CASE Flashcards
(285 cards)
1
Q
Lack of facial expression is indicative of?
A
Parkinson’s
2
Q
Startled expresion indicative of?
A
Hyperthyroidism
3
Q
Poor eye contact indicative of?
A
Depression
4
Q
Apathy and pale puffy skin indicative of?
A
Hypothyroidism
5
Q
Lugubrious expression and bilateral ptosis indicative of?
A
Myotonic dystrophy
6
Q
Agitated demeanour indicative of?
A
Anxiety, hyperthyroidism, hypermania
7
Q
Long, thin fingers a sign of?
A
Marfan’s syndrome (called arachnodactyly)
8
Q
Spoon shaped nails?
A
Iron deficiency (koilonychia)
9
Q
White nails?
A
hyperalbnuminaemia (leukonychia)
10
Q
White transverse grooves on nails?
A
Beau’s lines (appear after severe illness)
11
Q
Splinter haemorrhages?
A
Indicative of infective endocarditis
12
Q
Distal nail separation?
A
Psoriasis (onycholysis)
13
Q
What condition do you get dilated capillaries in proximal nail fold?
A
SLE
14
Q
What joints affected in RA?
A
Metacarpophalangeal and proximal interphalangeal
15
Q
What joints affected in OA and psoriatic arthropathy?
A
Distal interphalangeal
16
Q
Signs of carpal tunnel syndrome?
A
Wasting of thenar muscles
17
Q
Tremor in tongue due to?
A
Delirium tremens or Parkinson’s
18
Q
Fasciculations in tongue due to?
A
Lower motor neurone disorders
19
Q
Macroglossia sign of?
A
Acromegaly, amyloidosis or tumour
20
Q
Red lines and rings on tongue that change over weeks and days?
A
B2 deficiency (called geographic tongue)
21
Q
Smooth reddened tongue?
A
In alcoholics and coeliacs (called glossitis)
22
Q
Rubbery lymph nodes indicative of?
A
Hodgkin’s
23
Q
‘Matted’ lymph nodes indicative of?
A
TB
24
Q
Hard lymph nodes indicative of?
A
Cancer
25
Tender lymph nodes indicative of?
Infection
26
Fixated lymph nodes indicative of?
Malignancy
27
Bruising under skin called?
Purpura
28
Large bruises called?
Ecchymosis
29
Pinpoint bruises called?
Petechiae
30
What waist size for health risk in men and women?
37" men and 32" women
31
Sign of scurvy?
Easy bruising, extensive bruising
32
Sign of vitamin A deficiency?
Xeropthalmia (night blindness), keratomalacia (eye disorder where cornea becomes opaque
33
Sign of vitamin D deficiency?
Rickets in children, osteomalacia in adults
34
Sign of vitamin K deficiency?
Bleeding disorder
35
Sign of vitamin B1 deficiency?
Beriberi (heart failure or neuropathy)
36
Sign of vitamin B2 deficiency?
Glossitis, stomatitis
37
Sign of vitamin B3 deficiency?
Pellagra (Dermatitis, diarrhoea, and dementia)
38
Sign of vitamin B6 deficiency?
Polyneuropathy
39
Sign of biotin deficiency?
Dermatitis, alopecia, parathesiae
40
Sign of folate deficiency ?
Megoblastic anaemia
41
Sign of B12 deficiency?
Megoblastic anaemia and neurological disorders
42
What is oedema a sign of?
Fluid overload or hypoalbuminaemia (can use JVP to distinguish as it will be elevated in overload)
43
Definition of postural hypotension?
Drop of 20mmHg systolic when standing
44
Yellow plaques on skin or tendons?
Xanthomata
45
Yellow plaques around eyelids?
Xanthelasma
46
Flame shaped haemorrhage with white centre on the retina a sign of?
Called Roth's spots - bacterial endocarditis (also leukaemia, diabetes, pernicious anaemia)
47
What are the pulses?
Radial, brachial, carotid, femoral, popliteal, posterior tibial, dorsalis pedis
48
How does heart rate change with breathing?
Accelerates with inspiration, slows with expiration
49
How does blood pressure change with breathing?
