Final Exam Health Assessment Flashcards
(339 cards)
1
Q
What are the components of health history?
A
- Patient’s own past medical history
- Medication list
- Allergies with reaction
- Surgical history
- Family history
- Social history
- Health Maintenance
- Functional status for older adults
- Pediatric considerations
Includes aspects like general health perception, childhood and adult illnesses, lifestyle issues, and sensitive areas like sexuality and domestic violence.
2
Q
What does HPI stand for in health assessment?
A
History of Present Illness
HPI involves establishing the patient’s agenda and understanding their health concerns.
3
Q
What is the purpose of the ‘Old Carts’ method in health assessment?
A
- Onset
- Location
- Duration
- Character
- Alleviating/aggravating factors
- Radiation
- Timing
- Severity
This method helps to gather detailed information about the patient’s symptoms.
4
Q
Define subjective data in a health assessment.
A
Anything the patient tells you
Subjective data includes personal experiences, feelings, and health history provided by the patient.
5
Q
Define objective data in a health assessment.
A
What you observe (test results & physical exam)
Objective data includes measurable and observable findings during the examination.
6
Q
What are the three types of prevention in health care?
A
- Primary: Prevents onset of disease (e.g., vaccinations)
- Secondary: Early intervention to halt disease progression (e.g., screenings)
- Tertiary: Minimizes effects of disease (e.g., rehab)
Each type of prevention targets different stages in the disease process.
7
Q
What is included in a complete health history?
A
- Biographical Data
- Chief Complaint(s)
- History of Presenting Illness
- Past Medical History
- Family History
- Personal & Social History
- Functional Assessment with ADLs
- Review of Systems
A complete health history provides a comprehensive view of the patient’s health.
8
Q
What should be observed during a head examination?
A
- Size and Shape
- Skull
- Scalp
- Hair
- Face
- Skin
- Cervical lymph nodes
- Thyroid gland
Observations can indicate various health conditions.
9
Q
List the regions of the head.
A
- Frontal Region
- Parietal Region
- Temporal Region
- Occipital Region
- Orbital Region
- Nasal Region
- Oral Region
- Mental Region
- Auricular Region
- Buccal Region
- Mandibular Region
- Zygomatic Region
- Infraorbital Region
Each region has specific anatomical features and clinical significance.
10
Q
What are the components to assess in the neck during a physical examination?
A
- Symmetry
- Masses or Swelling
- Trachea Position
- Range of Motion
- Skin
These assessments help identify potential abnormalities or conditions.
11
Q
What are the chains of lymph nodes in the head and neck?
A
- Preauricular
- Posterior Auricular
- Occipital
- Tonsillar (Jugulodigastric)
- Submandibular
- Submental
- Anterior Superficial Cervical
- Posterior Cervical
- Deep Cervical
- Supraclavicular
Each lymph node group has specific locations and clinical relevance.
12
Q
How do you assess thyroid function?
A
- Inspection
- Palpation
- Auscultation
Important questions include weight changes, fatigue, skin texture changes, and bowel habits.
13
Q
List the external parts of the eye.
A
- Eyelids (Palpebrae)
- Conjunctiva
- Sclera
- Cornea
- Iris
- Pupil
- Lacrimal Apparatus
These parts play roles in protecting and lubricating the eye.
14
Q
What are the internal parts of the eye?
A
- Lens
- Retina
- Macula
- Optic Nerve
These structures are crucial for vision and light processing.
15
Q
What cranial nerves are involved in extraocular movements?
A
- CN VI: Abducens nerve
- CN IV: Trochlear nerve
- CN III: Oculomotor nerve
These nerves control eye muscle movements and coordination.
16
Q
Fill in the blank: The _______ is responsible for focusing light onto the retina.
A
Lens
The lens adjusts its shape to focus on objects at various distances.
17
Q
True or False: The conjunctiva is a highly vascularized mucous membrane that covers the sclera and inner eyelids.
A
True
This membrane is essential for eye lubrication and protection.
18
Q
What questions are important to ask when assessing thyroid function?
A
- Have you experienced unexplained weight changes?
- Do you feel unusually fatigued or energetic?
- Have you noticed changes in skin texture or hair?
- Do you experience sensitivity to cold or heat?
- Have you had changes in bowel habits?
- Are you experiencing palpitations or changes in heart rate?
These questions help evaluate thyroid health and function.
19
Q
What is the purpose of the convergence test in an eye examination?
A
To assess if the patient’s eyes follow an index finger to within 5 to 15 centimeters and observe pupil constriction.
Convergence also indicates if pupils constrict when focusing on nearby objects.
20
Q
What are key questions to ask patients about their eyes?
A
- Have you noticed any changes in vision?
- Do you experience pain, redness, or discharge?
- Have you had recent eye trauma?
- Do you have a history of eye conditions?
21
Q
How is the confrontation test conducted to assess visual fields?
A
Cover one eye and compare peripheral vision by wiggling fingers and asking the patient when they can see them.
This test compares the examiner’s vision with the patient’s vision.
22
Q
What additional information is needed if a patient reports a change in vision?
A
- Onset: sudden or gradual?
- Is vision worse for close work or distance?
- Is there blurred vision?
- Is it unilateral or bilateral?
23
Q
What causes sudden unilateral visual loss if painless?
A
- Vitreous hemorrhage
- Macular degeneration
- Retinal detachment
- Retinal vein occlusion
- Central retinal artery occlusion.
24
Q
What are some symptoms that indicate a need for immediate referral in cases of visual loss?
A
- Sudden visual loss
- Painful visual loss
- Associated headaches
- Bilateral visual loss.
25
What are important observations during an eye examination?
* Conjunctival color
* Pupil size and reactivity
* Ocular alignment
* Corneal reflexes.
26
What are the steps for using an ophthalmoscope?
* Darken the room
* Instruct the patient to fix gaze on a distant object
* Hold the ophthalmoscope at a 15-degree angle
* Move in to visualize the red reflex and fundus.
27
What is a common finding when examining the eardrum?
A cone of light is visible, located at the 5 o'clock position for the right tympanic membrane and 7 o'clock for the left.
The cone of light indicates a healthy tympanic membrane.
28
What are the two types of hearing loss?
* Conductive
* Sensorineural.
29
What causes conductive hearing loss?
* Blockage in external and middle ear:
* Cerumen impaction
* Otitis media
* Otosclerosis.
30
What are symptoms associated with sensorineural hearing loss?
Difficulty understanding speech, often exacerbated in noisy environments.
It is often caused by aging, noise exposure, and inner ear damage.
31
What are three differential diagnoses for ear pain?
* Otitis externa: Pain with auricle movement.
* Otitis media: Pain, fever, fluid behind tympanic membrane.
