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ScribeAmerica > Course 4 > Flashcards

Course 4 Flashcards

1
Q

Benign Exam “No Touch”: General

A

Well developed, Well nourished, NAD

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2
Q

Benign Exam “No Touch”: Eyes

A

PERRL

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3
Q

Benign Exam “No Touch”: ENT

A

Moist mucosa

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4
Q

Benign Exam “No Touch”: Neck

A

Supple

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5
Q

Benign Exam “No Touch”: Cardiovascular

A

Well perfused

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6
Q

Benign Exam “No Touch”: Respiratory

A

No respiratory distress

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7
Q

Benign Exam “No Touch”: Gastrointestinal

A

Non-distended

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8
Q

Benign Exam “No Touch”: Extremities

A

No edema

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9
Q

Benign Exam “No Touch”: Skin

A

Dry, No rashes

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10
Q

Benign Exam “No Touch”: Neurological

A

Alert and Oriented, Normal speech

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11
Q

Benign Exam “No Touch”: Psychiatric

A

Normal affect

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12
Q

Complete Benign Exam: Constitutional

A

Well, developed, well nourished, NAD

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13
Q

NAD

A

No Acute Distress

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14
Q

Complete Benign Exam: Eyes

A

PERRL, EOMI

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15
Q

EOMI

A

Extraocular Movements Intact

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16
Q

Complete Benign Exam: ENT

A

Moist mucous membranes

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17
Q

Complete Benign Exam: Neck

A

Supple, No lymphadenopathy

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18
Q

Complete Benign Exam: Cardiovascular

A

Well perfused, RRR, No murmurs, rubs, or gallops, Distal pulses intact

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19
Q

RRR

A

Regular Rate and Rhythm

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20
Q

Complete Benign Exam: Respiratory

A

No respiratory distress, Clear to auscultation bilaterally, No wheezes, rales, or rhonchi

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21
Q

Complete Benign Exam: Abdominal

A

Non-distended, Soft, Non-tender, No guarding, rebound, or rigidity

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22
Q

Complete Benign Exam: Extremities

A

No edema, Full ROM

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23
Q

Complete Benign Exam: Skin

A

Dry, No rashes, Warm

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24
Q

Complete Benign Exam: Neurological

A

Alert and Oriented, Normal speech

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25
Q

Complete Benign Exam: Psychiatric

A

Normal affect

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26
Q

Exam Findings: Auscultating the Heart (2)

A

RRR, No murmurs, rubs, or gallops

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27
Q

Exam Findings: Auscultating the Lungs (2)

A

Clear to auscultation bilaterally, No wheezes, rales, or rhonchi

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28
Q

Exam Findings: Palpating the Abdomen (4)

A

Soft, Non-tender, Non-distended, No guarding, rebound, or rigidity

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29
Q

Exam Findings: Examining the Legs (2)

