lecture final Flashcards by Rugger Style

Blue appearance around the umbilicus

Cullen’s sign

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What does Cullen’s sign indicate?

intra-abdominal hemorrhage

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blumberg sign

generalized abdominal pain upon manual rebound

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What causes portal hypertension?

liver cirrhosis

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which kind of hepatitis is most likely due to ingestion of contaminated food?

Hep A

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black tarry stool due to presence of blood, usually due to a peptic ulcer

melena

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Patient presented with pain in the left lower quadrant, nausea, vomiting, and altered bowel habits. Upon examination rebound tenderness was present in the left lower quadrant. Which of the following is the most likely diagnosis:

Meckel’s diverticulitis

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Rovsing sign indicates

appendicitis (think rovsing=refered)

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over liver, pain and catch breath, cholecystitis

Grey Turner sign

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Murphy’s sign indicates

nephritis

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Zollinger-Ellison tumors

secrete a hormone called gastrin that causes the stomach to produce too much acid, which in turn causes peptic ulcers

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Sister Mary Joseph nodules

suggests malignancy

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what do these things have in common

Murphy’s sign
percussion of the upper border of the liver
percussion of the lower border of the liver
Auscultation of the mitral area of the heart

Performed at midclavicular line

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Patient presented with right shoulder and scapular pain, examination of the shoulder seems to be unrewarding, upon performing physical exam the doctor identified positive Murphy’s sign. What is the most likely origin of the shoulder pain?

Cholecystitis

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The most common cause of bleeding per rectum is

hemorrhoids

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small crack which can happen from chronic constipation.

Anal Fissure

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A 40-year-old flight attendant presents to your office for evaluation of abdominal pain. It is worse after eating, especially if she has a meal that is spicy or high in fat. She has tried over-the-counter antacids, but they have not helped the pain. After examining her abdomen, you strongly suspect a condition that requires which sign on examination

The answer says murphie’s sign but I think it should be Grey Turner’s

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While palpating the epigastric area you felt pulsations coming from superior to inferior. This patient may be suffering from which of the following?

cor-pulmonale

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anatomical location is most painful regarding kidney stone

Ureter

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A 15 year old high school student presents to the clinic with a 1 day history of nausea and anoerxia. He describes the pain as generalized yesterday, but today it has localized to the right lower quadrant. You palpate the left lower quadrant and the patient experiences pain in the right lower quadrant. What is the name of this?

Rovsings

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Decreased amount of Serum albumin can indicate

Liver disease

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weakness of the linea alba

diastasis recti

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Referred pain is categorized under which of the following reflexes

viscero-somatic reflex

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apex beat is normally located at mid axillary line

False

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apex beat is formed by left ventricular contraction

true

precordial heaving is associated with left ventricular contraction

False, right

apex beat is normally located at the ______ left intercostal space

5th

A 28 year old man complains of periodic episodes of severe headaches that have occurred nightly for the past two weeks. The pain awakens him two or three hours after he has been asleep and lasts for about one hour the pain is always around the right eye and makes the affect eye water. Pain seems to be aggravated by alcohol intake. He had a similar episodes of headaches about two years ago. What is the clinical impression?

Cluster headaches

long term use of non-steroidal anti-inflammatory drugs | -aspirin and ibuprofen

Peptic Ulcers

sore on the lining of your stomach or duodenum espohageal ulcer imbalance between aggressive factors and mucosal protective mechanisms etiology

Peptic Ulcers

Barry Marshall

Discovered the link between peptic ulcers and H. pylori | Nobel Prize in 2005

peptic ulcer prevalence

10% world wide

Vagotomy sometimes used for peptic ulcer to combat

overactive vagus Nerve

part of heart that occupies most of the anterior surface

Right ventricle

primary cause of cyanosis at birth

overriding aorta on both ventricles

ventricular septal defect will create cyanosis at birth

false

The muscle that is implicated in cervicogenic headaches is

rectus capitus posterior minor

A common migraine patient will see an aura before onset (difference between classic/common)

false

Angela is a 48 year old female. She is a secretary for bell south, complaining of headaches started three months ago with slow and progressive course. She got worse last month. Head movement, leaning forwards, coughing and sneezing tend to worsen the attacks. Partially relieved with over counter medications. Mostly behind eyes, temporal and occipital areas and associated with visual difficulties. Worse in the morning and sometimes during nighttime. She has a hard time sleeping. No past history of headaches/trauma/hospitalization/major illness

