General Diagnosis (Irene Gold) Part II and III Flashcards Preview

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Flashcards in General Diagnosis (Irene Gold) Part II and III Deck (901):
1

What are the five components of a health history?

Chief Complaint
Past Health History
Personal and Social History
Review of Systems (ROS)
Present Illness

2

What six things need to be asked to the patient when asking about Present Illness?

Onset
Palliative/Provoking
Quality of Pain
Radiation/Referral
Site/Setting/Severity
Timing/Temporal Factors
(OPQRST)

3

What is indicated if there is a sudden onset of pain?

Neuromuscular Problem

4

If pain has an insidious onset, what is the likely cause?

Cancer

5

If nothing makes that pain better or worse, what does the patient possible have?

Cancer

6

How are you able to tell if a patient is having a neuromuscular skeletal problem?

The patient is able to find relief from pain in a certain position

7

If a patient complains of no localization of pain, where is the pain very likely from?

Originating from an organ

8

If pain is stated to be a "throbbing pain", what does it indicate?

Vascular

9

What is a descriptive word to describe a pain in the muscle?

Aching

10

If the patient describes the pain as "Burning" what is the likely cause of the pain?

Nerve

11

What kind of pain is described for a dissecting aneurism?

Tearing Pain

12

What questions need to be asked to the patient about past health history? (7 Things)

Surgeries
Hospitalizations
Illness (Serious)
Trauma

Previous Injury
Allergies
Medications

13

What five questions that need to be known from family history?

Cardiovascular Disease
Diabetes
Stroke
Cancer
Arthritis

14

What questions/categories do you need to ask about pertaining to the social/personal history of a patient? (8 Topics)

Marital Status
Occupation
Diet
Exercise
Bowel/Urinary Problems
Sleep
Alcohol, Tobacco, and Drug use
Stress

15

What is the questionnaire to help determine if someone may be an alcoholic?

CAGE Questionnaire

16

What are the four parts of the CAGE Questionnaire?

C- Cutting Down (Have you ever felt the need to cut down on your drinking?)
A- Annoyed by others criticisms (Have you ever felt annoyed by criticism of your drinking?)
G- Guilty Feeling (Have you ever felt guilty about your drinking?)
E- Eye openers (Have you ever felt that you needed a drink to start your day?)

17

What is the normal oral temperature?

98.6 F

18

What is the normal Rectal and Tympanic temperature?

99.6 F

19

What is the normal Axilla temperature?

97.6 F

20

What is considered normal range for body temperature?

96-99.5 F (35-37.5 C)

21

What is the normal pulse rate of an Adult?

60-100 Beats/Min

22

What is the normal pulse rate for a Newborn?

120-160 Beats/Min

23

What is the normal pulse rate for a person of older age?

70-80 Beats/Min

24

What is the normal Respiration Rate of an Adult?

14-18 Breaths/Min

25

What is the normal Respiration Rate of a Newborn?

44 Breaths/Min

26

What is the normal Blood Pressure in an Adult?

90-120/60-80

27

Do blood pressure values increase or decrease in elderly people?

Increase

28

What blood pressure would indicate Hypertension?

140/90

29

What blood pressure would indicate Hypotension?

90/60

30

In what population would it be common to see an auscultatory gap?

Patients with hypertensive blood pressures

31

What is the definition of an Auscultatory Gap?

The loss and reappearance of the pulsatile sound while listening with the stethoscope during cuff deflation

32

What is being described as "low pitched sounds produced by turbulent blood flow in the arteries"?

Korotkoff Sounds

33

If there is a difference of 10-15 mm Hg in systolic reading, what vessels are being disturbed and what is the name of this condition?

Arterial Occlusion- Vessels being disturbed

Subclavian Steal- Name of the condition

34

What is the AKA for Subclavian Steal?

Transient Ischemic Attack (TIA)

35

From what artery is blood taken, during a Subclavian Steal?

Vertebral Artery

36

When the blood pressure is taken in the lower extremity how much higher will the readings be?

20%
Coarctation of the Aorta

37

Which test can be used to determine if a patient has Vertebrobasilar Artery Insufficiency? (6 exams)

Barre-Lieou
DeKleyn's
Hallpike
Hautant's
Underberg
Maigne's

38

How do you perform the orthopedic test of: Barre-Lieou

Patient is seated, Doctor instructs patient to rotate the head maximally from side to side.

This is done slowly to start and then accelerated to patient tolerance

39

What does a positive Barre-Lieou test indicate?

Vertebrobasilar Artery Insufficiency

40

What is a positive finding of Vertebrobasilar Artery Insufficiency exams?

Dizziness
Light Headedness

41

How do you perform the orthopedic test of: DeKleyn's

Patient is Supine. Doctor instructs patient to rotate and extend the head off the table then to turn to each side for 15-45 seconds.

Doctor can lend minimal support

42

How do you perform the orthopedic test of: Hallpike

Enhanced DeKleyn's

Patient supine, head is extended off the table. Doctor offers support of the skull.

Doctor brings the head into extension, rotation and lateral flexion

43

How do you perform the orthopedic test of: Hautant's

Patient is seated, arms extended forward to shoulder level with the hands supinated. Patient maintains this position for a few seconds. Patent then closes the eyes, rotates and hyperextends the neck to one side.

Repeated on opposite side

44

How do you perform the orthopedic test of: Underberg

Patient stands with eyes open, arms at side, feet close together. Patient closes their eyes, extends arms and supinates hands, then the patient extends and rotates head to one side. Then in this position patient is instructed to march in place.

45

How do you perform the orthopedic test of: Maigne's

Patient is seated, Doctor brings had into extension and rotation

46

What clinical significance does scaly eyebrows have?

Seborrhea

47

In what two categories of people with you see a loss of the lateral 1/3 of the eyebrow?

Myxedema (AKA Hypothyroidism)
Elderly

48

What is another name for Myxedema?

Hypothyroidism

49

What condition is described by "sluggish pupillary reaction to light that is unilateral and caused by parasympathetic lesion of CN III"?

Adie's Pupil

(Similar to Argyll Robertson's; but seen after 25 years of Syphilis)

50

How would you describe Adie's Pupil?


What age is usually affected?

A sluggish pupillary reaction to light that is unilateral and caused by parasympathetic lesion of CN III

Younger Age: 10-20

51

What is the description of Anisocoria?

Unequal pupil size

52

What are three possible cause of Anisocoria?

Drugs
Pathological
Trauma

53

Name the condition that is described as the following: "bilaterally small and irregular pupils that accommodate but do not react to light"?

Argyll Robertson's

54

How would you describe Argyll Robertson's pupil?

A bilaterally small and irregular pupils that accommodate but do not react to light

55

In what gynecological disease is Argyll Robertson's pupil common in?

Syphilis
(Argyll Robertson's pupil with syphilis is called "Prostitutes Pupil")

56

What is Arroyo Sign?

Sluggish pupillary reaction due to hypo-adrenalism

57

What is another name for Hypo-adrenalism?

Addison's Disease

58

What is the common microorganism to produce Blepharitis?

Staphylococcus, found on the skin

59

What condition of the eye is described: "inflammation of the eyelid"?

Blepharitis

60

How would you describe Blepharitis?

Inflammation of the eyelid

61

In what condition would you commonly see Blepharitis? (3 Conditions)

Seborrhea
Staph Infection
Inflammatory Process

62

What condition is "opacities seen in the lens" Also had an "Absent Red Light Reflex"?

Cataracts

63

In what two populations are cataracts frequently found in?

Diabetics
Elderly

64

What is the description of a Chalazion?

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

65

How is the condition Corneal Arcus described?

Grayish opaque ring around the cornea

66

What significance does Corneal Arcus have in and elderly person?

No clinical problem and does not indicate anything pathological

67

If Corneal Arcus is seen in a younger (20-40 year old patient), what is a possible diagnosis?

Hyper cholesterolemia

68

Which vessel does the condition of Diabetic Retinopathy affect more?

Veins, more than arteries

69

What finding will you have with Diabetic Retinopathy? (3 Things)

Micro-aneurysms
Hard/Waxy Exudates
Neovascularization

70

Ectropion and Entropion are most commonly seen in what population?

Elderly

71

What is Ectropion?

Eyelid turned outward (Dry Eyes)

72

What is the name of the condition when the eyelid is turned inward?

Entropion

Eye Irritation from the eyelashes rubbing on the eyeball

73

How is Exophthalmosis described?

Lid lag/failure to cover the eyeball

74

What two conditions will often be associated with Exophthalmosis?

Grave's Disease (Aka- Hyperthyroidism)
**Will be seen Bilaterally**

Tumor
*Seen Unilaterally*

75

What condition is described by "increase intraocular pressure causing cupping of the optic disc"?

Glaucoma

Acute Glaucoma will be painful

76

In Glaucoma what is the cup to disc ratio?

Less than 1:2

77

What early visual problems with a patient have leading up to Glaucoma?

Blurring of their vision, especially in the peripheral fields
Rings around lights

78

What is it called in a patient that had Glaucoma and has a tangential lighting of the cornea?

Crescent Sign

79

What is the fastest blindness seen in a patient with Glaucoma?

Closed Angle Glaucoma

80

What is the name given to an infection of the sebaceous gland causing a pimple or boil on the eyelid?

Hordoleum (sty)

81

What are the common finding of a patient with Horner's Syndrome?

Ptosis
Miosis
Anhydrosis

82

Which side of the cervical sympathies are effected in Horner's Syndrome?

Ipsilateral side

83

What is a common radiographic finding with Horner's Syndrome?

Pancoast Tumor (Seen in the apex of the lung)

84

What are signs of Hypertensive Retinopathy? (5 Findings)

Copper Wire Deformity
Silver Wire Deformity
A-V Nicking
Flame Hemorrhages
Cotton Wool Soft Exudates

85

What eye condition will have "dilated pupil with ptosis and lateral deviation"?

Internal Ophthalmoplegia

86

What two things will Internal Ophthalmoplegia not react to?

Light
Accommodation

87

What serious disease has Internal Ophthalmoplegia paired with it?

Multiple Sclerosis

88

What is the name of the condition that has "inflammation of the iris"?

Iritis/ Uveitis

89

What condition has a finding of Iritis?

Ankylosing Spondylitis

90

What is the most common reason for blindness in the elderly?

Macular Degeneration

91

What are early signs of Macular Degeneration?

Central Vision Loss
Macular Drusen (Yellow deposits under the retina)

92

What is Macular Drusen?

Yellow deposits under the retina, seen in the condition of Macular Degeneration

93

What condition is described as "fixed and constricted pupils that react to light and accommodate"?

Miosis

94

What three conditions are commonly seen with Miosis?

Severe Brain Damage
Pilocarpine Medications
Narcotic Use

95

What is the description of Mydriasis?

Dilated and Fixed pupils

96

When would you most like see a patient with Mydriasis?

Anticholinergic Drugs (i.e. Atropine, Mushrooms, Death)

97

What is another name for a Choked Disc?

Papilledema

Use the rectangular slit on the Ophthalmoscope to test

98

What causes Papilledema?

Swelling of the optic disc due to increased intracranial pressure

99

When would you possible see Papilledema?

Patient with a:
Brain Tumor
Brain Hemorrhage

100

Is a sign of Papilledema, vision loss?

No

Vision loss is seen with Optic Neuritis

101

What is the name of the condition with "swelling around the eyes"?

Periorbital Edema

102

In what three conditions will you see Periorbital Edema?

Allergies (Most Common)
Myxedema
Nephrotic Syndrome (HEP; Hypertension, Edema, Proteinuria)

103

How would you describe a Pinquecula?

Yellowish Triangular NODULE in the bulbar conjunctiva, that is HARMLESS, and indicates aging

104

What condition is described as: "triangular THICKENING of the bulbar conjunctiva that grows ACROSS the cornea and is brought on by dry eyes"?

Pterygium

Surgery is needed

105

How is the condition of Ptosis described?

Drooping of the eyelid

106

What are four conditions that are common to have Ptosis found in them?

Horner's Syndrome
Cranial Nerve III (Oculomotor)
Myasthenia Gravis (Bilateral)
Multiple Sclerosis

107

What disorder is described as "painless sudden onset of blindness"?

Retinal Detachment

108

What three signs are described leading up to Retinal Detachment?