* TMJ dysfunction: Pain with jaw movement.
32
What additional information is needed if a patient reports dizziness or vertigo?
* Describe symptoms without using 'dizzy'
* Duration and triggers
* Associated symptoms like nausea or headache.
33
What should be observed during an ear examination?
* External ear shape
* Canal patency
* Tympanic membrane color.
34
What are the steps for using an otoscope?
* Pull the auricle upward and back
* Insert otoscope gently
* Inspect tympanic membrane.
35
How do you conduct a whisper test to assess hearing?
Stand behind the patient, whisper a word, and have them repeat it.
Ensure the non-test ear is occluded to prevent sound transfer.
36
What are three differential diagnoses for rhinorrhea?
* Viral infections
* Allergic rhinitis
* Vasomotor rhinitis.
37
What symptoms favor an allergic cause of rhinorrhea?
Presence of itching in the eyes, nose, or throat.
38
What indicates acute bacterial sinusitis?
Symptoms persist more than 7 days with purulent drainage and facial pain.
39
What drugs may induce nasal stuffiness?
* Topical decongestants
* Intranasal cocaine.
40
What conditions can cause unilateral nasal congestion?
* Deviated nasal septum
* Nasal polyps
* Foreign body
* Granulomatous disease
* Carcinoma.
41
What is required for a diagnosis of sinusitis?
Purulent drainage and facial pain must be present for at least 7 days
Sensitivity and specificity are above 50%
42
What medications may induce nasal stuffiness?
Oral contraceptives, alcohol, cocaine
Inquire about all medications or drugs
43
What conditions should be considered if nasal congestion is only on one side?
Deviated nasal septum, nasal polyps, foreign body, granulomatous disease, carcinoma
44
What are the common symptoms of Allergic Rhinitis?
Sneezing, itchy nose, eyes, or throat, clear nasal discharge
Patients may report history of allergies or exposure to allergens
45
What symptoms are characteristic of a Viral Upper Respiratory Infection?
Nasal congestion, clear or purulent nasal discharge, sore throat, cough, low-grade fever
46
Define Vasomotor Rhinitis.
Nasal congestion and clear rhinorrhea without an allergic cause
Triggers include irritants like smoke, strong odors, or changes in temperature
47
What symptoms differentiate sinusitis from a URI?
Facial pain or pressure, purulent nasal discharge, nasal congestion, fever
Symptoms of sinusitis persist for more than 10 days or worsen after initial improvement
48
What is epistaxis?
Bleeding from the nasal passages
Bleeding can also originate in the paranasal sinuses or nasopharynx
49
What local causes can contribute to epistaxis?
Trauma, inflammation, drying of nasal mucosa, tumors, foreign bodies
50
What should be assessed if a patient reports recurrent epistaxis?
Frequency and duration, identifiable triggers, medications, medical history, associated symptoms
51
What should be observed when examining the external nose?
Deformities, asymmetry, skin lesions
52
What does the internal examination of the nasal cavity involve?
Examine nasal mucosa for color, swelling, bleeding, exudate, ulcers, or polyps
Assess nasal septum for deviation, inflammation, or perforation
53
What are the steps for assessing the nose and sinuses?
Inspection, palpation, internal examination, sinus palpation
54
List three differential diagnoses for sore throat.
* Viral Pharyngitis
* Bacterial Pharyngitis
* Infectious Mononucleosis
55
What is a common symptom of Viral Pharyngitis?
Gradual onset of sore throat
Associated symptoms may include cough, nasal congestion, rhinorrhea, conjunctivitis, and hoarseness
56
What differentiates Bacterial Pharyngitis from Viral Pharyngitis?
Abrupt onset of sore throat, fever >38°C, tender anterior cervical lymphadenopathy, tonsillar exudates, absence of cough
57
What are common symptoms of Infectious Mononucleosis?
Severe sore throat, marked fatigue, fever, generalized lymphadenopathy, tonsillar enlargement, possible splenomegaly
58
What are the normal findings for teeth during an oral examination?
Clean, white, well-aligned, no caries, chips, or looseness
59
What is the location of the Aortic valve?
2nd intercostal space (left sternal border)
60
What heart sound corresponds to the closure of the AV valves?
S1 ('lub')
Occurs at the start of ventricular systole
61
What heart sound corresponds to the closure of the semilunar valves?
S2 ('dub')
Occurs at the start of ventricular diastole
62
What is a regurgitant murmur?
Caused by backward flow of blood through an incompletely closed valve
63
What is a turbulent forward flow murmur?
Occurs when blood flows abnormally through a narrowed or irregularly structured valve or vessel
64
Give an example of a systolic murmur.
Aortic Stenosis Murmur
Location: Right second and third intercostal space, often radiates to the carotids
65
How is Jugular Venous Pressure (JVP) measured?
Position the patient at a 45-degree angle, observe the neck veins for pulsations
66
What is the location of the point of maximal impulse (PMI)?
The location at which the cardiac impulse can be best palpated on the chest wall, usually the apical impulse.
67
How is Jugular Venous Pressure (JVP) measured?
JVP is measured in vertical distance above the sternal angle, which is around T4 adjacent to the second rib.
68
What maneuvers optimize the measurement of JVP?
* Place HOB at 30 degrees
* Patient turn head slightly to the left
69
What is a heave?
A sustained impulse that rhythmically lifts your fingers, usually produced by an enlarged ventricle.
70
What is a thrill?
A buzzing or vibratory sensation caused by underlying turbulent flow.
71
What is a bruit?
A murmur-like sound arising from turbulent arterial blood flow.
72
What are the normal values for Forced Vital Capacity (FVC)?
80% to 120%
73
What does FEV1 stand for?
Forced expiratory volume in one second.
74
What is the normal value for FEV1?
80% to 120%
75
What does a decrease in the FEV1/FVC ratio indicate?
The presence of an obstructive defect.
76
What is the significance of the FEV1/FVC ratio in children?
Less than 0.9 indicates obstruction.
77
What is the normal range for the QT interval?
0.36-0.44 seconds.
78
What is the normal range for the PR interval?
0.12-0.20 seconds.
79
What are the indications for a chest x-ray?
* Chronic cough for > 4-6 weeks
* New onset hypoxemia
* Suspected lung cancer
* Complex chest infection
* Vascular disease
* Chest trauma
80
What is the normal value for Functional Residual Capacity (FRC)?
75% to 120%
81
What is the normal value for Total Lung Capacity (TLC)?
80% to 120%
82
What is the purpose of the flow-volume loops in pulmonary function tests?
To assess for artifacts and abnormalities.
83
What does a low FVC indicate?
A value less than the lower limit of normal for adults or less than 80% of predicted for children.