Falls with inspiration, rises with expiration
50
How does the JVP change with breathing?
Falls with inspiration, rises with expiration
51
Signs of coarctation in children?
Pulses in arms normally normal, but leg pulses there is a delay and reduced volume
52
Signs of coarctation in adults?
Hypertension and heart failure
53
Beat to beat variation in pulse volume, with a normal rhythm?
Pulsus alternans (rare and happens in advanced heart failure)
54
Exaggeration of the normal variability pulse volume with the respiratory cycle?
Pulsus paradoxus (in tamponade and decreased intrathoracic pressure, ie severe asthma) - a decrease of 15mmHg on inspiration is pathological
55
What is a collapsing pulse? And what is is a sign of?
Peak of the pulse wave arrives early and followed by rapid descent. Is exaggerated with the arm raised.
Aortic regurgitation
56
What is a slow rising pulse? And what is is a sign of?
Gradual upstroke with a reduced peak occurring late in systole.
Severe aortic stenosis
57
What is a bisferiens pulse? And what is is a sign of?
2 systolic beats separated by a dip.
| Mixed aortic regurgitation and stenosis
58
What is blood pressure monitored with?
Sphygmomanometer
59
Causes of secondary hypertension?
Pheochromocytoma (tumour of adrenal medulla)
Conn's syndrome (tumour of adrenal cortex -aldosterone)
Cushing's syndrome (microadenoma of pituitary -ACTH)
Coarctation of the aorta
Polycystic kidney disease
60
What are Korotkoff sounds?
Noises from under the distal half of the BP cuff between systole and diastole because the artery collapses completely and reopens with every heartbeat)
61
What pressure does JVP represent?
Central venous or right atrial pressure and indirectly right ventricle function
62
What do the points of the jugular pulse wave represent (draw it!)
a = atrial systole
c = closure of the tricuspid valve
v = peak pressure in the right atrium immediately prior to opening of the tricuspid
a to x = descent due to downward displacement of tricuspid ring during systole
v to y = descent at commencement of ventricular filling
63
Elevated JVP sign of?
Right sided heart failure (ventricular), acute PE, COPD with cor pulmonale, mechanical obstruction of vena cava
64
What is Kussmaul's sign in the JVP and what is it a sign of?
A paradoxical rise of JVP on inspiration (normally falls).
| Seen in tamponade, severe right ventricular failure, and restrictive cardiomyopathy
65
What is a prominent 'a' wave in the JVP a sign of?
Any condition with delayed or restricted right ventricular filling (eg pulmonary hypertension or tricuspid stenosis)
66
What are canon waves in the JVP and what is it a sign of?
Giant 'A' waves, occur when right atrium contracts against closed tricuspid (tricuspid stenosis)
Irregular canon waves seen in complete heart block
Regular canon waves seen during junctional bradycardias and some ventricular tachycardias
67
What is a 'cv' wave in the JVP a sign of?
Fusion of c and v resulting in increased wave and associated with a pulsatile liver. Seen in tricuspid regurgitation
68
What are absent 'a' waves in the JVP a sign of?
Atrial fibrillation
69
What heart sounds do you hear best at the cardiac apex?
1st heart sound
3rd and 4th heart sounds
Mid diastolic murmur of mitral stenosis
70
What heart sounds do you hear best at the lower left sternal border ?
Early diastolic murmur of aortic regurgitation
| Pansystolic murmur of tricuspid regurgitation
71
What heart sounds do you hear best at the upper left sternal border ?
2nd heart sound
Pulmonary valve murmurs
Pansystolic murmur of ventricular septal defect
72
What heart sounds do you hear best at the upper right sternal border ?
Systolic ejection murmurs IE aortic stenosis
| Hypertrophic obstructive cardiomyopathy
73
What heart sounds do you hear best at the left axilla ?
Radiation of pansystolic murmur of mitral regurgitation
74
What heart sounds do you hear best below left clavicle?
Patent ductus arteriosus
75
Common causes of pathological 3rd heart sound?
Left ventricular failure, mitral regurgitation
| Can occur in heart failure with a tachycardia
76
What is a 4th heart sound?
