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Final HA 2 Flashcards

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1
Q

What is the normal appearance in a general survey?

A

Appears stated age, well-nourished, well-developed, alert, oriented, comfortable, appropriate mood and affect.

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2
Q

What are the normal vital sign ranges for adults?

A
  • Temp: 36.1-37.2°C or 97-99°F
  • HR: 60-100 bpm, regular
  • RR: 12-20 breaths/min, unlabored
  • BP: <120/80 mmHg
  • O2 Sat: >95% on room air
  • Pain score: 0/10
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3
Q

What are some abnormal findings in appearance during a general survey?

A
  • Acutely ill
  • Distressed
  • Cachectic
  • Obese
  • Lethargic
  • Confused
  • Agitated
  • Flat affect
  • Poor hygiene
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4
Q

What are some abnormal vital sign findings?

A
  • Fever
  • Hypothermia
  • Tachycardia
  • Bradycardia
  • Irregular rhythm
  • Tachypnea
  • Bradypnea
  • Dyspnea
  • Hypertension
  • Hypotension
  • Hypoxia
  • Significant pain
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5
Q

What are normal skin characteristics?

A
  • Warm
  • Dry
  • Intact
  • Color appropriate for ethnicity
  • Good turgor
  • No suspicious lesions, rashes, or ulcers
  • Few scattered nevi, uniform in color and shape
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6
Q

What are abnormal skin findings?

A
  • Cool, clammy, diaphoretic
  • Excessively dry or oily
  • Pallor, cyanosis, jaundice, erythema
  • Poor turgor
  • Suspicious nevi (ABCDEs)
  • Edema
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7
Q

What are the normal findings for hair and nails?

A
  • Hair: Evenly distributed, normal texture for age/gender
  • Nails: Pink nail beds, smooth, firm, capillary refill <2-3 seconds, angle of nail base ~160 degrees
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8
Q

What are abnormal findings in hair and nails?

A
  • Hair: Alopecia, hirsutism, brittle or excessively oily
  • Nails: Cyanotic or pale nail beds, clubbing, spooning, pitting, Beau’s lines, splinter hemorrhages
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9
Q

What is the normal head finding in a physical exam?

A

Normocephalic, atraumatic (NC/AT). Symmetrical facial features.

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10
Q

What does PERRLA stand for?

A

Pupils Equal, Round, Reactive to Light and Accommodation.

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11
Q

What are abnormal eye findings?

A
  • Anisocoria
  • Fixed/dilated or pinpoint pupils
  • Abnormal reactivity
  • EOM deficits
  • Conjunctivitis
  • Absent red reflex
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12
Q

What are normal findings for the neck during a physical exam?

A
  • Supple
  • Full range of motion
  • Trachea midline
  • Thyroid gland non-palpable or small, smooth, non-tender
  • No lymphadenopathy
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13
Q

What are abnormal findings in the neck?

A
  • Stiffness
  • Limited ROM
  • Tracheal deviation
  • Goiter
  • Thyroid nodules
  • Tenderness
  • Lymphadenopathy
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14
Q

What are normal thoracic and lung findings?

A
  • Thorax symmetric
  • Respirations regular, unlabored
  • No accessory muscle use
  • Symmetric chest expansion
  • Vesicular breath sounds
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15
Q

What are abnormal thoracic and lung findings?

A
  • Asymmetry
  • Deformities
  • Tachypnea
  • Dyspnea
  • Diminished or absent breath sounds
  • Adventitious sounds
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16
Q

What is the normal finding for the cardiovascular system during inspection?

A

No visible pulsations, lifts, or heaves. No JVD at 45 degrees.

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17
Q

What are abnormal cardiovascular findings?

A
  • JVD
  • Visible lifts, heaves
  • Displaced PMI
  • Diminished or absent peripheral pulses
  • Irregular rhythm
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18
Q

What are normal abdominal findings during inspection?

A
  • Flat or rounded
  • Symmetric
  • Skin intact
  • Umbilicus midline, inverted
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19
Q

What are abnormal abdominal findings?

A
  • Distension
  • Asymmetry
  • Striae
  • Visible peristalsis
  • Tenderness
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20
Q

What are normal musculoskeletal findings?

A
  • Full range of motion in all joints
  • No swelling, erythema, warmth, or deformities
  • Good muscle tone
  • Gait steady, balanced
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21
Q

What are abnormal musculoskeletal findings?

A
  • Limited ROM
  • Joint swelling
  • Deformities
  • Muscle atrophy or weakness
  • Unsteady gait
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22
Q

What are normal neurological findings for mental status?

A
  • Alert
  • Oriented x4
  • Appropriate mood/affect
  • Intact recent/remote memory
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23
Q

What are abnormal neurological findings?