Curtains closing over vision
Lighting Flashes
Floaters

109

What does the following color of sclera indicate:
White
Yellow
Blue

White: Normal
Yellow: Jaundice
Blue: Osteogenesis Imperfecta

110

What condition is described by: "fatty plaques on the nasal surface of the eyelids that may be normal or an indication of hypercholesterolemia"?

Xanthelasma

111

If you believe a patient has hypercholesterolemia, what two other conditions should you look for?

Xanthelasma
Other vascular problems

112

What is the clinical name for normal vision?

Emmetropia

113

What is the clinical word for Nearsightedness?

Myopia

114

What is the clinical word for Farsightedness?

Hyperopia

115

If a patient has decrease lens elasticity due to aging and is unable to see close up, but can see far away, they are said to have what clinical description?

Presbyopia

116

What four tests are carried out to check the integrity of Cranial Nerves II and III?

-Direct Light Reflex
-Consensual Light Reflex
-Swinging Light Test (Also Looking for any eye Pathologies)
-Accommodation

117

How is Visual Acuity tested on a patient?

Snellen Eye Chart

118

What cranial nerves are being checked, when Cardinal Fields of Gaze is carried out?

Cranial Nerves: III, IV and VI

119

What is the name of the cranial nerve IV?
What is it's primary function?
What would a problem or lesion here look like?

Name- Superior Oblique
Primary Function-
Lesion-

120

What is the name of the cranial nerve VI?
What is it's primary function?
What would a problem or lesion here look like?

Name- Lateral Rectus
Primary Function-
Lesion-

121

What Cranial Nerve is affected in Acoustic Neuroma?

CN VIII

122

What is Acoustic Neuroma and what is another name of it?

Benign tumor
AKA- Schwannoma

123

What are three common signs seen with Acoustic Neuroma?

Hearing Loss
Tinnitus
Vertigo

124

How is Acoustic Neuroma confirmed?

Tumor present on a CT or MRI

125

What is it called when there is a bacterial infection of the mastoid process?

Acute Mastoiditis

May present similarly to Purulent Otitis Media

126

What are two common signs will be seen with Acute Mastoiditis?

Inflammation and Palpatory tenderness over the mastoid
Hearing Loss is also commonly associated

127

What is the clinical term for "infection of the outer ear"?

Acute Otitis Externa

128

What is the more common name for Acute Otitis Externa?

Swimmer's Ear

129

What are the signs of Acute Otitis Externa?

Inflammation and Pain over the outer ear

130

What is a noninvasive way to see if someone has Acute Otitis Externa?

**Tugging on the Pinna will be painful**

131

What condition is brought on by change in head position and is usually brief in it's duration?

Benign Paroxysmal Positional Vertigo

132

How is Benign Paroxysmal Positional Vertigo diagnosed?

Orthopedic Exam: Dix-Hallpike Maneuver

133

How is the Dix-Hallpike Maneuver performed?

Patient rapidly moves from a seated to a supine position with head turned at 45 degrees to the left and waits 30 seconds.

Repeat this procedure on the right side if nystagmus is seen.

134

What finding indicate a positive Dix-Hallpike Maneuver?

Nystagmus
Nausea
Vertigo

135

If a patient has a "retraction of the tympanic membrane" what condition do they more than likely have?

Eustachian Tube Block

**No fluid bubbles**

136

What are two other names for Meniere's Disease?

Central Vertigo
Endolymphatic Hydrops

137

What are the characteristics of Meniere's Disease? (4 Possible)

Recurrent Prostrating Vertigo
Sensory Hearing Loss
Tinnitus (Ringing of the Ears)
Feeling a fullness in the ear

138

What condition is described as "Sensorineural hearing loss that occurs in people as they age and may be affected by genetic or acquired factors"?

Prebycussis

139

What is another name for Bacterial Otitis Media?

Purulent Otitis Media (PUS)

140

What may be a cause of Bacterial Otitis Media?

Bacterial or viral infection of the middle ear

141

What is the three classic findings of Bacterial Otitis Media?

Red tympanic membrane
Dilated blood vessels
BULGING tympanic membrane

142

What are two ways that someone can get Serous Otitis Media?

Effusion of the Middle ear by:
1. Incomplete resolution of acute otitis media
2. Obstruction of the Eustachian Tube

143

What is unique about Serous Otitis Media
AND
What does it look like clinically?

Unique- Chronic condition; Sucks the eardrum inward

Clinical Appearance- **Fluid is an Amber color and has bubbles**

144

What is the clinically term for "ringing in the ears"?

Tinnitus

145

How is the condition of Vertigo described?

Abnormal sensation of Rotatory movement

146

If someone has vertigo, what three things may they have difficulty with?

Difficulty with:
Gait
Balance
Navigation of the Environment

147

What is the clinical presentation of Allergic Rhinitis?

Nasal mucosa appears Pale/Blue and Boggy

148

How can you tell if a patient has Atrophic Rhinitis?

Thinning of the nasal mucosa with sclerosis, Crust formation and Foul odor

149

What condition typically will occur as a consequence of chronic inflammation of the nasal mucosa?

Polyps

150

If a patient has a nasal mucosa that appears red and swollen with a clear runny nose, what condition do they have?

Viral Rhinitis

151

What is another name for Cheilosis?

Angular Stomatitis

152

What condition is described by red sores at the corner of the mouth, that may be accompanied by bleeding?

Cheilosis AKA Angular Stomatitis

153

What may cause a patient to have Angular Stomatitis?

Deficiency of B2 (Riboflavin)

154

What is the clinical name for Thrush?

Candidiasis

155

What three populations are prone to get Candidiasis?

Pregnant Women
Bartenders
Diabetics

156

How is Candidiasis described?

What is a way to tell a patient has Thrush versus Leukoplakia?

Description: Thick white fungal patches

Thrush; will easily scrape off the tongue

157

What condition does a patient have if their tongue appears to be "Smooth and Glossy"?

Atrophic Glossitis

158

A deficiency of what two vitamins/minerals may cause Atrophic Glossitis?

B Vitamins (B-12)
Iron

159

What populations are common to have Leukoplakia?

Smokers and Tobacco users

160

What is the condition of "Pre-cancerous lesions of white patches that are adherent to the surface of the tongue and not easily removed"?

Leukoplakia

161

What is commonly found with Leukoplakia?

Fordyce Spots; Yellow Spots on the Tongue

162

What clinical condition is described by "excessive production of growth hormone, beginning in middle age"?

Acromegaly

163

What classic characteristics will you see in a person with Acromegaly?

Abnormal/Enlarged Growth in:
Hands
Feet
Facial Bones

164

In a patient that has Acromegaly, where is the problem located?

Pituitary Tumor

165

What is the definition of Gigantism?

Excessive production of growth hormone prior to skeletal maturity

166

What is the most common cause of Hyperthyroidism?

**Grave's Disease** (Autoimmune Disorder)

167

In Hyperthyroidism what hormone is:
Decreased
and
Increased

Decreased: Thyroid Stimulating Hormone (TSH)

Increased: Thyroid Hormones
-- T3- Triiodothyronine
-- T4- Thyroxine

168

What is another name for Hypothyroidism?

Myxedema

169

What causes Myxedema/Hypothyroidism?

Increase in Thyroid Stimulating Hormone (TSH)

170

What is the most common cause of Hypothyroidism in the United States?

Hashimoto's Thyroiditis

171

What is it called when someone has congenital hypothyroidism?

Cretinism

172

What two problems will and patient with Cretinism have?

Diminished Capacities for:
Physical
Mental

173

What two conditions will you often see a Barrel Chested appearance?

Chronic Obstructive Pulmonary Disease (COPD)
Cystic Fibrosis

174

On an x-ray what is the ratio of AP to Lateral, to determine if a patient has a Barrel Chest?

1:1

175

What are two Congenital Anomalies of the chest?

Pectus Excavatum
Pectus Carinatum

176

What is an AKA for Pectus Excavatum?

Funnel Chest

177

What is an AKA for Pectus Carinatum?

Pigeon Chest

178

How is Pectus Excavatum clinically described?

Marked depression noted in the sternum (Sunken In)

179

How does Pectus Carinatum present?

Forward protrusion of the sternum (Like the keel of the ship)

180

How is Tachypnea classified?

Rapid, Shallow Breathing

181

What is the clinical term for Slow breathing?

Bradypnea

182

A pattern of breaths defines as follows: "Group of quick, shallow inspirations, followed by IRREGULAR periods of apnea", is called _______________?

Biot's Breathing

No Pattern to Breathing

183

What is the clinically description of Cheyne Strokes Respiration?

Breathing pattern characterized by alternating periods of apnea (no breathing) and hyperpnea (has pattern)

184

In what condition will you see a patient present with Cheyne Strokes Respiration?

Respiratory Acidosis

185

What is the name of breathing found in patients with Diabetic Acidosis?

Kussmaul's

186

What kind of breathing pattern would a patient with Diabetic Acidosis present with?

Breaths would be rapid and shallow in the beginning, as metabolic acidosis get worse, breathing would become deep, slow, labored and gasping.

187

Patients that have Metabolic Acidosis, have breathing called:

"Air Hunger Breathing"

188

What condition would you commonly see Pitted Nails?

Psoriasis

189

What disorder does a patient have if they have, splinter hemorrhage in the nails?

Subacute Bacterial Endocarditis

190

A patient with transverse riding associated with acute severe disease has a condition called:

Beau's Lines

191

What is the clinically name given to inflammation of the nail fold near the cuticle?

Paronychia

192

If a patient has clubbing of the nails, what two conditions may they have? One being an early sign, the other being later.

Hypoxia (Early Sign)

COPD (Late)

193

Clubbing of the nails, indicates a decrease in oxygen in the blood, what condition may this be linked to?

Bronchogenic Carcinoma

194

If a patient presents with a spooning appearance to their nails, what are they likely deficient in?

Iron, Causing Iron Deficiency Anemia

195

What is the clinical name of Spoon Nail?

Koilonychia

196

How do you preform Respiratory Excursion?

Place hands over the patients ribs and have the patient take a few deep breaths

197

When preforming Tactile Fremitus, if vibrations are increased, what is that a indication of?

Pneumonia- Fluid in the lung

Possible Congestive Heart Failure (CHF); Pulmonary Edema

198

What may cause Tactile Fremitus to be decreased?

Air:
Emphysema
Pneumothorax

Sound Barrier is Created with:
Atelectasis
Pleurisy

199

What is the term used over normal lung tissue/sounds?

Resonate

200

What will cause lung sounds to be hyperresonant?

Increase air in the chest (i.e. Emphysema, Pneumothorax)

201

If a patient presents with Pneumonia or Atelectasis, what kind of lung sound will be produced?

Dull

202

How is Diaphragmatic Excursion performed?

Doctor ask patient to exhale and hold. Doctor percusses do the back of the intercostal margins (bone will be dull) starting below the scapula, until the sound changes from resonant to dull. Doctor marks that spot. Then the patient takes a deep breath in and holds. The doctor percusses down again, marking the spot where the sound changes from resonate to dull again. Doctor will measure the distance between the two spots.

If there is LESS than 3-5 cm, patient has pneumonia or pneumothorax, use chest x-ray to diagnose.

203

What should the tracheal duration be; ratio of Inspiration versus Expiration?

Inspiration should be equal to expiration

204

Where should the location of the tracheal breath sounds be heard?

Over the Trachea

205

When comparing Inspirations versus Expirations of the Bronchial breath sounds what is the duration?

Expirations should be LONGER than Inspirations

206

Where is the best location to hear bronchial breath sounds?

Over the Manubrium

207

What is normal duration for brochovesicular breath sounds?

Inspiration is equal to Expiration

208

Where is the best location to hear brochovesicular breath sounds?

Between 1st-2nd rib Anteriorly
Between the Scapulae Posteriorly

209

Vesicular breath sounds; what is normal duration?

Inspiration LONGER than Expiration

210

Where is the best location to listen to Vesicular breath sounds?

The remaining lung field

211

What condition are Rales often associated with?

Bronchitis

212

A small clicking, bubbling or rattling sound, maybe described as moist, fine, dry or coarse in the lung is a description of _______?

Rales

213

What abnormal lung sound resembles snoring?

Rhonchi

214

When does a Rhonchi happen?

When air is blocked or becomes rough through large airways

215

When is a rale likely to be heard?

When air opens and closed air space

216

What condition will be see with Rhonchi?

Bronchiectasis

217

What type of sound and how is a Wheeze produced?

High pitched sound, through narrow airways

Lower Airway Expansion

218

Is a wheeze herd upon inspiration or expiration?