84
What is the definition of tidal volume?
The volume of air inhaled or exhaled during each respiratory cycle.
85
What does the term 'heave' refer to in cardiac examination?
A sustained impulse that can indicate ventricular enlargement.
86
Fill in the blank: The _____ is the highest oscillation point of the jugular venous pulsation.
JVP
87
True or False: The PMI is usually located at the right sternal border.
False
88
What is the significance of measuring JVP?
It helps assess the right atrial pressure.
89
What is the average heart rate for adults?
60 - 100 bpm.
90
What is the role of pacemaker cells in the heart?
To generate and transmit electrical signals.
91
What is the primary purpose of the cardiac conduction system?
To facilitate the spread of electrical signals throughout the heart.
92
What are the two types of cardiac cells?
* Contractile myocardial cells
* Pacemaker cells
93
What is the normal value for FEF 25-75%?
Dependent on the FVC.
94
What does a significant reversibility in obstructive patterns indicate?
An increase in FEV1 or FVC after bronchodilator administration.
95
What are the components evaluated in full pulmonary function testing?
* Lung volumes
* Gas exchange
96
What should be assessed in the interpretation of a chest x-ray?
* Mediastinum
* Trachea
* Aorta
* Masses
* Pulmonary vessels
97
What is the primary view used for chest x-rays?
PA view
98
What can poor inspiration on a chest x-ray result in?
Crowding of lung fields, which can be confused for infiltrates.
99
Where can you hear the right upper lobe (RUL) of the lung?
Anteriorly: Above the 4th rib at the midclavicular line; Posteriorly: T1–T3 level; Laterally: Above the 4th rib in the midaxillary line
RUL is best auscultated in these specific locations.
100
Where can you hear the right middle lobe (RML) of the lung?
Best heard in the right lateral chest; Anteriorly: Between the 4th and 6th ribs at the midclavicular line; Laterally: Around the 5th and 6th ribs at the midaxillary line
RML is not well heard posteriorly due to its anterior positioning.
101
Where can you hear the right lower lobe (RLL) of the lung?
Posteriorly: Below T3-T4 to T10 (T12 with deep inspiration); Laterally: From the 6th to 8th ribs in the midaxillary line; Anteriorly: Below the 6th rib
Anteriorly, the RLL is not easily heard.
102
What is the best place to hear all three lobes of the right lung?
The right lateral chest (midaxillary line between the 4th and 8th ribs)
This is the only location where all three lobes can be auscultated together.
103
What does the acronym O in the dyspnea assessment stand for?
Onset
Questions related to the onset of shortness of breath help identify potential causes.
104
What questions would you ask to assess the onset of dyspnea?
When did the shortness of breath start? Was there a triggering event? Have you had this type of shortness of breath before?
Understanding onset can help assess conditions like pulmonary embolism or COPD.
105
What does the acronym D in the dyspnea assessment stand for?
Duration
Duration of symptoms provides insight into the nature of the dyspnea.
106
What questions would you ask to assess the duration of dyspnea?
How long have you been experiencing shortness of breath? Is it constant or does it come and go? Has it been getting worse over time?
Acute vs. chronic duration indicates different underlying conditions.
107
What does the acronym C in the dyspnea assessment stand for?
Character
Character of the dyspnea refers to how the patient describes their breathing difficulty.
108
What questions would you ask to assess the character of dyspnea?
Can you describe how the shortness of breath feels? Do you feel like you can’t get enough air in, or is it more like you can’t exhale?
The character can suggest specific conditions like heart failure or asthma.
109
What does the acronym A in the dyspnea assessment stand for?
Aggravating Factors
Identifying factors that worsen dyspnea can clarify the underlying cause.
110
What questions would you ask to assess aggravating factors of dyspnea?
What makes your breathing worse? Physical activity? Lying flat? Cold air or strong smells? Eating or swallowing? Time of day?
Each factor can indicate specific conditions.
111
What does the acronym R in the dyspnea assessment stand for?
Relieving Factors
Understanding what alleviates dyspnea aids in diagnosis.
112
What questions would you ask to assess relieving factors of dyspnea?
What helps ease your breathing? Rest or sitting upright? Use of inhalers or oxygen? Medication? Coughing or clearing mucus?
Relief from certain actions can point to underlying respiratory conditions.
113
What does the acronym T in the dyspnea assessment stand for?
Timing
Timing helps to understand the pattern of dyspnea.
114
What questions would you ask to assess the timing of dyspnea?
Does the shortness of breath occur at a specific time of day? Is it episodic or continuous? Do you wake up gasping for air?
Timing can indicate specific conditions like heart failure.
115
What does the acronym S in the dyspnea assessment stand for?
Severity
Assessing severity helps determine the impact of dyspnea on daily life.
116
What questions would you ask to assess the severity of dyspnea?
On a scale of 1-10, how bad is your shortness of breath? Has it worsened compared to when it first started? Is it limiting your daily activities?
Higher severity suggests more serious conditions.
117
What are the percussion technique steps for assessing the chest?
1. Positioning the patient; 2. Proper hand positioning; 3. Striking motion; 4. Percussing systematically
Each step is essential for accurate percussion.
118
What are the normal percussion sounds and their common causes?
* Resonant: Normal lungs; * Dull: Pneumonia, pleural effusion; * Hyperresonant: Pneumothorax, COPD; * Tympanic: Large pneumothorax
Each sound provides diagnostic information about lung conditions.
119
Where are bronchial breath sounds normally heard?
Over the trachea and manubrium
High-pitched and loud, these sounds have a longer expiratory phase.
120
Where are bronchovesicular breath sounds normally heard?
Over the mainstem bronchi and between scapulae
Moderate pitch and intensity, with equal inspiration and expiration duration.
121
Where are vesicular breath sounds normally heard?
Over most lung fields
Soft, low-pitched sounds with a longer inspiratory phase.
122
Where are tracheal breath sounds normally heard?
Over the trachea in the neck
Very loud and high-pitched with nearly equal inspiration and expiration duration.
123
What are the USPSTF recommendations for lung cancer screening?
Annual lung cancer screening with Low-Dose CT for adults aged 50 to 80 years with a 20 pack-year smoking history
Current smokers or those who quit within the last 15 years are included.
124
What are the discontinuation criteria for lung cancer screening?
* Has not smoked for 15+ years; * Develops a health condition that limits life expectancy or ability to undergo surgery
These criteria ensure appropriate use of screening.
125
What are the American Cancer Society recommendations for lung cancer screening?
Similar to USPSTF, but can extend to those past 80 years if they remain in good health
This recommendation allows for screening flexibility based on health status.
126
What are the NCCN guidelines for lung cancer screening?
