General Diagnosis Flashcards Preview

Part II/III Board Review > General Diagnosis > Flashcards

Flashcards in General Diagnosis Deck (157):
1

The CAGE questionaire indicates alcoholism. What does CAGE stand for?

Cutting down (felt the need to cut down)
Annoyed by other criticisms
Guilty Feelings
Eye openers (felt the need for a morning "eye opener" drink)

2

What are normal values of the following temps;
Oral?
Rectal & Tympanic?
Axilla?

Oral = 98.6F
Rectal & Tympanic = 99.6F
Axilla = 97.6F

3

What are normal pulse values in adults? Newborns? Elderly?

Adults: 60-100
Newborns: 120-160
Elderly: 70-80

4

What are normal respiratory rates for adults? Newborns?

Adult: 14-18
Newborn: 44

5

What is normal BP ranges for adults?

90-120/60-80

6

Low pitched sounds produced by turbulent blood flow in arteries when a BP cuff is deflated. (Sounds you hear when taking a BP)

Korotkoff sounds

7

A difference of 10-15mmHg b/w sides in systolic readings can indicate what?

Arterial occlusion such as subclavian steal syndrome on the side of decreased value

8

BP readings are what % higher in the LE?

20%

9

What are ortho tests for vertebrobasilar artery insufficiency?

Barre-Lieou
DeKleyn's
Hallpike
Hautant's
Underberg

10

Scaly eyebrows indicates what?

Seborrhea

11

Loss of lat. 1/3rd of eyebrows indicates what?

Myxedema

12

Drooping of the eyelid

Ptosis

13

Ptosis is assoc. w/ what conditions?

Horner's (also see meiosis & anhydrosis)
CN 3 paralysis (also see dilated pupil)
Myastenia Gravis

14

Lid lag/failure to cover the eyeball seen w/ Graves (bilateral) or tumor (unilateral

Exophthalmosis

15

Lid is turned outward & seen in the elderly

Ectropion

16

Lid is turned inward & seen in the elderly

Entropion

17

Swelling around the eye seen w/ allergies, myxedema, & nephrotic syndrome (HEP)

Periorbital edema

18

Inflammation of the eye seen w/ seborrhea, staph infection, & inflammatory processes

Blepharitis

19

Opacities seen in the lens that are commonly seen w/ diabetes & in the elderly. Also has an absent red light reflex

Cataracts

20

Grayish opaque ring around the cornea. Early (50yoa) is normal

Corneal Arcus

21

Triangular thickening of the bulbar conjunctiva that grows across the cornea & is brought on by dry eyes

Pterygium

22

A yellow sclera indicates what? Blue sclera?

Yellow =Jaundice
Blue = Osteogenesis Imperfecta

23

A pale conjuctiva indicates what? Bright red?

Pale = anemia
Bright red = Infection

24

An infection of the sebaceous glands causing a pimple or boil on the eyelid

Hordoleum (sty)

25

An infection of the meibomian gland causing a nodule which points inside the lid

Chalazion

26

A yellowish triangular nodule in the bulbar conjunctiva that is harmless & indicates aging

Pinquecula

27

Fatty plaques on the nasal surface of the eyelids that is normal or indicates hypercholesterolemia

Xanthelasma

28

Bilaterally small & irregular pupils that accommodate but don't react to light. Seen w/ syphilis (AKA prostitutes pupil)

Argyll Robertson pupils

29

Dilated pupil w/ ptosis & lat. deviation. Doesn't react to light or accommodation. Assoc. w/ MS

Internal Opthalmoplegia

30

Dilated & fixed pupils seen w/ anticholinergic drugs

Mydriasis

31

Fixed & constricted pupils that react to light & accommodate. Seen w/ severe brain damage, pilocarpine medications, & narcotic use

Miosis

32

Unequal pupil size

Anisocoria

33

Sluggish pupillary reaction to light that is unilateral & caused by a parasympathetic lesion of CN III

Adie's pupil

34

Sluggish pupillary reaction d/t hypoadrenalism (Addison's ds)

Arroyo Sign

35

Ptosis, miosis, & anhydrosis on the same side as an interruption to the cervical sympathetics

Horner's syndrome

36

Increased intraocular pressure causing cupping of the optic disc (cup to disc ratio is >1:2). Pt will notice blurring of their vision especially in the peripheral fields as well as rings around lights. Cresecent sign will be present upon tangential lighting of the cornea

Glaucoma

37

Swelling of the optic disc d/t increased intracranial pressure. No visual loss. May be seen w/ a brain tumor or brain hemorrhage

Papilledema AKA Choked disc

38

Painless sudden onset of blindness described as curtains closing over vision lightening flashes & floaters

Retinal detachment

39

M/C cause of blindness in the elderly, central vision lost

Macular degeneration

40

What is an early sign of Macular degeneration?