Exhalation

219

What two population will you hear wheezes in? One old and one young population.

Young: Asthma
Older: Emphysema

220

What is it called when you have a wheeze like sound on inspiration?

Stridor
Upper Respiratory Infection

221

Stridor is commonly found in children with _________?

Croup

222

How is stridor produced?

Usually a blockage of airflow

223

What is a positive finding for Bronchophony?

If clear, distinct sounds are heard as patient says "99", consolidation is present

224

What is a positive finding for Egophony?

If you hear "AAAA" as the patient says "EEEEE", consolidation is present

225

What is a positive finding for Pectoriloquy?

If the words "1,2,3" are heard clearly and distinctly, consolidation is present

226

What three Vocal Resonance test can be performed, to see if consolidation is present in the lungs?

Bronchophony
Egophony
Pectoriloquy

**Solid substances makes sounds better, knocking on a table**

227

When performing a hearing exam what is "Normal Hearing" for the Weber test?

Equal sound heard bilaterally

228

What is a positive finding in conduction loss, when performing Weber's test?

Lateralizes to the involved ear

229

Sensorineural hearing loss is a positive finding when the Weber test is heard in which ear?

Sound lateralizes to the uninvolved ear

230

What is considered a positive Rinne test?

Air Conduction (AC) is Greater then Bone Conduction (BC)
Normal Hearing

231

What two findings would indicated a negative Rinne test?

Air Conduction (AC) is Less then Bone Conduction (BC)
or
Air Conduction (AC) is Equal to Bone Conduction (BC)

Conduction Hearing Loss

232

What finding will you have in the Rinne test, with a patient who has Sensorineural hearing loss?

Air Conduction (AC) will be Greater than Bone Conduction (BC), with less time in the bad ear

233

What causes Secondary Hyperparathyroidism?

Decreased stimulation of Thyroid Stimulating Hormone (TSH), from the Pituitary gland

234

What are four other names for a Common Migraine?

Sick
Vascular
Ocular
Hormonal

235

What age/time and gender does a Common Migraine usually effect?

Age/time- Childhood and Early Adulthood

Gender- Females

236

What are the four characteristics of a Common Migraine?

Photophobia
Throbbing
Worse behind one eye
Nausea and/or vomiting

237

When are three other things to know about Common Migraines?

Familial
Decreases frequency as the person ages
Decreases with pregnancy

238

What seven things can provoke a Common Migraine and/or a Classic Migraine?

Bright light
Chocolate
Cheese
Tension
Red wine
Menstrual cycle
Hypoglycemia

239

What are six follow ups that can be done to help with Common Migraine?

Dietary log
Adjust
Avoid provoking/triggering factors
Decrease stress
Massage
FeverFu- 125QD (Drug to help decrease frequency)

240

What age/time and gender does a Classic Migraine usually effect?

*Classic Migraine, is a Neurologically Event*

Age/time- Childhood and Early Adulthood

Gender- Females

241

Is a Classic Migraine usually Unilateral or Bilateral?

Unilateral

242

What are the five characteristics of a Classic Migraine?

**Aura, Prodrome-sensory changes before it comes on**

(Same as Common Migraine)
Photophobia
Throbbing
Worse behind one eye
Nausea and/or vomiting

243

What age/time does a patient experience a Hypertension headache?

Adulthood

244

What is the common location of a Hypertension headache?

Occipital
Vertex

245

What are two characteristics of a Hypertension headache?

Throbbing
**Wake up with a headache**

246

What two follow ups would you do if a patient presents with a Hypertension headache?

Blood pressure
Lipid profile

247

What age/time and gender does a **Cluster** headache usually effect?

Age/time- Adolescents to Adulthood

Gender- Males

248

What are three common sites for a Cluster headache to show up?

Unilateral
Orbital
Temporal

249

What are the seven characteristics of a Cluster headache?

**Wake up at night with headache (Comes on after sleep)
**Last 15-180 minutes**
**Rhinorrhea** (Runny nose)
**Lacrimation**
Facial sweating
Red eye
Miosis
NOT aggravated by exertion

250

What are two provoking factors of a Cluster headache?

Alcohol
Seasonal (Allergy testing)

Headaches usually occur together in "clusters"

251

What age is effected by a Muscular tension headache?

Any age

252

What is the location/site of a Muscular tension headache?

Band like

253

What are three characteristics of a Muscular tension headache?

Pressure
Muscle tightness

254

What are four provoking triggers for a Muscular tension headache?

Fatigue
Tension
Stress
Work

255

What are two other names for Temporal Arteritis?

Giant cell
Polymyalgia Rheumatica

256

What age is usually effected by Temporal Arteritis?

**Over 50**

257

What site/location will you commonly see Giant Cell headaches?

Unilateral
Temporal
*Proximal muscle pain and stiffness*

258

What are the six characteristics of Temporal Arteritis?

Persistent burning
Aching
Throbbing
*Scalp tenderness*
*Pain with combing of the hair*
Pain with chewing (Jaw Claudication)

259

What are the two triggers that provoke Giant Cell headaches?

Scalp sensitivity
Tender arteries

260

What is the follow up with a patient that has Polymyalgia Rheumatica? (3 things)

ESR elevated
Biopsy of arteries
Look at the amount of inflammatory drugs, can cause blindness (Medical Realm)

261

What is another name for a Cervicogenic headache?

Veterbrogenic headache

262

What must be done before you adjust someone with a Veterbrogenic headache?

Flexion and Extension Films

263

What age usually gets Cervicogenic headaches?

Adults

264

What is the two common site/location or a Veterbrogenic headache?

Occipital
Upper cervical
*May have a congenital anomaly*

265

What may provoke a Veterbrogenic headache?

Head movement

266

What are three characteristics of a Cervicogenic headache?

Often daily
Decrease ROM in upper cervicals and occiput
Pain in the neck that refers to the head

267

What are the follow up to Cervicogenic headaches?

Flexion and Extension X-rays
**Adjust, best treatment**

268

What are three characteristics of a Sinus headache?

Steady throb
Localized tenderness
Worse in the morning

269

What provokes a Sinus headache?

Chronic sinusitis

270

Where is a common site of pain for someone who has a Subarachnoid hemorrhage?

Basilar area

271

What are the four characteristics of a Subarachnoid hemorrhage?

Abrupt onset
Constant
Stiff neck
Excruciating pain, pain like never felt before

272

What are the two provoking factors of a Subarachnoid hemorrhage?

Stress
Hypertension

273

What is the follow up to a patient with a Subarachnoid Hemorrhage?

Call 911
High Blood Pressure
Fever

274

What are the two characteristics of a Subdural hematoma?

Slow bleed following and trauma
Evident days to weeks post injury

275

What provokes a Subdural hematoma?

**Trauma/Injury**

276

What is the follow up to a Subdural hematoma?

Send to ER

277

What is the painful site/location of a Brain tumor?

Any place and changes with body position

278

What are the four characteristics or a Brain tumor?

Onset in the morning or evening
Mild to severe pain
Throbbing
Progressively worse

279

What is the follow up to a Brain tumor?

MRI or CT of the brain
Refer to a Neurosurgeon

280

What is the worse time of Meningitis?

Bacterial

281

Where will the pain be for Meningeal Irritation?

Neck

282

What are the four characteristics or Meningeal Irritation?

Intense pain
Deep pain
Stiff neck
Pain that has never been experienced before

283

What action will provoke Meningeal Irritation?

Flexion of the neck

284

What follow up will be done to confirm Meningeal Irritation?

Cerebrospinofluid (CSF) tap

285

What two orthopedic exams will be positive if a patient has Meningeal Irritation?

Brudzinski
Kernig

286

When a CSF tap, is done on a patient with Meningeal Irritation, what will be the findings in Bacterial and Viral Meningitis?

Bacterial- Decrease Sugar

Viral- Increase Protein

287

What can provoke a Hypoglycemic headache?

Skipping meals

288

Who would you refer a patient to that has a Hypoglycemic headache?

Endocrinologist

289

What is the follow up of a patient with a Hypoglycemic headache?

Fasting Blood Sugar (FBS)

290

What are the two characteristics of a Post Concussive injury?

Loss of memory
Visual disturbances

291

What four things could provoke a Post Concussive injury?

Fall
Motor Vehicle Accident (MVA)
Whiplash injury
Trauma

292

What is the follow up for a patient that has a Post Concussive injury?

Refer to Neurologist
ER

293

In what three conditions will you have a Resonant sound on Percussion?

Asthma
Bronchiectasis
Bronchitis

294

In what three conditions would you have a Dull/Flat sound during Percussion?

Atelectasis
Pleurisy
Pneumothorax

295

What two conditions will you have a Hyperresonant sound during Percussion?

Emphysema
Pneumonia

296

What is a common cause of Bronchiectasis?

Post nasal drip

297

What side will the Trachea deviate on a Pneumothorax and Atelectasis on X-ray?

Pneumothorax- Opposite Side

Atelectasis- Same Side

298

What five conditions will you have a Decrease in Fremitus?

Asthma
Atelectasis
Emphysema
Pleurisy
Pneumothorax

299

What condition will you have an Increase in Fremitus?

Pneumonia

300

What two conditions will you have a Normal Fremitus?

Bronchiectasis
Bronchitis

301

What breath sounds are heard with Asthma and Emphysema?

Wheezing

302

What breath sound is heard with Atelectasis?

Absent (Nothing heard)

303

What breath sound is heard with Bronchiectasis?

Rhonchi

304

What breath sound is heard in Bronchitis?

Rales

305

With Pleurisy, what breath sounds are heard?

Crackles (Friction Rub)

306

Are breath sounds increased or decreased with Pneumothorax?

Decreased

307

What breath sounds will be heard in a patient with Pneumonia?

Egophony (EEEE)
Brocholphony (99)
Whispered Pectoriloquy (1,2,3)
Crackles

308

What condition has consolidation of the lung?

Lobar Pneumonia

309

What are the three characteristics of Lobar Pneumonia?

Productive cough for around 10 days
**Rusty Brown Sputum**
Fever

310

What x-ray finding is seen with Lobar Pneumonia?

Silhouette Sign

311

What two populations will have Friedlander's Pneumonia?

Older aged individuals
Immune-compromised

312

What are two characteristics of Friedlander's Pneumonia?

Productive Cough
**Currant Red Jelly Sputum** Caused by Klebsiella Pneumonia

Seen frequently in Alcoholics

313

What is the common cause of Pneumocystis Carinii?

Yeast/Fungus

314

What population is most likely to get Pneumocystis Carinii and Cytomegalovirus?

AIDS patients, opportunistic infection

315

What is the common presentation of a patient with Tuberculosis? (4 Things)

Low grade fever
*Night sweats*
Productive cough
**Yellow/Green Sputum**

316

What X-ray finding are seen with someone with Tuberculosis?

Ghon lesions (small white lesions)

317

What three test will be positive in a patient with Tuberculosis?

Mantoux Test
Tine Test
Purified Protein Derivative

318

What is the most definitive test for Tuberculosis?

Sputum culture

319

What is the name of the condition that has; " stabbing chest pain worsened by respiration, with a dry/non productive cough"?

Pleurisy

320

What are four ways to help determine that a patient has Pleurisy?

Decreased respiration excursion
Deceased tactile fremitus
Dull on Percussion
Friction rub is present

321

What orthopedic exam is positive in a patient with Pleurisy?

Schepelmann's Test

322

What condition is defined as "A ruptured lung causing air to become trapped in the pleural space"?

Pneumothorax

Trachea goes Away

323

What two things will be deceased in Pneumothorax?

Chest expansion
Breath sounds

324

Who can a Pneumothorax happen to?

Young, tall thin, previous healthy male individuals (Spontaneous)

325

How is an Atelectasis described?

Collapse of the lung, usually a result of a Bronchial Obstruction due to a mucous plug

326

What condition is "Irreversible focal bronchial dilation that is present with a chronic, productive cough"?

Bronchiectasis

Diagnosed by: CT

327

What is another name for Chronic Bronchitis?

Chronic Obstructive Pulmonary Disorder (COPD)

328

What is the main cause of COPD?

Cigarette smoking, if the patient is not a smoker, Cigarette Smoke makes it worse

329

In a patient who has Asthma, what is happening in the lungs?

Bronchospasm constricting the airways

330

What triggers Type I hypersensitive Asthma?

Airborne allergens

331

What are two clinical presentations of a patient who has Asthma?