Group 1: Age 50+, ≥20 pack-year smoking history, and one additional risk factor
Annual LDCT screening is recommended for this group.
127
What is the recommended screening approach for individuals aged 50+ years with a history of smoking?
Shared decision-making approach for screening.
This applies to individuals with a ≥20 pack-year history and no additional risk factors.
128
What method significantly reduces lung cancer mortality according to Bates’ Guide?
Early detection via LDCT.
LDCT stands for Low-Dose Computed Tomography.
129
Is chest X-ray recommended for lung cancer screening?
No, chest X-ray is not recommended for lung cancer screening.
130
What is the most effective strategy to reduce lung cancer risk?
Smoking cessation.
131
Is routine screening recommended for children and adolescents?
No, routine screening is NOT recommended for children and adolescents.
132
What are the key focuses for pediatric lung health?
* Smoking prevention
* Secondhand smoke exposure reduction
* Education on vaping and e-cigarette risks.
133
What additional risk factors may justify lung cancer screening?
* Occupational exposures (Asbestos, radon, diesel fumes)
* Family history of lung cancer
* History of chronic lung disease (COPD, pulmonary fibrosis)
* Secondhand smoke exposure
* History of radiation therapy to the chest.
134
What are the limitations and risks of lung cancer screening?
* False positives can lead to unnecessary procedures
* Radiation exposure from LDCT
* Overdiagnosis may result in treating slow-growing tumors.
135
How many lobes does the right lung have?
3 lobes: Right upper, Right middle, Right lower.
136
How many lobes does the left lung have?
2 lobes: Left upper, Left lower.
137
What is the most common cause of acute cough?
Viral upper respiratory infections.
138
What defines an acute cough?
Lasting less than 3 weeks.
139
What are examples of acute cough causes?
* Viral upper respiratory infections
* Acute bronchitis
* Pneumonia
* Left-side heart failure
* Asthma
* Foreign body
* Smoking
* ACE inhibitor therapy.
140
What is hemoptysis?
Blood coughed up from the lower respiratory tract.
141
What are common causes of cough and hemoptysis?
* Bronchitis
* Malignancy
* Cystic fibrosis
* Less common: bronchiectasis, mitral stenosis, Goodpasture syndrome, granulomatosis with polyangiitis.
142
What are the sources of chest pain?
* Myocardium: angina pectoris, myocardial infarction, myocarditis
* Pericardium: pericarditis
* Aorta: aortic dissection
* Trachea and large bronchi: bronchitis
* Parietal pleura: conditions like pneumonia and pneumothorax.
* Chest wall: costochondritis, herpes zoster.
* Esophagus: GERD, esophageal spasm, esophageal tear.
143
What does cyanosis indicate?
Hypoxia.
144
What are the normal respiratory rates for adults and children?
* Adults: 12-20 breaths per minute
* Children (6-10 years): 16-22 breaths per minute
* Toddlers: 20-40 breaths per minute
* Newborns: 30-80 breaths per minute.
145
What does clubbing of nails suggest?
Chronic hypoxia (e.g., cystic fibrosis, lung cancer).
146
What are the signs of respiratory distress?
* Cyanosis
* Use of accessory muscles.
147
What does a clenched fist over the sternum indicate?
Angina pectoris.
148
What is the normal range for diaphragmatic excursion?
3-5 cm.
149
What indicates increased tactile fremitus?
Pneumonia, lung consolidation.
150
What does decreased fremitus indicate?
* Higher pitched voice
* Impeded transmission due to thick chest wall, obstructed bronchus, COPD, pleural effusion, fibrosis, pneumothorax, or infiltrating tumor.
151
What are the types of normal breath sounds?
* Bronchial
* Bronchovesicular
* Vesicular.
152
What causes crackles (rales)?
Fluid accumulation in alveoli (e.g., pneumonia, pulmonary edema, fibrosis).
153
What does wheezing indicate?
Narrowed airways (asthma, COPD).
154
What is the significance of stridor?
Upper airway obstruction requiring urgent airway evaluation.
155
What does egophony suggest?
Consolidation (pneumonia).
156
What is the AP ratio in a healthy adult?
0.7-0.9.
157
What are coarse crackles?
Louder, lower-pitched, longer duration sounds often heard in the lower lung fields
Caused by fluid accumulation in alveoli, seen in conditions like pneumonia and pulmonary edema.
158
What clinical conditions are associated with fine crackles?
Interstitial lung diseases, such as pulmonary fibrosis
Fine crackles are soft, high-pitched, and very brief.
159
What is the pitch and quality of wheezes?
High pitch, musical, continuous
Caused by airflow narrowing or obstruction, common in asthma and COPD.
160
Where are rhonchi typically heard?
Over bronchi, with sounds changing during coughing
Rhonchi are low-pitched, snoring, or gurgling sounds.
161
What causes stridor?
Upper airway obstruction
Conditions include croup, foreign body, and anaphylaxis.
162
What is a pleural friction rub?
A low-pitched, grating, leathery sound
Caused by inflamed pleural surfaces rubbing together.
163
What does diminished or absent breath sounds indicate?
Reduced airflow or lung collapse
Conditions include pneumothorax and pleural effusion.
164
True or False: Crackles are continuous sounds.
False
Crackles are discontinuous, nonmusical sounds.
165
What is the difference between fine and coarse crackles?
Fine crackles are softer and higher-pitched; coarse crackles are louder and lower-pitched
Fine crackles are heard mid to late inspiration, while coarse crackles are biphasic.
166
What can cause wheezes to become less audible?
More severe airway obstruction
This can lead to 'silent chest' in severe asthma.
167
What is mediastinal crunch?
A series of precordial crackles synchronous with the heartbeat
Caused by air entry into the mediastinum, often associated with tracheobronchial injury.
168
What are the characteristics of transmitted voice sounds in a consolidated lung?
Spoken 'ee' heard as 'ay', louder spoken words, and clearer whispered words
Indicates lung consolidation, such as in lobar pneumonia.
169
What are common factors that aggregate dyspnea in left-sided heart failure?
Exertion, lying down
Associated with cough and orthopnea.
170
Fill in the blank: Chronic bronchitis is characterized by excessive ______ production in bronchi.
mucus
171
What is a common symptom of chronic obstructive pulmonary disease (COPD)?
Slowly progressive dyspnea
Often accompanied by a mild cough.
172
What are the percussion notes for pneumonia?
Dull over the airless area
Indicates consolidation due to fluid in alveoli.
173
What happens to tactile fremitus in a consolidated lung?
Increased
Accompanied by transmitted voice sounds like egophony.
174
What does a hyperresonant percussion note indicate?
Pneumothorax
Suggests air in the pleural space.
175
What are common causes of dyspnea in asthma?
