CMC 2 Final Flashcards by Spencer Barlow

What does the acronym VINDICATE P stand for?

V- Vascular
I- Infectious
N- Neoplastic/Nutritional
D- Drug/Diet
I- Inflammatory
C- Congenital
A- Autoimmune
T- Traumatic
E- Endocrine/Environmental
P- Psych/Pregnancy

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What is considred a normal response to the Babinski test (plantar reflex)?

Downgoing toes (plantar flexion)

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What three situations most comonly exlicit an abnormal response to the Babinski test?

Nerve disease involving CNS
Alcohol intoxication
Post-ictal phase after seizure

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An abnormal response to the Babinski test is expected in children younger than what age?

12 months

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What is the most common cause of a positive pronator drift exam?

CNS/upper motor neuron disease

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What is the most common cause of a positive Romberg test?

Impaired proprioception from dorsal column disease

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Which myotome is tested by shoulder abduction?

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Which mytotome is tested by elbow flexion?

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Which myotome is tested by elbow extension?

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Which myotomes are tested by wrist extension & flexion?

C6 & C7

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Which myotome is tested by finger extension?

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Which myotome is tested by finger abduction & thumb opposition?

T1 (also ulnar & median nerve)

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Which myotome is tested by hip flexion?

L2 (also L1)

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Which myotome is tested by thigh adduction?

L3 (also L2)

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Which myotome is tested by knee extension?

L4 (also L3)

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Which myotome is tested by ankle dorsiflexion?

L5 (also L4)

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Which myotome is tested by knee flexion?

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Which myotome is tested by ankle plantar flexion?

S1 (also S2)

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What are major metabolic causes of distal sensory polyneuropathy?

Type 2 DM & prediabetes
Hyperlipidemia
B12 deficiency

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Approximately what percent of distal sensory polyneuropathies are idiopathic?

40%

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What is the most common toxic cause of distal sensory polyneuropathy?

Alcohol

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What are 3 significant immunological causes of distal sensory polyneuropathy?

MGUS (monoclonal gammopathy of uncertain significance)
Sjogren’s syndrome
Gullain-Barre syndrome

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Which muscles comprise the rotator cuff?

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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What is an availability heuristic?

The tendency to rely disproportionately on information recently learned, or cases that are very memorable when considering a ddx

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What is an anchoring heuristic?

The tendency to rely too heavily on the first piece of information offered when making decisions (i.e. anchoring too heavily on an ED dx when in the wards)

What is a representativeness heuristic?

A cognitive short-cut where a patient's presentation is a compared to a 'typical' case of specific diagnoses; this may fail to account for 'atypical' or less characteristic signs or symptoms

Define pretest probability:

The percentage of patients having a disease to begin with, given what is already known

Define posttest probability:

The percentage of patients having the disease given a positive test result

What does the acronym HEADSS stand for?

H: Home environment E: Education/Employment A: Activities D: Diet/Drugs S: Sexuality S: Safety/Suicide/Depresison

What is this finding on a breast exam called? What does it suggest?

Peau d'orange Lymphatic obstruction

What is this finding on a breast exam called? What does it suggest?

Nipple retraction Nothing necessarily, but new nipple retraction is a concern for cancer

What is this finding on a breast exam called? What does it suggest?

Breast dimpling It can suggest cancer attached to the skin and fascia of pectoral muscles

What is a normal lymph node diameter for axillay nodes? For supraclavicular nodes?

Axilla: < 3cm Supraclavicular: < 1cm

What questions are important for a menstrual history?

-Age at menarche -First day of last menstrual period (LMP) -Duration of cycle, duration of bleeding -Hx of heavy bleeding, pain

What are the most current recommendations for the breast self-exam?

It is no longer recommended on a monthly regular basis, and has evidence of harm due to increased intervention with benign lesions

Define gravidity:

The number of times a woman has been pregnant

Define parity:

The outcome of a woman's pregnancies

How are gravity and parity reported using the TPAL system?