Macular drusen (yellow deposits under the retina)

41

Damage to the retinal vessels. Background will show these signs; copper wire deformity, silver wire deformtiy, A-V nicking, flame & splinter hemorrhages, & cotton wool soft exudates

HTN Retinopathy

42

This affects the veins more than the arteries in the eyes & presents w/ microaneuryms, hard exudates, & neovascularization

Diabetic Retinopathy

43

Inflammation of the iris. Seen w/ AS

Iritis

44

Normal vision is called what?

Emmetropia

45

Nearsighted is AKA?

Hyopia

46

Farsighted is AKA?

Hyperopia

47

Loss of lens elasticity d/t aging

Presbyopia

48

Direct light reflex test what CN's?

CN II
CN III

49

Consensual Light reflex tests what CN's?

CN III

50

Accommodation tests what CN's?

CN II
CN III

51

Visual acuity is tested w/ what?

Snellen Chart

52

Cardinal fields of gaze tests what CN's?

CN III
CN IV
CN VI

53

The presence of ringing in the ears.

Tinnitus

54

Sensorineural hearing loss that occurs in people as they age & they may be affected by genetic or acquired factors

Presbycussis

55

An infection of the outer ear. Pt experiences inflammation & pain of the outer ear. Tugging on the pinna will be painful.

Acute Otitis Externa (Swimmer's Ear)

56

Bacterial infection in the mastoid process. Presents clinically w/ the same s/s of acute otitis media, w/ the addition of inflammation & palpatory tenderness over the mastoid. Hearing loss is commonly assoc.

Acute Mastoiditis

57

A bacterial or viral infection in the middle ear. The tympanic membrane presents w/ a red appearance, dilated blood vessels, & bulging.

Purulent Otitis Media AKA Bacterial Otitis Media

58

An effusion in the middle ear resulting from incomplete resolution of acute otitis media or obstruction of the Eustachian tube. This condition is usually chronic & the fluid is amber w/ bubbles

Serous Otitis Media

59

An abnormal sensation of rotary movement assoc. w/ difficulty in balance, gait, & navigation of the environment

Vertigo

60

A disorder charac. by recurrent prostrating vertigo, sensory hearing loss, tinnitus, & a feeling of fullness in the ear

Meniere's Disease

61

A brief episode of vertigo brought on by a change of head position.

Benign Paroxysmal Positional Vertigo

62

How is BPPV dx?

Perform the Dix-Hallpike Maneuver

63

Benign tumor of CN VIII (called a schwannoma). Hearing loss, tinnitus, vertigo, & presence of tumor on CT or MRI

Acoustic Neuroma

64

Nasal mucosa appears red & swollen w/ a clear runny nose

Viral Rhinitis

65

Nasal mucosa appears pale or blue & boggy

Allergic Rhinitis

66

Thinning of the nasal mucosa w/ sclerosis, crust formation, & foul odor

Atrophic Rhinitis

67

These typically occur as a consequence of chronic inflammation of the nasal mucosa

Polyps

68

Red sores at the corner of the mouth. Can be caused by a Vit. B2 (riboflavin) deficiency

Angular Stomatitis AKA Cheilosis

69

Thick white fungal patches on the tongue/mouth that are easily scraped off

Candidiasis AKA Thrush

70

Pre-cancerous lesion of white patches that are adherent to the surface of the tongue & are not easily removed

Leukoplakia

71

A deficiency of B vitamins or iron that causes the tongue to appear smooth & glossy

Atrophic Glossitis

72

Deep furrows on the surface of the tongue that is considered a normal variant.

Fissured tongue AKA Scrotal tongue

73

Excessive production of growth hormone prior to skeletal maturation

Gigantism

74

Excessive production of growth hormone beginning in middle age. Results in abnormal growth in the hands, feet, & facial bones

Acromegaly

75

M/C'ly caused by Grave's ds. TSH production is decreased & the thyroid hormones (T3 & T4) are produced in excess

Hyperthyroidism

76

Hypothyoidism (AKA Myxedema) is M/C'ly caused by what in the US?

