Key words/Findings Flashcards
(106 cards)
1
Q
Painful eye Loss of Vision Circumlimbal injection Fixed Mid-dialated pupil Tearing N/V, diaphoresis
A
Angle-Closure glaucoma
Emergency!
2
Q
Increased cup-to-disc ratio
Increased IOP
Mostly asymptomatic
LOSS OF PERIPHERAL VISUAL FIELD (main symptom)
A
Open-Angle Glaucoma
3
Q
Acute onset of uni/bilateral erythema of conjuctiva
Copious watery discharge
Ipsilateral tender preauricular lympadenopathy
A
Viral Conjunctivitis
4
Q
Acute onset of copious purulent discharge from eyes
Mild decreased visual acuity/discomfort
Eyes may be “glued shut” in mornings
Nontender preauricular adenopathy
A
Bacterial Conjunctivitis
5
Q
Recurrent vertigo (lasting mins->hours)
Lower range hearing loss
Tinnitus
One-sided aural pressure
A
Meniere Disease
6
Q
Fever Otalgia Ear pressure Hearing Impairment Tympanic membrane erythema Bulging/rupture of typanic membrane leading to otorrhea and decrease in pain
A
Acute Otitis Media
7
Q
Perforated TM
Chronic ear discharge w/ or w/o pain
Conductive hearing loss
A
Chronic Otitis Media
8
Q
Ear pain (especially w/ movement of tragus/auricle)
Redness/swelling of ear canal
Purulent exudate is also common
A
Otitis Externa
9
Q
Purulent nasal discharge Facial pain/pressure nasal obstruction/congestion Fever TTP over sinuses Decreased transillumination
A
Acute Sinusitis
10
Q
Bluish discoloration below eyes Rhinorrhea Itchy/watery eyes Sneezing Nasal congestion Dry Cough Pale/boggy/bluish mucosa Clear/Watery dischage
A
Allergic Rhinitis
11
Q
Fever
Tender ANTERIOR cervical adenopathy
LACK of cough
Pharyngotonsillar exudates
A
GABHS Phayringitis
12
Q
1-10 day history of cough Purulent sputum SOB Tachycardia Pleuritic chest pain Fever Crackles on auscultation Bronchial breath sounds over area of consolidation
A
Pneumonia
13
Q
Intermittent cough, chest tightness, breathlessness, wheezing
A
Asthma
14
Q
Hx of SOB, cough, sputum production Asthenia, dyspnea, pursed-lip breathing Increased AP diameter Percussion yields increased resonance Auscultation reveals decreased breath sounds and inspiratory crackles. Expiration is prolonged
A
COPD
15
Q
Acute onset of chest pain/dyspnea
Unilateral chest expansion
Decreased tactile fremitus
Diminished breath sounds on one side
A
Pneumothorax
tension pneumo has a mediastinal shift
16
Q
Sudden onset of pleuritic chest pain Dyspnea Cough/hemoptysis Diaphoresis Apprehension Tachycardia/pnea Crackles Increased S2
A
Pulmonary Embolism
17
Q
Drop in SBP by >20 upon postural changes
Drop in DBP by >10 upon postural changes
Rise in pulse >15bpm upon postural changes
A
Orthostatic Hypotension
18
Q
Increased blood pressure
Nonspecific headache is most commonly voiced symptom.
A
HTN
19
Q
Diastolic presure greater than 130.
