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Midterm Flashcards

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1
Q

COMPREHENSIVE hx

A

New patients
Hospital admission patients
Consultations
Annual Physicals

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2
Q

quiet pt

A

open ended

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3
Q

talkative pt

A

Use direct questions to fill in the gaps or direct the encounter. Transitional statements and summarizing works well.

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4
Q

INCAPACITATED PATIENT

A

Seek information from other people, EMT, family members, old records.
Detailed physical exam is essential.

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5
Q

Confusing Patient

A

Use direct questioning.

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6
Q

most impt reason for dr selection

A

provider’s interpersonal skills

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7
Q

Para linguistics

A

Tone, Rhythm, Pace/rate, Vibrancy, Volume, Pauses/silence, Encouraging gestures/sounds/nodding

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8
Q

health

A

A state of complete physical, mental and social well being and not merely the absence of disease or infirmity.”

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9
Q

global health 3 criteria

A

for the poor

1) Equitable access (to both prevention and treatment services, rural and urban)
2) Affordability regardless of income
3) Sustainability of services through long term political and financial support

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10
Q

leading risk factor of health

A

poverty

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11
Q

best prevention

A

education

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12
Q

4 leading causes of death overall

A

1) Ischemic Heart Disease
2) Cerebrovascular Disease/stroke
3) COPD
4) Lower Respiratory Infections

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13
Q

4 leading causes of infectious disease death

A

LRI
diarrhea
HIV/AIDS
TB

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14
Q

top 3 single organism killers

A

HIV/AIDS
Tuberculosis
Malaria

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15
Q

leading killer of HIV+ pts

A

TB is a leading killer of HIV-positive people

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16
Q

ebola

A

Human to human transmission via direct contact with blood or body fluids from an infected person.

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17
Q

secondary lesion

A

evolve from primary skin lesions, either because of the natural history of the disorder (e.g., crusts in chicken pox) or because of scratching or infection.

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18
Q

vellus hair

terminal hair

A

vellus-peach fuzz

terminal-pubic

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19
Q

3 phases of hair growth

A

Catagen phase – transitional phase – 3%
Telogen phase – resting phase – 10-15%
Anagen phase – Growing phase – 85-90%

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20
Q

clubbing causes

A 
Congenital  
Chronic hypoxia
Heart disease
Lung cancer
Hepatic cirrhosis
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21
Q

nail pits

A

psoriosis

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22
Q

mees and beaus lines

A

chemo

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23
Q

mobility and turgor

A

Note ease with which it lifts up (mobility) and speed with which it returns to place (turgor).

