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Fall- PE Exam > Yonkisms for Final > Flashcards

Yonkisms for Final Flashcards

1
Q

Internal/External of shoulders/arms involves _____ muscles

A

rotator cuff

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2
Q

Distrust and suspicion is a characteristic behavior pattern of what personality?

A

Paranoid

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3
Q

Detachment from social relations with a restricted emotional range is a characteristic behavior pattern of what personality?

A

Schizoid

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4
Q

Eccentricities in behavior and cognitirve distortions along with acute discomfort in close relationships is a characteristic behavior pattern of what personality?

A

Schizotypal

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5
Q

Disregard for the law and the rights of others is a characteristic behavior pattern of what personality?

A

Antisocial

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6
Q

Instability in interpersonal relationships, self-image and affective regulation along with impulsivity is a characteristic behavior pattern of what personality?

A

Borderline

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7
Q

Emotional overreactivty, theatrical behavior, and seductiveness is a characteristic behavior pattern of what personality?

A

Histrionic

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8
Q

Persisting grandiosity, need for admiration and lack of empathy for others is a characteristic behavior pattern of what personality?

A

Narcissitic

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9
Q

Social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation is a characteristic behavior pattern of what personality?

A

Avoidant

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10
Q

Sumissive and clining behavior, psychological dependence on others is a characteristic behavior pattern of what personality?

A

Dependent

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11
Q

Rigid, detail-oriented behavior, often associated with compulsions to perform tasks repetitively and unnecessarily and rigid confromtiy to rules is a characteristic behavior pattern of what personality?

A

Obsessive-compulsive

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12
Q

Injury from shoulder dislocation could affect which nerve?

A

Axillary nerve injury

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13
Q

Nerve for lateral aspect of foot

A

Tibial nerve

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14
Q

Workhorse muscle of shoulder abduction is

A

Supraspinatus

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15
Q

When performing ROM you should isolate?

A

the joint above

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16
Q

Intrinsic muscles of the hand are under what nerve control?

A

Ulnar nerve

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17
Q

Romberg test really tests

A

proprioception and vestibular function

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18
Q

Positive romberg with eyes open suggests

A

Cerebellar disease

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19
Q

Pronator drift tests for

A

corticospinal damage- CVA

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20
Q

Positive pronator drift is sensitive and specific for a stroke on the _________side

A

contralateral

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21
Q

Abdominal reflexes test nerves

A

T8-T12

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22
Q

What has a better prognosis? Decorticate posturing or decerebrate (extension of arms, flexions of wrists)

A

Decorticate

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23
Q

Rooting reflex should go away

A

at 4 months

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24
Q

Palmar grasp reflex normal until

A

6 months

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25
Q

Moro refelx normal up till

A

2 months

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26
Q

Plantar reflex abnormal after

A

1 year

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27
Q

Frontal release sigsn typically go with

A

frontal lobe diseases

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28
Q

Abnormal glabellar reflex seen in what disease?

A

Parkinsons (will not stop blinking)

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29
Q

Triad for Wernkicke-Korsakoff’s sydrome

A

Confusion, Opthalmoplegia, Ataxia
common in alcoholic pt, very malnourished (thiamine/B vitamin)
Give thiamine before giving glucose or you can precipiate them

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30
Q

In carpal tunnel there is inflammation of the

A

aponeurosis of median nerve

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31
Q

Median nerve entrapment symptoms include

A

pain and numbness on the VENTRAL surface of the first three digits

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32
Q

Phalen’s test

A

Flex wrist at 90 degrees and push ventral surfaces together, reproducing symptoms/ numbness in fingers. Sensitive for carpal tunnel

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33
Q

Tinel’s sign

A

Tap patients wrist right over median nerve/carpal tunnel, reproduction of paresthesias

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34
Q

What is Kernig’s sign?

A

pain in back and increased resistance to extending the knne with the hip flexed

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35
Q

Common initial finding of MS

A

Optic neuritis

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36
Q

Bilateral positve Kernig signs suggest

A

meningeal irritation

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37
Q

What is Brudzinski’s sign

A

Passively flexing neck. Pain and flexiion of knees and hips flex suggests meningitis

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38
Q

How do you test for peripheral neuropathy?