Allergens, irritants, respiratory infections, exercise, cold, and emotion
Symptoms are often acute with symptom-free periods.
176
True or False: Stridor is best heard over the trachea.
True
It is a high-pitched sound indicating upper airway obstruction.
177
What is the quality of breath sounds in chronic bronchitis?
Vesicular, but may have scattered coarse crackles
Indicates chronic inflammation and potential airway obstruction.
178
What is the condition characterized by slowly progressive disorder in which the distal airspaces enlarge and lungs become hyperinflated?
COPD
Chronic bronchitis may precede or follow the development of COPD
179
What is the typical percussion note over pleural air?
Hyperresonant or tympanic
This occurs due to the air blocking transmission of sound
180
In the case of tension pneumothorax, where is the trachea shifted?
Toward the unaffected side
This is a key sign in diagnosing tension pneumothorax
181
What is the typical breath sound over pleural air?
Decreased to absent
This indicates the presence of pleural air
182
What are the associated sounds in chronic bronchitis?
Crackles, wheezes, and rhonchi
These sounds may be present alongside COPD
183
What is the definition of asthma?
Widespread, usually reversible, airflow obstruction with bronchial hyperresponsiveness and underlying inflammation
Asthma attacks result in hyperinflation of the lungs as airflow decreases
184
What is the typical percussion note during an asthma attack?
Resonant to diffusely hyperresonant
This reflects changes in lung inflation
185
What organ systems are contained within the Right Upper Quadrant (RUQ)?
* Liver (right lobe)
* Gallbladder
* Duodenum
* Right kidney (upper part)
* Right adrenal gland
* Parts of the pancreas (head)
* Small intestine (part of the jejunum and ileum)
* Colon (right colic flexure and part of the ascending colon)
Important for diagnosing abdominal conditions
186
What organ systems are contained within the Left Upper Quadrant (LUQ)?
* Stomach
* Spleen
* Left lobe of the liver
* Pancreas (body and tail)
* Left kidney (upper part)
* Left adrenal gland
* Small intestine (part of the jejunum and ileum)
* Colon (splenic flexure and part of the transverse colon)
Critical for identifying potential issues in the abdominal region
187
What organ systems are contained within the Right Lower Quadrant (RLQ)?
* Cecum
* Appendix
* Right ovary and fallopian tube (in females)
* Right ureter
* Part of the small intestine (ileum)
* Right spermatic cord (in males)
Key area for appendicitis and gynecological issues
188
What organ systems are contained within the Left Lower Quadrant (LLQ)?
* Part of the small intestine (ileum)
* Colon (descending colon and part of the sigmoid colon)
* Left ovary and fallopian tube (in females)
* Left ureter
* Left spermatic cord (in males)
Important for diagnosing conditions like diverticulitis and gynecological disorders
189
What is nausea?
A feeling of queasiness or the urge to vomit, often accompanying digestive issues like gastritis, food poisoning, or appendicitis.
Nausea can be a symptom of various gastrointestinal conditions.
190
What are the possible causes of vomiting?
Infection, obstruction, or irritation in the GI tract.
Vomiting might bring temporary relief from abdominal pain.
191
Define diarrhea.
Loose or watery stools that can occur with conditions like gastroenteritis, irritable bowel syndrome (IBS), Crohn's disease, or food intolerances.
Diarrhea can lead to dehydration if severe.
192
What is constipation?
Difficulty passing stools or infrequent bowel movements, often seen in conditions like IBS, colonic obstruction, or diverticulitis.
Chronic constipation can lead to further complications.
193
What does bloating refer to?
A sensation of fullness or tightness in the abdomen, often linked to conditions like indigestion, gas buildup, or IBS.
Bloating can be uncomfortable and may be influenced by diet.
194
What is flatulence?
Excessive passing of gas, often associated with indigestion, food intolerances, or gastrointestinal infections.
Flatulence can be socially embarrassing but is a normal bodily function.
195
What is heartburn or acid reflux?
A burning sensation in the chest or upper abdomen, often associated with gastroesophageal reflux disease (GERD) or gastritis.
Heartburn can be triggered by certain foods or lifestyle factors.
196
Define indigestion (dyspepsia).
A general discomfort or pain in the upper abdomen, often accompanied by bloating, nausea, and a feeling of fullness after eating.
Indigestion can be a symptom of underlying digestive disorders.
197
What changes in stool color can indicate gastrointestinal issues?
Black, tarry stools may indicate bleeding in the upper GI tract; red or maroon stools might indicate bleeding in the lower GI tract.
Stool color changes should be evaluated by a healthcare professional.
198
What does blood in stool or vomit indicate?
It could indicate bleeding in the GI tract, such as from an ulcer, hemorrhoids, or gastrointestinal bleeding disorders.
Hematemesis refers specifically to vomiting blood.
199
What common symptom often accompanies infections or inflammation in the GI tract?
Fever.
Fever can indicate an underlying infection requiring medical evaluation.
200
What is loss of appetite?
A reduced desire to eat, which may occur in conditions like stomach ulcers, gastritis, or infections.
Persistent loss of appetite should be assessed for underlying causes.
201
What does unexplained weight loss indicate?
It can be a sign of chronic GI conditions, such as Crohn's disease, cancer, or malabsorption syndromes.
Unexplained weight loss should prompt further investigation.
202
How is the Rovsing Sign performed?
Gentle pressure is applied to the left lower quadrant (LLQ) of the abdomen and then released quickly.
A positive result indicates appendicitis.
203
What does a positive Psoas Sign suggest?
It suggests appendicitis, especially if the appendix is near the psoas muscle.
This sign is assessed by flexing the right hip.
204
What is the purpose of the Obturator Sign?
To indicate appendicitis, particularly when the appendix is located in the pelvis.
This sign is tested by rotating the hip inward.
205
What does Cullen's sign refer to?
Periumbilical bruising, indicating possible bleeding in the abdomen, often associated with acute pancreatitis or ruptured ectopic pregnancy.
This sign requires careful examination for tenderness.
206
What is Grey Turner's sign?
Bruising on the flanks indicating retroperitoneal bleeding, often from severe acute pancreatitis or trauma.
This sign is assessed through visual inspection and palpation.
207
What does Kehr's sign indicate?
Referred pain in the left shoulder caused by irritation of the diaphragm, often associated with a ruptured spleen.
This sign can be tested through abdominal palpation.
208
List the three most common types of breast complaints.
* Breast lumps or mass
* Breast pain
* Nipple discharge
Each complaint requires specific questions to assess their nature.
209
What are some concerning signs of breast cancer?
* Redness
* Thickening
* Prominent pores
* Flattening of the breast
* Asymmetry
* Eczematous rash
These findings warrant further investigation.