A
  • Lethargy
  • Disorientation
  • Memory deficits
  • Aphasia
  • Poor judgment/insight
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24
Q

What are the normal findings for cranial nerve function?

A

Intact bilaterally for all cranial nerves (I-XII).

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25
What are normal reflex findings?
2+ and symmetric DTRs (biceps, triceps, brachioradialis, patellar, Achilles).
26
What is the significance of a positive Babinski sign?
Indicates UMN lesion.
27
Fill in the blank: Normal vital signs include a heart rate of _______.
60-100 bpm
28
True or False: A normal respiratory rate for adults is between 12-20 breaths per minute.
True
29
What are the types of movement disorders mentioned?
tics, chorea, athetosis, dystonia ## Footnote These are various forms of involuntary or abnormal movements.
30
Define anesthesia.
Loss of sensation ## Footnote Anesthesia refers to the absence of sensation in a part of the body.
31
What does hyporeflexia indicate?
Reduced reflexes (0, 1+) ## Footnote Hyporeflexia can indicate lower motor neuron lesions.
32
What is a positive Babinski sign indicative of?
Upper motor neuron lesion ## Footnote A positive Babinski sign shows an upgoing toe response.
33
What does dysmetria refer to?
Past-pointing ## Footnote Dysmetria is a lack of coordination characterized by the inability to judge distance or scale.
34
What is the purpose of the 10-minute geriatric screener?
Screening for cognition and other changes in older adults ## Footnote This tool helps identify potential cognitive decline and other issues in elderly patients.
35
What does ADLs stand for?
Activities of Daily Living ## Footnote ADLs include basic self-care tasks such as eating, bathing, and dressing.
36
What is the significance of polypharmacy in older adults?
Increased risk of adverse drug events ## Footnote Polypharmacy refers to the use of multiple medications by a patient, often leading to complications.
37
What is the focus of developmental approach in children’s examination?
Child’s age dictates assessment and approach ## Footnote This means adapting the examination based on developmental milestones and cooperation.
38
What is the recommended order of examination for infants?
Non-invasive maneuvers first ## Footnote This approach helps to minimize distress in infants during physical examination.
39
What are the normal vital signs for a newborn?
HR 120-160; RR 30-60 ## Footnote These ranges are typical for healthy newborns.
40
What is a red flag for abnormal findings in a newborn?
Persistent central cyanosis ## Footnote This indicates potential serious underlying health issues.
41
What developmental milestones are crucial for infants?
Head control, rolling, sitting, crawling, pincer grasp, vocalizations ## Footnote These milestones are indicators of healthy neurological development.
42
What is a common abnormal finding in toddlers?
Significant speech delay ## Footnote Delays in speech development can indicate broader developmental issues.
43
What is the Tanner Staging used for?
Assessing pubertal development ## Footnote Tanner Staging helps evaluate sexual maturity in adolescents.
44
What does the HEEADSSS framework assess?
Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/Depression, Safety ## Footnote This framework is used for psychosocial screening of adolescents.
45
What should be considered when discussing confidentiality with adolescents?
Limits of confidentiality ## Footnote Clinicians must explain the circumstances under which confidentiality may be breached.
46
What is the significance of observing play in younger children?
Provides insights into social and emotional development ## Footnote Observation can reveal important behavioral and developmental information.
47
What is an important aspect of the assessment for school-aged children?
Begin screening for scoliosis ## Footnote Identifying scoliosis early can facilitate prompt intervention.
48
What is a common abnormal finding in adolescents?
Delayed puberty ## Footnote This can indicate underlying health issues that require further evaluation.
49
What does the acronym HEEADSSS represent?
Home, Education, Eating, Activities, Drugs, Sexuality, Suicide and Depression, Safety ## Footnote HEEADSSS is a psychosocial interview framework used to assess adolescents.
50
What is one example of a question related to substance use?
Have any of your friends ever tried cigarettes, vaping, alcohol, or other drugs? ## Footnote This question normalizes substance use discussions among peers.
51
What topics are covered under the 'Sexuality' component of the HEEADSSS interview?
* Romantic relationships * Sexual attraction/orientation * Sexual activity * Contraception use * STI prevention and history * History of pregnancy * Sexual pressure or coercion ## Footnote These topics help assess the adolescent's sexual health and experiences.
52
What is the definition of Primary Prevention?
Interventions to prevent disease or injury before it occurs. ## Footnote Examples include immunizations and counseling on healthy lifestyle choices.
53
What are the components of a Comprehensive Health History?