Optic disc edema (Papilledema)
A
Hypertensive Emergency
20
Q
Exertional dyspnea + Cough Fatigue Orthopnea Paroxysmal Nocturnal Dyspnea Basilar rales S3 Gallops (Slosh... in-ing)
A
Left-Sided CHF
21
Q
Jugular Vein Distension
Hepatomegaly
Decreased appetite/nausea
Dependent Pitting Edema
A
Right-SIded CHF
22
Q
Chest pain Diaphoresis Dyspnea Nausea Vomiting Weakness Anxiety Syncopy Cough
A
Acute Coronary Syndrome
23
Q
Irregularly Irregular pulse
Palpitations
Fatigue
A
Atrial Fibrillation
24
Q
Sharp, pleuritic substernal radiation pain relieved by SITTING UPRIGHT AND LEANING FORWARD
Cardiac friction rub on ausculation
A
Acute Pericarditis
25
```
Tachycardia
Tachypnea
Narrow pulse pressure
JVD
Pulsus paradoxus
```
Cardiac Tamponade
| Beck's Triad
Muffled heart sounds, JVD, Hypotension
26
Intermittent claudication of foot/lower leg w/ exercise relieved by rest
Femoral/distal pulses weak or absent
Aortic, iliac, or femoral bruit possible
Skin changes of lower extremity (hair-loss, shiny skin, pallor w/ dependent rubor)
Numbness, tingling and ulcerations possible in severe/chronic case.
Peripheral Arterial Disease
27
Dull pain/ erythema/ tenderness/ induration of vein (most commonly the long saphenous vein) Cord may be palpable .
Superficial Thrombophlbitis
28
Swelling, warmth, redness of lower leg.
| Homan's sign possible
Deep Venous Thrombosis (DVT)
| Homan's sign = forceful dorsiflexion of foot
unreliable
29
Progressive edema starting at ankle
Itching, dull pain w/ standing and pain w/ ulceration
Skin is shiny, thin, atrophic w/ dark pigmentary changes/induration
ULCERS MOST COMMONLY occur just above ankle (stasis ulcer)
Chronic Venous insufficiency
30
```
Unilateral temporal headache
Scalp tenderness
Jaw claudication
Throat pain
diplopia
Nodular, enlarged tender, or pulseless temporal artery
```
Giant Cell Temporal Arteritis
Steroids ASAP
31
```
Weakness
Fatigue
Palpitations
Tachycardia
Dyspnea
Positional dizziness
syncope
bleeding
possible angina
Jaundice possible if new onset
```
Anemia
```
TICS = Microcytic
Thalessemias
Iron Dificiency (pica = hallmark)
Chronic inflammation
Sideroblastic (lead tox until proven otherwise)
```
B12 & Folate = Macrocytic
Metformin use -->> possible B12 difficiency
((decreased vibratory sense/positional sense = B12 low)
B12 has neuro symptoms like parethesias, balance problems, and dementia.
32
Heartburn (worse after meals and lying down)
Relieved with antacids
Hoarseness, halitosis, cough, hiccupping, sore throat, atypical chestpain
Gastroesophageal reflux disease (reflux esophagitis)
33
```
Abdominal pain (burning/gnawing) radiates to back
IMPROVES w/ food!
```
Duodenal Ulcer
34
```
Abdominal pain (burning/gnawing) radiates to back
WORSE w/ food!
```
Gastric ulcer
35
Bloody diarrhea
Fever
Dysentery
Inflammatory diarrhea
(invasive organism or IBD)
E. Coli, Shigella, Campylobacter
36
Large volume of diarrhea w/o inflammation
Secretory Diarrhea
(Pancreatic insufficiency, or bacterial toxins, or laxitives)
Norovirus, Rotavirus, Clostridium perfrigencs, CHOLERA=Ricewater, Giardia, Crypto.
