Final

Question 1

acrus senilus

Answer 1

corneal acrus, thin grey circle close to the edge of the cornea
normal with aging, hyperlipoproteinemia

Question 2

keratoconus

Answer 2

thinning disorder of cornea

Question 3

aide’s tonic pupil

Answer 3

pupil is large, regular and unilateral

unresponsive or slow to respond to light

Question 4

argyll robertson pupil

Answer 4

small irregular pupils, accommodate but do not react to light
common with CNS syphilis

Question 5

crackles

Answer 5

brief

Question 6

wheezes

Answer 6

high pitches, suggest narrowed airway

Question 7

rhonchi

Answer 7

low pitch, suggest wide airways, heard on inspiration

Question 8

stridor

Answer 8

high pitched inspiratory noise from subglottic or tracheal obstruction

Question 9

lung resonance

Answer 9

normal, LHF, chronic bronchitis

Question 10

lung dullness

Answer 10

consolidation, atelectasis, pleural effusion

Question 11

lung hyper-resonance

Answer 11

pneumo, COPD, asthma

Question 12

a-wave

Answer 12

JVP corresponding to atrial contraction

immediately proceeds S1

Question 13

increased a-wave

Answer 13

increased resistance to RA emptying, decreased RV compliance, restrictive CMP, RVH, tricuspid stenosis

Question 14

decreased a-wave

Answer 14

afib, arrhythmias

Question 15

intermittent a-wave

Answer 15

AV dissociation, cannon a waves

Question 16

grade 1 murmur

Answer 16

must be tuned in

Question 17

grade 2

Answer 17

quiet but audible

Question 18

grade 3

Answer 18

moderately loud

Question 19

grade 4

Answer 19

loud with a thrill

Question 20

grade 5

Answer 20

can be heard with the stethoscope slightly off the body, thrill

Question 21

grade 6

Answer 21

can be heard with the stethoscope entirely off the body, thrill

Question 22

aortic stenosis

Answer 22

systolic, heard at A/P
heard best with pt sitting and leaning forward
radiates to the neck

Question 23

HOCM

Answer 23

systolic, heard at erbs
best with squatting and valsalva
radiates down L sternal border to apex

Question 24

pulmonary stenosis

Answer 24

systolic crescendo-decrescendo, heard at P

can have thrill, radiates to L shoulder and neck

Question 25

mitral regurg

Answer 25

holosystolic, heard at apex, can have S3 doesnt change with inspiration radiation to axilla

Question 26

tricuspid regurg

Answer 26

holosystolic, heard at T or apex increases with inspiration radiates to midclavicular line, sternum

Question 27

VSD

Answer 27

holosystolic murmur, usually with thrill heard at erbs or T small defects are louder

Question 28

aortic regurg

Answer 28

decrescendo diastolic, heard when leaning forward with exhalation can radiate to apex

Question 29

mitral stenosis

Answer 29

decrescendo diastolic, opening snap after S2, use bell heard in LLD with hand grips and exhalation heard at apex with no radiation

Question 30

venous hum

Answer 30

continuous, heard louder in diastole, use bell | pt should be sitting

Question 31

pericardial friction rub

Answer 31

sounds close to the stethoscope, best when leaning forward and exhalation minimal radiation scratchy sounding

Question 32

patent ductus arteriosus

Answer 32

machine like, at P

Question 33

S3

Answer 33

ventricular gallop, mid diastolic

Question 34

S3 normal

Answer 34

children, young adults, 3rd trimester

Question 35

S3 abnormal

Answer 35

40+, HF, volume overload

Question 36

S4

Answer 36

atrial gallop, just before systolic beat | d/t increased resistance to V filling

Question 37

L sided S4

Answer 37

HTN, myocardial ischemia, aortic stenosis, CMP

Question 38

R sided S4

Answer 38

pulmonary HTN, pulmonic stenosis

Question 39

visceral pain

Answer 39

distension of organs, typically palpable near midline hard to localize pain varying quality sweating, pallor, n/v, restlessness

Question 40

parietal pain

Answer 40

parietal inflammation steady, aching pain easier to localize aggravated by coughing or movement

Question 41

positive apley scratch test

Answer 41

rotator cuff disorder

Question 42

positive arc test

Answer 42

subacromial impingement, RTC tendonitis

Question 43

positive neers impingement

Answer 43

subacromial impingement, RTC tendonitis

Question 44

positive hawkins impingment

Answer 44

RTC impingement, tendonitis

Question 45

positive drop arm test

Answer 45

supraspinatus RTC tear

Question 46

positive empty can test

Answer 46

supraspinatus RTC tear

Question 47

positive babinski

Answer 47

alcohol/drug intoxication, postictal

Question 48

loss of proprioception

Answer 48

tabes dorsalis, MS, B12 deficiency, posterior column disease, DM neuropathy

Question 49

UMN lesion

Answer 49

hypertonia, hyperreflexia, no atrophy, no fasciculations, + babinski

Question 50

LMN lesion

Answer 50

hypotonia, hyporeflexia, atrophy, fasciculations, - babinski

Question 51

peripheral lesion of facial paralysis

Answer 51

bells palsy | half of the face is paralyzed including forehead

Question 52

central lesion of facial paralysis

Answer 52

cerebral infarction | lower half od the face is paralyzed, entire forehead wrinkles and eyebrows raise, eyes close with weakness

Question 53

dysdiadochokinesis

Answer 53

abnormal RAM with fingers touching thumb