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24
Q

extensor surface skin lesion

A

psoriosis

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25
flexor surface
atopic dermatitis
26
Macule
vitiligo | flat less than 1cm
27
patch
cafe au lait | flat more than 1cm
28
papule
psoriosis | small raised lesion
29
plaque
large raised lesion
30
nodule
dermafibroma | firm, hard lesion, deeper than a papule, greater than 0.5 cm
31
cyst
nodule filled with material, liquid or semi-solid. | Often encapsulated.
32
vesicles
herpes fluid filled lesions less than 1.0 cm. Single or in clusters.
33
bulla
fluid filled lesion greater than 2.0 cm.
34
wheal
urticaria superficial localized raised area of skin. Blanche with pressure.
35
scale
Ichthyosis vulgaris | flaking of dead exfoliated epidermis.
36
crust
impetigo | dried residue of skin exudates such as serum, pus or blood.
37
fissure
tinea pedis
38
ulcer
deep epidermis loss
39
Lichenification
thickening of the epidermis and roughing of the skin surface often from rubbing or scratching.
40
Excoriation
linear erosions caused by scratching.
41
Koebner phenomena
skin trauma from scratching may cause new lesions spreading poisin ivy.
42
KOH
fungus-hyphae
43
tzanck
herpes (giant cells)
44
oil mount
scabies
45
BCC
80% of the skin cancers Grow slowly, rarely metastasize “rodent ulcer” pearly white with talengitelisis
46
SCC
Arise from the upper layer of the epidermis Can metastasize actinic keratoses
47
left shift Neutrophil
more immature cells-May indicate Bacterial Infection, toxemia, hemorrhage, more acute problems
48
right shift neutrophil
more mature cells Liver disease, megaloblastic anemia, iron def. disease, more chronic problems?
49
hyperglycemia
DM
50
hypoglycemia
pancreatic disease
51
high bun:creatine | low bun: Creatine
prerenal-dehydration | renal issue
52
AST>ALT
alchoholic hep
53
ALT>AST
viral hep
54
JNC-VII
pre=120-39/80-89 stage 1= 140-59/90-99 Start drugs stage 2= >160/>100
55
JNC-VIII
In general population, initiate pharmacologic tx when BP is 150/90 or greater *; adults age 60 or older BP is 140/90 or greater*; adults younger 60 years In patients with HTN and diabetes, initiate pharm tx when BP is 140/90 or greater*, regardless of age.
56
orthostatic hypotension
Drop of >20mm systolic or >10mm diastolic
57
BMI
18.5-24.9=normal 25-29.9=overweight 30-39=obese >40= extreme obese
58
most impt part of eye exam
visual acuity
59
autophony
chronically open Eustachian Tube
60
parts to see in ear
malleus, cone of light, incus, pars tensa and pars flaccida
61
Nonmobile TM
fluid, mass, sclerosis
62
Hypermobile TM:
ossicle bones disrupted
63
conductive loss
BC>AC, external and middle ear, foreign body, ottits media, perforated eardrum, osteoclerosis
64
sensoneurial loss
When the inner ear cochlear nerve is abnormal, this defines sensorineural hearing loss and both bone and air conduction is poor. loud noise, inner ear infxn, tumors, aging
65
Sudden vision loss
retinal detachment vitreous hemmorage CVA (stroke)
66
gradual vision loss
``` cataracts glaucoma HIV-CMV Diabetes macular degeneration ```
67
presbyopia
aging vision- hard seeing close
68
heterophoria
cross eye (bad eye moves in cover test) 2 types esophoria-inward exophoria-outward
69
anterior chamber
bw cornea and iris
70
post chamber
bw iris and lens
71
homonymous hemianopsia
w/b w/b left to right | named for region you can't see out of
72
bitemporal hemianopsia
b/w w/b left to right | caused by pituitary tumor
73
horizontal defect
top to bottom difference
74
blephoritis
inflamed lid margins
75
entropion
eyelid inwards
76
ectropion
eyelid outward
77
Bulbar conjunctiva Palpebral conjunctiva
covers the anterior eye lines the eyelids
78
anisocoria
unequal pupils
79
accomadation
near and far
80
convergence
near coming closer
81
fundus
Optic disc (blind spot) in middle of physiologic cup Retina Retinal vessels
82
medial to lateral in eye
disc, macula, fovea
83
Pinguecula
small nodule on the bulbar conjunctiva, does not cross over to the cornea.
84
Pterygium
thickening of the bulbar conjunctiva which grows across the cornea.
85
sty
infxn at margin of eyelid
86
chalazion
painless nodule involving the meibomian gland
87
bells palsy
CN 7
88
conjunctivitis
bottom up
89
ciliary injection
limbus to out; corneal injury, iritis, glaucoma inflammation of the radiating vessels around the limbus. Very painful, vision affected. Can be a ocular emergency.
90
papilledema
disc is swollen with blurred margins. Physiologic cup is not visible. Increased intracranial pressure.
91
Glaucomatous cupping
Increased intraocular pressure. Causes increased disc cupping. The physiologic cup is enlarged occupying more than half of the Disc’s diameter.
92
HTN eye chnages
AV nicking-veins taper as artery crosses copper wiring-thickened arteries Cotton wool patches – infarcted nerve fibers. Can also be seen in patients with diabetes.
93
av nicking
veins taper as artery passes in HTN
94
cotton wool patches
infarcted nerve fibers. | Can be seen in patients with HTN or diabetes.
95
List things that factor in health determination
- Income - Education - Knowledge of healthy behaviors - Social status - Sex - Genetic makeup - Access to health care
96
Explain why we have multi-drug resistant and XDR tuberculosis.
Multi-drug resistant: Once diagnosed, insufficient means to follow through with full treatment, causing some of organism to become drug-resistant - Can be due to price, insufficient infection control, side effects of the medications - Complacency of government acknowledgement and response to disease itself (in wealthy and disease-endemic countries) XDR: Extensively drug-resistant

PCM (2 decks)

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