A

Monofilament

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39
Q

Stocking glove electric burning is an early sign for

A

peripheral neuropathy

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40
Q

Neuropathy can progress to involve

A

Orthostasis
Gastroparesis
Neurogenic bladder
cardiac arrhythmias (and sudden cardiac death)
Posterior column/ impaired vibratory sense
Sexual dysfunction

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41
Q

Rigidity, bradykinesia, and tremor at rest is diagnostic of

A

Parkinsons Disease

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42
Q

Parkinson’s disease pts often have a gait described as

A

slow, shuffling gait with loss of arm swing

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43
Q

Upper motor neuron signs include

A

Spastic weakness
Hyperactive reflexes
+ Babinski
Pronator drift (corticospinal)

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44
Q

Lower Motor Neuron Signs include

A

Flaccid weakness
Hypoactive reflexes
Muscle atrophy
Fasciculations

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45
Q

Extrapyramidal signs include (HD, PD)

A

Resting tremor, rigidity
Postural deformity
Slowed RAM

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46
Q

Cerebellar signs include (B1 def)

A

Intention tremor
Ataxia
Impaired RAM

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47
Q

Diplopia, eye pain, scanning speech, and paresthesias top ddx should be

A

MS

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48
Q

Guillain-Barre is mostly _____ neuron features

A

Lower motor neuron

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49
Q

white matter

A

axons and tracts

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50
Q

gray matter

A

cell bodies

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51
Q

Nerve for front and back of neck

A

C3

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52
Q

Nerve for thumb

A

C6

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53
Q

Nerve for fifth finger

A

C8

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54
Q

Nerve for nipple line

A

T4

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55
Q

Nerve for umbilicus

A

T10

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56
Q

Nerve for inguinal

A

L1

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57
Q

Nerve for anogential

A

S2/3

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58
Q

Nerve for knee

A

L4

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59
Q

Nerve for back of hand thenar space

A

Radial nerve

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60
Q

Nerve for middle three digits anterior and posterior

A

Median nerve

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61
Q

Nerve for lateral aspsect 5th digit

A

Ulnar nerve

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62
Q

Serial 7s

A

Assess attention, Subtract 7 from 100 multiple times

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63
Q

Pathway that is sensorimotor to maintain balance

A

Cerebellar

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64
Q

lesion velow corticospinal (pyramidal) tract cross causes _____ symptoms

A

Contralateral

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65
Q

lesion above corticospinal (pyramidal) tract cross causes _____ symptoms

A

Ipsilateral

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66
Q

complex motor and movement pathways in deep grey matter

A

Basal ganglia

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67
Q

Positive baninski

A

sign of upper motor neuron lesion (ie MS)

