final exam Flashcards
(130 cards)
1
Q
Pain in RLQ
rebound tenderness over McBurneys point
Positive Rovsings sign
A
appendicitis
2
Q
LLQ pain
radiating down left side of abdomen
inflammation of sac or pouch in walls of organ or canal
A
diverticulitis
3
Q
what are the red flags of headaches?
A
recent onset
positional headaches = space occupying lesion
focal neurological sings = ringing in ears, tingling, weakness
cognitive changes in behavior
progressive headaches = getting worse no improvement
4
Q
primary lymph node malignancies?
A
lymphosarcoma
hodgkin’s disease
lymphatic leukemia
5
Q
secondary lymph node malignancy
A
due to metastasis from other parts of body = breast cancer
6
Q
what are benign/inflammatory lymph node characteristics?
A
soft to firm
painful to tender (most likely due to inflammation)
movable
7
Q
what are malignant/suspicious lymph node characteristics?
A
fixated
painless
hard
discrete
8
Q
what is a virchow nodule?
A
signal or sentinel node
located at supraclavicular area
usually left side
due to metastic carcinoma (usually clue to thoracic/abdominal malignancy)
9
Q
what is Sister Mary Joseph Nodule?
A
malignant lymph node around umbilicus that indicates intra-abdominal malignancy
10
Q
heart murmur
A
audible turbulence of blood flow
11
Q
mitral stenosis
A
narrowed mitral valve that restricts blood flow FORWARD
results in forceful ejection FROM left atrium into left ventricle
12
Q
what can cause mitral stenosis?
A
rheumatic fever or cardiac infection
can also occur with mitral regurgitation
13
Q
aortic stenosis
A
calcification of aortic valve cusps
restricts blood flow FORWARD
results in forceful ejection from LEFT VENTRICLE into SYSTEMIC circulation
14
Q
what can cause aortic stenosis?
A
congenital bicuspid valve
rheumatic heart disease
arthersclerosis
15
Q
pulmonic stenosis
A
pulmonic valve restricts FORWARD blood flow
results in forceful ejection from RV into PULMONIC circulation
16
Q
tricuspid stenosis
A
calcification of tricuspid valve cusps
restricts forward blood flow
results in forceful ejection from RIGHT atrium into RIGHT ventricle
17
Q
causes of tricuspid stenosis
A
rheumatic heart or congential defect
occurs with mitral stenosis usually
18
Q
mitral regurgitation
A
mitral valve incompetence
allows BACKFLOW of blood from LV into LA
19
Q
mitral valve prolapse
A
valve incompetency early in systole
prolapse into atrium later in systole
20
Q
aortic regurgitation
A
aortic valve incompetence
allows backflow of blood from aorta into LV
21
Q
pulmonic regurgitation
A
allows backflow of blood from pulmonary artery into RV
22
Q
what causes pulmonic regurgitation?
A
congenital defect
bacterial endocarditis
pulmonary hypertension
23
Q
tricuspid regurgitation
A
allows backflow of blood from RV into RA
24
Q
what causes tricuspid regurgitation?
A
congenital defect
bacterial endocarditis
pulmonary hypertension
cardiac trauma
25
normal vital signs
```
pulse 60-90 bpm
temp 98.6 F
bp 120/80 mmHg
pulse pressure (systolic - diastolic) NO MORE than 50 mm Hg
respiration rate 10-20 breaths per min
```
26
graves disease
hyperthyroidism -> cretinism and myxedema
27
cushing's syndrome
moon face
Addison's
excessive hormone production of adrenal cortex
28
systemic lupus erythematosus (SLE)
butterfly rash over face
| autoimmune disease
29
acromegaly
abnormal increase in production of growth hormone by pituitary gland (hyperfunction)
occurs AFTER puberty
30
gigantism
abnormal increase in production of growth hormone by pituitary gland (hyperfunction)
occurs BEFORE puberty
31
vitiligo
lack of pigment occurring in various areas on body especially face
32
exopthalmos
extrusion of eyeballs pushed by excessive fat behing the eyes (retroorbital fat)
33
george's test
vertebrobasilar system assessment
bilateral pulse and bp = look for diff of 10 mm Hg
auscultate subclavian and carotid arteries
VBAI maneuver = head rotation
34
murphy's sign
application of any one of 3 feeling liver edge tests and gallbladder palpation
patient experiences relfex apnea and pain
caused by acute cholecystitis
35
murphy's punch
doctor strikes patient's posterior costovertebral angle
blow should not cause pain or tenderness
pain caused by nephritis
36
blumberg's sign
rebound tenderness and pain in any 4 quads indicates peritonitis
37
rovsing's sign
rebound tenderness and pain in LLQ referred to RLQ over McBurneys point indicates appendicitis
38
caput medusa
portal hypertension -> advanced liver cirrhosis
39
HIV to AIDs clinical latency?