210
In a male with acute testicular pain, would the cremasteric reflex likely be present or absent?
Absent.
This can indicate testicular torsion or other acute conditions.
211
What symptoms does a patient with Peyronie disease typically complain of?
Crooked, painful erections.
Peyronie disease can affect sexual function and quality of life.
212
What findings in a prostate exam might indicate prostate cancer?
* Hard, nodular, or irregular mass on the prostate
* Asymmetry in prostate size or shape
* Loss of the median sulcus
* Firm or fixed prostate
These findings require further evaluation.
213
List three common causes of gynecomastia.
* Increased estrogen
* Decreased testosterone
* Medication side effects
Gynecomastia can occur in various age groups.
214
What is the first step in a female genitalia examination?
Perform an external examination
This includes assessing sexual maturity, inspecting the mons pubis, labia, and perineum for inflammation, ulceration, discharge, swelling, nodules, or lesions.
215
What should be inspected during the internal examination of the female genitalia?
Inspect the cervix and vagina for color, position, surface characteristics, ulcerations, nodules, masses, bleeding, and discharge
The cervix and vagina are examined for abnormalities that could indicate various conditions.
216
What is the purpose of using a speculum in a female genitalia examination?
Collect samples
Speculums are used to gain access to the cervix and vagina for sampling and inspection.
217
What does a bimanual examination involve?
Palpate the cervix, uterus, and ovaries, and assess pelvic floor muscles
This examination assesses the size, shape, consistency, mobility, and tenderness of these structures.
218
What does a yellowish discharge on the endocervical swab commonly indicate?
Mucopurulent cervicitis from Chlamydia trachomatis, Neisseria gonorrhoeae, or herpes simplex
This finding requires further investigation and treatment.
219
What is a common risk factor for vaginal cancer?
Diethylstilbestrol (DES) exposure in utero and HPV infection
These factors increase the risk of developing vaginal cancer.
220
What condition may present with excoriations or itchy, small, red maculopapules?
Pediculosis pubis (lice or 'crabs')
This condition is often found at the bases of the pubic hairs.
221
What is the most common type of hernia in women?
Indirect inguinal hernias
Femoral hernias rank second in prevalence.
222
What are common concerning symptoms in a male genitourinary exam?
Penile discharge or lesions, scrotal or testicular pain, swelling, or lesions
These symptoms can indicate sexually transmitted infections or other conditions.
223
What should be inspected during the male genitalia examination?
Skin, prepuce, glans, urethral meatus, and scrotum
Inspect for ulcers, scars, nodules, inflammation, and discharge.
224
What is phimosis?
A tight prepuce that cannot be retracted over the glans
Paraphimosis is when the prepuce is retracted and cannot be returned.
225
What is the mnemonic for remembering cranial nerves and their functions?
Some say marry money, but my brother says big brains matter more
This mnemonic helps remember which cranial nerves are sensory, motor, or both.
226
What is the function of the olfactory nerve?
Smell
It is a sensory nerve tested by having the patient sniff aromatic substances.
227
How is the optic nerve function tested?
Visual acuity, fundoscopy, and pupillary light reflex
These tests assess vision and the health of the retina.
228
What does a positive Romberg sign indicate?
Issues with balance, often due to vestibular dysfunction, cerebellar ataxia, or proprioceptive loss
This occurs when a patient sways or falls significantly with eyes closed.
229
What does Hoffmann's sign test for?
Upper motor neuron lesions
It is indicative of spinal cord lesions affecting the corticospinal tract.
230
What is the grading scale for deep tendon reflexes?
4+: brisk, 3+: active, 2+: normal, 1+: diminished, 0: no response
This scale helps categorize reflex responses during examination.
231
How is muscle strength graded?
5: normal, 4: against some resistance, 3: against gravity, 2: with gravity eliminated, 1: trace contraction, 0: no contraction
This grading assesses muscle function.
232
What is the purpose of sensory function tests?
Evaluate the patient’s ability to perceive various stimuli
These tests can indicate damage to sensory pathways.
233
What is the significance of a painless nodule on the testis?
It raises the possibility of testicular cancer
Testicular cancer is more common in young men aged 15 to 34.
234
How is proprioception tested?
Move a toe or finger up or down and ask the patient to identify the direction of movement
This assesses the patient's awareness of body position.
235
What does a positive Hoffmann's sign indicate?
Upper motor neuron lesions, suggesting spinal cord lesions affecting the corticospinal tract
Conditions such as cervical myelopathy or multiple sclerosis may be involved.
236
What is the normal response for the Babinski sign test?
Toes curl downward (flexion)
A positive Babinski sign indicates upper motor neuron dysfunction.
237
What is the purpose of the Straight Leg Raise (SLR) Test?
To assess for lumbar nerve root irritation or disc herniation, particularly at the L5-S1 level
This test evaluates for radiculopathy and sciatica.
238
What does a positive Tinel's sign indicate?
Nerve irritation or compression
Commonly used for carpal tunnel syndrome and ulnar neuropathy.
239
What condition does Finkelstein’s test evaluate?
De Quervain’s tenosynovitis
This involves inflammation of the tendons of the abductor pollicis longus and extensor pollicis brevis.
240
What does a positive clonus test indicate?
Upper motor neuron pathology
Conditions like spinal cord lesions, stroke, or multiple sclerosis may be involved.
241
What are the components of the mental status examination (MSE)?
* Appearance and behavior
* Speech and language
* Mood
* Thoughts and perceptions
* Insight and judgment
* Cognitive function
242
What does abnormal grooming and personal hygiene indicate?
Possible depression, schizophrenia, or dementia
Excessive fastidiousness may indicate obsessive–compulsive disorder (OCD).
243
What does speech fluency reflect in a mental status examination?
Rate, flow, melody of speech, and content use
Abnormalities may include hesitancies, gaps, and paraphasias.
244
What are hallucinations?
Perception-like experiences that seem real but lack actual external stimulation
They may be auditory, visual, olfactory, gustatory, tactile, or somatic.
245
What is insight in the context of mental status examination?
Awareness of symptoms or disturbed behaviors as normal or abnormal
Patients with psychotic disorders often lack insight into their illness.
246
What does judgment assess in a mental status examination?
Comparing and evaluating alternatives when deciding on a course of action
Influenced by anxiety, mood disorders, intelligence, education, and cultural values.
247
What is cognition?
Mental processes involved in gaining knowledge and comprehension
Includes orientation, attention, memory, and higher cognitive functions.
248
What is the purpose of assessing orientation in a mental status examination?
To evaluate awareness of personal identity, place, and time
Disorientation is common when attention is impaired, such as in delirium.
249
What does attention refer to in cognitive function?