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68
Q

Decreased DTRs indicate______ lesion

A

lower motor neuron lesion

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69
Q

Guillan-Barre is an example of _________ lesion

A

lower motor neuron lesion

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70
Q

Upper motor neuron lesions likely to have _______ DTRs

A

increased DTRs

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71
Q

Ipsilater weakness likely seen in _______ neuron lesion

A

lower motor neuron lesion

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72
Q

Spinothalamic pathways cross

A

in the cord

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73
Q

Spinothalamic pathways responsible for

A

pain, temp, crude touch

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74
Q

posterior column pathways cross

A

in the medulla

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75
Q

posterior column pathways responsible for

A

position, vibration, fine touch

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76
Q

Diabetic neuropathy likely to have damage to

A

posterior column

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77
Q

hypermanesium will have _______ DTRs

A

decreased

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78
Q

DTR of Biceps is CN

A

5,6

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79
Q

DTR of Triceps is CN

A

6,7

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80
Q

DTR of brachioradialis is CN

A

5,6

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81
Q

DTR of patellar is nerve

A

L2,3,4

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82
Q

DTR of achilles is nerve

A

S1

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83
Q

Absent DTR is grade

A

O

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84
Q

Hypoactive DTR is grade

A

1+

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85
Q

Normal DTR is grade

A

2+

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86
Q

Hyperactive DTR is grade

A

3+

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87
Q

Hyperactive DTR with clonus is grade

A

4+

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88
Q

Classic cerebellar disease signs

A

Dysmetria (finger to nose) nystagmus (probably up and down) and intention tremor

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89
Q

Patting thighs is an example of

A

Rapid alternating movements, tests cerebellar function

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90
Q

finger spread tests what nerve

A

ulnar nerve

91
Q

wrist extension tests what nerve

A

radial nerve

92
Q

finger opposition tests what nerve

A

median nerve

93
Q

Normal muscle strength grade is

A

5 out of 5

94
Q

Movement against gravity but not against resistance is graded

A

3 out of 5

95
Q

Visible muscle contraction but no joing movement is graded

A

1 out of 5

96
Q

Movement of joing but not against gravity is graded

A

2 out of 5

97
Q

Movement against resistance, but less than normal is

A

4 out of 5

98
Q

Axillary nerve injury may cause shoulder____

A

drop, paresthesia over deltoid, weakness of abduction

99
Q

proximal muscle weakness is more suggestive of

A

myopathy

100
Q

distal muscle weakness is more selective of

A

polyneuropathy or disorder of peripheral nerve

101
Q

Fibrous joints are

A

immovable

like skull

102
Q

passive motion means

A

you as the examiner provides the motion

103
Q

Expected head and neck flexion is

A

40 degrees, more is okay

104
Q

Expected head and neck extension is

A

30 degrees, more is okay

105
Q

Expected lateral head flexion is

A

30 degrees

106
Q

Head and neck movement may reproduce radicular pain. This is from _____ commonly vertebrae____

A

spinal nerve root compression, C6 C7

107
Q

Passive head rotation should probably not go past

A

60 degrees

108
Q

Winged scapula is caused by paralysis of

A

Long thoracic nerve

-serratus anterior

109
Q

Torticollis is

A

“wry neck”
lateral deviation and rotation of the head
from unilateral SCM contraction

110
Q

What can cause torticollis

A

hematoma, muscle tear, dystonic rxn from phenothiazines (thorazine)

111
Q

the TMJ is what kind of joint

A

condylar

112
Q

What muscles open the mouth

A

pterygoid

113
Q

Closing the mouth uses what muscles

A

masseter and temporalis

114
Q

Chewing, fx of TMJ is with what CN

A

CN5

115
Q

What major condition can have deferred pain to the TMJ

A

Giant cell arteritis

116
Q

Normal convexity of cervical spine is

A

concave/ lordotic

117
Q

Normal convexity of the thoracic spine is

A

convex/ kyphotic

118
Q

Most mobile part of the spine is

A

cervical and then lumbar….

119
Q

Unequal height of iliac crests of pelvic tilt suggests

A

leg length discrepancy
scoliosis
hip abduction

120
Q

Expected active flexion of back is

A

90 degrees

121
Q

Expected active extension of spine is

A

30 degrees

122
Q

Normal active lateral flexion of spine is

A

30 degrees

123
Q

What should risk is higher in those with scoliosis

A

atrophy of supraspinatus and infraspinatus with rotator cuff tears

124
Q

inability to abduct shoulder and ttp over bicipital grove suggests

A

rotator cuff tear

125
Q

Localized shoulder pain is suggestive of what disorders

A

subacromial bursitis
subdeltoid bursitis
arthritis

126
Q

Restricted ROM in shoulder is seen in what major disorders

A

Bursitis, adhesive capsulitis, tendonits, cuff injuries, or fx

127
Q

Two sensitive indicators for radiculopathy stemming from spine issues are

A

straight leg raise

contralateral straight leg raise

128
Q

Expected active forward flexion of shoulder/UE is

A

180 degrees

129
Q

Expected active extension of shoulder/UE is

A

60 degrees

130
Q

Expected active abduction of shoulder is

A

180 degrees

131
Q

Expected external and internal rotation of should is

A

180 degrees

132
Q

Muscles of the rotator cuff

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

133
Q

Palpation of step on spine is suggestive of

A

spondylolisthesis

134
Q

Common fractured area of spine from osteoporosis is

A

T10-12

135
Q

2 major bursa in shoulder

A

subacromial and subdeltoid

136
Q

what muscle is responsible for the majority of abduction of the shoulder

A

supraspinatus

137
Q

two tests for impingement syndrome is

A

Neers and Hawkings test

138
Q

Yergason test is

A

With the patient’s elbow flexed at 90 degrees the examiner palpates the bicipital groove as the patient attempts forearm supination against resistance
= biceps tendonitis

139
Q

What nerve transverses the elbow

A

ulnar

140
Q

what muslces are needed for supination

A

biceps and supinator

141
Q

tennis elbow=

A

lateral epicondylitis

overuse with wrist extensors

142
Q

golfers elbow=

A

medial epicondyle

muscles responsible for flexion of the wrist

143
Q

Herberden’s nodes and Bouchard’s nodes are seen in

A

OA

144
Q

Ulnar deviation, swan neck deformity, and boutonniere deformity are seen in

A

Chronic RA

145
Q

Expected wrist extension/flexion is

A

75 degrees

146
Q

What joints does Heeberden’s nodes develop on

A

DIP

147
Q

What joint does Bouchard’s nodes develop on

A

PIP

148
Q

Positive Finkelstein test suggests

A

De Quervain’s Tenosynovitis

149
Q

53 y/o M showing flexion contractures at PIP joints of 3rd digit. Dx=

A

Dupuytren’s contracture

150
Q

What is Trendelenburg test?

