Exam 2 ( Ch. 3, 4, 5, 6, 7) Flashcards
(100 cards)
1
Q
What is Referred pain?
A
• Referred pain is felt at a particular site but originates from another location. Both sites are innervated by the same spinal nerve, and it is difficult for the brain to differentiate the point of origin.
2
Q
What is Cutaneous pain?
A
• Cutaneous pain is derived from skin surface and subcutaneous tissues. The injury is superficial, with a sharp, burning sensation.
3
Q
What is somatic pain?
A
• Deep somatic pain comes from blood vessels, joints, tendons, muscles, and bone. Injury may result from pressure, trauma, or ischemia.
4
Q
What is Visceral pain?
A
• Visceral pain originates from larger interior organs. The pain can stem from direct injury or stretching. Examples include ureteral colic, acute appendicitis, ulcer pain, and cholecystitis. It is transmitted by ascending nerve fibers along with nerve fibers of the autonomic nervous system, hence presentation is with autonomic responses (vomiting, nausea, pallor, and diaphoresis).
5
Q
What percent of body fat is in subQ tissue?
A
• Tricepts skinfold = use caliper, 50% of body fat is present in SubQ tissue
6
Q
Waist to Hip ratio
A
- Waist - >35 inches in womenand > 40 inches in men = DM II, HTN, CVD, Hyperlipidemia
- Waist to Hip ratio = waist divided by hip, > 1 in men or >0.85 in women = obesity related disorders
7
Q
Medications that cause weight loss
A
Medications causing weight loss: chemotherapy, diuretics, appetite suppressants, laxatives, oral hypoglycemicds
8
Q
Medications that cause weight gain
A
Medication causing weight gain: steroids, oral contraceptives, antidepressants, insulin
9
Q
When does stature decline
A
After age 50 stature declines
10
Q
What is Grehlin?
A
- Peptide synthesized in the peripheral tissues and gastric mucosa
- Helps control growth hormone release
- Influences food intake and obesity development
11
Q
What is leptin?
A
- Key role in regulating body fat mass
- Its concentration is thought to be a trigger for puberty.
- Gonads begin to secrete estrogen and testosterone during puberty.
- Growth at puberty is dependent on the interaction of growth hormone, IGF-1, and the sex steroids (androgens).
12
Q
Thyroid Hormone
A
- Stimulates growth hormone secretion
- Stimulates production of IGF-1 (insulin-like growth factor 1) and interleukins (6 and 8) that have an important role in bone formation and resorption
- Affects the growth and maturation of other body tissues
13
Q
•Insulin-like growth factor I
A
- Growth hormone–dependent peptide primarily produced by the liver
- Synthesis regulated by insulin
- Mediates the direct effects of growth hormone on the peripheral tissues
- Negative feedback effect on growth hormone secretion
- Stimulates target cells that control connective tissue growth and ossification to stimulate muscle and skeletal growth
14
Q
• Gonadal hormone: Testosterone & estrogen & androgen
A
- Secreted by the gonads during puberty
- Rising levels cause release of gonadotropins (luteinizing hormone and follicle-stimulating hormone), which further increase testosterone and estrogen release.
- Genitalia grow to adult proportions.
- Promotes bone maturation and epiphyseal fusion
- Secreted by the adrenals
- Promote masculinization of the secondary sex characteristics and skeletal maturation
15
Q
Growth Hormone
A
- Anterior pituitary
- Secreted in pulses with 70% secreted during sleep
- Promotes growth and increase in organ size
- Regulates carbohydrate, protein, and lipid metabolism
16
Q
What is Lability ?
A
Rapidly shifting emotions
17
Q
What is inappropriate affect?
A
: Affect clearly not matched with the content of the person’s speech
18
Q
What is the role of the limbic system?
A
mediates behavior needed for survival (mating, aggression, fear, affection)
19
Q
What is the temporal lobe?
A
= LTM, perception, comprehension of language (Wernicke speech area)
20
Q
What is the paretial lobe?