Soft and low pitched, nest heard with bell of stethoscope.
| Caused by forceful contraction of atrium against still ventricle
77
How best to hear pericardial rub?
Diaphragm of stethoscope and breath help on expiration
78
What is Cheyne-Stokes respiration?
Cyclical increasing rate and depth of breathing followed by diminishing effort ending in apnoea
79
What is Kussmaul respiration?
Deep sighing respirations in response to metabolic acidosis
80
Eryhthema nodosum on shins might indicate?
Sarcoidosis, IBD and pregnancy
81
Causes of clubbing?
Tumours, interstitial lung disease, bronchiectasis, CF, bacterial endocarditis, UC, CD
82
Tremor in hands could be a sign of?
Excessive use of B-agonist
83
Flapping tremor a sign of?
CO2 retention
84
Name lymph nodes in the neck
Supraclavicular, cervical (SCM), posterior (behind SCM), postauricular, preauricular, submental, submandibular, pretracheal
85
Prominence of the sternum (pigeon chest?) and the other sign that comes with this ?
Pectus carinatum
| Harrison's sulci- indrawing of ribs to form horizontal grooves
86
Depression of the sternum
Pectus excavatum
87
What is hyper resonant chest on percussion a sign of?
Pneumothorax
88
What is dull chest on percussion a sign of?
Consolidation, collapse, fibrosis
89
What is stony dull chest on percussion a sign of?
Effusion, haemothroax
90
What are crackles on the chest a sign of?
Early inspiration - small airway disease
Middle- pulmonary oedema
Late - pulmonary fibrosis, secretions in COPD, pneumonia
Biphasic, coarse - broniectasis
91
Causes of respiratory acidosis?
Severe acute asthma, severe pneumonia, COPD, kyphoscoliosis
| CO2 and HCO3 are raised
92
Causes of respiratory alkalosis?
Hyperventilation due to anxiety, stroke, salicylate poisoning
(CO2 and HCO3 are decreased)
93
Causes of metabolic acidosis?
DKA, poisoning, renal failure (CO2 and HCO3 are decreased)
94
Causes of metabolic alkalosis?
Loss of acid from severe vomiting, excess diuretic therapy, hyperaldosteronism, Cushing's syndrome
(CO2 and HCO3 are raised)
95
What is recorded in spirometry?
Forced vital capacity (FVC)- total exhaled (reaches residual volume)
Amount exhaled in one second (FEV1)
96
FEV1/FVC ratios useful for?
Usually above 75%
Decreased ratio indicative of obstructive disease
Preserved ratio but decreased FVC indicative of restrictive disease (fibrosis, sarcoidosis)
97
Night time wakening with coughing and wheeze a sign of?
This is characteristic of poorly controlled asthma
98
Causes of chronic cough with no X-ray changes?
Smoking, sinusitis, GORD, asthma or ACE inhibitors
99
Surface markings of the liver?
5th intercostal space on full inspiration (upper border)
| Costal margin in mid-clavicular line on full inspiration (lower border)
100
Surface markings of spleen?
Underlies left ribs 9, 10 and 11 posterior to mid axillary line
101
Surface markings of gallbladder?
Intersection of right lateral vertical plane and costal margin (ie tip of 9th costal cartilage)
102
Surface markings of pancreas?
Neck lies at level of L1, head below and right, the tail above and left
103
Surface markings of kidneys?
Upper poles deep to the 12th rib posteriorly 7cm from midline - right is 2-3cm lower than the left
104
What is fancy word for dry mouth?
Xerostomia
105
What is fancy word for bad breath?
Halitosis due to gingival or pharyngeal infection
106
What is cacogeusia?
Foul taste in mouth
107
What is fancy word for altered tase sensation ?
Dysguesia
108
What is the Iliopsoas sign/test?
Flex thigh against resistance. Pain is a positive test- indicates inflammation involving the psoas muscle. (retroileal appendicitis, iliposoas abscess, perinephric accesses)
109
What is Murphy's sign?
