Final Exam Flashcards
(125 cards)
1
Q
normal lymph nodes
A
less than 1/2 cm, movable, firm, non-tender
2
Q
infected node
A
enlarged, tender
3
Q
malignant lymph node
A
hard, non-tender, irregular, fixed
4
Q
thyroid assessment
A
below cricoid, need to do labs to see hyper/hypo, have pt swallow
5
Q
presbycusis
A
lose hearing of higher frequency
6
Q
weber test
A
Tuning fork top of head or forehead
Should be equal in both ears
-lateralization is bad!
7
Q
rinne test
A
air is twice as long as bone conduction (indicates conductive hearing loss, external and middle air)
8
Q
acute closed angle glaucoma
A
medical emergency
- dilated pupil, red sclera
- pt can go blind
9
Q
aging eyes
A
-thick cornea, astigmatism, arcus senilus, glaucoma, acuity issues, floaters, presyopia
10
Q
arcus senilus
A
white fat deposits around rim of cornea
11
Q
presbyopia
A
lose close vision as you age
12
Q
exam far vision
A
snellen chart, 20 20 normal
13
Q
glaucoma
A
Usually complain about peripheral vision
14
Q
macular degeneration
A
loss of central vision
15
Q
peritonsillar abscess
A
increasing difficulty with swallowing, speaking
-monitor airway, drooling is bad
16
Q
mono
A
exudates on tonsils
-inflamed posterior nodes and spleen issues
17
Q
group a strep
A
inflammation with white/gray tonsilar exudate
-anterior lymph nodes palpable
18
Q
strep vs mono
A
anterior nodes-strep
posterior nodes-mono
19
Q
infant skin
A
- lanugo, vernix caseosa
- stork bite, cradle cap, milia
- more prone to fluid loss (poor temp regulation)
20
Q
psoriasis
A
a plaque
- silvery appearance
- usually on extensor surfaces like knuckles or elbows
- can have systemic changes like pitting nails
21
Q
HARMM melanoma risk model
A
hx previous melanoma
- age > 50
- reg dermatologist absent
- mole change
- male gender
22
Q
ABCDE for lesions
A
A (asymmetrical) B (borders) irregular C (color) is it changing or multicolored D (diameter) > ½ cm *head of an eraser E (elevation)- is it enlarging?
23
Q
basal cell carcinoma
A
translucent nodule, firm border with depressed center
Normally on sun exposed areas
Very common
24
Q
squamous cell carcinoma
A
firm scale; often face or back of hand
scaly!
25
actinic keratosis
pre-cancerous squamous cell
| -white scale
26
malignant melanoma
- irregular, can be dark
- blacks can get this in nail
- can be anywhere on body
27
comprehensive health history
- patient identifiers
- reliability
- chief complaint
- HPI, PMH, FH, SH, ROS
28
Fungal
(tinea, candidiasis under skin folds) red, drainage, satellite lesions
29
papilledema looks like
a bright sun spot or blown up disc
30
pneumonia
- bronchial breath sounds, rales, crackles, dullness, egophony, whispered pectoriliquoy , inc fremitis
31
COPD
- dec breath sounds, dec tactile fremities, hyperresonance
32
pleural effusion
- dullness and asymmetry
33
clubbing
>180 degrees
34
s1
best heard at apex
35
s2
best heard at base
36
s3
worse sound, early diastolic, best heard with bell at apex, low sound, associated with CHF in adults
37
s4
late diastolic, stressed heart, assoc with HTN, CAD, best heard at apex, ventricular filling sound
38
PMI
shouldn't be bigger than2 cm
39
grading scale murmurs
- - starting at 4 you can feel it, not normal, called a thrill if feel it
40
rubs
- high pitched scratchy sounds, pericarditis (best heard at LLSB with diaphragm)- pt will have chest pain. Will be systolic and diastolic
41
Arterial insufficiency
- no pulses, cool feet, shiny pale hairless, can be ruddy, get sores on toes first
42
venous insufficiency
- edema, pulses, thick leathery skin, brownish coloring, get sores at ankles
43
DVT
what are risk factors? On the pill, smoke, calf pain and swelling and redness, pregnancy
44
ABI
test for arterial insufficiency, can't use with diabetics
| -test for peripheral artery disease
45
ascites
- shifting dullness, fluid wave
46
gray turner
flank bruising
47
cullen
bruising around umbilicus
48
murphys
gallbladder test, have pt hold breath and they have pain with palpation
49
appendicitis tests
rebound pain upon release in RLQ, Rovsing (pain R when feeling L), Psoas (lay left when right leg is bent), Obturator (flex right leg and knee)
50
hepatitis
- jaundice, pain in RUQ, dry itchy skin, icteric sclera, darkening urine
51
Abdominal pain
gallbladder can be referred to shoulder, triple A can be back pain, GERD can have sore throat and cough
52
diverticulitis
LLQ pain
53
most common disability
speech impediment or other communication disorders
54
effects of disability
access to care is problem
55
changes in elderly
-incontinence not normal, weak pelvic floor, kyphosis, more prone to PNAs and atelectasis
56
Muscle grading system
- 0 = paralysis, no muscle contraction
- + 1 = slight muscle contraction
- + 2 = movement with gravity
- + 3 = movement against gravity
- + 4 = movement against gravity with some resistance
- + 5 = movement against gravity with full resistance
57
kyphosis
bend over, accentuated thoracic curve
58
Scoliosis
have patient lean forward and you look at scapula, look at scapula and iliac crest to see if they are even
59
Lordosis
- accentuated lumbar curve, flatten back out against wall? pregnancy
60
RA
systemic, fever, rash, ulcers, younger patients, can be multiple joints
-swan neck, ulnar deviation, boutineer
61
DJD/osteo
wear and tear, herbertans on dip, bochards on pips
62
swan neck
hyperextension of the PIP with flexion of the DIP
63
boutineer
- flexion of PIP with hyperextension of DIP
64
carpal tunnel tests
- numb and tingle up to 3rd finger
| phalen and tineal
65
phalens
put back of palms together
66
tineal test
tap on median nerve and get a zinger
67
herniated disc test
pain on straight leg raise and cross-over test
68
cauda equina syndrome
- pressure on cord that leads to permanent damage, ask about bowel and bladder function
69
Tennis elbow
lateral epicondylitis
70
Golfers elbow
medial epicondylitis
71
nerve root compression can cause
absent or depressed DTR
72
McMurray test
- meniscus tear, Flex the knee, place forefingers on lateral side of joint line, then with applying valgus stress and internal rotation of leg, extend the knee looking for both pop/click and pain
73
Apley’s Test
with knee flexed apply pressure to foot and counter pressure to knee, twist and listen for clicks.