A
processes sensory data
21
Q
What is the role of the frontal lobes?
A
STM, Speech, , emotions, affect, drive, self-awareness, goal –oriented behaviors
22
Q
_____ is portion of brain responsible for mental status
A
Cerebrum
23
Q
Organic disorders
A
= brain disorder due to organic cause (ETOH, CVA, Dementia, Delirium)
24
Q
Inorganic disorders
A
Psychiatric mental illness
25
Where are baroreceptors?
found in the heart and large blood vessels
26
What is postural hypotension?
= ≥20 mm Hg drop in SBP or ≥10mm Hg in DBP with position change
27
PVR
– When vessels become smaller or constricted it takes greater pressure to push blood through
28
VCR
– Increased blood volume increases pressure on walls (pregnancy)
29
Mean Arterial pressure (MAP) = pressure forcing blood into the tissues averaged over the cardiac cycle
- Mathematical formula determining a rough estimate = (PP x 1/3) + DBP
Before puberty – no difference in gender BP
Puberty – female BP lower
Menopause – BP increases
30
What is pulse pressure?
Difference of diastolic from systolic pressure
31
What is Diastolic?
arterial resting (recoil) between contractions
32
What is Systolic?
= arterial pressure during left ventricular contraction
33
What is Dysphoria?
A disorder of voice/volume/quality (nasal, breathy)
34
What is Dysarthria?
Difficulty articulating sounds, stuttering
35
What is Circumlocution?
Rather than say a word or phrase they use gestures
36
What is Perseveration?
Repeating a word or gesture over and over
37
What is Flight of ideas?
Disordered words or sentences
38
What is world salad?
Meaningless disconnected words
39
What is Neologisms?
Making up words as they go
40
What is clang association?
Word choice based on sound
41
What is Echolalia?
Repeating other words
42
Global aphasis?
Both receptive and expressive aphasia together
43
Vitamin A deficiency
Dry eyes, night blindness, severe drying & skin scaling
44
What is a good source of vitamin A?
Liver, butter, dark green and deep yellow fruit/veg
45
Vitamin D deficiency
Bowed legs, enlarged skull, epiphyseal enlargment, costochondral beading
46
What is a good source of vitamin D?
Liver, fatty fish, sunlight, egg yolk
47
Vitamin E deficiency
Hyporeflexia, retinal degeneration
48
What is a good source of vitamin E?
Green leafy veg, whole-grain cereals, liver, butter
49
Vitamin K deficiency
Prolonged bleeding
50
What is a good source of vitamin K?
Green leafy veg, pork, liver, veg. oils
51
What type of pain would cholyctitis cause?
Visceral
52
True or false
| Patients with chronic pain may show few or no signs of pain
True
53
The joint commision requires that...
Pain be assessed on surgical patients
54
The perception of pain is....
is impacted by emotions and quality of sleep
55
Which of the following infection control guidelines are currently recommended by the centers for disease control and prevention?
Standard precautions
56
A patient with multiple raised lesions on her skin. Which instrument should be used to examine these lesions?
Ruler
57
How does an examiner determine the correct size of a blood pressure cuff on an adult?
The cuff should be 40% of the circumference of the arm
58
How is a blood pressure reading affected if an adult cuff is used on a small child?
Blood pressure readings will be falsely low
59
As a component of palpation, which surface is most sensitive to vibration?
Ulnar surface of the hand
60
How deep should the examiner hands press while performing deep palpation?
4 cm
61
Indirect finger percussion involves striking the middle finger of the non dominant hand with...?
The tip of the middle finger of the dominant hand
62
A patient has a UTI. The examiner wishes to assess tenderness over the kidney. Which examination technique is appropriate?
Firm fist percussion over the kidney
63
Ideally auscultation should be carried out last except when examining the...
Abdomen
64
When measuring the length of an infant, the measurement should extend from the..
Crown to heel in supine position
65
The tubing of the stethoscope should be less than 18 inches long to prevent....
Distortion of the sounds during auscultation
66
What is true about the correct use of a stethoscope?