Pt takes a deep breath in while you gently palpate in right upper quadrant of abdomen - as the gallbladder comes into contact with fingers pain is elicited - sign of acute cholecystitis
110
What is Rovsing's sign?
Palpation in left iliac fossa produces pain in right iliac fossa - sign of acute appendicitis
111
What are Grey-Turner's and Cullen's signs?
Bleeding into falciform ligament - bruising around umbilicus (Cullen's) or in the loins (Grey-Turner's).
Sign of haemorrhagic pancreatitis, aortic rupture, ectopic pregnancy
112
What is menarche?
When periods start
113
What is measured in pregnancy test?
B-HCG - useful for ectopic pregnancies
114
Ovarian cancer marker?
CA125
115
Gravidity?
Total no of pregnancies
116
Parity
Live births and still births + no of miscarriages, terminations and ectopics
117
Puerperium?
Post partum period - approx 6 weeks while uterus returns to how it was - involution of uterus is complete
118
Lie of the foetus?
Spine axis compared to the mother.
| Usually longitudinal but may be transverse or oblique
119
Presentation of foetus?
Leading part of the foetus in the lower pole of the uterus
| Normally cephalic, but can be breech or shoulder
120
What is polyhydramnios?
Too much amniotic fluid resulting in tense uterus
121
What are linea nigra?
Increased melanocyte activity results in dark midline
122
Striae gravidarum?
Pink/red stretch marks caused by pregnancy
123
Old striae gravidarum?
Striae albicans
124
What should fundal height be equivalent to?
Gestation in weeks + or - 3cm
125
How many fifths palpable if head fixed?
| If engaged?
3 fifths
| 2 and 1 fifths
126
What cells are testosterone produced from?
Leydig cells
127
Two cylinders in penis?
Corpora cavernosa
128
Muscles lining scrotum?
Dartos muscle- highly contractile to regulate temp
129
What is hydadid of Morgani?
Appendix testis - vestigal of Mullerian duct
130
Causes of epididymitis
STIs
| E. coli infection
131
Prevention of retraction of foreskin?
Phimosis - narrowing of preputial orifice
132
Paraphimosis?
Inability to pull foreskin forward after retraction due to constriction in the prepuce
133
Where are the cell bodies of the sensory nerves?
Dorsal root ganglia
134
Where are the cell bodies of the motor nerves?
Anterior horns
135
Signs of lower neurone lesions?
Weakness and wasting in the muscles, reduced tone and absent reflexes
136
Signs of upper neurone lesions?
Increased tone and brisk reflexes
137
Unsteadiness of standing with eyes open is a sign of?
Called Romberg's test - cerebellar disorders
138
Instability with eyes closed?
Proprioceptive sensory loss
139
Hemiplegic gait sign of?
Unilateral upper motor neurone lesion
140
What is dystonia?
Sustained muscle contractions leading to twisting, repetitive movements and tremor
141
What is chroea and athetosis?
Writhing movements
142
Ballism?
Violent flinging movements caused by contractions of proximal limb muscles.
143
Fancy word for pain on swallowing?
Odynophagia
144
What is water brash?
Excess saliva in the mouth
145
Fancy word for rectal bleeding?
Haematochezia (fresh blood in stools)
146
Fancy word for persistant urge to empty rectum?
Tenesmus
147
Black tarry stools?
Melaena
148
Achalasia?
Failure of smooth muscle fibres to contract which can cause oesophageal sphincter to remain closed
149
Neuromuscular causes of dysphagia?
Achalasia, Myasthenia gravis, Pharyngeal pouch
150
Mechanical causes of dysphagia?
Oesophageal cancer, peptic oesophagitis
151
What is cause of vomiting blood after vomiting?
Mallory-Weiss syndrome lower mucosal osephageal tear due to vomiting
152
Pain in the right hypochondrium and epigastric region and tip of scapula a sign of?
Gallbladder/biliary colic
153
Inguinal canal pain a sign of?
Ureteric pain
154
Epigastrium pain a sign of?
Peptic ulcer
155
Epigastric/left hypochondrium pain eased by sitting upright?
Acute pancreatitis
156
Fancy word for audible bowel sounds?
