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Flashcards in Bread and Butter (Hx and PE) Deck (35):
1

Kernig's sign

is positive when the thigh is bent at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance).[3] This may indicate subarachnoid hemorrhage or meningitis

2

Brudzinski's sign

is the appearance of involuntary lifting of the legs when lifting a patient's head off the examining couch, with the patient lying supine

3

Aaron sign

epigastric pain with pressure on McBurney's point; appendicitis

4

Adson's sign

Compression between the anterior and middle scalene by having the patient take a deep breath, extend the neck, and rotate the head toward the painful shoulder; thoracic outlet sydrome

5

Auspitz's sign

punctate bleeding when scales are scraped; psoriasis

6

Babinski sign

Dorsiflection of the hallux with fanning of the remaining phalanges upon soft stimulation of the lateral plantar surface of the foot

7

Beck's triad

hypotension
increased JVP
distant heart sounds

8

Bence Jones Protein

Multiple myeloma

9

Auer Rods

Acute Myeloid Leukemia

10

Chadwick sign

cianosis of vulva, vagina, and cervix

11

Cullen's sign

Ecchymosis around umbilicus predicts onset of acute pancreatitis

12

What is koebner's phenomenon?

The Koebner phenomenon describes skin lesions which appear at the site of injury. It is seen in:[2]

Psoriasis
Pityriasis rubra pilaris
Lichen planus
Lichen nitidus
Vitiligo
Lichen sclerosus
Elastosis perforans serpiginosa
Kaposi sarcoma
Necrobiosis lipoidica
Systemic Lupus Erythematosus

A similar response occurs in pyoderma gangrenosum and Adamantiades-Behcet's syndrome, and is referred to as pathergy.[2]

Warts and molluscum contagiosum are often listed as causing a Koebner reaction, but this is by direct inoculation of viral particles

13

Allis sign

noted when knees are of unequal level at full flexion of the hip. This usually presents with unequal gluteal skin folds; congenital dislocation/developmental dysplasia of the hip

14

Grey turner's sign

flank ecchymosis; retroperitoneal hemorrhage

15

Gunn's sign

AV nicking; hypertensive retinopathy

16

Homans' sign

Knee bent, ankle abruptly dorsiflexed, popliteal pain

17

Hutchinson's sign

lesion on the tip of the nose which an presage ocular herpes zoster

18

Janeway lesion

palmar or plantar erythematous or hemorrhagic papules

19

Murphy's sign

hesitation on inspiration while gall bladder is palpated

20

Nikolsky's sign

Mild shear stress applied to skin causes bullae to form

21

Pratt's sign

Pain elicited by compression of posterior calf; DVT

22

Rovsing's sign

Palpation of LLQ elicits pain in RLQ; appendicitis

23

Russel's sign

Scarring of the dorsum of one hand (contact with incisors while purging); bulimia nervosa

24

Spurling's test

Axial compression and rotation of cervical spine to the side of symptoms causes pain; cervical radiculopathy

25

The inferior tip of the scapula is approximately at which rib/interspace?

7th rib interspace

26

You place your hands on the 10th rib area and ask the pt to breathe deeply. You notice that the chest expansion is unequal. Name some causes of unilateral decrease or delay in chest expansion.

Chronic fibrosis of underlying lung or pleura, pleural effusion, lobar pneumonia, pleuritis with associated splinting, unilateral bronchial obstruction

27

How would you describe the following breath sounds:
Inspiratory sounds last longer than expiratory. Inspiratory: soft; Pitch of expiratory: relatively low; heard over most of both lungs

Vesicular

28

How would you describe "Broncho-vesicular" breath sounds?

Inspiratory and expiratory sounds about equal; Intensity of inspiration and pitch of expiration are intermediate: often heard in the 1st and 2nd interspaces anteriorly and between scapulae

29

Rapid, deep, labored breathing

Kussmaul breathing

30

You hear and observe Kussmaul breathing. What is on your DDx?

DKA; Metabolic acidosis; peritonitis; pneumonia; renal failure; severe hemorrhage; uremia

31

Irregularly interspersed periods of apnea in a disorganized sequence of breaths

Biot respirations

32

Varying periods of increasing depth of respirations, interspersed with apnea

Cheyne-Stokes respiration

33

You hear/see Cheyne-Stokes respirations. What is on your DDx?

heart failure; strokes; traumatic brain injuries; brain tumors; high altitudes; toxic metabolic encephalopathy; carbon monoxide poisoning; morphine use

34

What is the difference between Cheyne-Stokes respirations and Biot respirations?

Cheyne–Stokes respirations are not the same as Biot's respirations ("cluster breathing"), in which groups of breaths tend to be similar in size.

35

DDx of Biot's respiration?

Biot's respiration is caused by damage to the medulla oblongata due to strokes or trauma or by pressure on the medulla due to uncal or tentorial herniation.

It can be caused by opioid use