37
Less than 3 stools per week
Decrease volume or number of stools
Increased firmness of stools + strainnig
Constipation
| older than 50 new-onset -> eval for colon cancer
38
Abdominal pain
Distension
Vomiting of partially digested food
Small Bowel obstruction
bowel sounds high pitched then go silent
39
Abdominial pain/distension
Large Bowel obstruction
bowel sounds high pitched then go silent
40
```
Abdominal cramps and diarrhea
Younger than 40
Low-grade fever
Polyarthralgia
Anemia
Fatigue
Blood in stool
```
Crohn Disease (regional enteritis)
- Skip areas characteristic
- most commonly terminal ileum and right colon
- anywhere mouth to anus
41
Tenesmus w/ bloody, pus fill diarrhea
Pain in lower left quadrant
Weight loss, malaise, fever
scleritis, arthritides, erythema nodosum
Ulcerative Colitis
- continuous (no skip areas)
- most commonly sigmoid colon
42
Abdominal pain worse with food and better with defecation
Bowel can be distended with gas
hyperresonance on percussion over abdomen
Constipation and diarrhea can alternate
Dyspepsia is common
Irritable bowel syndrome
43
Sudden onset abdominal pain (usually LLQ)
Altered bowel movements as well as n/v common
Sudden-onset large-volume hematochezia is possible
Diverticular disease
44
Intermittent periumbilical or epigastric pain
In 12 hours it localizes to RLQ (McBURNEY'S Point)
Constant and worsened by movement
Rebound tenderness
Nausea and anorexia are common (diarrhea is not)
Low grade fever
PSOAS sign (leg raise against resisitance)
OBTURATOR sign (bend knee and internally rotate)
Appendicitis
Psoas sign
Obturator sign
McBurney's point
45
Epigastric pain radiating to Back
Pain lessens when patient leans forward or lies in fetal position
N/V common
Fever, leukocytosis, and sterile peritonitis may occur
Bleeding into flanks (GREY TURNER sign)
Bleeding into umbilical area (CULLEN sign)
Acute Pancreatitis
46
Everything that Acute Pancreatitis is + STEATORRHEA
| malabsorption
Chronic Pancreatitis
47
Colicy epigastric/ RUQ pain that becomes steady and increases in intensity. Often after High-Fat meals.
Right shoulder/subscapular pain
Nausea,Vomiting,low-grade fever
Consitpation/mild paralytic ileus
Acute Cholecysitis
48
RUQ tenderness
Jaundice
Fever
Altered mental status
Hypotension
Acute Cholangitis
(Charcot Triad) RUQ+Jaundice+Fever
(Reynolds pendtad) +AMS+hypotension
49
```
Fatigue
Malaise
Anorexia
Nausea
Tea-colored urine
Vague abdominal discomfort
```
Hepatitis
50
```
Nausea
Vomiting
Diarrhea
Pruritus
Drowsiness
Dizziness
hiccups
SOB
Anorexia
```
Acute Renal Failure
(idk its so vague) just get a urinalysis
51
```
Fatigue
Malaise
Anorexia
Nausea
Vomiting
Metallic taste
hiccups
dyspnea
everything
```
CKD (stages 3-5)
again get a urinalysis
52
```
Hematuria (tea or cola colored)
Oliguria or anuria
Edema of eyes or face in morning
Edema of feet and ankles in afternoon
Hypertension is common
```
Glomerulonephritis
53
```
Huge kidneys
Headaches
Nocturia
Hematuria
Hypertension
Recurrent UTI
Weight loss
Renal colic
Nausea
Vomiting
```
Polycystic Kidney Disease
54
```
Unilateral back pain
Renal Colic
Hematuria, dysuria, urinary frequency, fever, chills, n/v
Abdominal pain
Diaphoresis
Costovertebral Angle Tenderness
```
Nephrolithiasis
55
Polyuria, Nocturia, Polydipsia
Seizures if hypernatremia develops
Diabetes insipdus
56
```
Decreased ROM
Joint Crepitus
Pain WORSENING throughout day
DIP (heberden nodes)
PIP (Bouchard nodes)
wrist, hip, knee, spine
```
Osteoarthritis
57
Decreased ROM
PIP
MCP
Extra-articular manifestations (skin, lungs, eyes, kidneys, bloodstream, heart, liver)
Rheumatoid Arthritis
(Rheumatoid factor + Anti-CCP) tests
58
Arthritis + PITTING OF THE NAILS
| Sausage-finger appearance
Psoriatic Arthritis
59
Arthritis + infection (gonorrhea)
Infectious (septic) arthritis
60
```
Metatarsal Phalangeal Joint of Great Toe (inital attack)
Pain
Swelling
Erythema
Exquisit Tenderness
```
Gout
| Rod-shaped negatively birefringent urate crystals
61
Painful inflammation of joint
Most commonley knee, wrist, and elbow
Aspiration reveals Rhomboid-shaped calcium pyrophsphate crystals that are positively birefringent
Calcium Pyrophospahte dihydrate disease (CPPD)
Pseudogout
62
Malar rash
Photosensitivity Relapsing and remitting pattern of symptoms
ANA test +
Oral ulcers
Systemic Lupus Erythematosus
63
Dry mucous membranes
Dry mouth (xerostomia)
Dry eyes (xerophthalmia or keratoconjunctivitis sicca)
Enlarged Parotid Glands
Sjogren Syndrome
64
Restricted ROM of jaw
Clicking or poping of jaw
Pain of jaw
Temporomadibular joint disorder
| (TMJ)
65
Night pain, numbnes, paresthesias (sparing little finger), clumsiness and weakness.
