Health Assessment Final

Question 1

Cotton wool spots are caused by

Answer 1

vascular disease from HTN and Diabetes Mellitus

Question 2

Papilledema is caused by

Answer 2

increased intracranial pressure

Question 3

optic nerve head cupping is caused by

Answer 3

glaucoma increased intraocular pressure

glaucoma can cause intense ocular pain, blurred vision, halos around lights a red eye, and dilated pupil

can even cause stomach pain, N/V

Question 4

Dot hemorrhages and cotton wool spots can be caused by

hemorrhage at disc margin

Answer 4

diabetic retinopathy

undiagnosed glaucoma

Question 5

Hypertensive retinopathy look like what in the eye

Answer 5

hemorrhage dot, blot, cotton wool spots if severe papilledema

Question 6

interruption of red reflex with opacities may indicate

Answer 6

cataract, retinoblastoma, or other serious intraocular pathology

Question 7

at _ years of age vision test such as _ can begin

Answer 7

4, HOTV or LEA

Question 8

macular degeneration in elderly is seen as what in the eye

this is the leading cause of legal blindness in people older than

Answer 8

drusen bodies

55 in US

Question 9

white reflex on photos could indicate (Also called cat eye reflex)

Answer 9

retinoblastoma in children

mutation in RB1 (embryonic malignant tumor arising from the retina).

Question 10

pregnant patients can experience nasal stuffiness, decreased sense of smell, and impaired hearing from

Answer 10

elevated estrogen

can also have hoarseness, vocal changes, persistent cough

Question 11

smell begins to deteriorate at

taste at what age

Answer 11

60

50

Question 12

otitis externa signs and symptoms

What type of hearing loss occurs?

Answer 12

itching in ear canal, typically with swimming

Pain intense with movement on pinna and chewing

Watery and purulent and thick mixed with pus and epithelial cells FOUL smelling

Conductive hearing loss exudate and swelling of canal

Canal is red edematous, tympanic membrane obscured

Question 13

otitis media with effusion

Answer 13

Sticking or cracking sound on yawning or swallowing

discomfort feeling of fullness

no discharge

conductive as middle ear fills with fluid

tympanic membrane retracted or bulging yellowish air fluid level and bubbles

Question 14

acute otitis media

Answer 14

abrupt onset of fever, feeling of blockage, anorexia, irritability

Deep- seated earache, that interferes with sleep pulling at the ear

discharge only if tympanic membrane ruptures foul smelling

conductive loss of middle ear fills with pus

Tympanic membrane distinct erythema, thickened clouding bulging air fluid level or bubbles

Question 15

Rinne postive=

Answer 15

air-conduction longer then bone conduction 2:1 (Good)

Question 16

infants chest is generally round AP diameter is

Answer 16

equal to lateral and circumference is roughly equal to that of head until 2 years old

Question 17

PDA and foramen ovale

Answer 17

usually close at birth in minutes however if not large PDA can cause murmur on auscultation and left ventricular overload/heart failure.

Question 18

Biot or ataaxic respiration

Answer 18

associated with severe and persistent increased intracranial pressure, resp compromise drug poisoning, brain damage at level of medulla and indicates poor prognosis.

Question 19

DULLNESS to percussion and DECREASED tactile fremitus means

Answer 19

pleural effusion

Question 20

decreased or absent fremitus can also mean

Answer 20

obstruction, air, empysema, pleural thickening, bronchial obstruction.

Question 21

anterior mediastinal mass signs

Answer 21

leaning foward, stridor may compress trachea

Question 22

resonance on percussion means

hyperresonance

dullness /flatness

Answer 22

healthy lung tissue

empysema, asthma, pneumo

pleural effusion, pneumonia, atlectasis, asthma

Question 23

Vesicular lung sounds

Bronchovesicular

Bronchial

Answer 23

heard over healthy lung tissue over most lung low pitch

Heard over main bronchus medium pitch

heard over trachea high pitch

Question 24

hyperresonnace is common in

also bronchial and bronchovestibular sounds are common in this age group

Answer 24

children

Question 25

s1 sound is

Answer 25

lub and when systole contraction occurs sound is from mitral and tricuspid valves closing

Question 26

s2 sound is

Answer 26

dub and is diastole is when arotic and pulmonic close

Question 27

s3 is during s4

Answer 27

diastole and is sometimes there when the heart is filling is when the atria contract to make sure all blood is ejected

Question 28

sounds of heart sounds are best heard where

Answer 28

in the area away from the anatomic site because sound is transmitted in the direction of blood flow.