10 years
40
emphysema/COPD
air takes over and dominates space to disrupt function
reduces number of alveoli
permanently hyperinflates lung
41
signs and symptoms of emphysema
```
barrel chest
decreased chest expansion
hyperresonant
decreased tactile fremitus
decreased breath sounds
patient older, smoking, weight loss, malaise
polycythemia
decreased oxygen
```
42
nails of emphysema patients are _____
clubbed
43
hemoptysis means
cough up blood
44
hemoptysis is seen in
tuberculosis or malignancy
45
hematemesis is
vomiting blood
46
hematemesis is seen in
peptic ulcer
47
somato-somatic reflex
neck pain shooting down arm or lumbar disc problem
48
somato-visceral reflex
hand in cold water increase heart rate (nerve to organ)
49
viscero-somatic reflex
heart problem down left side of body (organ to nerve)
50
vesicular lung sound
heard over lung field
51
bronchovesicular lung sound
heard over main stem of bronchi
52
bronchial
heard over trachea
53
what muscle implicated in cervicogenic headaches?
rectus capitis posterior minor
54
classic migraine
aura
55
tension headache
muscular in nature - hat band
56
cluster headache
worst kind of pain
unilateral and alcohol makes worse
short duration accompanied by tearing and nose running
cyclic in nature
57
CDC definition of AIDS
HIV positive and CD4 (T-cell) count below 200
| presence of one or more opportunistic infections
58
time from AIDS to death
2-3 years
59
cullen's sign
blue appearance around umbilicus
60
intra-abdominal hemorrhage and blue
cullen's sign
61
generalized abdominal pain upon manual rebound
blumberg's sign
62
what condition is associated with hematemesis
peptic ulcer
63
portal hypertension is caused by what
liver cirrhosis
64
what is likely to occur due to ingestion of contaminated food
hepatitis A
65
abdominal aorta is normally palpated at the ___ and up to the ____
umbilicus and up to left
66
what is associated with peptic ulcer?
melena - black tarry stool due to presence of blood
67
patient presents with pain in LLQ, nausea, vomiting, altered bowel habits. upon exam rebound tenderness present in LLQ. what is most likely diagnosis
Meckel's diverticulitis
68
syndrome where tumors secrete hormone called gastrin that causes the stomach to produce too much acid causing dudodenal and stomach ulcers
zollinger-ellison syndrome
69
sister mary joseph nodules may suggest
malignancy
70
tests performed at midclavicular line
murphy's sign
percussion of the upper border of liver
percussion of the lower border of liver
auscultation of the mitral area of the heart
71
patient presents with right shoulder and scapular pain exam is unrewarding but positive murphy's sign. what is the origin of the pain? what reflex is this an example of?
cholecystitis and viscero-somatic
72
most common cause of bleeding per rectum is
hemorrhoids or piles
73
anal fissure
small crack that can happen from chronic constipation
74
a 40 year old flight attendant presents for abdominal pain. it is worse after eating especially is she has a meal that is spicy or high in fat. over the counter antacids have not helped. you strongly suspect a condition that requires which sign on examination?
murphy's sign
75
while palpating the epigastric area you felt pulsations coming from S to I. this patient may be suffering from what?
cor pulmonale
76
which area is most painful regarding kidney stone?
ureter
77
15 year old high school student present with 1 day history of nausea and anorexia. hes describes pain as generalized but today it has localized to RLQ. you palpate LLQ and patient experiences pain in the RLQ. what is the name of this?
rovsings
78
with liver disease you have a decreased amount of ____
serum albumin
79
what indicates weakness of the linea alba?
diastasis recti
80
referred pain is categorized under which of the following reflexes
viscero-somatic reflex
81
apex beat is normally located at mid axillary line (T or F)
false
82
apex beat is formed by LV contraction (T or F)
true
83
precordial heaving is associated with LV contraction (T or F)
false - right
84
apex beat is located where?