A

Pt asked to stand on one hip, opposite hip (off ground) should point upward

151
Q

knee deformities -> bow legged is aka

A

genu varum

152
Q

Inward turning of knees is known as

A

genu valgus

153
Q

When is genu varum normal?

A

up to 3 years old

154
Q

when is genu valgus normal

A

3- 8

or look for skeletal dysplasia or rickets

155
Q

How can you test ACL injury

A

Lachman test- flex knee at 20-30degrees, stabilize femur, pull tibia anteriorly. If it moves it is (+)
Anterior drawer test- knee at 90 degrees, pull tibia forward

156
Q

How can you test PCL injury?

A

Posterior drawer rest- try to displace tibia posteriorly

157
Q

How can you test meniscal injury?

A

McMurray test- knee flexed 90deg, gently ext/int rotate and extend knee (+) is pain or feel click

158
Q

What is patellar grind test

A

leg fully extended, examiner places downward pressure on patella compressing it against patellofemoral groove. (+) elicits pain

159
Q

MC injured collateral ligament is

A

MCL

160
Q

When should routine digital rectal exams be done in otherwise healthy population?

A

Age 40

161
Q

Is DRE specific for ruling out disease?

A

Yes but not sensitive

162
Q

Purpose of digital rectal exam

A 
evaluate symptoms
prostate cancer screening
colorectal cancer screening
evaluation of a retroverted uterus
any rectal complaints
163
Q

How is prostate cancer staged

A

Gleeson score
-histology
+TNM scoring

164
Q

MC cancer in men

A

Prostate Cancer

165
Q

PSA guidelines determines >_____ mg/dL as associated with CA

A

4

166
Q

When should baseline PSA be obtained?

A

40? from AUA

but American Cancer Society says at 50

167
Q

If PSA is less than 2.5 and normal DRE they should be repeated

A

Every two years

168
Q

What drugs on the market could effect PSA

A

finasteride
5 alpha reductase inhibitors
so get baseline before starting

169
Q

What gene mutation is associated with prostate cancer?

A

BRCA2

170
Q

If you feel a nodule on prostate what is the next step?

A

transrectal ultrasound

and biopsy

171
Q

What hyperplastic process can lead to obstruction of urethra?

A

BPH

172
Q

Normal prostate is how long

A

2.5cm

173
Q

prostate should feel like

A

rubbery, nontender, symmetrical, no nodules

174
Q

what is an infectious febrile condition caused by bacterial infection?

A

acute prostatitis

175
Q

MC culprit of acute prostatitis of a man >35

A

GC/ chlamydia

176
Q

MC culprit of acute prostatitis of man >40

A

GNR- enterobacteraciae

177
Q

In what case is DRE contraindicated for acute prostatitis?

A

Immunocompromised

also, prostatic massage in any state in contraindicated

178
Q

What are internal hemorrhoids associated with?

A

Liver disease and portal HTN

179
Q

Which hemorrhoid is painful?

A

External

180
Q

What position for DRE Is best for short fingers and is more comfortable for patient

A

Lateral decubitus (sims position)

181
Q

Mammogram should be started at

A

age 40 and annually

182
Q

Testicular cancer screening recommendation

A

in teen years 15

recommended to have your pts start doing it monthly after a hot shower

183
Q

Clinical breast exam should be done

A

start at age 20 and then q3 years

annually at age 40

184
Q

self breast exams should be done

A

starting in 20s monthly 5-7 days after menses

185
Q

screening for cervical cancer

A

Pap smear +HPV testing at age 21 to 65
q3 years or if after age 30 q5 if previous have been normal

total abdominal hysterectomy-don’t need one if no previous problems

186
Q

which HPV strains are “bad”

A

6 and 11 cause most condylomas/ warts
16 and 18 are most oncogenic
(Gardasil covers these 4)