Tachycardia (Increased heart rate)
Tachypnea (Increased breathing)

332

What two microorganisms will increase with an Asthma patient?

IgE
Eosinophils

333

What two lab test are done to confirm Asthma?

**Curshmann's Spirals**
**Charcot Laden Crystals**

(Crystals and spirals in the sputum from IgE)

334

What condition is described as "destruction of elastic pulmonary connective tissue resulting in permanent dilation of the alveoli air sacs"?

Emphysema

335

What is the cause of Emphysema?

Deficiency of Alpha 1 Anti Trypsin

336

What is Bronchogenic Carcinoma?

Primary malignant lung tumor, starts in bronchus of the lung

337

What population is diagnosed with Bronchogenic Carcinoma?

Long term smokers, 20-30 years

338

What are the four common characteristics of Bronchogenic Carcinoma?

Non productive cough for more than 30 days
Afebrile (No fever)
Dyspnea (Difficult breathing)
Weight loss

339

In a patient that has Costochondritis, will there be swelling?

No

340

Where is the pain felt in a patient with Costochondritis?

On the cartilage between the ribs and the sternum (Cartilage is inflamed)

341

What makes Costochondritis worse?

Physical activity, get worse with exercise
Deep breath

342

Where is the most likely place to palpate Costochondritis?

3rd, 4th, 5th costosternal articulation

343

What is another name for Herpes Zoster?

Shingles
Vascular lesion

Must have had chicken pox to have Shingles

344

Where is Herpes Zoster often found?

Painful rash, along a dermatome (Single nerve root)

345

What structures are primarily involved in Shingles?

Dorsal root ganglion
If cranial nerve is involved- Cranial Nerve V

346

What population is Sarcoidosis most commonly seen in?

African Americans in the United States

347

What is Sarcoidosis?

Abnormal collection of inflammatory cells (granulomas) that form an nodule

348

What two locations does Sarcoidosis most commonly appear?

Lungs
Lymph nodes

349

What is a cancer that if from the lymphatic system and can spread to the spleen?

Hodgkin's

350

What population most commonly has Hodgkin's?

Young Caucasian males

351

Is Hodgkin's unilateral or bilateral?

Unilateral

352

What is the best diagnosis for Hodgkin's?

Biopsy

353

What must Hodgkin's have to be termed cancer?

Reed Sternberg Cells

354

What characteristics will a patient present with if they have Hodgkin's?

Fever
Night sweats
Weight loss
Intense pruritus (Release of IgE)
Enlarged spleen

355

What appearance will a Cystic Fibrosis patient have?

Barrel chested, similar to COPD

356

What do the glands of a Cystic Fibrosis patient produce?

Sweat and/or mucus

357

What characteristics will a Cystic Fibrosis patient present with?

Chronic progressive cough
Frequently a fatal genetic disease, of the body's mucus glands

358

What two places does the mucus of a Cystic Fibrosis patient accumulate?

Lungs
Intestine

359

What test can be done on a patient with Cystic Fibrosis?

Sweat test, loss of excessive amounts of salt, Salty Tears

360

What organ is insufficient in a Cystic Fibrosis patient?

Pancreas

Calcium Channel Insufficiencies

361

What side of the heart does Jugular Venous Pulsations measure?

Right

362

When is it possible to have more pronounced Jugular venous pulsations?

When Congestive heart failure (CHF) is present and pressure is applied to the liver (Heptojugular Reflex)

363

What is a "Bounding" peripheral pulse termed?

Pulsus Magnus

364

In what four conditions will you see Pulsus Magnus?

**Increase in Cardiac Output**
Exercise
Anxiety
Fever
Hyperthyroidism

365

How is Pulsus Parvus defined?

Weak or Thready

366

What three conditions would you likely see Pulsus Parvus?

**Decrease in Stroke Volume**
Hypervolemia
Aortic stenosis
Congestive heart failure (CHF)

367

What pulse would be seen in Left ventricular failure?

Pulsus Alternans

368

What peripheral pulse is defined as an "alternates in amplitude"?

Pulsus Alternans

369

What peripheral pulse is described as "two strong systolic peaks separated by mid systolic dip"?

Pulsus Bisferiens

370

What location is Pulsus Bisferiens felt at?

Carotid artery

371

What two valve conditions is Pulsus Bisferiens seen?

Aortic Stenosis
Aortic Regurgitation

372

What is the name of the peripheral pulse that has a "decrease amplitude on inspiration and increased with expiration"?

Pulsus Paradoxus

373

How big of a change does the amplitude need to be for a positive Pulsus Paradoxus?

Greater than 10 mm Hg

374

What four conditions will you see Pulsus Paradoxus?

Chronic Obstructive Pulmonary Disease (COPD)
Bronchial asthma
Emphysema
Pericardial effusion

375

What is the name of the peripheral pulse that is "a jerky pulse that is rapidly increasing and then collapsing because of aortic insufficiency"?

Water hammer pulse

376

What is the clinical term for "vibrations produced by turbulent blood flow within the heart"?

What does this cause?

Term- Thrills

Cause- Murmurs

377

What is it called when the ventricles of the heart contract?

Systole

378

When the ventricles are relaxed and filling this is termed what?

Diastole

379

What causes the S1 heart sound?

Closure or the AV valves (Mitral and Tricuspid)

380

What two valves make up the Atrioventricular valves?

Mitral on the Left
Tricuspid on the Right

381

What to valves make up the Semilunar valves?

Aortic on the Left
Pulmonary on the Right

382

What causes the S2 heart sound?

Closure of the Semilunar valves (Aortic and Pulmonary)

383

The S3 heart sound is called ___________?

Ventricular gallop

384

The S4 heart sound is called ____________?

Atrial gallop

385

In what population is the S3 heart sound heard in?

Normal in:
Children
Young Adults
Athletes

386

If the S3 heart sound is heard in a patient over the age of 40, what may that be an early sign for?

**Congestive heart failure (CHF)**

387

Which heart sound, is "related to stiffness of the ventricular myocardium to rapid filling"?

S4 (Atrial gallop)

388

Atrial gallop is always classified as __________?

Pathological

389

What test is done to evaluate all of the heart valves?

Echocardiogram/Doppler (Ultrasound of the heart)

390

What is the best place to hear the Aortic heart valve?

2nd intercostal space on the right at the sternal boarder

391

What is the best patient position to listen to the Aortic heart valve?

Patient seated, leaning forward and exhaling

392

Where is the Pulmonic valve best heard?

Left sternal boarder at the 2nd intercostal space

393

Erb's point is best heard where?

Left sternal boarder at the 3rd intercostal space

394

What clinical significance does Erb's point have?

Best place to hear murmurs

395

What is the location to place the stethoscope to listen to the Tricuspid valve?

Left sternal boarder at the 5th intercostal space

396

Which valve is best auscultated at the mid-clavicular line on the left at the 5th intercostal space?

Mitral valve

397

What patient position is the best to listen to the Mitral valve?

Left lateral decubitus

398

What sound will a Stenosis make when listening to the heart?

Snapping sound

399

What does Stenosis mean?

The valve does not open all the way

400

What sound does a Regurgitating valve make?

Clicking sound

401

Regurgitation is defined as ____________?

Valve not closing all the way

402

What kind of sound will a Stenosis murmur have?

Low pitch

403

Which side of the stethoscope is used for Stenosis murmurs?

Bell

404

What sound will a Regurgitation murmur make?

High pitch

405

What side of the stethoscope is used when listening to Regurgitation murmurs?

Diaphragm

406

What is the pneumonic used to help with Diastolic murmurs?

ARMS and PRTS
Aortic Pulmonic
Regurgitation Regurgitation
Mitral Tricuspid
Stenosis Stenosis

Opposite in Systolic Murmurs

407

What congenital heart defect is described as "Failure of shunt to close between the aorta and left pulmonary artery"?

Patent Ductus Arteriosus

408

What kind of murmur is produced when a patient has Patent Ductus Arteriosus?

Continuous/Machinery like
Heard in both phases of the heart cycle

409

What is Tetralogy of Fallot?

Congestive heart defect
D-dextapositon/overriding of the aorta
R-right ventricular hypertrophy
I-intraventricular septal defect
P-pulmonic stenosis

**Know exactly what each of these are**

410

When is the murmur of Tetralogy of Fallot heard and what condition may be present?

Murmur- Ejection murmur during Systole
Condition- Severe cyanosis

411

What is it called when there is "constriction of the descending aorta"?

Coarctation of the Aorta

412

Where does Coarctation of the Aorta usually take place?

*Distal* to the left subclavian

413

What happens to the patient's blood pressure if they have Coarctation of the Aorta?

Increased Blood pressure in the upper extremities by 20 mm Hg, when compared to the lower extremity

414

What is the condition called when there is "proximal stenosis of the subclavian artery"?

Subclavian Steal Syndrome

415

In what population do you see Subclavian Steal Syndrome?

Young females who faint (syncope/drop attacks) while exercising

416

What is the most common cause of left sided heart failure in 35-55 year old people?

Hypertension

417

What is the 2nd most common cause of left sided heart failure?

Aortic stenosis

418

What are the three early signs of left sided heart failure?

Pulmonary edema (Fluid in the lungs)
Shortness of breath (Exertional dyspnea)
Orthopnea (Feeling of drowning when laying flat, patient is able to be in a semi recumbent position)

419

Where does the fluid collect first in left sided heart failure?

Costophrenic angles, (Will be blurred/blunted or nonexistent on x ray)

420

What is the most common cause of right sided heart failure?

Left sided heart failure

421

What is the most common cause of Mitral stenosis?

Rheumatic fever

422

What is the definition of Cor Pulmonale?

Right side of the heart fails by itself (LUNG CONDITION that causes right sided heart failure)

423

If there is an increase in the right ventricle what condition is likely to be present?

Chronic Obstructive Pulmonary Disease (COPD)

424

When right sided heart failure occurs, where is the blood back up into?

Superior and Inferior Vena Cava

425

What eight complications does right sided heart failure lead to?

Edema and fluid in the extremities
Jugular vein distension (via Superior vena cava)
Enlargement of liver and Spleen
Positive Heptojugular reflex
Ascites (Fluid in abdomen caused by portal hypertension)
Caput medusa/ Spider angioma
Pitting Edema
Stasis dermatitis

426

Will there be an increase or decrease in heart rate, when a patient has Right sided heart failure?

Increase

427

What heart sound is heard in a patient that has Right sided heart failure?

S3 gallop

428

What will the blood pressure of a patient with Right sided heart failure do, increase or decrease?

Decease

429

What condition is possible if there is bilateral pitting edema?

Hepatomegaly

430

What is "an interruption of the intima allowing blood into the vessel wall with immediate "tearing" pain"?

Aortic Dissection

431

What three conditions are Aortic Dissection associated with?

Hypertension
Arteriosclerosis (Descending Aorta)
Marfan's (Ascending Aorta)

432

How is Marfan's Syndrome defined?

Inherited connective tissue disorder with ventricular weakening and enlargement

433

What is a common patient presentation with Marfan's Syndrome? (4 things)

Tall
Long finger/limbs
Lens subluxation
Cardiovascular and Lung problems

434

What is another name for Angina Pectoris?

Coronary Vasospasm

435

During rest of activity does Angina Pectoris come on?

Exertion (Activity)

436

When does Printzmetal Angina come on?

At rest

437

How is Angina Pectoris relieved?

Vasodilators, under tongue
(Usually nitroglycerin)

438

What may cause a myocardial infarction?

Atherosclerosis

439

What labs will be elevated in a Myocardial infraction?

1. CK-MB
2. LDH
3. SGOT

Lab levels decrease in the opposite order (3,2,1,)

440

What condition is described as "abnormal widening that involves all 3 layers; defect in elastic-media tissues"?

Aneurysm

441

What does the P wave on an ECG indicate?

Atrial depolarization

442

What does the QRS complex represent on the ECG?

Depolarization of the ventricles.
Repolarization of the atria are hidden here

443

The T wave on an ECG, represents ____________?

Repolarization of the ventricles

444

Which wave on the ECG represents repolarization of the papillary muscles?

U wave

445

What does an increased PR interval indicate?

Prolonged AV nodal delay (Primary heart block)

446

If there is two P waves on and ECG before the QRS complex, this is indicative of what?

Weinkbochs- Block at the bundle of HIS (2nd Heart Block)

447

If there is complete heart block, no ventricular contraction what part of the ECG will not be seen?