Borborygmi
157
Fancy word for feeling of impending death?
Angor animi
158
What kind of jaundice:
| -urine normal, stool normal
Unconjugated
159
What kind of jaundice:
| -urine dark, stool normal
Hepatocellular
160
What kind of jaundice:
| -urine dark, stool pale
Obstructive
161
What kind of jaundice:
| Congenital disorder
Gilbert's syndrome- impaired bilirubin excretion
162
Painful hacks at the side of the mouth?
Angular cheilitis (iron deficiency)
163
Troisier's sign?
Gastric and pancreatic cancer may spread to left supraclavicular lymph nodes
164
Distended veins on the tummy?
Caput medusae - portal vein hypertension
165
What could cause an epigastric mass?
Gastric cancer, pancreatic cancer, aortic aneurysm
166
Fetor hepaticus?
Sweet, musty smell on breath
167
Chilaiditi's sign?
Resonance below 5th intercostal space due to transverse colon getting between the diaphragm and the liver
168
What is Courvoisier's sign?
If gallbladder is palpable, and painless in jaundiced patient, not likely to be gallstones but cancer.
169
Causes of enlarged spleen?
Lymphoma, glandular fever, endocarditis, RA, SLE.
| Must be 3X as large to be palpable
170
Cause of hydroceles?
Usually idiopathic, may be secondary to inflammatory conditions or tumour.
171
MRC scale or power?
0 - none
1 - flicker of contraction, no movement
2 - joint movement when gravity is eliminated
3 - movement against gravity but not against resistance
4 - weak movement against resistance
5 - normal
172
Dysdiadochokinesis?
Impairment of rapid alternating movements - sign of cerebellar disorders
173
Where does dorsal column cross over and what type of sensory pathways?
Right up to the medulla - proprioception and vibration
174
Where does spinothalamic column cross over and what type of sensory pathways?
Within one or two segments - pain and temperature
175
Brown-Sequard syndrome?
Ipsilateral motor weakness and loss of vibration and proprioception with contralatereal loss od pain and temp
176
What are the secretions in the eye and from what glands?
Mucin from goblet cells
Aqueous humour form accessory lacrimal glands
Oil from Meibomian glands
177
Path of tears?
From the lacrimal glands on top of and lateral to the eye, across eye into lacrimal canaliculi into lacrimal sac, and from there into nasolacrimal duct which opens into nasal inferior meatus
178
Where is the aqueous humour that fills the anterior chamber produced from?
Ciliary body in the posterior chamber
179
Three layers of the eye?
Outer sclera
Choroid
Retina
180
Loss of lateral vision in both eyes?
Bitemporal hemianopia caused by optic chiasm compression
181
Loss of right side of vision in both eyes?
Right homonymous hemianopia - lesion of optic tract
182
Top right quarter loss of vision in both eyes?
Upper right quadrantanopia from a lesion of the lower fibres of the optic radiation in the temporal lobe
183
Lower right quarter loss of vision in both eyes?
Lower right quadrantanopia from a lesion of the upper fibres of the optic radiation in the anterior part of parietal lobe
184
Loss of right side of vision in both eyes but macula spared?
Right homonymous hemianopia due to lesion of optic radiation in the posterior part of the parietal lobe
185
Fancy name for inverted and everted eyelid?
Entropion and Ectropion
186
Signs of acute angle-closure glaucoma?
Severe unilateral pain, cloudy cornea, oval non-reactive pupil
187
Signs of acute iritis?
Small irregularly shaped pupil, and redness around the limbus (inflamed iris sticks to the underlying lens)
seen in . -ankylosing spondylitis, IBD or psoriasis
188
Signs of scleritis?
Pain on moving a red eye
| May be first sign of systemic vasculitis. Frequently bilateral
189
Sign of conjunctivitis?
Feels uncomfortable, always associated discharge, inner eyelid inflamed
190
Copper deposited around the cornea called?
Kayser-Fleischer rings, seen in Wilson's disease
191
Fancy word for long sighted?
Hypermetropia
192
Fancy word for short sightedness?
Myopia
193
Astigmatism?
