and anterior bulging of physiologic cup

Papilledema

Papilledema suggests:

Meningitis, subarachnoid hemorrhage, trauma, mass lesions

Loss of venous pulsations signifies:

Head trauma, meningitis, mass lesions, elevated intracranial pressure

Exostoses

Nonmalignant overgrowths in ear canals

Skin of ear canal is thickened, red, and itchy in addition to being swollen

Chronic Otis Externa

Red, bulging, ear drum indicates:

Otitis media

Prominent short process and prominent handle suggests:

Retracted Drum

Sound is heard in the impaired ear in:

Unilateral conductive hearing loss

Sound is heard in the good ear in:

Unilateral sensorineural hearing loss

BC= AC or BC>AC

Conductive hearing loss

AC>BC

Neural hearing loss

Nasal mucosa is reddened and swollen in:

Viral rhinitis

Nasal mucosa is pale, bluish, or red in

Allergic rhinitis

Nasal polyps come from:

Middle meatus

Ulcers result from

Nasal use of cocaine

Local sinus tenderness with pain, fever, and nasal discharge suggests

Acute sinusitis

Connects lip with gingiva

Labial frenulum

Connects tongue to floor of the mouth

Lingual Frenulum

Swollen interdental papillae, redness of gingiva suggests:

Gingivitis

A benign midline lump of hard palate of roof of mouth

Torus palatinus

Asymmetric protrusion of tongue suggests

Lesion of CN XII (Hypoglossal)

Soft palate fails to rise and uvula deviates to opposite side

CN X paralysis

Tender lymph nodes suggest:

Inflammation

Hard/fixed lymph nodes suggest:

Malignancy

Tracheal deviation may signify

Thorax issues such as mediastinal mass, atelectasis, opr large pneumothorax

Elarged thyroid gland

Goiter