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general med > General Combanium > Flashcards

General Combanium Flashcards

1
Q

What is pulse

A

Waveform generated by left ventricular systolic which traverses arterial tree in a peripheral direction at a tmrate faster than blood column

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2
Q

Physiological bradycardia

A

Athlete
Sleep

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3
Q

Pathological bradycardia

A

. Acute inf wall mi
. Heart block
. Sick sinus syndrome
. Ict
. Hypoxia
. Hypothermia

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4
Q

Physiological tachycardia

A

Emotion
Exertion
Age

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5
Q

Pathological tachycardia

A

Anemia
Fever
Acute ant wall mi
Phaeochromocytoma

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6
Q

Regularly irregular rhythm

A

Atrial flutter

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7
Q

Irregularly irregular

A

Atrial fib

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8
Q

Hypokinetic pulse

A

Cardiac failure
Shock
Ms
As

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9
Q

Hyperkinetic pulse

A

Mr
Vsd
High output states

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10
Q

Anacrotic (pulsus parvus et tardus)

A

Severe aortic stenosis

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11
Q

Dicrotic

A

Left vent failure
Typhoid fever
Cardiac tamponade
Dilated cardiomyopathy
Dehydration

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12
Q

Waterhammer pulse(collapsing pulse)

A

Ar
Patent ductus arteriosus
Av fistula
Rupture of sinus of valsakva

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13
Q

Pulsus bisferens

A

As with ar
Severe ar
Hocm

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14
Q

Pulsus alterans

A

Severe left vent failure

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15
Q

Pulsus bigeminis

A

Digitalis toxicity

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16
Q

Paradoxical pulse

A

Cardiac tamponade
Constrictive pericarditis
Acute severe asthma
SVC obstruction

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17
Q

Reverse pulsus paradoxus

A

Hocm
Av dissociation

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18
Q

Korotkoff sounds

A

Phase 1- clear and tapping
Phase 2- soft murmur
Phase 3- murmur becomes louder
Phase 4- muffling of sounds
Phase 5- disappearance of sounds

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19
Q

Tachypnea

A

Anxiety
Exertion
Fever
Hypoxia
Acidosis
Pneumonia
ARDS
Acute pulm edema

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20
Q

Bradypnea

A

Alkalosis
Hypothyroidism
Increased ict

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21
Q

Hyperpnea

A

Acidosis
Brain stem lesion
Hysterical state

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22
Q

Intermittent fever

A

Sepsis
Abscess

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23
Q

Remittent fever

A

Viral uri
Mycoplasma

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24
Q

Continuous fever

A

Brucellosis
RMSF

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25
Q

Relapsing fever

A

Infection
TB
Histoplasmosis

26
Q

Pel ebsteins fever

A

Hodgkins lymphoma

27
Q

What Is jugular venous pressure

A

The vertical height from the sternal angle to the zone of transition of distended and collapsed internal jugular veins. Normally 4-5 cm

28
Q

Why do we use ijv for jvp

A

. Direct continuation of right atrium
. No valves
. Doesn’t go through muscular plane
. Right is more straighter than left
. Located between two heads of sternocleidomastoid

29
Q

Causes of elevated jvp

A

Innominate vein thrombosis
Pleural effusion
COPD
Cardiac tamponade
Constrictive pericarditis
TS
Tr
Ascites
Pregnancy

30
Q

Causes of fall in jvp

A

Hypovolemia
Shock
Addisons

31
Q

Waves in jvp

A

A wave- right atrial contraction
C wave- tricuspid valve ascends carotid artery impact
X descent- right atrial relaxation
V wave- venous filling into atrium
Y descent- tricuspid valve opens atrial emptying

32
Q

Prominent a wave

A

TS
Pah
Ps

33
Q

Cannon a wave

A

Complete heart block

34
Q

Absent a wave

A

Af
Atrial standstill

35
Q

Prominent v wave

A

Tr
Rvf
Restrictive cardiomyopathy

36
Q

A wave = v wave

A

Cardiac tamp
Constrictive pericarditis
Hypovolemia

37
Q

Prominent x descent

A

Cardiac tamp
Asd

38
Q

Prominent y descent

A

Constrictive pericarditis
Tr
Asd

39
Q

Blunted x descent

A

Tr
Af

40
Q

Blunted y descent

A

Cardiac tamp
Ts

41
Q

Kussmals sign

A

During inspiration,mean jvp falls, due to inability of the heart to accommodate increased venous return caused by negative intra pleural pressure
Seen in,
Constrictive pericarditis
Rvf
Right vent infarction

42
Q

Absent abdominal jugular reflex

A

Budd chiari syndrome

43
Q

Sites of pallor

A

Lower palpebral conjunctiva
Tongue
Finger nailbed
Palms

44
Q

Serum bilirubin in icterus

A

More than 2 mg percent

45
Q

DD jaundice + malnutrition

A

Pancreatic malignancy
Cirrhosis

46
Q

DD jaundice + virchow nodes+/ sister Mary Joseph’s nodules

A

Intra abd malignancy

47
Q

DD jaundice + elevated jvp+ tender hepatomegaly

A

Hepatic congestion

48
Q

DD jaundice+ ascite+ pleural effusion

A

Advanced cirrhosis
Disemminated malignancy

49
Q

DD jaundice+ tender hepatomegaly

A

Viral hepatitis
Alc hepatitis

50
Q

DD jaundice+ Murphy’s sign

A

Acute cholecystitis
Ascending cholangitis

51
Q

What is clubbing

A

Selective bulbous enlargement of distal portion of the distal phalanx due to proliferation of connective tissue

52
Q

Grading of clubbing

A

1- fluctuation of nail
2- obliteration of angle
3- drumstick,parrotbeak
4- hypertrophic pulm osteo arthropathy

53
Q

Sign to demonstrate clubbing

A

Schamroth sign

54
Q

Theory of clubbing

A

PDGF mediated
Megakaryocytes - endothelium of small arteries - forms plugs - activated - PDGF production - CT proliferation
Vag stimulation
Humor substances(GH,pth)

55
Q

Pseudo clubbing seen in

A

Hansens disease
Leukemia
Hyperparathydoism
Vinyl chloride worker

56
Q

Sites of cyanosis

A

Lips
Nailbed
Ears
Conjunctiva
Oral cavity

57
Q

Intermittent cyanosis

A

Ebsteins anomaly

58
Q

Classification of cyanosis

A

Central( cyanotic heart disease,pulm av fistula,methhemoglobinemia)
Peripheral( frost bite,arterial obstruction,venous obstruction)
Differential( lowerlimb only - PDA with elsenmengers, upper limb only- PDA+TOGV+ Elsenmenger)
Intermittent -( ebsteins anomaly)

59
Q

Signs of dehydration

A

Cool clammy skin
Delayed cap filling
Dry mucous membranes
Change in mental state
Tachycardia
Tachypnea
Hyptension
Oliguria
Sunken eyes

60
Q

Grading of obesity

A

Grade 1- overweight(BMI 25-30)
Grade 2- obese(BMI 30-40)
Grade 3- very obese(BMI >40)

61
Q

Causes of underweight

A

Malnutrition
Thyrotoxicosis
Db
Addisons
TB
HIV
Chronic bronchitis
Depression

general med (10 decks)

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