G - # of pregnancies P - (TPAL) T- Term births (>37 weeks) P- Preterm births (20 >#>37) A- Abortions (any kind) L- Living children

Define oligomenorrhea:

Menstrual periods with >35 days between cycles

Define primary amenorrhea:

No history of menarche

Define secondary amenorrhea:

No menses for > 6 months

Define metorrhagia:

Menstrual bleeding at irregular intervals

Define menarche:

The first menstrual period

What word could be used to describe the primary lesion pictured here?

Macule

What word could be used to describe the primary lesion pictured here?

Patch

What criteria is shared by a macule and a patch? What criteria differentiates them?

Flat lesion Macule: < 1cm diameter Patch: > 1cm diameter

What word could be used to describe the primary lesion pictured here?

Papule

What word could be used to describe the primary lesion pictured here?

Plaque

What criteria is shared by a papule anda plaque? What criteria differentiates them?

Raised lesion Papule: < 1cm diameter Plaque: > 1cm diameter

What word could be used to describe the primary lesion pictured here?

Vesicle

What word could be used to describe the primary lesion pictured here?

Bulla

What criteria is shared by a vesicle and a bulla? What criteria differentiates them?

Fluid-filled lesion Vesicle: < 1cm diameter Bulla: > 1cm diameter

What word could be used to describe the primary lesion pictured here?

Nodule

What word could be used to describe the primary lesion pictured here?

Tumor

What word could be used to describe the primary lesion pictured here?

Pustule

What word could be used to describe the primary lesion pictured here?

Comedo

What characterizes a pustule?

A vesicle filled with purulent fluid

What characterizes comedo?

Lesions of acne, with pilosebaceous units filled with keratin

What word could be used to describe the primary lesion pictured here?

Cyst

What word could be used to describe the primary lesion pictured here?

Wheal

What characterizes a wheal?

A pink, edematous papule or plaque, often annular

What characterizes a scale?

Scales are accumulation of stratum corneum due to increases proliferation or delayed desquamation

What characterizes a crust?

Serum, blood, or purulent material that appears scaly

What secondary characteristic describes the lesion pictured here? What characterizes it?

Excoriation Exogenous injury to epidermis

What secondary characteristic describes the lesion pictured here? What characterizes it?

Fissure Linear clefts in skin

What secondary characteristic describes the lesion pictured here? What characterizes it?

Erosion Partial loss of epidermis

What secondary characteristic describes the lesion pictured here? What characterizes it?

Ulcer Full thickness loss of epidermis. May have loss of dermis or subcutis

What secondary characteristic describes the lesion pictured here? What characterizes it?

Petechiae Non-blanchable macules < 2mm diameter

What secondary characteristic describes the lesion pictured here? What characterizes it?

Purpura Non-blanchable macules, patches, papules or plaques

What secondary characteristic describes the lesion pictured here? What characterizes it?

Atrophy Depression of skin from thinning of epidermis, dermis or fat

What secondary characteristic describes the lesion pictured here? What characterizes it?

Lichenification Thickening of the epidermis and accentuation of natural skin lines

What characteristic best describes the shape of these lesions?

Annular

What characteristic best describes the shape of these lesions?

Nummular

How are annular and nummular lesions differentiated?

Annular lesions are ring shaped Nummular lesions are coin shaped

How would skin lesions in a coalescing circle, ring, or incomplete ring be described?

Polycyclic

How would snakelike or serpentine skin lesions be described?

Serpiginous

What word best describes the lesions presented?

Polycyclic

What word best describes the lesions presented?

Serpiginous

How would lesions found in the distal extremities be characterized?

Acral

How would skin lesions found in skin creases and folds be characterized?

Intertriginous

How would the configuration of this skin lesion be characterized?

Linear

How would the distribution of this skin lesion be characterized?

Clustered

How would the presentation of this skin lesion be characterized?

Targetoid

How would the distribution of this skin lesion be characterized? What events might precede its presentation?

Photodistributed Exposure to sunlight

A skin lesion distribution that resembles a geometric shape would be characterized how?

Geometric