Final Exam Material Flashcards by Austin Shackelford

What are the 7 attributes of the History of Present Illness? (HPI)

Location 2. Quality 3. Quantitiy (Severeity) 4.Timing 5. Setting 6. Exacerbating 7. Manifestations

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What is the BMI at the border of normal and overweight?

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What is the term given for describing the pulse of a pt with Atrial Fibrillation?

irregularly irregular

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What is the standard positioning for a chest xray: PA or AP? What causes a difference? What is the most significant difference?

PA..gravity…enlargement of heart/mediastinum/ in AP view

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How do you label ribs in a chest xray?

Anterior ribs on the left. Posterior ribs on the right. (We read left to right and A comes before P in the alphabet)

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Which side will display a wider mediastinum?

patient’s left (placement of the heart)

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What 2 conditions can cause BLUNTING of the ocstophrenic angle?

1.Pleural fluid 2. fibrosis

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On a chest xray the LOWER margin of the _____ hilum is at the level of the UPPER margin of the _____ hilum

LEFT…..RIGHT (again position of the heart pushing left hilum more superior)

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_______ _______ can cause misinterpretation of vascular and intersitial markings on a chest xray

Breast shadows (espescially lactating breasts)

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On a side view chest xray which side of the diaphragm is partially obstructed?

Left (due to heart placement, the right diaphragm is completely visible)

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Lou’s angle on side view chest xray divides what anatomical structure?

the mediastinum

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What is the distinction between mallampati II and III as it relates to the uvula?

MII = about 1/2 the uvula visible and MIII = almost all of uvula hidden

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What are the 2 clinical appearances of a fracture in the base of the skull (e.g. temporal bone)?

Raccoon eyes and battle sign

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The pupillary reaction of a size change in the pupils in response to light and focusing is a funciton of which 2 cranial nerves?

II - optic (afferent sensory) & III - oculomotor (efferent reflex)

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Eye movements: The left eye moving laterally is a function of which muscle and cranial nerve?

lateral rectus… VI abducens LR6(SO4)3

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Eye movements: The left eye moving lateral and superior is a function of which cranial nerve?

superior rectus… III oculomotor LR6(SO4)3

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Eye movements: The left eye moving superior and medial is a function of which cranial nerve?

inferior oblique… III oculomotor LR6(SO4)3

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Eye movements: The left eye moving medial is a function of which cranial nerve?

medial rectus … III oculomotor LR6(SO4)3

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Eye movements: The left eye moving medial and inferior is a function of which cranial nerve?

superior oblique… IV trochlear LR6(SO4)3

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Eye movements: The left eye moving inferior and lateral is a function of which cranial nerve?

inferior rectus … III oculomotor LR6(SO4)3

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The first aspect of ______ is CONDUCTIVE and the second is SENSOINEURAL

HEARING

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Which hearing test? 256 hz tuning fork to the middle of the head.

weber

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Which hearing test? 512 hz tuning for to the mastoid.

Rinne

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What is the cut off Glasgow coma score for a patient to be comatose?

8 or less

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CN Exam: Usually not tested. Eyes closed, occlude one nostril and test smell (coffee, vanilla, soap)

CN I - Olfactory

CN Exam: Visual Acuity / Visual fields

CN II - Optic

CN Exam: Extra-ocular movements --> EOMI (Please give 3 CN's with the answer)

III - oculomotor, IV - trochlear, VI - abducens **LR6(SO4)3**

CN Exam: checking muscles of mastication

V - trigeminal

CN Exam: checking sensory of the skin of the face

V - trigeminal

CN Exam: checking the muscles of facial expression

VII - facial

CN Exam: What two nerves are checked with the corneal blink reflex

sensory of V-1-trigeminal and motor of VII - facial

CN Exam: Which cranial nerve are you checking with the webber, rinne test?

VIII - vestibulo-cochlear

CN Exam: the gag reflex and observing symmetrical position of the uvula during the 'ahh' sound?

IX - glossopharyngeal and X - vagus

CN Exam: If the uvula deviates when the pt is making the 'ahh' sound, which side will it deviate towards? The affected or unaffected side?

unaffected

CN Exam: Which nerve is checked by shrugging the shoulders (Traps) and turning the head? (SCM)

XI - accessory

CN Exam: Which nerve can present with a deviation of the tongue? Which side will it deviate towards?

XII - Hypoglossal...towards the affected side

What mechanism makes the first heart sound?

The AV valve closing

What mechanism makes the second heart sound?

The aortic valve closing

Which heart sound is called a "gallop" or "kentucky"(turbulence in the ventricle during early diastole)?

Which heart sound is in late diastole and is known as the "atrial kick" or "Tennessee"?

The sound caused by turbulent flow through a valve is called a ______

murmur

The sound made by an inflammed pericardial sac is called a ______

rub

A heart that makes S1, S2, and S3 is called a _____

gallop

What is the most common murmur?

innocent murmur during mid-systole

What are the 6 places to check a pulse?

carotid, brachial, and radial, popliteal, dorsalis pedis, post. tibial

What is the threshold for bradycardia and tachycardia?

brady <60bpm, tachy>100bpm

When measuring HR on an EKG, how many "big boxes" equal a second? Overall 1 EKG = how many seconds?