Hashimoto's thyoiditis

77

Congential hypothyroid is AKA what?. Causes a diminished physical & mental capacity.

Cretinism

78

What are charac. of hyperthyoidism?

- Weight loss w/ increased appetite
- Irritable & nervous
- Intolerance to heat
- Moist skin & fine hair
- Exophthalmos
- Possible neck swelling d/t goiter
- Increased T3, T4, & decreased TSH

79

What are charac. of hypothyroidism?

- Weight gain w/ decreased appetite
- Depression, weakness, & fatigue
- Intolerance to cold
- Coarse, dry hair & skin
- Periorbital edema
- Macroglossia & loss of lat. 1/3rd of eyebrows
- Decreased T3, T4, & increased TSH

80

Barrel chest is seen w/ what ds's?

COPD
Cystic fibrosis

81

Marked depressio nnoted in the sternum

Pectus Excavatum AKA Funnel Chest

82

Forward protrusion of the sternum

Pectus Carinatum AKA Pigeon Chest

83

Rapid, shallow breathing

Tachypnea

84

Slow breathing

Bradypnea

85

Charac. by groups of quick, shallow inspirations followed by irregular periods of apnea (no pattern)

Biot's Breathing

86

Breathing pattern charac. by alternating periods of apnea & hyperpnea (has pattern); Respiratory acidosis

Cheyne-Stokes Respiration

87

Breathing is first rapid & shallow but as metabolic acidosis worsens, breathing gradually b/co deep, slow, labored, & gasping. "Air hunger breathing"

Kussmaul's

88

Pitted nails are assoc. w/ what condition?

Psoriasis

89

Splinter hemorrhage in the nails is assoc. w/ what?

Subacute bacterial endocarditis (Strep organism)

90

Transverse ridging of the nails assoc. w/ acute severe ds is called what?

Beau's Lines

91

Inflammation of the nail fold near the cuticle

Paronychia

92

When the nail base has an angle >180 deg. & may indicates hypoxia/COPD

Clubbing

93

Koilonychia AKA Spoon nails are assoc. w/ what condition?

Iron deficiency anemia

94

Small, clicking, bubbling, or rattling sounds in the lung. They are believed to occur when air opens closed air spaces. Can be described as moist, dry, fine, & coarse. Assoc. w/ bronchitis

Rales

95

Lung sounds that resemble snoring. They occur when air is blocked or b/co rough through the large airways. Assoc. w/ Bronchiectasis

Rhonchi

96

Lung sounds that a high-pitched sounds produced by narrowed airways. They can be heard upon exhalation. Assoc. w/ asthma in young people & emphysema in older people

Wheezes

97

A wheeze-like sound heard upon inspiration. Usually d/t a blockage of airflow

Stridor

98

Consolidation of the lung. Occurs in 4 stages (consolidation, red hepatization, grey hepatization, resolution). Percussion is dull (over fluid), rales aka crackles, increased tactile fremitus, productive cough at 10 days, rusty brown sputum, possible fever, silhouette sign, & air bronchogram

Lobar Pneumonia

99

Productive/currant red jelly sputum & caused by Klebsiella pneumonia. Seen w/ old age or immunocompromised hosts

Friedlander's Pneumonia

100

Lung condition caused by yeast/fungus. M/C seen in AIDS pts.

Pneumocystis Carinii

101

Caused by CMV. M/C seen in AIDS pts

Cytomegalovirus

102

Presents w/ low grade fever, night sweats, productive cough, yellow/green sputum, small white lesions called Ghon lesions seen on x-ray, starts in apices of the lung, crackles in upper lobe, tine test/Mantoux test, positive purified protein derivative. Most definitive test for dx is sputum culture

TB (caused by mycobacterium tuberculosis)

103

Inflammation of the pleura, usually producing an exudative pleural effusion & stabbing chest pain worsened by respiration & cough. Dull on percussion, dry/non-productive cough, decreased respiratory excursion, decreased tactile fremitus, dull on percussion, friction rub is present, decreased breath sounds, (+) Schepelmann's Test

Pleurisy

104

A ruptured lung causing air to b/co trapped in the pleural space. Decreased chest expansion, decreased tactile fremitus, hyper-resonant, decreased breath sounds. Can occur in young, previously healthy individuals. Unilateral darkening of the chest d/t collapse of the lung; tracheal shift away from lesion.