* Identifying Data * Chief Complaint(s) * History of Present Illness (HPI) * Past Medical History (PMH) * Family History (FH) * Personal and Social History (SH) * Review of Systems (ROS) ## Footnote This structure provides a thorough understanding of a patient's health background.
54
What does the acronym SOAP stand for in clinical documentation?
* Subjective * Objective * Assessment * Plan ## Footnote SOAP notes help organize patient information clearly.
55
What is a key examination technique for HEENT?
Ophthalmoscopy ## Footnote This technique is used to assess the fundus of the eye for abnormalities.
56
What is the normal finding for the eyes during a HEENT exam?
Visual acuity 20/20, PERRLA, EOMI, conjunctiva pink, sclera white ## Footnote These findings indicate healthy eye function.
57
What are the characteristics of Systolic Murmurs?
* Occur between S1 and S2 * Midsystolic, Pansystolic, Late Systolic ## Footnote Systolic murmurs can indicate various cardiac conditions.
58
What does a reduced FEV1/FVC Ratio indicate?
It indicates an obstructive pattern of lung disease ## Footnote Conditions like asthma and COPD exhibit this pattern.
59
What is an example of a question to assess suicidal thoughts?
Have you ever felt so down or hopeless that you've thought about hurting yourself or ending your life? ## Footnote This question is crucial for evaluating mental health risks.
60
Fill in the blank: The __________ is the volume of air exhaled in the first second of a forced exhalation.
FEV1 ## Footnote FEV1 is an important measure in pulmonary function tests.
61
What is the normal range for FEV1/FVC Ratio?
≥70-75% ## Footnote This ratio is essential for diagnosing obstructive and restrictive lung diseases.
62
What are the types of Health History?
* Comprehensive Health History * Focused (or Problem-Oriented) Health History ## Footnote These types serve different purposes in patient assessment.
63
What does S1 heart sound signify?
Marks the start of systole, caused by closure of mitral and tricuspid valves ## Footnote S1 is typically louder than S2 at the apex of the heart.
64
What is a common abnormal finding in the throat during a HEENT exam?
Dental caries, gingivitis, pharyngitis ## Footnote These conditions can indicate oral health issues.
65
What is one of the key components to assess in the neck during a HEENT exam?
Thyroid gland examination ## Footnote This includes checking for goiter or nodules.
66
What is the purpose of the Review of Systems (ROS)?
To inquire about common symptoms across each body system ## Footnote The ROS helps identify potential health issues.
67
What is a hallmark of obstruction in pulmonary function tests?
FEV1/FVC Ratio <70% ## Footnote This finding is critical for diagnosing obstructive lung diseases.
68
What is a characteristic of Early Diastolic Murmurs?
Start right after S2, then diminish ## Footnote These murmurs often indicate heart disease.
69
What does the 'Assessment' component of a SOAP note include?
Your diagnosis or differential diagnoses based on subjective and objective findings ## Footnote This is crucial for guiding patient management.
70
What is FEV1?
Volume of air exhaled in the first second of a forced exhalation.
71
What does the FEV1/FVC Ratio indicate?
The percentage of FVC exhaled in the first second. Normally ≥70-75%.
72
What is a hallmark of an obstructive pattern in lung function tests?
FEV1 is significantly reduced, and FEV1/FVC Ratio is reduced (<70%).
73
What is the bronchodilator response?
Improvement in FEV1 after bronchodilator suggests reversible obstruction (asthma).
74
What characterizes a restrictive pattern in lung function tests?
FEV1 and FVC are both reduced, with FEV1/FVC Ratio normal or increased (≥70-75%).
75
What are the key elements to interpret in a basic chest X-ray?
A - Airway, B - Bones & Soft Tissues, C - Cardiac Silhouette & Mediastinum, D - Diaphragm & Pleura, E - Effusions/Fields.
76
What are normal breath sounds?
Vesicular, Bronchovesicular, Bronchial, Tracheal.
77
What are crackles (rales)?
Discontinuous, nonmusical, brief sounds.
78
What is the definition of wheezes?
Continuous, musical, high-pitched sounds suggesting narrowed airways.
79
What does a pleural friction rub indicate?
Inflamed pleural surfaces rubbing together (e.g., pleurisy).
80
What is rebound tenderness (Blumberg's sign)?
Pain on withdrawal after pressing deeply and evenly, indicating peritoneal inflammation.
81
What does Murphy's Sign indicate?
Cholecystitis, as sharp increase in tenderness occurs with deep breath.
82
What is McBurney's Point Tenderness indicative of?
Appendicitis when maximal tenderness is located 1/3 from ASIS to umbilicus.
83
What is the significance of Rovsing's Sign?
Pain felt in the RLQ when pressing in the LLQ suggests appendicitis.
84
What is the purpose of the Psoas Sign?
To indicate appendicitis or retroperitoneal irritation.
85
What does the Shifting Dullness test assess?
Ascites by checking for dullness that shifts when the patient rolls.
86
What are normal findings in breast examination?
Breasts symmetric, smooth skin, everted nipples, no palpable masses.