74
propulsive
parkinsons
75
scissor
cerebral palsy
76
spastic
hemiplegic, CVA
77
waddling
toddlers, hip dislocation
78
steppage
neuropathy, MS
79
Romberg
for balance
80
pronator
shows balance
81
torn meniscus tests
apley and mcmurrary
82
torn ACL tests
Lachman, if tug on tibia and fibula they shouldn't move
83
referred gallbadder pain
right scapular pain
84
rotator cuff injury
cant raise hand above shoulder
85
rotator cuff tests
abduct and bring down slowly the arm just stops (drop arm test), empty can movement and arm drops
86
ligament tear tests
lachman or drawer
87
NIH
don't want a high score
88
first test for stroke
=pre-hosp screen
will make a decision at that point to call stroke alert (smile, droop, slurred speech, look for pronator drift) CT, vitals and glucose then NIH
89
Cushings
(widening pulse pressure, bradycardia, irregular breathing)
90
DTR
- Biceps- indirect, will have contraction
- Triceps- will have extension
- Brachioradialis- may have a slight supination and flexion of hand
- Patellar- extension of leg
- Achilles- will have plantar flexion
91
cerebellar function
balance, Romberg test (feet together eyes open then closed), ability to walk, 4 inch base of support, stride length 14 inches
92
pronator drift
muscle weakness
| -hold out hands like holding a pizza
93
cystic breast
occur 20-30s, tender, change according to point in cycle, can be affected by chocolate and caffeine
94
Fibroadenoma
one round firm non-tender mass, often in teens-20s
95
Breast cancer
- hard irregular non-tender, occur more when older
96
Inflammatory breast ca
- red and inflamed, can have orange peel skin
97
Pagets
- breast ca around nipple, will see redness/discharge/flaking
98
when to check breast tissue
4th to 7th day after cycle pre-menopausal
| -can do exam anytime when post-menopausal
99
gonorrhea
bacterial, white/yellow discharge, burning urination
100
herpes
hurts, small ulcers on red bases, recurrent outbreaks
101
genital warts, HPV
cauliflower
102
primary syphilis
- one painless lesion, develops into a rash covering entire body
103
bacterial vaginosis
(fishy smell)- inc risk with multiple partners, douching or smoking
104
candidiasis
cottage cheese
105
prostate
digital rectal exam, specific antigen, usually first present as urinary problems
106
testes
torsion, severe pain, one sided, cremasteric (stroke inner aspect of thigh, normal testes will move up)
107
vaginal complaint also checks
associated urinary symptoms (CVA tenderness)
108
PID can lead to
infertility
109
Apgar
initial then 5 min
| - Assesses neurologic recovery from delivery and adaptation to extrauterine environment
110
low APGAR 1 min
nervous system depression, very low scores need resuscitation
111
low APGAR 5 min
- high risk for ongoing developmental problems
112
Examine older infant
- use a toy or other distractor, do exam in parents lap, gather developmental info from parent, make sure infant is fed beforehand
113
milia
- pin-head sized white papular lesions on nose, chin, forehead caused by sebum retained in sebaceous glands; also clear in a few weeks
114
Acrocyanosis
common in 1st few days of life and early infancy & into infancy- caused by exposure to cold
115
Mongolian spots
dark bluish or dark pigmentation over the buttocks & lower back- these tend to fade with age, but should be documented to avoid concern about bruising later.
116
Jaundice
physiologic occurs in half of infants, appearing 2-3 days after birth, jaundice within first 24 hours is hemolysis, jaundice longer than 2 weeks is liver or biliary disease
117
peds respiratory
obligatory nose breathers, nasal flaring is bad
118
normal newborn HR
120s
119
Social development in infants
- relationship between them and caregiver is critical
120
gross motor age
1-4 years
121
fine motor age
4 years
122
age 5-10 development
- is goal directed, concrete operational stage, learn from school and family
123
early adolesence
10-14, start puberty
124
middle adolesence
15-16
125
late adolesences
appear as adults