The ability to focus or concentrate over time on a particular stimulus or activity
Inattentive individuals may be easily distractible.
250
What is the significance of blocking in thought process abnormalities?
A sudden interruption in the flow of thought, often seen in schizophrenia
It indicates a potential disruption in cognitive function.
251
What does circumstantiality in thought processes indicate?
Excessive detail in responses, often seen in obsessional disorders
Patients may provide irrelevant information before reaching the point.
252
What is neologism?
The creation of new words or phrases that have meaning only to the patient
Commonly observed in schizophrenia and certain psychotic disorders.
253
What defines a delusion?
A firmly held false belief despite evidence to the contrary
Delusions are often categorized as paranoid, grandiose, or somatic.
254
What is disorientation often associated with?
Impaired attention due to conditions like delirium
Disorientation can manifest as confusion about time, place, or person.
255
Define attention in a medical context.
The ability to focus or concentrate over time on a particular stimulus or activity.
256
What is the Digit Span test used to assess?
A patient's ability to concentrate and recall numbers.
257
In the Digit Span test, what should a person normally be able to repeat?
At least five digits forward and four digits backward.
258
What does the Serial 7s test evaluate?
The ability to perform serial subtraction from 100.
259
What indicates a positive result in the Serial 7s test?
Completion in 1½ minutes with fewer than four errors.
260
What does memory encompass?
The process of registering or recording information.
261
What are the two types of memory?
* Recent (short-term) memory
* Remote (long-term) memory
262
What does the New Learning Ability test involve?
Asking the patient to remember a list of words for immediate and delayed recall.
263
What are higher cognitive functions assessed by?
* Vocabulary
* Fund of information
* Abstract thinking
* Calculations
* Construction of objects
264
List three warning signs of suicide.
* Feeling like a burden
* Increased anxiety
* Talking or posting about wanting to die
265
True or False: Men are more likely to use poison to commit suicide.
False.
266
What percentage of all suicides are accounted for by non-Hispanic whites?
About 90%.
267
Who has the highest suicide rates among racial/ethnic groups?
American Indian/Alaska Native men ages 15-24.
268
What is the estimated ratio of suicide attempts to deaths by suicide?
25 attempts for each death.
269
What is the purpose of the Crossover or crossed body adduction test?
To assess for pain in the AC joint.
270
What does a positive Apley scratch test suggest?
A rotator cuff disorder or adhesive capsulitis.
271
What indicates a positive Painful Arc test?
Shoulder pain from 60-120 degrees.
272
What does the Neer test assess?
Subacromial impingement or rotator cuff tendonitis.
273
What is tested in the Hawkins impingement sign?
Supraspinatus impingement or rotator cuff tendonitis.
274
What does the Finkelstein test evaluate?
Tenosynovitis.
275
What is a positive sign for carpal tunnel syndrome?
Aching and numbness over the median nerve.
276
What does the McMurray test assess?
Medial and lateral meniscus tears.
277
What does a positive Spurling test indicate?
Cervical nerve root compression.
278
Define a macule.
A flat lesion <1 cm.
279
What is a patch?
Circumscribed flat area of change in color of the skin >1 cm.
280
What is an example of a vesicle?
Herpes infections.
281
What is the definition of a bulla?
Circumscribed elevation of the epidermis containing clear fluid >1 cm.
282
What does the term 'pustule' refer to?
A small elevation filled with purulent fluid.
283
What is the recommended SPF for sunscreen according to AAD?
SPF 30 or higher.
284
How much sunscreen is recommended for full-body application?
About 1 ounce (a shot glass full).
285
When should sunscreen be reapplied?
Every 2 hours.
286
What is the significance of anticipatory guidance in pediatric health promotion?
It helps promote healthy habits and prevent injuries.
287
List components of pediatric health promotion.
* Age appropriate developmental achievement
* Health supervision visits
* Integration of physical examination findings with health promotion
* Immunizations
* Screening procedures
* Oral health
* Anticipatory guidance
288
What are the components of anticipatory guidance?
* Healthy habits
* Nutrition and healthy eating
* Safety and prevention of injury
* Physical activity
* Sexual development and sexuality
* Self-responsibility, efficacy, and healthy self-esteem
* Family relationships
* Positive parenting strategies
* Reading aloud with the child
* Emotional and mental health
* Oral health
* Recognition of illness
* Sleep
* Screen time
* Prevention of risky behaviors
* School and vocation
* Peer relationships
* Community interactions
Anticipatory guidance refers to proactive advice provided to parents and caregivers to promote healthy development in children and adolescents.
289
What is a clinical pearl for examining newborns?
Use a calm comforting approach and a soothing voice
This approach helps to create a positive environment for the newborn during the examination.
290
Newborns should gain ______ grams per day and return to birth weight by ______ weeks of life.
15-30 grams; 2 weeks
Monitoring weight gain is crucial for assessing the health and growth of newborns.
291
What should be discussed during a newborn examination regarding feeding?
Feeding frequency and type
Newborns typically require feeding every 2-3 hours around the clock.
292
What is a recommended approach when examining infants?
Approach the infant gradually, using a toy or object for distraction
This helps ease the infant's anxiety and makes the examination smoother.
293
During an infant examination, what should be done if the infant is cranky?
Ensure the infant is well fed before proceeding
A well-fed infant is more likely to be calm and cooperative during the examination.
294
What is a fun way to engage toddlers during an examination?
Have the child 'blow out' the otoscope light
This technique checks their ability to follow instructions in a playful manner.
295
What should be included when discussing anticipatory guidance with school-aged children?
Stranger danger, car/bike safety, limiting screen time, nutrition, sleep
Direct discussions with children about safety and health topics can help them understand and remember important concepts.
296
How should healthcare providers approach adolescent patients?
Build rapport, explain procedures, be non-judgmental, and discuss sensitive topics without parents present
This fosters trust and encourages open communication about important issues.
297
What does the HEEADSSS approach stand for?
Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/Depression, Safety
This framework is used to assess various sensitive topics with adolescents.
298
What is a clinical pearl for examining school-aged children?
Make the examination fun and involve the child in the process
Engaging children in a playful manner can help them feel more comfortable and cooperative.
299
What does HEEADSSS stand for?
Home, Education/Employment, Eating, Activities, Drugs and Alcohol, Sexuality, Suicide and Depression, Safety
HEEADSSS is a psychosocial screening tool used for adolescents.
300
Why is the HEEADSS assessment important in adolescent assessments?
It identifies risk factors, mental health concerns, and support areas in a young person's life.
It builds rapport, allows early identification of high-risk behaviors, and promotes adolescent-centered care.
301
What is the main goal of the preparticipation physical evaluation (PPE)?