QRS pattern

448

If the ST segment of an ECG is either enlarged or inverted what does that mean?

Myocardial Infraction (Acute heart failure)

449

What wave will be absent in a Myocardial Infarct?

Q wave

450

If not P wave is present what condition is present?

Atrial Fibrillation

451

What is the proper order to perform an abdominal exam?

Inspection
Auscultation
Percussion
Light Palpation
Deep Palpation

452

When there is a an early intestinal obstruction, what happens to the bowel sounds?

Increase in bowel sounds (Car Accident Analogy)

453

There is a decrease or absent in bowel sounds when?

Late intestinal obstruction

454

With a late intestinal obstruction what may be present?

Adynamic (paralytic) ileus

455

What is the clinical term for "vomiting up blood"?

Hematemesis

456

What does the term Hemoptysis mean?

Coughing up blood

457

Blood in the stool is called ______________?

Hematochesia

458

What test is best for testing the liver?

Alkaline Phosphatase

459

What test is best for seeing if a patient is an alcoholic?

Gamma-Glutamyl Transpeptidase (GGT)

(Gotta Get Tanked)

460

What lab is done to test Liver and Kidney?

Blood Urea Nitrogen (BUN)

461

What will the BUN test do for each Liver and Kidney?

Liver- Decrease

Kidney- Increase

462

What is another word for Jaundice?

Icterus

463

What condition is classically described as "yellowing of the skin, sclera and mucus membranes"?

Jaundice (Can occur in any liver disorder)

464

What is the most common destruction of the liver?

Alcoholism

465

What three things can Cirrhosis of the liver cause?

Portal hypertension
Ascites
Esophageal varices

466

If an alcoholic has, coughing, tearing of the esophageal blood vessels and hematemesis, with a rash on the palmer surface due to bile salts, what condition do they have?

Mallory-Weiss Syndrome

467

What syndrome is described as a "Thiamin deficiency form alcoholism that leads to dementia"?

Wernicke Korsakoff Syndrome

468

What is Beri Beri Syndrome?

Thiamin deficiency without alcoholism

469

What is the name of the disease when "liver may be tender and enlarged but the edge remains soft and smooth"?

Hepatitis

470

How does one contract Hepatitis A?

From food through oral/fecal route

Self limiting and NOT a carrier

471

Which type of Hepatitis is obtained via blood transfusions?

Hepatitis C

472

This type of Hepatitis is most common to become liver cancer?

Hepatitis B

473

What are two ways someone get Hepatitis B?

Dirty needles
Sexual contact

474

Which type of Hepatitis is a carrier for life and has to do with both blood and venereal diseases?

Hepatitis B

475

What kind of cancer is the most common site for metastatic disease?

Liver Cancer

476

What are two common findings of liver cancer?

Enlarged liver
Hard and irregular boarder

477

What is a specific marker for Hepatocellular Carcinoma?

Alpha fetoprotein (Liver Cancer)

478

Is Direct/Conjugated bilirubin water soluble?

Yes

479

Under what three conditions will there be in increase in Conjugated bilirubin?

Duct obstruction **(Gallstones)**
Hepatic disease
Pancreatic cancer

480

If there is an increase in the amount of direct bilirubin in the blood, it may go to the urine, what is it called?

Urobilinogen

481

Which type of bilirubin is not water soluble; Direct (Conjugated) or Indirect (Unconjugated)?

Indirect (Unconjugated) Pre-hepatic

Sickle Cell Anemia, Rh- condition

482

What are three conditions that will have an increase in Indirect bilirubin?

Hemolytic disease
Drugs
Spleen disorders

483

An increase in reticulocyte count is called_________?

Hemolytic Anemia

484

Is Hemolytic anemia pre or post hepatic?

Pre-Hepatic

485

What is the name of the test to determine Hemolytic Anemia?

Coomb's Test

486

Where is the two pain points of referral for a gallbladder issue?

Right shoulder
Tip of the right scapula

487

What is the classification of Gallbladder pain to the shoulder region?

Viscerosomatic
Grey Poop

488

What is the most common population of patient to have Cholecystitis?

Females over the age of 40
(Female, Forty, Fertile, Fatty Fast Food, Fatty Stool, Flatulence)

489

If a patient has Cholecystitis what are the four characteristics they will present with?

Severe right upper quadrant pain
Nausea
Vomiting
After eating a large fatty meal

490

What is Murphy's Sign?

Inspiration Arrest Sign

491

Who would you refer a patient with Cholecystitis to?

Gastroenterologist

492

Which two test would be ordered to confirm Cholecystitis?

Diagnostic ultrasound
Oral Cholecystogram (Swallow Contrast Medium)

493

What condition is defined as "Calcification that can become malignant due to chronic inflammation"?

Porcelain Gallbladder

494

What is the location of epigastric pain?

Straight through the T10-T12 area like a knife

495

In what condition would you see chronic pancreatitis?

Alcoholism

496

What is the approach to be carried out for acute pancreatitis?

Call 911 Emergency

497

What is a positive Grey Turner sign?

Bleeding of the flanks

498

What "Sign" is present with "Periumbilical ecchymosis caused by intraperitoneal hemorrhage or seen with a ruptured ectopic pregnancy"?

Cullen's Sign

499

What two lab values will be increased with Pancreatitis?

Amylase
Lipase

500

What part of the pancreas is usually effected with cancer?

Head of the Pancreas

501

What are three signs, that a patient has pancreatic cancer?

Dark urine
Clay colored stool
**Jaundice**

502

What condition is being described in the following: "condition in which the pancreas does not produce a sufficient amount of **insulin** to take the sugar out of the blood and transport it to the tissues of the body"?

Diabetes Mellitus

503

If the tissues of the body do not have enough insulin to work, what will they breakdown to obtain energy?

Fats

504

What are the classic three signs of Diabetes Mellitus?

Polydipsia (Increase in Thirst)
Polyphagia (Increase in Hungry)
Polyuria (Increase in Urination)

505

What lab would you order for a screening of Diabetes Mellitus?

Fasting Blood Sugar (FBS)

506

What three labs would you order to help confirm Diabetes Mellitus?

Glucose Tolerance Test (GTT)
Fasting Plasma Glucose (FPG)
HbA1C (Glycosylated Hemoglobin)

507

In what population do you usually see Type 1 or Insulin Dependent diabetes?

Juvenile, under 30, usually thin

508

What population is often associated with Type II or Non-Insulin Dependent diabetes?

Adult, over 40, usually obese

Diet choice and lack of exercise, is what causes this!!

509

In the condition of Diabetes Insipidus, what structure is not functioning properly and what hormone is being decreased?

Structure- **Posterior Pituitary Gland**

Hormone- Insufficient Anti-diuretic hormone (ADH) AKA Vasopressin

510

What sign will NOT show up in Diabetes Insipidus?

Polyphagia (Increase in Hungry)

511

What is another name for Diffuse Idiopathic Skeletal Hyperostosis? (DISH)

Forestier's disease

512

When you see Forestier's Disease, what is a common condition that goes along with it?

Diabetes, do a Fasting Blood Sugar (FBS) and/or Glucose Tolerance Test (GTT)

513

What condition should be suspected if you see an air bubble around the diaphragm on an X-ray?

Hiatal hernia

514

What is a Hiatal hernia?

Protrusion of the stomach above the diaphragm

515

In a patient that has a hiatal hernia, what are six signs they have this condition?

Tenderness in Left Upper Quadrant
Reflux esophagitis (Acid Reflux)
Dyspepsia (Indigestion)
Pain worse when lying down
Pain worse after eating a large meal
Difficulty Breathing

516

Barrett's esophagus is a precursor to what?

Esophageal cancer

517

What condition is caused by a sliding Hiatal hernia?

Reflux Esophagitis

518

What four things make Reflux Esophagitis worse?

Lying down
Eating a large meal
Valsava's Maneuver
Bearing down

519

What two special test would you order to confirm Reflux Esophagitis?

X-ray
Upper GI series

520

What two categories are included in peptic ulcers?

Gastric (Stomach)
Duodenal

521

What is the causative agent for Peptic ulcers?

H. Pylori bacteria

522

Why is pain in Peptic ulcers, "pinpoint pain"?

Hydrochloric acid is burning a hole in the epigastric region

523

What is the appearance of vomit from a patient with a Peptic ulcer?

Coffee ground appearance

524

Does gastric ulcers have a consistent pain pattern?

No

525

What is the unique thing about Gastric ulcers?

Pain is decreased by eating
Pain comes on right after eating

526

What is the most common type of peptic ulcers?

Duodenal

527

When does the pain of a duodenal ulcer occur?

Two hours after eating

528

What kind of stool is found in a patient that has a duodenal ulcer?

Black/tarry stool

529

What is the confirmatory test done, looking for occult blood in the stool, common in patients with duodenal ulcers?

Guaiac test

530

What condition is seen often in males and first time mothers and described as "projectile vomiting in a newborn"?

Pyloric Stenosis

String Sign on x-ray: palpable node in the epigastric area

531

What location of the stomach is the most common for gastric carcinoma?

Lesser curvature

532

What is it called when the **left supraclavicular lymph node** is involved?

Virchow's node

533

What is the most common cause of Mononucleosis?

Epstein Barr Virus

534

What age is most likely to have Mononucleosis?

Young adults (18-25)

535

What is the name of the atypical lymphocytes found in the blood of patients with Mononucleosis?

Downey Cells

536

What are the symptoms of Mononucleosis? (5 symptoms)

Similar to the flu
Fever
Headache
Fatigue
Splenomegaly
Lymphadenopathy in cervical region

537

What condition is called "Marble Bone"?

Osteopetrosis

538

What two organs become enlarged in Osteopetrosis?

Liver
Spleen

539

Where is the referral pain of the small intestine to?

Periumbilical region

540

What is another name for Regional Ileitis?

Crohn's Disease

541

Where is Crohn's disease located?

Right side of the intestine

542

What disease is described as a nonspecific inflammatory disorder that affects the distal ileum and colon?

Regional Ileitis

543

Patient's that have Crohn's disease, will have what three symptoms?

Pain in Right Lower Quadrant (RLQ)
Chronic diarrhea (Usually bloody)
Cobblestone appearance on Sigmoidoscopy

544

Regional Ileitis leads to malabsorption of what vitamin?

B 12

545

How is Crohn's disease confirmed? What is a finding on the test?

Sigmoidoscopy, Skip lesions will be present

546

What can cause Regional Ileitis?

Non-Tropical Sprue/Celiac Sprue (Gluten Allergy)

547

Where is Ulcerative Colitis located?

Left side of the intestine

548

In what two parts of the intestine is Ulcerative Colitis most commonly found?

Colon
Rectum

549

What is the major indicator of Ulcerative Colitis?

Bloody Diarrhea

550

How is Ulcerative Colitis diagnosed?

Sigmoidoscopy

551

What is another name for Irritable Bowel Syndrome?

Spastic Colon

552

What disorder has "variable degrees of constipation and diarrhea in response to stress"?

Irritable Bowel Syndrome

553

What gender more commonly has Spastic Colon?

Females

554

What age, gender,symptom is it common to see Diverticulitis?

Over the age of 50, Female with a Fever

555

What causes someone to get Diverticulitis?

Inadequate fiber in the diet

556

What condition is described as "Chronic constipation which causes small out pouchings within the colon that become infected?

Diverticulitis

557

Where is the pain in a patient that has Diverticulitis

Lower Left Quadrant (LLQ)

558

What is Meckel's Diverticulitis?

Out pouching of the Ilium

559

If a patient has an appendicitis, where should they be referred to?

ER

560

What special test can be done, to confirm and Appendicitis?

CT

561

What four (orthopedic) tests will be positive in a patient that has an Appendicitis?

Rebound Tenderness (Peritonitis)
Rovsing's Sign
Psoas Sign
Obturator Sign

562

What is the name of the test that is done to diagnosis an Appendicitis and what does it indicated?

Test name- **Shilling Shift**
Indicates- Increase in White Blood Cells (WBC)

563

What four symptoms will a patient with an appendicitis present with?

Fever
Nausea
Vomiting
Anorexia

564

Where will the pain be present at in a patient's abdominal region if they have an appendicitis?

Dull Periumbilical region or epigastric pain that radiates to the lower right quadrant (LRQ) (McBurney's Point)

565

What are the six characteristics of Cushing's Disease?