Thenar atrophy in late disease
```
TINEL sign (percuss volar aspect of wrist)
PHALEN test (press back of hands together for a min)
```
Carpal Tunnel Syndrome
66
Pain on lifting objects when arm is pronated
| Pain when pronating arm and then extending fingers and wrist against resistance.
Lateral Epicondylitis (Tennis Elbow)
67
Pain on resisted pronation or flexion of wrist
| Paresthesias in distribution of ulnar nerve
Medial epicondylitis
68
Pain and tenderness on wrist at base of thumb radiating to forearm
Swelling and thickinging of tendon sheath
Finkelstein test (hold thumb in hand and ulnarly deviate)
de Quervain disease (tenosynovitis)
69
Pain originating in back and radiating down leg
| Point tenderness
Low back pain
70
Low back pain + pain in butt, posterior thigh, posterolateral aspect of leg around lateral malleolus to lateral dorsum of foot and entire sole
Sciatica
71
Elderly patient with lower back pain that is increased by walking
Relieved by leaning forward
Spinal Stenosis
72
Joint line knee pain
Inability to fully extend knee (locking)
Knee giving way
Swelling over hours after injury
Meniscal injury
McMurray test
Apley test
73
Complaint of pop in knee
Knee instability
Hemarthrosis within 3-4 hours
Cruciate ligament injuries
Lachman test
Anterior + Posterior drawer tests
74
Kidney Stones
Bone Pain
Abdominal Cramps
Irritablity, psychosis, depression
Deep Tendon Reflexes depressed
Hyperparathyroidism
Stones, Bones, Groans, Moans
75
```
Chvostek sign (face twitch after tapping)
Increased DTRs+ spasms
Abdomnial cramps
Parethesias
Lethargy
```
Hypoparathyroidism
76
```
Weight loss
Anxiety
Palpitations/Tachycardia
HEAT Intolerance
bowel pattern change, menorrhagia, brittle hair
Hyperreflexia on DTRs
```
Hyperthyroidism
Graves disease is one type of hyperthyroidism associated with inflammation of the eyes. (Exophthalmos in five percent)
77
```
Weakness
Dry skin
Lethargy
Slow speech
COLD Intolerance
Eyelid edema
forgetfulness
facial edema
constipation
coarse hair
weight gain
depression
Myxedema of pretibial area (nonpittting edema)
Hyporeflexia
```
Hypothyroidism
palpable diffusely enlarged thyroid with fine nodules is often present
78
```
Polydipsia
Polyuria
Nocturia
Rapid weight loss
blurred vision
pruritis
weakness
parethsias
DKA
```
Type 1 diabetes mellitus
79
```
Polyuria
Polydipsia
Overweight commonly
Fatigue
Pruritis
Cadidial vaginitis
blurred vision
poor wound healing
Large for gestational age babies
```
Type 2 diabetes mellitus
80
```
Hemiparesis
Hemisensory deficit
Aphasia
Apraxia
Visual field defects
Coma
vomiting
vertigo
ataxia
```
Stroke
81
Focal weakness, numbness, tingling, optic neuritis, blindness, diplopia, fatigue
Most commonly sensory complaints in limbs followed by vision loss
Syptoms last days to weeks
Multiple Sclerosis
82
Band-like head pain
Steady or aching (nonpulsitile)
Possible tenderness to neck or head muscles
Tension headache
83
Throbbing head pain for hours to days
Photophobia, phonophobia
Nausea, vomiting, anorexia
Migraine
Can have auras and sometimes transient neuro deficits
84
Unilateral headache
Ipsilateral lacrimation, conjunctival injection, nasal congestion, miosis, and ptosis
Pain not relieved by rest
Cluster headache
85
Resting tremor + bradykinesia + rigidity + postural instability
Parkinson Disease
86
Progressive chorea and dementia
Earliest signs are behavior changes, restlessness or fidgetiness
Huntington disease
87
Spasicity, Lack of coordination, fine motor difficulties, ataxia, lethargy, hypotonia or dystonia.