When the cornea is irregularly curved - requires correction with cylindrical lenses.
194
What is nystagmus?
Involuntary oscillations of the eyes that is often rhythmical
195
One pupil bigger than the other and both behave normally?
Essential anisocoria - common normal variant
196
Cotton wool spot formation on the retina a sign of?
Arteriolar occlusion
197
Large rapidly progressing cotton wool retina spot?
Retinitis due to herpes infection
198
Cherry red spot sign in the eye?
Central retinal artery occlusion - pallor in the rest of the eye, optic nerve head, the fovea and posterior retina is unaffected due to supply from the ophthalmic arteries
199
Nodes on hands due to osteoarthritis?
Heberden's and Bouchard's
200
Firm white irregular subcutaneous crystal collections?
Gouty tophi
201
Gibbus?
Spinal deformity caused by anterior wedge deformity localised to a single vetrebrae
202
Spondylolsis?
Degenerative change in the spine
203
Spondylolysis?
Defect in the pars interarticularis of a vertebral arch
204
Spondylolisthesis?
One vertebra slipping anteriorly on an inferior vertebra
205
Retrolisthesis?
One vertebra slipping posteriorly on an inferior vertebra
206
What spinous processes are level with pelvic brim?
L4/5
207
Where does the spinal cord end?
L2
208
Flexor of the DIP joint?
Flexor digitorum profundus
209
Flexor of the PIP joint?
Need to eliminate action of the flexor digitorum profundus 9hold the other fingers back)
Flexor digitorum superficialis
210
Flexor and extensor of the thumb IP joint?
Flexor and extensor pollicis longus
211
Nerve roots and muscles in hip flexion?
ileopsoas. Femoral nerve/ branches of spinal nerves – L1,2
212
Nerve roots and muscles in hip extension?
gluteus maximus : inf gluteal nerve – L5, S1
213
Nerve roots and muscles in knee flexion?
hamstring muscles : Sciatic Nerve – L5/S1
214
Nerve roots and muscles in knee extension?
quadriceps, femoral nerve – L2,3,4
215
Nerve roots and muscles in foot dorsiflexion?
tibialis anterior : deep peroneal nerve – L4,5
216
Nerve roots and muscles in foot plantarflexion?
gastrocnemius : tibial nerve – S1,2
217
Nerve roots and muscles in great toe dorsiflexion ?
extensor halluces longus : deep peroneal nerve – L5,S
218
Nerve root in knee reflex?
Knee – L4
219
Nerve root in Ankle reflex?
Ankle – S1
220
Temporary loss of vision in one or both eyes, might be like a black curtain?
amaurosis fugax
221
Myotome for hip flexion?
L2
222
Myotome for knee extension?
L3
223
Myotome for dorsiflexion foot?
L4
224
Myotome for big toe extension?
L5
225
Myotome for plantarflexion foot?
S1
226
Nerve root patella reflex?
L3/L4
227
Nerve root tibialis anterior?
L4/L5
228
Myotome for cervical extension?
C2
229
Myotome for cervical flexion?
C1
230
Myotome for cervical side flexion?
C3
231
Myotome for shoulder elevation?
C4
232
Myotome for shoulder abduction?
C5
233
Myotome for elbow flexion?
C6
234
Myotome for elbow extension?
C7
235
Myotome for thumb extension?
C8
236
Myotome for finger abduction?
T1
237
Nerve root for biceps reflex?
C5/C6
238
Nerve root for brachioradialis reflex?
C5/C6
239
Nerve root for triceps replex?
C7/C8
240
Myotome of the deltoid?
C5
241
Myotome of the lat dorsi?
C6/C7/C8
242
Myotome of the triceps?
C7/(C8)
243
Myotome of the biceps?
(C5)/C6
244
Myotome of the long finger extensors?
C7/(C8)
245
Myotome of the finger flexors?
C8
246
Myotome of the iterossei?
T1
247
Test for median nerve?
Push thumb toward palm
248
Test for ulnar nerve?
Resist fingers being pushed together
249
Hypovalaemic patient, how much IV fluid?