Pneumothorax

105

Collapse of the lung that is usually the result of bronchial obstruction d/t a mucous plug. Presents w/ decreased tactile fremitus, dull on percussion, decreased chest expansion, decreased or absent breath sounds, on x-ray the collapsed lung will display increased density, & mediastinal shift to the same side

Atelectasis

106

Irreversible focal bronchial dilation that presents w/ a chronic, productive cough. CT is necessary to dx/confirm

Bronchiectasis

107

Defined by a long term cough w/ mucus, shortness of breath & wheezing. Cigarette smoking is the main cause. Lon g exposure to other things such as chemical fumes, dust & other substances may cause this

Chronic bronchitis/COPD

108

Bronchospasm constricting airways. Type I hypersensitivity rxn that is usually triggered by airborne allergens. Presents w/ tachycardia, tachypnea, decreased tactile fremitus, wheezing, eosinophils & IgE rise. Labs: Curshmann's spirals & Charcot Laden Crystals (crystals & spirals in sputum from IgE)

Asthma

109

Destruction of elastic pulmonary connective tissue results in permanent dilation of the alveoli air sacs & caused by a deficiency of alpha I anti-trypsin. Presents w/ decreased tactile fremitus, hyperresonant percussion, decreased breath sounds, & prolonged expiration w/ an expiratory wheeze likely. Fluid will accumulate first in the costophrenic recesses. X-ray findings: bilat. darkened lung fields; narrowed compressed heart; horizontal ribs; flattening of the diaphragmatic domes

Emphysema

110

Primary malignant lung tumor that starts in the area of the bronchus. Long term hx of smoking (20-30yrs). Coughing (non-productive) more than 30 days, afebrile, dyspnea, weight loss & clubbing of the fingernails

Bronchogenic Carcinoma

111

Inflammation of the cartilage connection b/w the ribs & sternum. It develops as a consequence of physical activity & is worse w/ exercise. The pain increases while taking a deep breath. There will be palpable tenderness at the costosternal articulation.

Costochondritis AKA Tietze Syndrome

112

Painful rash following the course of a dermatome usually a single nerve. Primarily involves the DRG but when it does involve CN it is M/C'ly CN V

Herpes Zoster aka Shingles

113

A ds in which abnormal collection of inflammatory cells (granulomas) form as nodules. Most often appear in the lungs or lymph nodes. M/C seen in African descent in the US. X-ray: bilat. hilar lymphandenopathy

Sarcoidosis

114

Cancer of the lymphatic system that can spread to the spleen. M/C seen in young Caucasian males. Presents w/ fever, night sweats, weight loss, intense pruritis (release of IgE), & enlarged spleen. Best dx from biopsy looking for Reed Sternberg cells. X-ray: Unilateral hilar lymphadenopathy.

Hodgkin's

115

Chronic, progressive, & frequently fatal genetic (inherited) ds of the body's mucus glands; an abnormality in the glands that produce or secrete sweat & mucus; Loss of excessive amounts of salt; Thick accumulation of mucus in the intestines & lungs; COPD, barrel chest, pancreatic insufficiency, meconium ileus.

Cystic fibrosis

116

Measures the pressure of the R side of the heart. Can be made more pronounced when CHF is present by applying pressure to the liver (hepatojugular reflex)

Jugular Venous Pulsations

117

"Bounding" pulse; Seen w/ increased cardiac output; exercise anxiety, fever, hyperthyroidism

Pulsus Magnus

118

Weak or thready pulse. Seen w/ decreased stroke volume, hypovolemia, aortic stenosis, CHF

Pulsus Parvus

119

Pulse that alternates in amplitude. Seen w/ L ventricular failure

Pulsus Alterans

120

2 strong systolic peaks separated by mid-systolic dip (best felt at carotid artery; Seen w/ aortic regurgitation, aortic stenosis

Pulsus Bisferiens

121

Pulse w/ decreased amplitude on inspiration, increased w/ expiration (>10mmHg amplitude change); Seen w/ COPD, bronchial asthma, emphysema, pericardial effusion

Pulsus Paradoxus

122

A jerky pulse that is rapidly increasing & then collapsing b/c of aortic insufficiency

Water Hammer Pulse

123

Vibration produced by turbulent blood flow w/i the heart

Thrills (murmurs)

124

This heart sound is normal in children, young adults, & athletes. In >40yoa it is the earliest sign of CHF

S3 (Ventricular gallop)

125

This heart sound is related to stiffness of the ventricular myocardium to rapid filling

S4 (atrial gallop)

126

This type of murmur has a low pitch & is best heard w/ the bell of the stethoscope

Stenosis

127

This type of murmur has a high pitch & is best heard w/ the diaphragm of the stethoscope

Regurgitation

128

The mnemonic for heart murmurs which occur in diastole is ARMS & PRTS. What does it stand for?