A

No edema, Distal pulses intact

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30
Q

Extra Exam Findings: Examines the throat

A

Pharyngeal erythema or exudates

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31
Q

Extra Exam Findings: Examines the inner-ear

A

TM erythema or bulging

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32
Q

Extra Exam Findings: Auscultates the abdomen

A

Hyperactive/hypoactive BS

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33
Q

BS

A

Bowel Sounds

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34
Q

Extra Exam Findings: Touches the wrists

A

Radial pulses

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35
Q

Extra Exam Findings: Squeezes the calf muscles

A

Calf tenderness

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36
Q

Extra Exam Findings: “Pounds” on the back

A

CVA tenderness

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37
Q

Benign

A

Normal

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38
Q

Anatomical Position

A

A frame of reference used to describe anatomy and movement

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39
Q

Tenderness

A

Pain felt on the release of pressure

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40
Q

Atraumatic

A

Without trauma

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41
Q

Icterus

A

Yellowing, also known as jaundice

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42
Q

Purulent

A

Pus-like

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43
Q

Erythema

A

Redness

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44
Q

Organomegaly

A

Organ enlargement

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45
Q

Perfusion

A

The flow of blood through the body’s blood vessels

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46
Q

Affect

A

Feeling and emotion

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47
Q

Consolable

A

Able to be comforted

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48
Q

GCS

A

Glascow Coma Exam

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49
Q

Glascow Coma Exam

A

Used to assess level of consciousness in trauma pts

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50
Q

Normal

A

Benign

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51
Q

A frame of reference used to describe anatomy and movement

A

Anatomical Position

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52
Q

Pain felt on the release of pressure

A

Tenderness

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53
Q

Without trauma

A

Atraumatic

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54
Q

Yellowing, also known as jaundice

A

Icterus

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55
Q

Pus-like

A

Purulent

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56
Q

Redness

A

Erythema

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57
Q

Organ enlargement

A

Organomegaly

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58
Q

The flow of blood through the body’s blood vessels

A

Perfusion

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59
Q

Feeling and emotion

A

Affect

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60
Q

Able to be comforted

A

Consolable

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61
Q

Used to assess level of consciousness in trauma pts

A

GCS, Glascow Coma Exam

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62
Q

Contradiction: well developed, well nourished (3)

A

Cachectic, Emaciated, Malnourished

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63
Q

Contradiction: alert (3)

A

Somnolent, Obtunded, Unresponsive

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64
Q

Somnolent

A

Responsive to verbal

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65
Q

Obtunded

A

Responsive to pain

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66
Q

Contradiction: Mild/Mod/Severe Distress

A

No Acute Distress

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67
Q

Contradiction: Cachectic/Emaciated/Malnourished (2)

A

Well developed, Well nourished

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68
Q

Contradiction: Somnolent, Obtunded, Unresponsive

A

Alert

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69
Q

Contradiction: Sinus tenderness, Angioedema, Any signs of trauma

A

Atraumatic/Normocephalic (AT/NC)

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70
Q

Swelling of face (esp. with allergic reactions)

A

Angioedema

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71
Q

Contradiction: PERRL

A

Anisocoria

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72
Q

Anisocoria

A

unequal pupils

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73
Q

Contradiction: EOMI

A

EOM entrapment

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74
Q

Not characterized by jaundice

A

Anicteric

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75
Q

Contradiction: Sclera are anicteric

A

Scleral icterus

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76
Q

Contradiction: Normal conjunctiva (2)

A

Pale conjunctiva, Conjunctival infection

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77
Q

Contradiction: Scleral icterus

A

Sclera are anicteric

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78
Q

Scleral icterus

A

Characterized by jaundice

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79
Q

Instrument used for fundoycopic exam of the internal eye

A

Ophthalmoscope

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80
Q

Contradiction: Retinal detachment, Papilledema, Hyphema (2)

A

Clear anterior chamber, Sharp disc margins

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81
Q

Swelling behind eye

A

Papilledema

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82
Q

Bleeding in the eye

A

Hyphema

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83
Q

Used for external eye exam (2)

A

Wood’s lamp, Fluorescein

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84
Q

Contradiction: Normal cornea (3)

A

Corneal abrasion, corneal ulcerations, fluorescein uptake

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85
Q

Earwax

A

Cerumen

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86
Q

“Eardrum blocked by earwax”

A

TM obscured by cerumen

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87
Q

Benign nose exam

A

Normal Nares (or naris)

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88
Q

Swollen inner nose

A

Boggy turbinates

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89
Q

Collection of blood in pocket of nose

A

Septal hematoma

90
Q

DMM

A

Dry Mucous Membranes

91
Q

Benign mouth/throat exam (2)

A

Moist Mucous Membranes, OP Normal

92
Q

OP

A

Oropharynx

93
Q

PTA (not prior to arrival)

A

Peritonsillar Abscess

94
Q

Cavities

A

Dental Caries

95
Q

adj. Lacking teeth

A

Edentulous

96
Q

Redness in back of throat

A

Pharyngeal Erythema

97
Q

White plaque on tonsils

A

Tonsillar Exudate

98
Q

Swollen tonsils

A

Tonsillar Hypertrophy

99
Q

Benign neck and cervical spine exam

A

Supple

100
Q

“swooshing” in neck artery

A

Carotid bruit

101
Q

Swollen lymph nodes

A

Cervical lymphadenopathy

102
Q

More serious tenderness on spine

A

Vertebral Point (Midline) Tenderness

103
Q

Less serious tenderness left and right of spine

A

Paraspinal Tenderness

104
Q

Enlargement of thyroid

A

Thyromegaly

105
Q

Contradiction: Regular Rhythm

A

Irregularly Irregular Rhythm

106
Q

Benign cardiovascular exam (2)