Moon face/ "pie face"
Buffalo hump
Pendulous abdomen with purple striae
Hirsuitsm (Male hair growth pattern usually on women)
Weakness
Hypertension

566

What causes Addison's Disease?

Decrease in aldosterone

567

What are the two cause of Cushing's Disease?

Increase production of adrenal cortex hormone
Long standing Cortical Steroid use

568

What are two other names for Cushing's Disease?

Hyperadrenalism
Hypercortisolism

569

What are two other names for Addison's Disease?

Hypoadreanalism
Hypocortisolism

570

In increase in what hormone will cause melanin deposition in a person with Addison's Disease?

Adrenocorticotropic Hormone (ACTH)

571

What eight signs/symptoms will a person with Addison's Disease present with?

*Decreased blood pressure*
Thin
Weakness
Fatigue
Lethargy
Nausea
Vomiting
Hair loss

572

What is it called when there is a tumor or the Adrenal Medulla?

Pheochromocytoma
Grey Cell Tumor

573

If a person has an increase in ACTH, (Addison's Disease)where will the hyperpigmentation show up?

Mouth
Face

574

In the condition of Pheochromocytoma what is increased?

Catecholamine
(Epinephrine and Norepinephrine)

575

What condition has a similar appearance to hyperthyroidism?

Pheochromocytoma

576

What is the name of the condition that produces EXTREME hypertension?

Pheochromocytoma

Diastolic number if over 100

577

What would you refer a patient that you think has a Pheochromocytoma?

ER (Medical Emergency)

578

What condition is has an increase of calcium made in the body?

Nephrolithiasis

579

What are the three "things" made of calcium in the condition of Nephrolithiasis?

Calcium oxalates (Most Common)
Calcium urates
Calcium phosphates

580

Where will the pain be located in a patient with Nephrolithiasis?

Flank pain described as writhing

581

What orthopedic test will be positive in a patient with Nephrolithiasis?

Murphy's Test (Kidney Punch)

582

What four test will be increased in a patient with Nephrolithiasis?

Blood Urea Nitrogen (BUN)
Uric acid
Creatinine clearance
Kidney, Ureter, Bladder (KUB) study

583

What is the most specific test for Nephrolithiasis?

Creatinine clearance

584

What is always one positive finding in Nephrolithiasis?

Blood will be found in the urine

585

What can Hydronephrosis cause?

Staghorn calculi

586

In a patient with Nephrolithiasis, if they take in Vitamin C what will that lead to?

Increase in kidney stones

587

What is another name for Acute Glomerulonephritis?

Nephritic Syndrome

588

What causes Acute Glomerulonephritis?

Group A hemolytic strep, will have a Positive ASO Titer test

589

What are the findings in Nephritic syndrome?

Red blood cells (RBC) cast in the urine with small amount of protein

590

What are the three classic signs in Nephrotic syndrome?

HEP

Hypertension
Edema
Proteinuria (Massive)

591

What is Nephrotic syndrome in a pregnant woman called?

Pre-eclampsia

592

What is the definition of Eclampsia?

Nephritic syndrome with convulsions during pregnancy

593

What kind of cast are found in the urine in a patient that has Nephrotic syndrome?

Waxy or fatty

594

How does someone get Polynephritis?

E-coli infection for a Urinary Tract Infection (UTI)

595

In the condition of Polynephritis what kind of cast will be found in the urine?

White Blood Cell (WBC) cast

596

What condition is described as "Inherited disorder with many bilateral renal cysts that increase renal size but reduce function of the renal tissue"?

Polycystic Kidney Disease

597

What three findings will be present in a person who has a Renal Carcinoma?

Bleeding
Flank pain
Enlarged mass

598

What is found in the urine of a person with Urethritis?

Nitrites

599

What is the most common cause of Urethritis in females?

E. Coli

600

What are the two diagnosis of Urethritis?

What causes each classification?

Gonococcal (Caused by Gonorrhea) More often seen in Males

Non-Gonococcal (Caused by Chlamydia)

601

What two areas will the patient with Cystitis have pain?

Suprapubic
Low back pain

602

How is Cystitis defined?

Noninfectious bladder inflammation
Urination will be:
Burning
Pain (During and after urination)
Frequent urination with incontinence

603

What is another name for a Wilm's tumor?

Nephroblastoma

604

What condition is seen in a younger person, with abdominal mass and hematuria?

Nephroblastoma

605

What is a Nephroblastoma?

Malignant tumor of the kidney

606

What is the clinical term for an "Overactive Bladder"?

**Urinary Incontinence**; Neurological Problem

607

What is the most common cause of Urinary Incontinence?

Stress

608

How is Stress Incontinence define?

Increase in Abdominal pressure
i.e.: Exercise, Cough, Sneeze, Laugh

609

What causes Urinary Incontinence?

Weakness in the pelvic floor muscles

610

What exercises may be given to a patient with an Overactive Bladder?

Kegal Exercises

611

What type of urinary incontinence has "the inability to completely empty your bladder when you urinate"?

Overflow

612

What is a common result of an Overflow bladder? (Urinary Incontinence)

Constant flow
Frequent dribble

613

What is a condition that is common in people with an Overflowing bladder?

Prostate Enlargement

614

What type of urinary incontinence is most commonly seen in "older adults with arthritis, Parkinson's and Alzheimer's"?

Functional

615

What is the most common type of hernia?

What is the location of this type of hernia?

Indirect Inguinal Hernia

Location-Lateral and Inferior to the Epigastric Vessels

616

What population do you see Indirect Inguinal hernias in?

Children and young adults

617

How is an Indirect Inguinal Hernia described?

Passes down the inguinal canal and exits the external inguinal ring and into the scrotum

618

Where does a Direct Inguinal hernia exit from?

What is the Location of a Direct Inguinal Hernia?

External inguinal ring, does not pass through the inguinal canal

Location-Medial and Inferior to the Epigastric Vessels

619

What two things usually cause a Direct Inguinal hernia?

Obesity
Heavy lifting

620

During what two times is a Direct Inguinal hernia often felt?

When the patient:
Coughs
Bears down

621

What age is a Direct Inguinal hernia often seen?

Older, over the age of 40

622

Where is a Femoral Hernia found?

Bulge lateral and inferior to the external inguinal ring at the site of the femoral pulse

623

Is a femoral hernia, classified as a inguinal hernia?

No

624

What condition is "Abnormal endometrial tissue found outside of it's normal location"?

Endometriosis

625

Where is endometriosis most commonly found?

Ovaries

626

What are five signs of Endometriosis?

Abdominal pain
Back pain
Severe menorrhagia
Painful intercourse (Dyspareunia)
Possible infertility

627

What is the most common reason for a hysterectomy?

Uterine fibroids

628

What condition is described as "Benign uterine tumor of smooth muscle origin"?

Uterine fibroids

629

What are three symptoms present with Uterine Fibroids?

Heavy menstrual bleeding
Pelvic pain
Painful intercourse

630

How will the uterus feel in a patient with Uterine Fibroids?

Painless nodules that are irregular and firm

631

What condition is an "infection of the upper female genital tract"?

Pelvic Inflammatory Disease

632

Which two STD's are the most common cause of Pelvic Inflammatory Disease?

Gonorrhea
Chlamydia

633

What other condition is often seen with Pelvic Inflammatory Disease?

Salpingitis (Inflammation of the fallopian tubes)

634

What condition is described as a "pregnancy in which implantation has happened outside of the endometrial cavity"?

Ectopic pregnancy

635

What three signs will be present is a patient with an Ectopic pregnancy?

Spotting
Decreased blood pressure
Decrease in Human Chorionic Gonadotropin (HCG)

636

What is the common cause for the first and second reason for an Ectopic Pregnancy?

First- Prior Gonococcal infection

Second- Intrauterine Device (IUD)

637

What are four common finding in normal pregnancy?

Increase in Human Chorionic Gonadotropin (HCG)
Nausea
Weight gain
Breast tenderness

638

What condition will have a very high level of Human Chorionic Gonadotropin (HCG)?

Hydatiform Mole

639

What is the condition that is described as "A non-viable embryo which develops in the placenta and presents with all the signs of pregnancy"?

Hydatiform Mole

640

What is the name of the condition that is "A malignancy of the placenta due to abnormal epithelium"?

Choriocarcinoma

641

What condition is found in young women, that have *Multiple*, round, freely movable masses that can be palpated?

Fibrocystic Breast Disease

Lumpy Bumpy Breast around menses

642

What make Fibrocystic Breast Disease worse?

Caffeine
Ovulation
Menses

643

In what population is Fibrocystic Breast Disease commonly seen in?

Overweight Diabetics

644

What is the most common benign breast tumor?

Fibroadenoma

645

What age is Fibroadenoma usually seen in?

Less than 30

646

What are three things to know about Fibroadenoma?

Non tender
*Singular lesion*
Unilateral 75% of the time

647

What is the 2nd most common cause of death in women?

Breast cancer

648

What is the most common location of breast cancer?

Upper/outer quadrant (Axillary area, tail of Spence)

649

What are the four common findings associated with breast cancer?

Nipple retraction
Dimpling (Paget's Disease of the breast)
Bleeding
Orange peel appearance

650

Where will breast cancer metastasis to?

What kind of appearance does breast cancer have on bone?

Metastasis- Axilla via lymphatic system

Appearance- Lytic (Metastases from the Lymph vessels)

651

What is it called when there is "Tortuous dilation of the spermatic veins"?

Varicocele

652

When will the pain from Varicocele diminish?

Standing
Supine

653

What is a common name for Varicocele?

**"Bag of Worms"**

654

What condition is "A fluid filled mass in the epididymis"?

Spermatocele

655

Is a Spermatocele and Hydrocele transiluminatable?

Yes, it's fluid filled

656

Where is a Spermatocele located?

Superior and posterior to the testicle

657

What are three characteristics of a Spermatocele?

Painless
Moveable
Pea sized lump

658

What is a Hydrocele?

Excessive accumulation of water in the testicles

659

What are four characteristics of a Hydrocele?

Swollen
Painless
Heavy
Tight scrotum

660

How is a Hydrocele able to be distinguished from a scrotal hernia?

Being able to palpate about the mass, indicates its a Hydrocele

661

How does a patient get Epididymitis?

Consequence of an STD

662

What is a positive finding of a Epididymitis?

Enlarged tender scrotum

663

What is the most common type of cancer found in men aged 20-34?

Testicular cancer

664

What is the most common type of testicular cancer?

Seminoma

665

Is testicular painful and/or transiluminatable?

No

666

What condition is "Enlarged, Non tender, Firm, Smooth, and has not Median Sulcus"?

Benign Prostatic Hyperplasia

667

What condition happens in younger men from the venereal disease of Gonorrhea?

Prostatitis

668

What are the four characteristics of Prostatitis?

Boggy
Soft
Enlarged
Tender; Painful

669

What is one complication of Prostatitis?

Urinary problems, increased urgency

670

What does Prostatic Carcinoma almost always look like/be associated with on x-ray?

Blastic Mets- Blood

671

Where is the most common place for Prostatic Carcinoma to metastasize to?

Lumbar spine via Batson's plexus

672

What are the finding of Prostatic Carcinoma?

Hard Posterior lobe
Nodular
Painless
Enlarged

673

What is the skin temperature in an arterial problem?

Cool

674

What color is the skin in an arterial issue?

Pale or Blue

675

What kind of pulse is found in a patient that has an arterial issue?

Weak or absent

676

What two things will be present in a patient with an arterial problem?

Numbness
Raynaud's Phenomenon

677

Is there swelling in an arterial issue?

Not usually

678

Will and venous or arterial issue have thin/shiny skin?

Arterial (Think about wrapping a rubber band around your finger, for all Arterial signs and symptoms)

679

What is the skin temperature of a patient with a venous problem?

Warm

(Venous problem, think of a Deep Vein Thrombosis (DVT) in the femoral vein)

680

In a patient that has a venous issue what two categories will be Normal?

Skin color
Pulse

681

Will numbness and Raynaud's Phenomenon be absent or present in a patient with a venous issue?

Absent

682

If a patient has a venous issue what two things will be present?

Swelling
Valve incompetence

683

What kind of tropic changes would you expect to see in a venous issue?

Stasis Dermatitis

684

What type of claudication is predictable?

Vascular

685

In what position would a patient with Neurogenic claudication find relief?

Flexed, this is a position related condition

686

What type of claudication always has relief at rest?

Vascular

687

What are three common cause of Neurogenic Claudication?