The bell is pressed lightly against the skin to detect low frequency sounds
67
In which direction should the ear pieces of the stethoscope be pointing?
Pointing forward
68
In which of the following situations is the use of a doppler indicated?
Auscultation of a nonpalpable pulse in a patient with peripheral vascular disease
69
The red numbers on a lens selector dial of a ophthalmoscope indicate:
negative magnification
70
While performing an internal eye examination, the examiner observes a fundal lesion. What feature on the opthalmoscope permits the examiner to estimate the size and location of the lesion?
Grid light
71
An opthalmoscope has positive and negative magnification in order to:
compensate for myopia or hyperopia in the examiners or the patients eyes
72
In which of the following situations is the pnuematic attachment of an ototscope indicated?
Assessment of pressure behind the tympanic membrane of a child
73
The difference between a tuning fork for auditory screening and one for vibratory sensation is:
The sound frequency generated.
74
Very young children may feel threatend by the use of a reflex hammer during examination. What could the examiner use in place of a reflex hammer that would be less threatening
Examiners finger
75
According to the centers for disease control and prevention, the health care provider should apply infection control measures when caring for which group of patients?
All patients regardless of there infectious status
76
A patients inability to follow simple instructions could indicate which of the following findings?
Depression
77
A patient scores a 22 out of 40 on a isaac set test to evaluate mental function as a whole. What does this score indicate?
Need for further evaluation
78
The examiner asks the patient to complete this statement " a bird is to air as a fish is to ___" This is an example of what type of testing.
Analogy
79
Assume that the patients response to the examiner in question 3 is "scales" what does this response likely reflect?
Left cerebral hemisphere lesion
80
What technique should be used to evaluate the mental status of a patient with head trauma?
Glasgow coma scale
81
Which part of the following indicates possible cognitive impairment?
Suspicious or inappropriate affect
82
A 65 year old woman is brought to the clinic by family members, who report that they have noticed a change in her mental abilities over the past two weeks normally they say she is independent intelligent and very socially oriented. Her medical history is unremarkable except for congestive heart failure for which she takes digoxin. She has had no major changes in her health. What question would be the most important for the examiner to ask the woman's family?
When was her digoxin blood level last checked
83
A patient who has difficulty writing or drawing is most likely to have which condition?
Cerebral dysfunction
84
A mother brings her 18 month old son to the clinic she states that the child rarely talks or smiles. She has also noticed that he does not like to be held. She says his motor development seems to be normal. These symptoms are consistent with what condition?
Autistic disorder
85
A patient with Alzheimer disease classically displays which of the following?
Disintegration of personality
86
A 16 year old female with absence of sexual development, also has short stature and increased carrying angle of elbow
Turner syndrome
87
Woman with hyperpigmentation to skin, round face, and fat accumulation in lower posterior cervical area
Cushing syndrome
88
A 5 year old girl with pubertal changes
Precocious puberty
89
Child with pronounced head enlargement and increased intracranial pressure
Hydrocephalus
90
Half of an individuals ideal weight gained during this period
Adolescence
91
A 60 year old man with exaggerated facial features and massive hands
Acromegaly
92
A patients frame size can be estimated by..
Measuring the elbow breadth
93
Brain growth is completed by _____
3 years of age
94
A child has an arm span that measures greater than his height. This finding is consistent with what condition?
Marfan syndrome
95
Growth at puberty is dependent on the interaction of which of the following?
IGF-I and sex steriods
96
To accurately assess height velocity, the examiner must measure a childs height at...
12 month intervals
97
During an interview a patient reports she has frequent sores at the corner of her mouth. What nutritional deficiency should be considered?
B vitamins
98
An adolescent aged patient has an LDL level drawn. A diagnoses of hyperlipidemia would be made only if the patients LDL level is above...
130 mg/dl
99
Which lab test is an indicator for protein status of a patient?
Albumin
100
It is known that a persons metabolic rate increases after eating. How much of an increase occurs in the total energy expenditure of the body?
7%