To ensure safety before engaging in physical activity or sports by identifying medical conditions that may risk injury, illness, or sudden death.
PPE helps establish a medical home and provides preventive health counseling.
302
What are the primary objectives of the PPE?
* Identify conditions that may predispose to injury or illness
* Detect life-threatening medical issues
* Ensure safe participation
* Establish a medical home
* Meet legal requirements
Examples of life-threatening issues include undiagnosed cardiac disorders and concussions.
303
List the pediatric age groups highlighted in clinical assessments.
* Newborns or neonates (0–30 days)
* Infants (1 month–1 year)
* Preschool children (1–5 years)
* School-aged children (6–11 years)
* Adolescents (12–18 years)
Each age group requires different assessment approaches.
304
What is the first principle of child development according to the text?
Child development proceeds along a predictable pathway governed by the maturing brain.
Milestones are achieved in a predictable order.
305
What factors can affect child development and health?
* Chronic illnesses
* Child abuse
* Adverse childhood experiences (ACEs)
* Disabilities
These factors can alter the rate and course of development.
306
What are the five critical domains of development assessed in pediatrics?
* Physical
* Cognitive
* Language
* Social–emotional
* Health supervision
Each domain encompasses specific milestones and assessments.
307
What is the significance of anticipatory guidance in pediatric care?
It promotes healthy habits, nutrition, safety, and prevention of risky behaviors.
It also includes emotional and mental health considerations.
308
List five findings consistent with the normal aging process.
* Mild short-term memory decline
* Decreased muscle mass and strength
* Increased systolic BP
* Diminished cough reflex
* Thinner skin
These findings reflect changes across various body systems due to aging.
309
What are the '3 D’s' under Mentation?
* Delirium
* Dementia
* Depression
These conditions can overlap in older adults but have distinct causes and treatments.
310
Define delirium.
An acute confusional state marked by sudden onset, fluctuating course, and inattention.
Delirium is often common in hospitalized patients and can be screened using the Confusion Assessment Method (CAM).
311
What is dementia?
A chronic, progressive decline in cognitive function affecting memory, language, and problem-solving.
Common causes include Alzheimer's disease and vascular dementia.
312
What is depression characterized by?
Persistent feelings of sadness, hopelessness, and lack of interest in activities.
Depression is often underdiagnosed in older adults due to symptom overlap with dementia.
313
What is the difference between ADLs and IADLs?
ADLs are basic self-care abilities; IADLs are more complex tasks like managing finances and using the phone.
ADLs include bathing, dressing, and feeding, while IADLs include shopping and housekeeping.
314
What does the 10-minute geriatric screener assess?
Cognitive, psychosocial, and physical functions.
It's a functional assessment tool for geriatrics.
315
What is the purpose of the 4 M’s of Age-Friendly Healthcare?
To ensure older adults receive evidence-based, patient-centered care.
The 4 M's are: What Matters, Medication, Mentation, and Mobility.
316
What is included in the screening for vision in older adults?
Asking about difficulties with daily activities due to eyesight, followed by a Snellen chart test.
A positive screening is indicated by an inability to read >20/40 on the chart.
317
What is the significance of screening for urinary incontinence?
To identify whether an individual has lost urine on at least six separate occasions in the past year.
This screening helps address potential health issues related to incontinence.
318
What is the screening measure for memory in older adults?
Three item recall test.
A positive screening is when the individual cannot remember all three items after one minute.
319
What are the 4 M’s of Age-Friendly Healthcare?
1. What Matters
2. Medication
3. Mentation
4. Mobility
These components ensure older adults receive patient-centered care.
320
What does 'What Matters' focus on in Age-Friendly Healthcare?
Aligning care with the older adult’s specific goals, values, and preferences
This includes understanding health outcomes, quality of life, and end-of-life care.
321
What should be ensured regarding 'Medication' in Age-Friendly Healthcare?
Medications should not interfere with what matters to the patient, mobility, mentation, or quality of life
Review for polypharmacy and inappropriate medications.
322
What are the 3 D's related to 'Mentation' in Age-Friendly Healthcare?
1. Delirium
2. Depression
3. Dementia
These cognitive impairments need to be prevented, identified, treated, and managed.
323
What is the focus of 'Mobility' in Age-Friendly Healthcare?
Ensuring older adults move safely every day to maintain function and independence
Assess for fall risk and provide interventions like physical therapy.
324
What does the presence of nitrite in a gram-negative organism suggest?
It indicates that you are dealing with the Enterobacteriaceae family
This includes organisms like E. coli, Klebsiella, Enterobacter, Salmonella, Shigella.
325
What is the normal range of erythrocytes in 1 cubic mm of blood for men?
4.6-5.9 million cells/mm³
For women, the normal range is 4.1-5.4 million cells/mm³.
326
What condition is characterized by an overproduction of RBC?
Polycythemia Vera
This is a proliferative disease of the bone marrow.
327
What lab value is typically low in cases of hypochromia?
MCHC (Mean Corpuscular Hemoglobin Concentration)
Pale hemoglobin under the microscope indicates low MCHC.
328
What does MCV measure?
The average size of red blood cells
It may be low in microcytic anemia such as iron deficiency anemia.
329
What does RDW measure?
The variation in red blood cell size
It can be high in conditions like iron deficiency anemia.
330
What does hematocrit measure?
The volume of cells as a percentage of the total volume of cells and plasma in whole blood
Usually, it is about three times the hemoglobin total.
331
True or False: Troponin elevation always indicates a myocardial infarction (MI).
False
Troponin elevation can occur without an MI.
332
What should you consider before ordering a test?
Whether the test result will change your treatment plan
If it won't, do not order the test.
333
What is a key guideline for working with an interpreter?
Use qualified interpreters, not family members or children
This helps maintain patient autonomy and informed decision-making.
334
What should be noted during introductions when working with an interpreter?
Introduce all individuals in the room and their roles
This establishes clarity in the communication process.
335
What should the provider focus on during an encounter with an interpreter?
The patient should remain the focus of the encounter
Providers should interact with the patient, not the interpreter.
336
What is the purpose of using simple language when working with an interpreter?
To ensure that comparable words can be found in the second language
This helps convey information clearly.
337
What is the age range for pediatric questions in the lifespan quiz?
10 pediatric questions
This is part of a larger quiz structure including adult and geriatric questions.
338
What should be assessed in older adults according to the 10-minute geriatric screener?
Cognition and other changes in the older adult
## Footnote
Special areas of concern include specific extra questions or tests.
339
What does HEEADSSS stand for in pediatric assessments?
Home, Education, Eating, Activities, Drugs, Sexuality, Suicide, Safety
These topics guide the assessment based on the child's developmental age.