DJD- thin disc, overriding of the facets
Spinal Canal stenosis

688

What two causes will lead to Vascular Claudication?

Arteriosclerosis
Buerger's

Stoop Test- will decrease pain (Flexed Position)

689

How is the claudication test performed?

Patient walks at a rate of 120 steps/min for 1 minute

690

What is a positive finding for the claudication test?

Pain in the claves

691

What does the Bicycle test confirm?

Pain in the calves, vascular Claudication

692

What is another name for Buerger's?

Thromboangitis Obliterans

693

How do you test for Buerger's?

Claudication time

694

What is the population that is usually effected with Thromboangitis Obliterans?

Males 20-40 years old
**Excessive tobacco/smoking use**

695

What three other symptoms is Buerger's associated with?

Intermittent vascular claudication
Non-healing ulcers
Gangrene (Amputation)

696

What two populations and what age are often seen with Varicose veins?

Population:
Pregnant women
Overweight adults

**Age: Older than 20 years old**

697

What three symptoms are present with Deep Vein Thrombosis?

Tenderness
Edema
Pain

698

What orthopedic test is done to diagnosis Deep Vein Thrombosis?

Homan's test

699

How is Homan's test performed?

Patient is supine with leg extended while the doctor raises the leg off the table to a 45 degree angle, dorsiflex the foot and squeeze the calf

700

What is a positive finding to Homan's test?

Pain in the calf

701

What labs can be ordered to help diagnosis Deep Vein Thrombosis?

D-Dimer
Complete Blood Count (CBC), Thrombocyte count

702

Who often has Raynaud's?

Females

703

What three other conditions are seen with Raynaud's?

Buerger's
Collagen Disease
Scleroderma

704

What are three triggers of Raynaud's Phenomena?

Cold
Stress
Emotion

705

What orthopedic exam can be done to diagnosis Raynaud's/

Allen's Test

706

What five other signs are present with Raynaud's?

Arterial spasms
**Triphasic color changes (White, Blue, Red)**
Finger tip ulcers
Cold sensitivity
Gangrene

707

What is the clinical term for a pinpoint hemorrhage?

Petechia

708

What condition is described as "Blockage of an artery in the lung by a substance that has come from somewhere else in the body via the bloodstream"?

Pulmonary Embolism

709

What is the main cause of a Pulmonary Embolism?

Thrombus (blood clot) from the veins of the legs

710

What are the three symptoms often associated with a Pulmonary Embolism?

Difficulty breathing
Chest pain on inspiration
Palpitations

711

What are two increased risk of someone with Pulmonary Embolism?

Flying
Prolonged bed rest

**(Both will lead to Deep Vein Thrombosis (DVT))

712

What condition is described as "small superficial dilated blood vessels"?

Telangiectasia

713

What is the common location of Telangiectasia?

Around the:
Nose
Cheeks
Chin

714

What are the two other names for Reflex Sympathetic Dystrophy?

Complex Regional Pain Syndrome
Sudeck's Atrophy

715

What is the treatment for Reflex Sympathetic Dystrophy?

Sympathetic nerve block
Tens Unit

716

What are the typical associated findings with Sudeck's atrophy?

-Dramatic changes in skin color and temperature in the affected area
-Intense burning
-Skin sensitivity
-Swelling
-Sweating (Excessive sweating; Hyperhidrosis)
-Hypertrichosis (excessive hair growth)

717

What condition is "a chronic pain condition, with continuous intense pain out of proportion to the severity of the injury, which gets worse rather than better over time"?

Complex Regional Pain Syndrome

718

What does an increase in Red Blood cell indicate?

1: Polycythemia Vera
2: High altitude

719

A decrease in what three hematology categories will indicate Anemia?

Red blood cells
Hemoglobin
Hematocrit

720

What two things does an increase in Hemoglobin and Hematocrit indicate?

Dehydration: loss of blood fluid volume
Polycythemia Vera

721

What type of Anemia is present if there is an increase in:
Mean Corpuscular Volume (MCV)
Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hemoglobin Concentration (MCHC)

Macrocytic Anemia (>100)

722

What would cause a patient to have Microcytic Anemia?

A decrease in anyone of the following: (

723

What three conditions will have an increase in Platelets Thrombocytes?

Polycythemia
Trauma
Blood loss

724

What three conditions can a decrease in Platelets Thrombocytes be seen in?

Anemia Extensive
Burns
Thrombocytopenia

725

What is the of number Leukocytes that must be seen in a person to be diagnosed as Leukemia?

Over 50,000

726

What three conditions will have an increase in White Blood Cells (WBC)?

Acute Infection
Inflammation
Leukemia

727

What two conditions will see a decrease in White Blood Cells (WBC)?

Overwhelming infections
Viral conditions

728

What are the five different categories of White Blood Cells (WBC) and there associated percentages?

Neutrophils-60%
Lymphocytes-30%
Monocytes-8%
Eosinophils-3%
Basophils-0%

Never
Let
My
Engine
Blow

60,30,8,3,0

729

What does an increase in Neutrophils indicate?

Bacterial Infection

730

In increase in what White Blood Cell (WBC) category would indicate a viral infection?

Lymphocytes

731

What does and increase in Monocytes indicate?

Chronic inflammation

732

An increase in Eosinophils means what?

Allergies
Parasites

733

What is the radiographic finding of a Sickle Cell Anemia patient?

H-shaped vertebrae

734

What population makes up about 10% of those with Sickle Cell?

African American

735

What is another name for Thalassemia?

Mediterranean Anemia

736

What two conditions are present with Thalassemia?

Microcytic anemia
Target cells

737

What is the cause of Erythroblastosis Fetalis?

Rh+ Father and Baby
Rh- Mother

738

What is the most common Megaloblastic Anemia?

Macrocytic Normochromic

739

In what type of Megaloblastic Anemia will be seen in chronic alcoholics, pregnancy and malabsorption?

B9/Folic Acid

740

What type of Anemia is seen in "Lack of intrinsic factor due to chronic atrophic gastric mucosa causing loss of parietal cell"?

B12/Cyanocobalamin
Pernicious Anemia

(Unconjugated, Indirect bilirubin= Pre-Hepatic (All have Prefixes)--> Decrease in B Vitamins

741

What test is done for the diagnosis of Pernicious anemia?

Schilling test (24 hour urine)

742

What is the treatment for Pernicious Anemia?

B12 Shots

743

What can prolonged Pernicious Anemia lead to and what is it's AKA?

Posterolateral Sclerosis (PLS)

AKA- Combined systems disease

744

Iron Deficiency anemia is what kind of anemia?

Hypochromic Microcytic (Too Tiny)

745

Who often is seen with having Hypochromic Microcytic anemia?

Chronic blood loss
Pregnancy

746

In Iron Deficiency Anemia where is blood often found?

Occult blood in the stool

747

What type of anemia is Aplastic Anemia?

Normochromic Normocytic

748

What nine populations are seen to have Normochromic Normocytic Anemia?

*Drug users*
*Chemotherapy*
*Radiation*
Multiple Myeloma
Rheumatoid Arthritis
Leukopenia
Acute Blood Loss
Benzene poisoning
Thrombocytopenia

749

What two things does red urine indicate?

Blood (Infections or Cancer)
Food pigments

750

What are three things green urine indicate?

Biliary duct obstruction
Pseudomonas Infection
Bad protein digestion

751

What are three problems if a patients urine is Blue?

Diuretic Therapy
Pseudomonas infection
Bad protein digestion

752

What are the indications associated with Brown urine?

Bile Pigments
Blood
Biliary duct obstruction
Occult blood
Homogentisic acid

753

What does black urine indicate?

Homogentisic Acid
Urobilin
Ochronosis (Accumulation of Homogentisic Acid)
Hemolysis
Bacteria

754

What six things can cause the appearance of urine to be hazy/cloudy?

Epithelial Cells
White Blood Cells (WBC)
Red Blood Cells (RBC)
Crystals
Sperm
Microorganisms

755

What two things will give urine a Milky appearance?

Fat
White Blood Cells (WBC)

756

What three things can cause an increase in Specific Gravity of urine?

Bacterial infections
Diabetes Mellitus
Kidney Abnormalities

757

What five conditions will be seen if there is an increase in **glucose** in the urine?

Diabetes Mellitus
Shock
Head injury
Pancreatic disease
Renal tubular disease

758

An increase in ________ in the urine will indicate the following:
Starvation
Diabetes Mellitus
Weight loss diets
Inadequate Carbohydrate intake

**Ketones**

759

What four conditions are seen with and increase in **protein** in the urine?

Kidney disorder
Toxemia of Pregnancy
Diabetes Mellitus
Multiple Myeloma

760

What does and increase in Urobilinogen indicate? (Two things)

Hemolytic Disease
Hepatic Disease

761

What does and increase in Urobilinogen indicate?

Biliary Obstruction

762

What two conditions are indicated with an increase in Bilirubin in the urine?

Hepatic Disease
Biliary Obstruction

763

An increase of blood in the urine can indicate ____________? (6 Things)

Tumor
Trauma
Kidney Infection
Kidney Stone
Hypertension
Bleeding Disorder

764

What is the clinical term for Red Blood Cell Cast?

Glomerulonephritis

(Know what all Cast means for Boards)

765

What is the clinically term for White Blood Cell Cast?

Pyelonephritis

766

What does a waxy cast indicate? (Two things)

Renal failure
Nephritis

767

What does and Increase on the Acid Phosphatase (PAP) indicate?

Prostatic Carcinoma

768

What does a reversed *Albumin/Globulin (A/G) Ratio* indicate?

Multiple Myeloma

769

What three things does an increase in *Alkaline Phosphatase* indicate?

Osteoblastic lesions
Hepatic Disease
Hyperparathyroidism

770

What does an increase in the Amylase test indicate?

Acute Pancreatitis

771

What does the *ANA (FANA*) test indicate?

Collagen diseases
i.e. Systemic Lupus Erythematous
Scleroderma

772

What is the spelt out name of *ASO-Titer*?

Antistreptolysin-O

773

What two conditions have an increase in **ASO-Titer**?

Rheumatic Fever
Acute Glomerulonephritis

774

What does an increase in direct *bilirubin* indicate? (Two things)

Hepatitis
Duct obstruction

775

What does an increase in indirect *bilirubin* indicate?

Hemolytic Disease

776

What does an increase in Blood Urea Nitrogen (BUN) indicate? (Four things)

Renal disease
Dehydration
Hypotension
Urinary tract infection

777

What two indications does a decrease in Blood Urea Nitrogen (BUN) have?

Hepatic disease
Pregnancy

778

What four conditions have an increase in Calcium?

Muscle weakness
Hyperparathyroidism
Hypervitaminosis D
Metastatic Disease

779

What four conditions does an decrease in Calcium indicate?

Muscle tetany
**Chvostck's Sign; Hypocalcaemia (tap facial nerve, mastication muscle contracts)**
Renal Failure
Malnutrition

780

What does CK BB indicate?

Brain tissue

781

What does CK MB indicate?

Myocardial Tissue

782

What does CK MM indicate?

Skeletal Muscle

783

What does and increase in Creatine Phosphokinase (CPK) indicate?

Muscle Necrosis

784

What is the best test for the kidney?

Creatinine

785

What two conditions are indicated by in increase in Creatinine?

Kidney disease
Hypovolemic Shock

786

What does a decrease in Creatinine indicate?

Muscular Dystrophies

787

An increase in C-Reactive Protein indicates what three conditions?

Tissue necrosis
Infections
Rheumatoid Arthritis

(This test is more Sensitive than Erythrocyte Sedimentation Rate (ESR))

788

What is the name of the Screening test for AIDS?

ELISA

789

What two conditions are indicated by a decrease in Erythrocyte Sedimentation Rate (ESR)?

Sickle Cell Anemia
Polycythemia

790

In increase in Erythrocyte Sedimentation Rate (ESR) is indicative of what five conditions?

Infection
Rheumatoid Arthritis
Tuberculosis
Temporal Arteritis
Multiple Myeloma

791

What test is positive in Syphilis?

Florescent Treponema Antibody (FTA)

792

An increase in blood Glucose indicates what three possible conditions?

Diabetes Mellitus
Cushing's
Renal/Liver Disease

793

What does a decrease in blood glucose indicate? (3 conditions)

Insulin overdose
**Addison's**
Starvation

794

What Is the best test for Chronic Alcoholism?

