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PCM Exams OMS-1 Fall > Fall Final > Flashcards

Flashcards in Fall Final Deck (53):
1

What is a MS screen?

Focused on whole MS system for complaints of non-specific pain or weakness; looking for normal or abnormal function

2

What is a focused MS exam?

Focused on a specific joint, limb or region of spine

3

What does GALS stand for in a MS medical history?

Gait
Arms
Legs
Spine

4

Do you examine the affected or unaffected side first?

Unaffected to gain a sense or normalcy

5

What is the rule of 15 in PVD?

15% of patients with PVD develop ulcer on foot
15% of those foot ulcers lead to osteomyelitis
15% of foot ulcers lead to amputation

6

What is the rule of 50 in PVD?

50% of amputations are trans-femoral or trans-tibial
50% of patients have a second amputation in 5 years
50% of patients die in 5 years or less

7

What causes ulceration?

Once the skin has thickened and circulation has become compromised

8

What characterizes an arterial insufficiency ulceration?

Painful discrete edges with punched out appearance rapid development; bone or tendon may be showing

9

What characterizes a venous insufficiency ulceration?

Painless, medial lower leg
Cobblestone appearance and slower growing

10

What is the most important finding in an examination of arterial pulses?

Decreased or absence of a pulse

11

Which pulse are you able to use your thumb for?

Brachial artery

12

When comparing time of femoral and radial pulse, what is a delayed femoral pulse indicative of?

Coarctation of the aorta

13

What is the grading of pulses?

0- Absent
1- Diminished
2- Normal
3- Increased
4- Bounding

14

What is the ankle brachial index (ABI)?

Ratio of BP in the lower legs to the blood pressure in the arms

15

What is lower BP in ankles compared to arms indicative of?

Peripheral vascular disease

16

How do you calculate ABI?

Dividing the highest systolic BP at the ankle by the highest systolic BP in the arm

17

Values for ABI?

1.30 uncompressible calcified vessels
.91-1.29 normal
.41-.9 mild peripheral art. disease

18

What is the diaphragm best used for?

Hearing high-pitched sounds S1-S2 and most heart murmurs

19

What is the bell best used for?

Hearing low-pitched sounds S3-S4 and a few murmurs

20

What causes the S2 split?

The aortic valve closing just before the pulmonic

21

What is the S2 split noted?

A2 (aortic) P2 (pulmonic)

22

What is the S3 heart sound?

A gallop (SLOSH-ing-in)

23

What causes the S3 sound?

Passive flow of blood from atria to non-compliant LV or dilated LV during rapid ventricular filling

24

What causes S4 sound?

Diminished ventricular compliance (stiff) increasing resistance to ventricular filling

25

What is the mnemonic to remember S4 sound?

a-STIFF-wall

26

What is a thrill?

A vibratory sensation produced by turbulent flow (palpable murmur)

27

What is a heave?

An upward lifting of your palm (visible)

28

What is a heave indicative of?

Left ventricular hypertrophy

29

What has a crescendo-decrescendo shape/sound?

Aortic stenosis

30

What has a decrescendo sound?

Aortic regurgitation

31

What has a holosystolic shape/sound?

Tricuspid regurgitation

32

Which heart murmurs are increased in inspiration?

Increased venous return so right side of the heart

33

Which heart murmurs are increased with expiration?

Left sided heart sounds

34

What does valsalva do?

Increase intra-thoracic pressure decreasing heart murmurs except for mitral prolapse and hypertrophic obstructive cardiomyopathy

35

What increases afterload on the heart?

Hand grip
Squatting (pre and afterloads)

36

When does ejection click occur and what causes it?

Early systole
Abrupt halting of the semilunar valves/decreased mobility

37

When does opening snap occur and what causes it?

Early diastole
Abrupt deceleration of mitral leaflet

38

What causes mid-systolic click?

Prolapsed mitral valve

39

What is dyspnea?

Shortness of breath

40

What is pectus excavatum?

Sunken in sternum

41

What is pectus carinatum?

Sternum protruding

42

What is the order of examination in a MS exam?

Inspection
Palpation
Range of motion
Strength assessment
Neurological assessment

43

What is the Stanford scale of aortic aneurysms?

Type A: includes the ascending aorta
Type B: begins after the brachiocephalic vessels

44

What causes wheezing?

Air going through an airway diminished in size typically due to mucous

45

What is rhonchi?

Wet coarse sounding

46

What is Cheyne-Stokes?

Respirations that gradually increase, then decrease in volume interspersed with periods of apnea

47

What is Kussmaul breathing?

Deep and labored breathing pattern

48

What is biot?

Abnormal pattern characterized by groups of quick, shallow inspirations followed by periods of apnea

49

What is hyperpnia?

Deep fast breathes for metabolic demand

50

What is stridor?

Wheeze high pitch from blocked trachea

51

Do you do PA or AP x-ray?

PA because it makes the heart the correct size (AP makes heart larger)

52

What is radio dense?

X-rays are absorbed making a white figure on film

53

What is radio lucent?

X-rays pass through the empty space looks black