5th left intercostal space
85
character of cardiac pain is usually ___ like
pressure
86
character of pleurisy is usually ___ like
knife
87
28 year old man complains of periodic episodes of severe headaches that occurred nightly for past two weeks. pain awakens him 2 or 3 hours after he has been asleep and lasts for about one hour the pain always around right eye and makes eye water. pain is aggravated by alcohol intake. he had similar episodes about 2 years ago. clinical impression?
cluster headache - lacrimation, rhiorrhea
88
world population that has peptic ulcers
10%
89
part of the heart that occupies most of the anterior surface is
the right ventricle
90
which cardiac problem is a primary cause of cyanosis at birth
overriding aorta on both ventricles
91
fallot's tetrology
pulmonary stenosis
aorta overriding on both ventricles
ventricular septal defect
RV hypertrophy
92
will ventricular septal defect create cyanosis at birth?
no
93
a COMMON migraine patient will see an aura before onset
false - CLASSIC
94
A 28 year old man compains of periodic episodes of severe headaches that have occurred nightly for the past two weeks. The pain awakens him two or three hours after he has been asleep and lasts for about one hour. The pain is always around the right eye and makes the affected eye water. Pain seems to be aggravated by alcohol intake. he had a similar episode of headaches about two years ago. What is the clinical impression?
cluster
95
Angela is a 48 year old female. She is a secretary for bell south, complaining of headaches started three months ago with slow and progressive course. She got worse last month. Head movement, leaning forwards, coughing and sneezing tend to worsen the attacks. Partially relieved with over counter medications. Mostly behind eyes, temporal and occipital areas and associated with visual difficulties. Worse in the morning and sometimes during nighttime. She has a hard time sleeping.
No past history of headaches/trauma/hospitalization/major illness
space occupying lesion and refer patient
96
dejerine's triad
pain upon coughing sneezing or straining indicates space occupying lesion
97
Giovanni is 25 year old male complaining of acute abdominal discomfort for several days. Initial eval. revealed that a tinge of yellowish discoloration in his sclera. Examination reveals tenderness in right upper quadrant. Which of the following...
```
Gastrointestinal system (for the liver)
nature of jaundice is INFECTIOUS
```
98
which of the following inquiries for patient's history (choose two)
sexual history/ illicit drug use
| history of ingestion of contaminated food
99
what is the most commonly injured abdominal organ from trauma
spleen
100
what are two presentations that may be caused by peptic ulcers
hematemesis and melena
101
two causes of bleeding per rectum
colorectal cancer
| hemorrhoids
102
While palpating the epigastric area you felt pulsations coming from superior to inferior. This patient may be suffering from which of the following?
cor pulmonale (RV enlargement)
103
hep A
fecal oral
104
hep B
more severe than A
blood is transmission
post-hepatitis cirrhosis
105
hep A prevention
proper hygiene
106
h. pylori is strongly related to development of peptic ulcer T/F
true
107
The proper protocol for abdominal exam is inspection, palpation, percussion, and auscultation T/F
false
108
Diastases recti (bulging of linea alba) may suggest weak abdominal muscles T/F
true
109
You are assessing a patient with abdominal pain and fever. You are performing an abdominal examination to assess for peritoneal signs. Which one of the following is NOT a peritoneal sign?
voluntary guarding
110
acute abdomen condition possible causes
```
appendicitis
cholecystitis
IBS
kidney stone
nephritis
gall stone
diverticulitis
cholitis
pancreatitis
```
111
pain in LUQ possible causes
```
ruptured spleen
peptic ulcer
gastritis
myocardial infarcation
pneumonia
rib fracture
pleurisy
cholitis
nephritis
gas
food poisoning
bowel obstruction
```
112
RLQ possible causes
appendicitis
| ruptured appendix
113
most common congenital heart disease
ventricular septal defect
114
cor pulmonale is
right ventricular enlargement due to pulmonary pathology
115
structural abnormalities of the chest is usually associated with
TB
| emphysema
116
clubbing of fingernails due to
chronic hypoxia
117
OPQRST falls under which major patient history category
present problem
118
start at the superior vena cava, a drop of blood will follow the following valvular sequence
tricuspid
pulmonic
mitral
aortic
119
constant low-back pain which is unrelieved by position, activity or rest is most likely the result of which of the following?
visceral disease
120
a condition most commonly caused by systemic hypertension
LV hypertrophy
121
apex beat is located
at midclavicular line
122
tricuspid valve stenosis may lead to?
RA enlargement
123
fourth heart sound occurs physiologically due to
passive blood flow from the atria to the ventricles
124
positive egophony, brochophony and whispered pectoriloquy during auscultation of the lung indicate
lung consolidation
125
periphery of lung during auscultation of an asthmatic patient is
generalized wheezing
126
aortic stenosis can cause
blackouts
127
diff btwn myocardial infarction and angina pectoris is based on what
the duration of the pain
128
sinister headaches?
subdural hematoma
129
amino acids which increase production of human growth hormone
need weight lifting for human growth hormone (needs to be enough weight to make 7th rep very difficult)
secretagogues
130
arginine, ornithine, lysine, and glutamine. black beans and white meat chicken have these
secretagogues