Space Occupying Lesion | Refer patient

- pain upon coughing, sneezing, or straining = space occupying lesion

Dejerine's triad

Case: Giovanni is 25 year old male complaining of acute abdominal discomfort for several days. Initial eval. revealed that a tinge of yellowish discoloration in his sclera. Examination reveals tenderness in right upper quadrant. Which of the following...

Gastrointestinal system (for the liver)

What is the most commoly injured abdominal organ from trauma

Spleen

Hematemesis

vomiting blood

Melena

Black, Tarry stool due to digested blood

Peptic ulcer can cause one or both of these

Hematemesis, Melena

2 causes of bleeding from the rectum

colorectal cancer, peptic ulcer

Hepatitis A transmission

fecal oral (food)

Hepatitis B Transmission

Blood

What is worse Hep A or B?

Which Hepatitis has greater levels of post hep Cirrhosis?

Prevention of Hepatitis

keep lemon on cerveza, proper hygene, universal precautions

Diastases recti (bulging of linea alba) may suggest weak abdominal muscles

true

The proper protocol for abdominal exam is insepction, palpation, percussion, and auscultation

false

Caput Medusa is associated with portal hypertension

true

You are assessing a patient with abdominal pain and fever. You are performing an abdominal examination to assess for peritoneal signs. Which one of the following is NOT a peritoneal sign?

Voluntary guarding

Acute abdomen condition (possible causes)

``` appendicitis cholecystitis IBS kidney stone nephritis gall stone diverticulitis cholitis pancreatitis ```

pain in left upper quadrant:

``` ruptured spleen peptic ulcer gastritis myocardial infarcation pneumonia rib fracture pleurisy cholitis nephritis gas food poisoning bowel obstruction ```

right lower quadrant

appendicitis | ruptured appendix

most common congenital heart disease

ventricular septal defect

cor pulmonale is

right ventricular enlargement due to pulmonary pathology

structural abnormalities of the chest is usually associated with

TB, emphysema

clubbing of fingernails occurs due to

chronic hypoxia

patient with barrel chest, tachypnea, clubbing of fingernails is most likely _____ upon percussion

hperresonant

OPQRST falls under which major patient history category

present problem

start at the superior vena cava, a drop of blood will follow the following valvular sequence

tricuspid, pulmonic, mitral, aortic

constant low-back pain which is unrelieved by position, activity or rest is most likely the result of which of?

visceral disease

a condition most commonly caused by systemic hypertension

Left ventricular hypertrophy

apex beat is normally located at

midclavicular line

tricuspid valve stenosis may lead to?

right atrium enlargement

fourth heart sound occurs physiologically due to

passive blood flow from the atria to the ventricles

positive egophony, brochophony and whispered pectoriloquy during auscultation of the lung indicate

lung consolidation

periphery of lung during auscultation of an asthmatic patient is

generalized wheezing

difference between myocardial infarcation and angina pectoris, based on

duration of the pain

rectus capitus posterior minor

cervicogenic headaches

sinister headaches are caused by

subdural hematoma

one portion bleach to nine water is sufficient to remove anything infectious from a table (like with HIV)

(oYo)

should spread them out throughout the day (at breakfast/lunch/dinner

antioxidants

Sugar/fat are particularly bad for

black beans and white meat chicken have these

secretagogues

amino acids which increase production of human growth hormone need weight lifting for human growth hormone (needs to be enough weight to make 7th rep very difficult)

arginine, ornithine, lysine, and glutamine

secretagogues

lecture final Flashcards

(81 cards)