Child - 20ml/kg
| Adults 500ml-1L bolus, reasses
250
Maintenance IV fluids?
Water - 35mls/kg
Glucose - 1g/kg
Sodium - 2mmols/kg
Potassium - 1mmol/kg
251
What is osmolarity?
| What is osmolality?
Osmoles per L
| Osmoles per KG (independent of temp)
252
What is human osmolality?
275- 296 mosm/kg
253
Test for anxiety?
GAD-7
254
Test for depression?
PHQ-9
255
Large peaked T waves?
Hyperkalaemia
256
Flattened T waves?
Hypokalaemia
257
Leads looking at anterior of heart?
V1 V2 V3 (L ventricle)
258
Leads looking at lateral heart?
V3 V4 V5 (L ventricle)
259
Leads looking at inferior of heart?
II, III and aVF (r ventricle, right coronary artery)
260
Leads to see a septal wall injury?
V1 V2
261
Blood tubes?
1. Blood culture
2. BLUE - blood clotting/INR
3. RED - Thyroglobulin, Serology and Abs
4. GOLD - Thyroid function tests, hormones, B12, folate, tomour markers
5. GREEN- amino acids, Insulin
6. PURPLE - FBC
7. PINK- cross matching
8. GREY - glucose, alcohol, lactate
262
DeMussett's sign?
Head nodding in severe aortic regurgitation
263
Gower's sign?
Duchennes leads to difficulty standing- patient tolls over and walks hands and feet together, then claims their legs swinging from side to side
264
What to measure baby length?
Neonatal stadiometer
265
Link discolouration at nape of neck, eyelids, glabella?
Storks beak mark - not significant
266
Collodion baby?
Varnished appearance, may be post mature
267
Baby head descriptions?
```
Microcephalic (small)
Megalen- (large)
Hydro- (large due to enlarged ventricles)
Brachy- (short headed)
Dolicho- (long headed)
Plagio- (asymmetrical)
```
268
Eye size in neonates?
Small may suggest conventual abnormalities (microphthalmia)
| Large, feel them, if firm suggests glaucoma (buphthalmos)
269
Resp rate for sleeping baby
20-40/min.
May be above 60 if baby cold, Hungry or crying
30-50 in term neonate
270
Heart rate for term neonate?
100-140
| Preterm it's 120-160
271
Intestines protruding through umbilicus?
Exomphalos - covered in think layer of peritoneum
272
Herniation of bowel in neonates?
Gastroschisis - not covered in membrane
273
Tethering of foreskin?
Chordee, causes glans to curve
274
Palsies in babies?
Erb's - upper brachial root plexus (c5/c6), reduced movement of arm, medial rotation of the forearmand failure to extend wrist
Klumpke's might be seen after breech delivery (c8and T1), weakness in forearm and hand
275
Primary club foot?
Talipes equinovarus
276
Test for developmental dysplasia of the hip?
Barlow manieuver and ortolani manoeuvre
277
To measure testicular volume?
Prader orchidometer
278
How to measure expected delivery date of baby?
Add 1 year and 7 days and subtract 3 months from 1st day of last period (if 28 day cycle, if eg, 35, add 7)
279
Damage to Broca's area?
(broca's area is more anterior) reduction in words used , non fluent speech, with errors in grammar and syntax
280
Damage to Wernicke's area?
(wernicke's areas more posterior) poor comprehension, speech my be fluent but non-sensical
281
Damage to arcuate fasciculus?
(connection between Broca's area and Werrnicke's) patient unable to repeat phrases said by examiner
282
What does Glossopharyngeal nerve do?
Sensation from pharynx and tonsils, sensation and taste from posterior third of the tongue
283
What does Hypoglossal nerve do?
Innervates muscles of the tongue
284
What nerve for taste from anterior two thirds of tongue?/
Facial nerve (via chordae tympani branch)
285
Stages of GCS?
Eyes (4)
-normal -open to speech -open to pain - nothing
Verbal (5)
-normal -talks in sentences but disoriented -words not sentences -grunts not words - nothing
Motor (6)
- obeys commands -localises to pain, -flexes to pain -abnormal response to pain -extension to pain -nothing