5 big boxes = 1 second..........1 ekg = 10 seconds (10 sets of 5 big boxes)

When counting HR on an EKG: what is the rule of 300?

divide 300 by the number of boxes between each QRS rate (so 6 boxes in between each QRS is 50bpm)

What type of EKG block? PR interval fixed and > 0.2 seconds (prolonged)

First degree block

What type of EKG block? PR gradually lengthened, then DROP QRS?

Second degree block, Mobitz Type 1

What type of EKG block? PR fixed, but drops QRS randomly

Second degree block, Mobitz Type 2

What type of EKG block? PR and QRS dissociated

third degree block

Which wave on an EKG points out ischemia the best?

T wave

Which EKG segment can indicated sub endocardial infarction?

ST segment depression

WHICH ECG SEGMENT GIVES EVIDENCE OF AN ACUTE MI?

ST segment ELEVATION

Irregularly irregular on an EKG indicates A fib, whereas irregularly regular indicates ______

Atrial flutter

What two organs can present with the clinical symptoms of dysphasia or odontophagia?

liver or kidney (bleeding diathesis vs dialysis)

On the abdominal exam, which area do you palpate last?

area of pain/concern (*same as oral exam)

What liver condition might present as enlarged and hard on palpation?

cirrhosis

Ascites can be indicative of what organ's end stage disease?

end stage liver disease

What condition can present with costovertebral angle tenderness?

PYELO-nephritis

Appendicitis classically pain begins near the umbilicus and radiates to the RLQ...this area is known as _______

Mc Burney's Point (McBurney Sanders lol)

Whats the differential dx assuming appendicitis?

Tubo-ovarian abscess or ovarian torsion

What is MURPHY's sign?

Acute cholecystitis - sharp increase in tenderness with a sudden stop in inspiratory effort

What condition? Fertile, fat, forty, female...

Cholecystitis

A GUAIAC exam is to look for what condition?

Colon cancer

What condition? Newborn, 3-7 wks, projective vomiting, OLIVE SIGN,

Pyloric stenosis (corrected with pyloromyotomy)

What condition? Bowel telescopes itself, infants, colicky, intermittent pain, classic BLOODY DIARRHEA, air enema for diagnosis/therapy

IN-TUS-SUCEPTION

How many ribs are attached to the sternum? Which two ribs are "floating"?

RIbs 1-7 attached, Ribs 11 and 12 floating

Always perform your respiratory exam in the same order, which is...

IPPA: Inspect, Palpate, Percuss, Auscultate

What condition is associated with a barrel shaped chest?

COPD

Asthma (narrowed airway) can sound like _______ upon auscultation

wheezing

Bronchitis (secretions in LARGE airways) can sound like ______ upon auscultation

Rhonchi

Crackles on pulmonary auscultation can indicate what 3 situtations in the lung?

1. fluid 2.atelectasis (alveoli collapse) 3.pneumonia

STRIDOR on pulmonary auscultation indicates narrowing of the _______ airway

UPPER

A pleural friction rub sound can indicate what three situations in the lungs?

1.pleuracy 2. TB 3. embolism

Medialstinal CRUNCH is associatated with what condition?

mediastinal EMPHYSEMA

Respiratory conditions: Tightness can indicate _______

asthma

Respiratory conditions: sharp, stabbing, pleuritic pain can indicate what three scenarios?

pneumothorax, pleural effusion, pulmonary embolism

Respiratory conditions: burning, crushing, squeezing can indicate what etiology of pain?

cardiac

Elective dental care is best avoided during which trimester (s)?

1st and 3rd

What is the SAFEST trimester to deliver dental care?

2nd

When is pregnancy gingivitis at its peak? What two hormones can cause a decreased performance in the immune system?

8th month...estrogen and progesterone

What positioning is best for a pregnant patient in their 3rd trimester to avoid occluding the aorta and IVC?

left lateral position

Dental radiography during pregnancy: max risk attributable to __ cGy (>1000FMS) of in utero radiation exposure estimated to be about 0.1%

1cGy

Xylocaine/Lidocaine is a category __ for pregnant patients

Bupivicaine/Marcaine is a category __ for pregnant patients

Septocaine/Articaine and Mepivicane/Carbocaine are category __ for pregnant patients

What is the analgesic drug of choice for pregnant patients?

acetaminophen

What two analgesic drugs/NSAIDS are contraindicated in prganacy?

Aspirin and codeine

Which antibiotic is contraindicated with a pregnant patient?

tetracycline

Which antibiotic is controversial to give to pregnant patients, studies show carcogenesis in rodents...

metronidazole

Which antibiotic MUST be avoided in the 3rd trimester?

Sulfonamide

What anxiolytic agent is NOT recommended during pregnancy?

Diazepam

What is the main cause of hyperkalemia?

renal failure

What is the normal range for the pH of blood?

7.35 - 7.45

The principle ACID in the body is ____ and it is a RESPIRATORY parameter

CO2

The principle BASE in the body is ____ and it is a METABOLIC parameter

HCO3

Elevated CO2 =

Respiratory acidosis

Decreased HCO3 =

Metabolic acidosis

The ALLEN test is to check for what?

collateral perfusion between radial and ulnar arteries

Homan's sign is associated with what condition?

(Homan's = calf pain on dorsifelxion) DVT

Final Exam Material Flashcards

To pass the test (102 cards)