Aortic Regurgitation, Mitral Stenosis
Pulmonic Regurgitation, Tricuspid Stenosis
(opposite occurs during systole)

129

Failure of shunt to close b/w the aorta & L pulmonary art. Creates a continuous/machinery like murmur that can be heart in both phases of the heart cycle

Patent Ductus Arteriosus

130

Dextraposition of the aorta, R ventricular hypertrophy, Interventricular septal defect, & Pulmonic stenosis. Creates a loud ejection murmur during systole & severe cyanosis

Tetralogy of Fallot (DRIP)

131

Constriction of the descending aorta (usually distal to the L subclavian). Causes higher blood pressure in the UE by 20mmHg (diagnostic) when compared to the LE. Commonly assoc. w/ Marfan's Syndrome.

Coarctation of the Aorta

132

Narrowing prox. to the vertebral art. Seen in younger females who faint (syncope/drop attacks) while exercising.

Subclavian Steal Syndrome ("Subclavian steals from the vertebral")

133

What are the M/C causes of L-sided heart failure?

HTN (M/C)
Aortic stenosis

134

What is the M/C cause of R-sided heart failure?

L-sided heart failure

135

What is the M/C cause of mitral stenosis?

Rheumatic fever

136

Lung condition that causes R-sided heart failure. When the R-side fails by itself

Cor Pulmonale

137

On an ECG, an increased PR interval indicates what?

Prolonged AV nodal delay (primary heart block)

138

On an ECG, two P waves before the QRS is what?

Weinkbochs-block of bundle of HIS (Secondary heart block)

139

On an ECG, no QRS wave indicates what?

Complete heart block (no ventricular contractions)

140

On an ECG, if the ST segment is enlarged or inverted it indicates what?

MI (acute heart failure)

141

Increase in what lab values indicate MI?

Creatine Phosphokinase (CPK)
SGOT
LDH

142

BUN is used to test what organ(s) functions?

Liver
Kidneys

143

Tumor marker specific for hepatocellular carcinoma

Alpha fetoprotein

144

Calcification of the gallbladder that may b/co malignant d/t chronic inflammation

Porcelain Gallbladder

145

This organ can refer pain to the R shoulder or tip of R scapula

Gallbladder

146

Epigastric pain going straight through the T10-T12 area like a knife should make you think what organ?

Pancreas (pancreatitis)

147

Bleeding into the flank assoc. w/ pancreatitis is what sign?

Grey Turner sign

148

Periumbilical ecchymosis assoc. w/ pancreatitis is what sign?

Cullen's Sign

149

Pancreatic cancer usually affects what part of the pancreas?

Head

150

Condition of the pos. pituitary gland in which there is insufficient ADH. May have polydypsia, polyuria, but not polyphagia

Diabetes Insipidus

151

Protrusion of the stomach above the diaphragm. PResents w/ palpable tenderness in LUQ, reflux esophagitis, dyspepsia, made worse after eating large meal or when lying down

Hiatal Hernia

152

Projectile vomiting in the newborn

Pyloric Stenosis

153

Presents w/ symptoms similar to the flu such as fever, HA, fatigue, lymphadenopathy in the cervical region, splenomegaly. Atypical lymphocytes in blood (Downey cells). Tested w/ Monospot AKA Heterophile Agglutination AKA Paul Bunnell Test. Caused by Epstein Barr Virus

Mononucleosis

154

A systemic or metabolic condition that involves every bone. The bone marrow b/co sclerotic so RBCs aren't made. The liver & spleen make RBCs & b/co enlarged

Osteopetrosis "Marble Bone"

155

Nonspecific inflammatory disorder that affects distal ileum & colon. Inflammation is patchy w/ healthy tissue b/w the patches, which is referred to as a 'cobblestone' appearance. Doesn't absorb B12.

Regional Ileitis AKA Crohn's Ds

156

M/C at the colon & rectum. Presents w/ bloody mucous in diarrhea, fever. Can lead to sacroiliitis (enteropathic arthropathy)

Ulcerative Colitis

157

Variable degrees of constipation & diarrhea in response to stress. Seen more commonly in females. Abdominal pain & gas relieved by bowel movements

IBS AKA Spastic colon