Gamma-Glutamyl Transferase (GGT)

795

What is the name of the test used for Diabetics?

Glucose Tolerance test (GTT)

796

What is the best test to monitor the progression of Diabetes Mellitus over a 2-3 month period?

Glycosylated Hemoglobin

797

What is the Hetrophile (Paul Bunnel) test used to indicate? (2 things)

**Mononucleosis**
Viral Meningitis

798

In what five conditions will there be an increase in Human Chorionic Gonadotropin (HCG)?

*Hydatiform mole*
*Choriocarcinoma*
Seminoma
Testicular Teramtoma
*Multiple pregnancies*

799

What are two indications where you would see a decrease in Human Chorionic Gonadotropin (HCG)?

Ectopic pregnancy
Threatened abortion

800

What four conditions will you see Human Leukocyte Antigen Locus (HLA) B27?

Psoriatic Arthritis
Enteropathic Arthritis
Ankylosing Spondylitis
Reiter's (Reactive Arthritis)

PEAR

801

An increase in HDL cholesterol indicates what?

Low risk of coronary heart disease

802

What test would indicate a high risk of coronary heart disease?

Decreased levels of HDL cholesterol

803

What does and M-spike on Immunoelctrophoresis indicate?

Multiple Myeloma

Immunoelctrophoresis is the BEST test for Multiple Myeloma

804

What two conditions are indicated by a decrease in Cerebrospinal Fluid (CSF) glucose?

**Bacterial Meningitis**
Acute Pyogenic infections

805

What two indications does and increase in I-131 uptake have?

Hyperthyroidism
Endemic Goiter

806

What does a decrease in I-131 uptake indicate? (Two conditions)

Hypothyroidism
Thyroid Cancer

807

In what two conditions would you test for ketones?

*Carb Restriction*
Diabetic Acidosis
Starvation

808

What test is specific for AIDS?

Western Blot

809

What is the name of the serologic screening test for *syphilis*?

Venereal Disease Research Laboratory (VDRL)

810

What does an increase in uric acid indicate? (Two conditions)

Gout (Podagra; inflammation of the big toe)
Renal Failure

811

What test indicates *Syphilis*?

Treponema Pallidum Immobilizing Agent (TPI)

812

What three conditions are indicated by an increase in Lactic Dehydrogenase (LDH)?

Myocardial Infarction (MI)
Congestive Heart Failure (CHF)
Muscular Dystrophy

813

When would you expect to see a decrease in Lactic Dehydrogenase?

Cancer Therapy

814

What does an increase in Lipase indicate?

Acute Pancreatitis

815

An increase in Cholesterol lipids indicates what two things?

Early starvation
Diabetes Mellitus

816

What two conditions are seen with a decrease of Cholesterol lipids?

Late starvation
Liver disease

817

A decrease in Triglyceride lipids indicates what two conditions?

Cirrhosis
Malabsorption

818

What three conditions are seen when there is an increase in Triglyceride lipids?

Hyperlipidemia
Diabetes Mellitus
Atherosclerosis

819

In what condition would you expect to see LE Cell

Active Systemic Lupus Erythematous

820

In what three conditions would you see and increase in Phosphorous?

Acromegaly
Kidney disease
Hypervitaminosis D

821

What are three conditions that you would see a decrease in Phosphorous?

Rickets
Hypovitaminosis D
Hyperparathyroidism

822

What two conditions will you see an increase in Proteins?

Multiple Myeloma
Diabetic Acidosis

823

In what two conditions will you see a decrease Proteins?

Liver disease
Kidney syndrome

824

What will be increased if a patient has Viral Meningitis?

Proteins of the Cerebrospinal Fluid (CSF)

825

In what two conditions will there be an increase in Prothombin time?

*Clotting Time*
Vitamin K deficiency
Hepatocellular disease

826

In what three conditions will you see an increase in Serum Glutamic Oxaloacetic Transaminase (SGOT/AST)?

Myocardial Infarction
Liver conditions
Muscular Dystrophy

827

When would you expect to see a positive RA Latex? (7 Conditions)

Seropositive Arthritis
Systemic Lupus Erythematous (SLE)
Tuberculosis (TB)
Cancer
Sjogren's
Still's Disease
Scleroderma

828

In what two conditions would you see in increase in Serum Glutamic Pyruvic Transaminase (SGPT/ALT)?

Hepatitis
Myocardial Infarction (MI)

829

In what two condition would you see an increase in Triiodothyronine (T3) and Thyroxine (T4)?

Hyperthyroidism
Pregnancy

830

In what two condition would you see an decrease in Triiodothyronine (T3) and Thyroxine (T4)?

Cirrhosis
Hypothyroidism

831

What condition are you looking for if you order an Arterial Blood Gas test?

Advance Chronic Obstructive Pulmonary Disease (COPD)

832

What two conditions are confirmed by an Aspiration test?

Gout
Bacterial Arthritis

833

What condition does a Balloon Angioplasty test for?

Obstructive Atherosclerosis

834

What does a biopsy test for?

Cancer, Tumor; i.e Hodgkin's

835

What two conditions can a Bone Scan be helpful for?

Intrinsic Bone changes
Hidden fracture

836

What condition would you order a Bronchoscopy?

Bronchogenic Carcinoma (Lung Cancer)

837

For what condition would a Colonoscopy be ordered?

Lower Gastrointestinal (GI) Disease

838

What conditions would you order a Computed Tomography (CT)? (Five Topics)

Trauma
Infection
Vascular
Neoplastic
Arthritic/Metabolic Disorders

Lung, Appendix, Canal Stenosis

839

For what condition is a DEXA scan ordered?

Osteoporosis

840

When is a Doppler ultrasound ordered?

Arterial Alterations

841

What three conditions would you order a Electroencephalography (EEG)?

Epilepsy
Sleep disturbance
Encephalopathies

842

When would you order a Electromyography (EMG)?

Muscle Atrophy

Lower Motor Neuron Lesion (LMNL)

843

What is an Endoscopy test for?

Gastrointestinal (GI) tract

844

What test is used for indicating an abdominal tumor?

Laparoscopy

845

What condition is the Mantoux test ordered to confirm?

Tuberculosis (TB)

Additional test to be ordered:
TINE
PPD

846

What conditions would be appropriate to order a Magnetic Resonance Image (MRI)? (Six Topics)

Soft Tissues
Spinal tumor
Disc
Rotator Cuff
Meniscus
Avascular Necrosis

847

What is the appropriate test for Peripheral nerves?

Nerve Conduction Velocity (NCV)

Lower Motor Neuron Lesion (LMNL)

848

What two test "should be" order together?

Nerve Conduction Velocity (NCV)-Peripheral nerves
Electromyography (EMG)- Muscle Atrophy

Lower Motor Neuron Lesion (LMNL)

849

What conditions should a Positron Emission Tomography (PET) be ordered? (Four Topics)

Bone and Soft tissue
Tumor
Heart
Brain

850

What is the Spirometer used for?

Chronic Obstructive Pulmonary Disease (COPD)

851

What two conditions are indicated using a Sputum culture?

Strep throat
Tuberculosis (TB)

852

What two conditions are confirmed by the use of the Stress Test?

Atherosclerosis
Angina

853

How is Glaucoma tested?

Tonometer

854

Ultrasound is used to test what three conditions?

Aneurysm
Organs
Pregnancy

855

What is the Stalk Test used to diagnosis?

Spondylolisthesis

856

For what five conditions would you order a Single Photon Emission Computed Tomography (SPECT)?

Musculoskeletal System
Heart
Brain
Abdomen
Spondylolisthesis

857

What is the most important part of a patient history, for Boards?

Age

858

What is the least important part of a patient's history for Boards?

Gender

859

When a patient has a fever what two things will increase?

Heart Rate; 10 beats per minute for every degree increased

Respiratory Rate

860

What are three causes of Horner's Syndrome?

Thoracic Outlet Syndrome (TOS)
Whiplash
Apical Lung Tumor (Pancoast)

861

All cranial nerve lesions are considered what?

Ipsilateral Lesions

862

When two cranial nerves are affected in a condition which one is sensory?

The lower numbered of two cranial nerves will be considered sensory AKA Afferent

863

When two cranial nerves are affected in a condition which one is motor?

The higher numbered of two cranial nerves will be considered motor AKA Efferent

864

If there is a Cranial Nerve II problem when doing Direct/Indirect light reflex which pupils are affected?

Both, Cranial Nerve II (2 Pupils are effected, even numbers go together)

865

If there is a Cranial Nerve III problem when doing Direct/Indirect light reflex which pupils are affected?

One, Cranial Nerve III (1 Pupil is effected, odd numbers go together)

866

In Secondary Hyperparathyroidism (2 HPT), there is a decrease stimulation for the Pituitary Gland and also a decrease in Thyroid-stimulating hormone (TSH), what are three finding associated with this condition?

Breast Atrophy
Amenorrhea
Macroglossia

867

What are three causes of Chronic Obstructive Pulmonary Disease (COPD)?

Chronic Bronchitis
Asthma
Emphysema

868

What condition has an x-ray finding of Bilateral Hylarlymphadnopathy AKA Angel Wings?

Sarcoidosis

869

What condition to *Tietze Syndrome* which only affects one articulation and radiates pain?

Costochondritis

870

How can you tell Hodgkin's from Paget's and Blastic Metastases?

Hodgkin's: Anterior Vertebral Scalloping
Paget's: Ivory White Vertebra is much BIGGER than the others

871

If Tetralogy of Fallot is left untreated what will happen?

Clubbing of the fingernails

872

What condition is associated with Coarctation of the Aorta?

Marfan's Syndrome

873

Where do all signs and symptoms of Left Sided Heart Failure show up?

In the Lungs

874

Who do you refer a patient to that has Heart Failure?

Cardiologist

875

What condition has pain in the chest for longer than 10-15 minuets?

Myocardial Infarction (MI)

876

How is an Aneurysm diagnosed?

When the aorta is wider than the vertebral bodies

877

After a Myocardial Infraction, when does the enzyme CK-MB appear?

3-6 hours

878

After a Myocardial Infraction, when does the enzyme CK-MB peak?

24-36 hours

879

After a Myocardial Infraction, when does the enzyme CK-MB return to normal?

By day 3

880

After a Myocardial Infraction, when does the enzyme SGOT/AST appear?

6-8 hours

881

After a Myocardial Infraction, when does the enzyme SGOT/AST peak?

24 hours

882

After a Myocardial Infraction, when does the enzyme SGOT/AST return to normal?

By day 4-6

883

After a Myocardial Infraction, when does the enzyme LDH appear?

10-12 hours

884

After a Myocardial Infraction, when does the enzyme LDH peak?

48-72 hours

885

After a Myocardial Infraction, when does the enzyme LDH return to normal?

After 14 days

886

What are two things to understand about Myocardial Infarction enzymes for Board questions?

Order of:
Elevation
How long
Return to Normal

First (CK-MB) to Last (LDH), follow the same order

887

What is the most common cause of Cholecystitis?

Cholelithiasis (Gall Stones)

888

What is Zenker's diverticulum?

Out pouching of the Esophagus

889

The Shilling test does not absorb Vitamin B12 leading to what condition?

Pernicious Anemia

890

What condition has a rapid, steady decrease of renal function with or without no urine production?

Acute Renal Failure

891

What are three things you will see in an older male patients urinary functions?

Patient will have:
Frequency
Urgency
Hesitancy

892

An increase in the D-Dimer test indicates what condition?

Deep Vein Thrombosis (DVT)

893

What headache is relieved by Alcohol?

Muscular Tension headache

894

What condition will the patient present with neck and shoulder stiffness?

Polymyalgia Rheumatica (Temporal Arteritis, Giant Cell)

895

Who do you refer a patient to that has Polymyalgia Rheumatica?

Ophthalmologist

896

What age do you often seen a patient with a Tempromandibular Joint (TMJ) Headache?

Teens

897

What signs and symptoms will you seen in a Tempromandibular Joint (TMJ) Headache?

Pain in the jaw, Tempromandibular Joint (TMJ) area
Pain with chewing
Clicking of the jaw

898

What will you see in the past history of a patient with Tempromandibular Joint (TMJ) Headache?

Recently visited the dentist

899

Who do you refer a patient with Tempromandibular Joint (TMJ) Headache to?

Back to the Dentist

900

What term is associated with Uterine Fibroids?

Leiomyoma

901

What is both a treatment and a diagnosis of Endometriosis?

Laparoscopy