A

Regular Rate and Rhythm, Heart sounds nl

107
Q

Contradiction: Tachycardic, Bradycardic

A

Regular Rate

108
Q

Contradiction: Irregularly Irregular

A

Regular Rhythm

109
Q

Contradiction: Murmurs, Rubs, Gallops, Extra Systoles

A

Heart Sounds Normal

110
Q

Pulse on top of foot

A

Dorsalis Pedis (DP) Pulse

111
Q

Pulse on side of foot

A

Posterior Tibialis (PT) Pulse

112
Q

Pulse in groin area

A

Femoral Pulse

113
Q

Pulse on neck

A

Carotid Pulse

114
Q

Pulse on wrist

A

Radial Pulse

115
Q

Benign perfusion exam (2)

A

Pulses Equal and Symmetric, Capillary Refill less than 2 seconds

116
Q

Contradiction: Capillary Refill less than 2 seconds

A

Delayed capillary refill

117
Q

Scale for pulse (normal?)

A

0 to 4+ (2+)

118
Q

Contradiction: Tachypnea, Accessory Muscle Use

A

No respiratory distress

119
Q

Contradiction: Diminished breath sounds, Wheezes, Rales, Rhonchi

A

Clear to auscultation bilaterally

120
Q

CTA

A

Clear to Auscultation

121
Q

Abdomen S and NT

A

Soft and Non-tender

122
Q

Contradiction: Mild/Moderate/Severe Tenderness To Palpation (TTP)

A

Soft and Non-tender

123
Q

3 Peritoneal Signs

A

Voluntary Guarding, Rebound Tenderness, Rigidity

124
Q

Involuntary Guarding

A

Rigidity

125
Q

TTP

A

Tenderness To Palpation

126
Q

Enlarged liver

A

Hepatomegaly

127
Q

Enlarged spleen

A

Splenomegaly

128
Q

HSM

A

Hepatosplenomegaly

129
Q

Abdomen very full

A

Distended

130
Q

Tenderness in RUQ sign

A

Murphy’s sign

131
Q

Blood in stool

A

Heme positive

132
Q

adj. Black stool color

A

Melanotic

133
Q

3 descriptions of hemorrhoids

A

Internal, External, Thrombosed

134
Q

Alternative name for Heme Positive

A

Guaiac Positive

135
Q

Swollen and inflamed veins in anus or rectum

A

Hemorrhoids

136
Q

Rectum extends outside body

A

Rectal Prolapse

137
Q

DDx: decreased rectal tone

A

Spinal Cord Injury

138
Q

Document for rectal exam

A

“Female/Male chaperone present”

139
Q

Contradiction: Normal External Genitalia (3)

A

Sores, Lesions, Rashes

140
Q

Contradiction: Normal Bimanual Exam (3)

A

Cervical motion tenderness (CMT), Uterine tenderness, Adnexal tenderness (Ovaries)

141
Q

Orifice separating vagina and uterus

A

Cervical os

142
Q

Document for male genital exam

A

“Male chaperone present”

143
Q

Document for female genital exam

A

“Female chaperone present”

144
Q

Type of hernia seen in male genital exams

A

Inguinal Hernia

145
Q

Catheter left in the bladder

A

Indwelling Catheter

146
Q

DDx: Bony tenderness

A

Fx

147
Q

Raised area of tissue with bruising

A

Contusion

148
Q

DDx: Soft tissue tenderness

A

Contusion

149
Q

DDx: calf tenderness

A

DVT

150
Q

Severity scale for Pitting Pedal Edema

A

Trace to 4+

151
Q

Hard, thickened palpable vein

A

Palpable cords

152
Q

Sign tested by passively flexing foot backwards

A

Homan’s sign

153
Q

DDx: Homan’s sign/Palpable cords

A

DVT

154
Q

“loose ligaments”

A

Tendon Laxity

155
Q

Contradiction: Pulse/Sensory/Motor deficits

A

Distal CSMT intact

156
Q

CSMT

A

Circulation, Sensory, Motor, Tendon

157
Q

Contradiction: Cool/hot to touch

A

Warm

158
Q

Contradiction: Dry

A

Diaphoretic

159
Q

Yellow color

A

Jaundice

160
Q

Blue color

A

Cyanotic

161
Q

Pale skin

A

Pallor

162
Q

Contradiction: Jaundice

A

Normal color

163
Q

Hives

A

Urticaria

164
Q

Rash of purple spots on skin

A

Purpura

165
Q

Small red or purple spot (“tiny red rash”)