187
Q

often develops in adolescents
come in with heavy feeling in scrotum
scrotum doesn’t elevate as much as normal
“bag of worms”

A

Varicocele

  • varicosities of venus plexus in spermatic cord
  • infertility unless corrected in 50%
188
Q

Following trauma or spontaneously
Immediate severe pain in testicle and abdomen
Loss of cremasteric reflex
elevating testicle makes pain worse

A

testicular torsion
emergent US with color Doppler
EMERGENCY 6hrs to save from ischemia

189
Q

fluid accumulation around test

transilluminate

A

Hydrocele

  • benign
  • but look for underlying malignancy/testicular cancer
190
Q

Phren’s sign- relief with elevation of epididymis

Mild to moderate pain in testicle

A

Epididymitis

191
Q

Cryptorchidism

A

testicles don’t descend

-have much higher risk of testicular cancer

192
Q

gynecomastia

A 
abnormal breast development
consider:
liver failure
THC use
Spironolactone use
finasteride use
193
Q

If there is galactorrhea in men you should look for:

what visual deficit might be present?

A

prolactinoma
visual field deficit: bitemporal hemi

also phenothiazine antipsych meds (halidol)
HCG
renal?

194
Q

strawberry cervix/ punctate petechae

A

Trichomonas

195
Q

sexually transmitted inflammatory condition of cervix that can spread and lead to ascending of infection of organs (PID)

A

cervicitis

196
Q

Chandelier sign

A

palpating during bimanual exam of cervix
will jump from extreme pain
=cervical motion tenderness (CMT)
PID

197
Q

Pelvic heaviness that radiates to inner thighs along with menorrhagia/ heavy periods think

A

uterine fibroid

  • benign overgrowth of myometrium
  • tx varies
198
Q

Mastitis in a non-lactating woman or persistent dermatitis of the nipple you must

A

r/o inflammatory breast carcinoma (DEADLY)

mc staph aureus

199
Q

What might you see on exam that suggests ductal breast cancer

A

nipple retraction, dimpling, edema (orage peel sign), unilateral bloody nipple discharge

200
Q

DDx in non-lactating galactorrhea

A

prolactinoma
phenothiazines
hypothyroidism

201
Q

mc type of breast cancer

A

ductal breast cancer

202
Q

Post-menopausal vaginal bleeding is

A

endometrial cancer until proven otherwise

203
Q

Pt with insulin resistance, trunkal obesity, and hirsute (male pattern hair growth) think

A

PCOS
poly cystic ovarian syndrome
related to insulin resistance= diabetes

204
Q

acanthosis nigricans can indicate

A

internal malignancy

205
Q

in otherwise healthy adult digital rectal exams should be performed

A

age 40

206
Q

DRE is good at ruling_____ prostate cancer

A

ruling out

but not in

207
Q

Prostate cancer is staged via

A

Gleeson score

+TNM scoring

208
Q

Feeling a hard fixed nontender mass in prostate is

A

suspicious for CA

209
Q

prostate swollen, firm, warm and VERY tender to palpation is likely

A

acute prostatitis

210
Q

DRE is strictly contraindicated in

A

immunocompromised

-also no prostatic massage (anyone)

211
Q

Internal hemorrhoids are often related to disease to what organ?

A

liver disease, portal HTN

212
Q

when are mammograms performed

A

40 and annually

213
Q

breast exams start at

A

age 20 q3yrs

annually at 40

214
Q

Phren’s sign (relief of testicle pain with elevation) is seen in

A

epididymitits

215
Q

an enlarged testicle that you can transillumiate

A

hydrocele

-look for underlying tumor

216
Q

testicle with “heaviness, “bag of worms”

A

varicocele

infertility unless corrected in 50%

217
Q

strawberry cervix

A

trichomons

218
Q

chandelier sign

A

cervicitis/PID

219
Q

new onset IBS symptoms in older woman

A

must r/o Ovarian CA

220
Q

mastitis in a non-lactating woman or persistent dermatitis of the nipple

A

r/o inflammatory breast carcinoma

DEADLY

221
Q

acanthosis nigricans consider

A

internal malignancy

222
Q

post-menopausal vaginal bleeding is

A

endometrial CA until proven otherwise

223
Q

hirsute, truchal obesity, insulin resistance think

A

PCOS

Fall- PE Exam (8 decks)

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