87
What indicates abnormal findings in male GU examination?
Lesions, swelling, undescended testes, palpable masses.
88
What are normal findings in female gynecological examination?
Intact skin, symmetric labia, pink moist vaginal mucosa, normal cervical appearance.
89
What is the function of CN I (Olfactory)?
Sense of smell.
90
What is tested in CN II (Optic)?
Visual acuity, visual fields, funduscopic exam, pupillary light reflex.
91
What motor functions does CN VII (Facial) assess?
Facial movements including raising eyebrows, frowning, and smiling.
92
What does the plantar reflex test assess?
Normal: plantar flexion of toes; Abnormal: dorsiflexion of great toe (Babinski sign).
93
What is the grading scale for Deep Tendon Reflexes (DTRs)?
0 (absent), 1+ (hypoactive), 2+ (normal), 3+ (hyperactive), 4+ (hyperactive with clonus).
94
What is Clonus?
Test if reflexes are hyperactive (esp. at ankle).
95
What is the normal response for the Plantar Reflex (Babinski)?
Plantar flexion of toes (downgoing).
96
What indicates an abnormal Babinski sign?
Dorsiflexion of great toe and fanning of other toes.
97
What components are included in a Motor Exam?
Inspection, Tone, Strength.
98
What does the strength grading scale range from?
0-5.
99
What does a strength grade of 0 indicate?
No muscular contraction.
100
What is the significance of Rapid Alternating Movements (RAMs)?
Tests for dysdiadochokinesia (abnormal).
101
What does the Romberg Test assess?
Impaired proprioception or vestibular function.
102
What does a positive Romberg Test indicate?
Increased sway or loss of balance with eyes closed.
103
What is assessed in the Mental Status Examination (MSE)?
Appearance and Behavior, Speech and Language, Mood, Affect, Thoughts and Perceptions, Cognitive Functions, Insight and Judgment.
104
What does the term 'Affect' refer to?
Observable feeling tone expressed through voice, facial expression, and demeanor.
105
What are some risk factors for suicide?
* Previous suicide attempt(s) * Mental disorders * Substance abuse * Family history * Hopelessness * Impulsivity and aggression * Significant losses * Chronic physical illness * Social isolation * Access to lethal means * Recent psychiatric hospitalization.
106
What differentiates Delirium from Dementia in terms of onset?
Delirium has an acute onset; Dementia has an insidious onset.
107
What is the typical duration of Delirium?
Hours to weeks.
108
What is the McMurray Test used for?
Testing for medial or lateral meniscal tears.
109
What does a positive Tinel's Sign indicate?
Median nerve compression (Carpal Tunnel Syndrome).
110
What are primary skin lesions?
* Macule * Patch * Papule * Plaque * Nodule * Tumor * Vesicle * Bulla * Pustule * Wheal * Cyst.
111
What is an example of a secondary skin lesion?
* Scale * Crust * Lichenification * Erosion * Ulcer * Fissure * Scar * Keloid * Atrophy * Excoriation.
112
What are some skin cancer risk factors?
* History of previous skin cancer * High UV exposure * Fair skin type * Number of nevi * Family history of melanoma * Immunosuppression * Genetic syndromes.
113
What type of sun exposure increases the risk of melanoma?
Intermittent intense sun exposure (e.g., vacations) ## Footnote Intense sun exposure is particularly harmful and can lead to skin damage over time.
114
What is the definition of fair skin type?
Skin that burns easily, freckles, red or blonde hair, light-colored eyes (Fitzpatrick skin types I and II) ## Footnote Fair skin is more susceptible to UV damage.
115
How does the number of nevi (moles) affect melanoma risk?
Many nevi, especially atypical (dysplastic) nevi ## Footnote Atypical moles are more likely to develop into melanoma.
116
What family history increases the risk of melanoma?
Family history of melanoma in a first-degree relative ## Footnote Genetic predisposition plays a significant role in melanoma risk.
117
How does immunosuppression relate to melanoma risk?
Immunosuppression due to illness (e.g., HIV) or medications (e.g., organ transplant recipients) ## Footnote A weakened immune system can reduce the body's ability to fight cancer.
118
What genetic syndrome is associated with increased melanoma risk?
Xeroderma pigmentosum ## Footnote This condition causes extreme sensitivity to UV light and higher cancer risk.
119
How does age affect the risk of melanoma?
Risk increases with age ## Footnote Older adults are generally at higher risk for various skin cancers.
120
What types of exposure are linked to increased melanoma risk?
Exposure to arsenic, radiation, or other carcinogens ## Footnote Environmental and occupational exposures can contribute to cancer development.
121
What are key assessment areas in older adults for lifespan AG/peds?
Assessing ADLs/IADLs and developmental milestones ## Footnote These assessments are crucial for understanding functional abilities and development.
122
What screening tools are important for assessing developmental milestones?
Age-specific examination techniques ## Footnote These tools help identify delays or concerns in child development.

Health Assessment (10 decks)

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