Question 29

closure of the ductus arteriosus occurs when the heart lies more _ in children and infants the location is where? adult heart position occurs at what age

Answer 29

24-48 hours horizontally, fourth left intercostal space 7

Question 30

blood volume for prego increases by returns to prepregnancy volume by cardiac output increases by 30-40%

Answer 30

40-50% 3-4 weeks

Question 31

Chest pain in a _ or _ is seldom due to a cardiac problem

Answer 31

child or adolescent

Question 32

feeling for a thrill in second inter-coastal spaces can detect

Answer 32

aortic and pulmonic stenosis, atrial septal defect or pulm htn

Question 33

a loud _ always suggest pathology and needs additional eval Kentucky goes with which heart sound Tennessee

Answer 33

s4 s3 s4

Question 34

pregnancy more audible _ is abnormal _ ejection murmurs may be heard over pulmonic , but _ murmurs is not normal

Answer 34

S1 S2 and S3 s4 systolic , diastolic should not be louder than grade II

Question 35

Markle sign is seen with

Answer 35

peritoneal irritation (positive heel jar test)

Question 36

Tests for appendicitis are

Answer 36

Aaron sign (pain in heart stomach when pushing on mcburney point) Blumberg (rebound tenderness) Mcburney sign (pain in right lower quadrant) Rovsing (Pain in right lower quadrant when left lower quadrant palpated)

Question 37

Peritoneal irritation tests

Answer 37

Ballance (Dullness on percussion on left and right flank changes with position) Blumberg (Rebound tenderness) Markle (heel jar) heel to floor causes abdominal pain Rovsing (Pain in right lower quad when pushing on left lower)

Question 38

Murphy results from

Answer 38

cholecystitis | cessation of inspiration when palpating gallbladder

Question 39

Cullen sign seen with

Answer 39

Ecchymosis around umbilicus Hemoperitoneum, pancreatitis, ectopic pregnancy

Question 40

Gray turner

Answer 40

flank bruising Hemoperitoneum, pancreatitis

Question 41

Dance sign is seen with

Answer 41

intussusception Absence of bowel signs right lower quadrant

Question 42

Kehr sign seen with

Answer 42

abdominal pain radiating to left shoulder spleen rupture, renal calculi, ectopic pregnancy

Question 43

iloopsoas muscle test is done to look for

Answer 43

appendicitis , push down on leg when patient lifts if pain means positive psoas sign

Question 44

Obturator muscle test is done to look for

Answer 44

ruptures appendix or pelvic abscess lift leg to 90 degree grab by ankle and turn medially and laterally if pain R hypogastric region obturator muscle irritated

Question 45

spider nevi in newborn

Answer 45

liver disease

Question 46

superficial veins normal on abdomen in distended veins across abdomen

Answer 46

thin infant abnormal

Question 47

peristaltic waves in infant can mean

Answer 47

pyloric stenosis or intestinal obstruction

Question 48

Hepatitis b coinfection is Hep E is self limited and occurs from

Answer 48

hep D contaminated water fecal or food

Question 49

cirrhosis is mostly caused by

Answer 49

hep C and alcohol in US

Question 50

example of a hinge joint is the ball and socket joint

Answer 50

elbow, knee shoulder, hip

Question 51

ligaments are stronger than bone in _ and _ until _

Answer 51

infants children , adolescents (more prone to fractures)

Question 52

bone growth is completed by which age

Answer 52

20

Question 53

Osteoarthritis risk factors

Answer 53

``` obesity female family history hypermobility syndromes aging >40 injury high level sports peripheral neuropathy occupation with overuse of joints ```

Question 54

osteoporosis risk factors

Answer 54

Nulliparous ammenorhea, menopause inadequate vitamin D, calcium excessive carbonated drinks sedentary lifestyle, lack of aerobic or weight bearing exercise race white, asian, native american

Question 55

passive range of motion often exceeds active by if joint increase or limitation in ROM use

Answer 55

5 degrees goniometer to measure angle

Question 56

muscle strength grading

Answer 56

0-5 0 no movement 1 trace movement 2 Full ROM not against gravity 3 Full ROM against gravity not resistance 4 Full ROM against gravity and some resistance, but weak 5 Full ROM against gravity and resistance

Question 57

RA signs

Answer 57

deviation of fingers to ulnar side boutonniere disease swan neck

Question 58

osteoarthritis seen as these nodules are called

Answer 58

hard nontender nodules 2-3 mm in distal interphalangeal joints Heberden nodes Bouchard nodes

Question 59

subcurtaneous nodule on ulnar side may indicate

Answer 59

RA or gout tophi

Question 60

olecranon bursitis results in

Answer 60

swelling, tenderness of bursa

Question 61

crepitus, locking or popping in TMJ can mean

Answer 61

TMJ dysfunction

Question 62

kyphosis is common in Lordosis in Gibbus

Answer 62

elderly prego or obese collapsed verterbrae from osteoporosis (sharp , angular deformity)

Question 63

gouty arthritis suspected when

Answer 63

inflamed big toe

Question 64

Thickened achiles tendon

Answer 64

tendonitis

Question 65

HEAT, swelling, tenderness, redness, signs of inflamed joint caused by

Answer 65

RA, gout, septic joint, fracture, tendonitis

Question 66

genu valgum genu varum

Answer 66

knock knees bow legs (common in children till 18 months)

Question 67

carpal tunnels tests (medial nerve integrity)

Answer 67

``` Katz test hand diagram thumb abduction (weakness when push on thumb) tinel sign (tap on wrist) phalen test (1 min hold if numbness or paresthesia) ```

Question 68

Allis sign is for _ to detect

Answer 68

infants , hip dislocation or shortened femur

Question 69

Barlow/Ortalani used to detect

Answer 69

hip dislocation or subluxation (clunk or sensation)