Sz disorders and mental retardation possible.
Cerebral Palsy
88
Unilateral Facial muscle weakness begins abruptly
Pain can preceed weakness
Peaks in about 21 days
Bells Palsy
Cranial nerve 7 + HSV activiation
89
Weakness and fatigable muscles
Symptoms fluctuate throughout day
Ptosis, diplopia, dysphagia common
Myasthenia gravis
Ach receptors destruction (test with edrophonium)
90
```
AMS
Fever
Headache
Vomiting
Stiff neck
```
```
KERNIG sign (lift leg w/ knee bent -> straighten knee )
BRUDINSKI sign (grab head push to chest - knees will bend)
```
Meningitis
CT scan + LP
91
Persistent, excessive anxiety tht last more than 6 months
Generalized Anxiety Disorder
92
Inflammatory follicular, papular, and pustular eruptions involving pilosebaceous apparatus
Acne Vulgaris
93
Erythematous, annular patch with distinct borders and central clearing.
Itching, stinging, burning common
```
Tinea ____
tinea pedis (foot)
tinea cruris (groin)
tinea corporis (trunk, leg, arm, neck)
tinea barbae (beard area)
tinea unguinum (nails)
tinea manuum (hand)
tinea facialis (face)
tinea capitis (head)
```
94
Rash with diffuse erthema that blances, w/ fine red papules (sunburn w/ goose bumps)
Strawberry tounge
Rash fades in 2-5 days
Scarlet fever
95
```
Carditis
Erythema marginatum
Subcutaneous nodules
Arthritis
Fever
15-20 days after exposure to Streptococcal pharyngitis
```
Acute Rheumatic Fever
96
Rice water poops
Cholera
97
```
Catarrhal stage (sneezing, stuffy, malaise, hacking cough at night)
Paroxysmal stage (spasms of rapid coughing fit followed by high-pitched inspiration (whoop))
Convalecent stage (decreased paroxysms)
```
In adults it is a cough for more than 2 weeks rarely with fever.
Pertussis
98
```
POSTERIOR CERVICAL NODES
Splenomegaly
Sore throat
Fever
Possible hepatitis, mononeuropathy, meningitis
```
EBV
99
```
Vomiting
Lethargy
Jaundice
Seizures
Hypoglycemia
AMS
```
after aspirin + viral infection in kids
Reye Syndrome
100
Painful eruptions following a dermatomal pattern
Herpes Zoster
(most commonly on trunk)
Trigeminal = tip of nose (Hutchinson sign) --risk corneal involvement
101
Dewdrop on rose petal (erythematous acules and papules that crust over.
Appear in crops and all at different stages
Mucous membranes can be involved
Varicella (chicken pox)
102
Fever, malaise, myalgias, arthralgias, splenomegaly, abnormal liver enzymes, leukopenia, atypical lymphocytes
Cytomegalovirus (CMV)
similar to EBV but w/o pharyngitis and respiratory symptoms
103
Erythema migrans (bull's eye rash)
Arthritis
Flu like symptoms
Lyme disease
104
Fever, chills, headache, nausea, vomiting, myalgias, restlessness, insomnia, irritablity.
Faint macules to maculopapules to petechea all over body including palms and soles
Rocky Mountain spotted fever
105
Rash everywhere including palms and soles
After a painless ulcer
Everything may be involved too
Syphilis
106
Shaking chills then Fever then diaphoresis... over and over again
fatigue between attacks
Liver and spleen enlargement if symptoms continue more than 4 days
Malaria