A

Petechiae

166
Q

Increased warmth

A

Calor

167
Q

Condition of spot hardening on skin

A

Induration

168
Q

DDx: Induration

A

Cellulitis

169
Q

Moveable and compressible (on skin)

A

Fluctuance

170
Q

DDx: Fluctuance

A

Abscess

171
Q

“Pus leaking”

A

Purulent Drainage

172
Q

Inflammation of walls of lymphatic vessels

A

Lymphangitis

173
Q

Like abrasion seen in elderly

A

Skin Tear

174
Q

Flap of skin

A

Avulsion

175
Q

A bruise

A

Ecchymosis

176
Q

Like hematoma

A

Contusion

177
Q

Contradiction: Alert

A

Somnolent

178
Q

Contradiction: Normal Speech (2)

A

Aphasia, Dysarthria

179
Q

Condition of Difficulty speaking

A

Dysarthria

180
Q

Condition of Not able to speak

A

Aphasia

181
Q

Drowsy

A

Somnolent

182
Q

Mentally dulled, “out of it”

A

Obtunded

183
Q

Decreased sensation

A

Hypoesthesia

184
Q

Absent sensation

A

Numbness

185
Q

Contradiction: Hypoesthesia, Numbness

A

Sensation intact

186
Q

Motor Strength: Normal strength

A

5/5

187
Q

Motor strength: slight contraction, no movement

A

1/5

188
Q

Motor strength: Unable to overcome gravity

A

2/5

189
Q

Motor strength: Flaccid, limp

A

0/5

190
Q

Motor strength: Unable to overcome resistance

A

3/5

191
Q

Motor strength: Very mildly weak

A

4/5

192
Q

Sign seen when pt asked to hold arms outwards with palms facing upwards

A

Pronator Drift

193
Q

Scale for Deep Tendon Reflexes (DTRs) (and normal)

A

0 to 4+ (2+ normal)

194
Q

Written as roman numerals

A

Cranial Nerves

195
Q

Drooping of upper eyelid

A

Ptosis

196
Q

Unequal pupils

A

Anisocoria

197
Q

When one eye does not move in concert with other

A

EOM palsy

198
Q

Fail test to stand with feet together and eyes closed

A

Positive Romberg

199
Q

Rapid, repetitive, and involuntary movement of the eye

A

Nystagmus

200
Q

Contradiction: Normal finger-to-nose, Normal heel-to-chin

A

Dysmetria

201
Q

Contradiction: Normal RAM (Rapid Alternating Movements)

A

Dysdiadochokinesia

202
Q

“Loose associations”

A

Flight of ideas

203
Q

Contradiction: Flat/Odd affect, Tearful, Anxious, Depressed, Hypomanic, Poor eye contact

A

Normal affect

204
Q

Contradiction: Suicidal/Homicidal, Hallucinations, Flight of idea, Paranoid

A

Normal judgement

205
Q

Contradiction: Denies illness/symptoms, Non-compliant with treatment

A

Normal insight

206
Q

Contradiction: Tangential/Pressure Speech

A

Normal speech

207
Q

Inappropriately happy/energetic

A

Hypomanic

208
Q

Detailed/descriptive speech

A

Tangential Speech

209
Q

Hesitant to talk/respond

A

Pressured Speech

210
Q

Blood coming out of ears

A

Hemotympanum

211
Q

Jaw misalignment

A

Malocclusion

212
Q

“Crunching” respiratory sound

A

Crepitus

213
Q

Decreased rectal tone

A

Rectal laxity

214
Q

Neurological scale for trauma pts

A

Glawgow Coma Scale

215
Q

GCS scale

A

3-15

216
Q

Make sure to document for Code Exam

A

“A full examination is unable to be obtained due to clinical condition”

217
Q

Normal Neurological Pediatric Physical Exam (3)

A

Alert, Appropriate for Age, Moves All Extremities x 4

218
Q

MAE

A

Moves All Extremities

219
Q

Sucking in of skin around bones of chest between breathing (esp. pediatric)

A

Retractions

220
Q

Normal General Pediatric Physical Exam (6)

A

Alert, Interactive, Playful, Smiling, Crying with tears on exam, Quickly consolable

ScribeAmerica (8 decks)

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