Flashcards in Bread and Butter (Hx and PE) Deck (35):
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). This may indicate subarachnoid hemorrhage or meningitis
is the appearance of involuntary lifting of the legs when lifting a patient's head off the examining couch, with the patient lying supine
epigastric pain with pressure on McBurney's point; appendicitis
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
punctate bleeding when scales are scraped; psoriasis
Dorsiflection of the hallux with fanning of the remaining phalanges upon soft stimulation of the lateral plantar surface of the foot
distant heart sounds
Bence Jones Protein
Acute Myeloid Leukemia
cianosis of vulva, vagina, and cervix
Ecchymosis around umbilicus predicts onset of acute pancreatitis
What is koebner's phenomenon?
The Koebner phenomenon describes skin lesions which appear at the site of injury. It is seen in:
Pityriasis rubra pilaris
Elastosis perforans serpiginosa
Systemic Lupus Erythematosus
A similar response occurs in pyoderma gangrenosum and Adamantiades-Behcet's syndrome, and is referred to as pathergy.
Warts and molluscum contagiosum are often listed as causing a Koebner reaction, but this is by direct inoculation of viral particles
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
Grey turner's sign
flank ecchymosis; retroperitoneal hemorrhage
AV nicking; hypertensive retinopathy
Knee bent, ankle abruptly dorsiflexed, popliteal pain
lesion on the tip of the nose which an presage ocular herpes zoster
palmar or plantar erythematous or hemorrhagic papules
hesitation on inspiration while gall bladder is palpated
Mild shear stress applied to skin causes bullae to form
Pain elicited by compression of posterior calf; DVT
Palpation of LLQ elicits pain in RLQ; appendicitis
Scarring of the dorsum of one hand (contact with incisors while purging); bulimia nervosa
Axial compression and rotation of cervical spine to the side of symptoms causes pain; cervical radiculopathy
The inferior tip of the scapula is approximately at which rib/interspace?
7th rib interspace
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
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
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
Rapid, deep, labored breathing
You hear and observe Kussmaul breathing. What is on your DDx?
DKA; Metabolic acidosis; peritonitis; pneumonia; renal failure; severe hemorrhage; uremia
Irregularly interspersed periods of apnea in a disorganized sequence of breaths
Varying periods of increasing depth of respirations, interspersed with apnea
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
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.