NBS II General Diagnosis random notes Flashcards
(131 cards)
1
Q
Ear crusty discharge
A
Otitis externa, swimmers ear
2
Q
Bulging tympanum
A
Otitis media
3
Q
Retracted tympanum - blocking Eustachian tube
A
Serrous (bubbly) and altitude
4
Q
Myringitis
A
Redness (acute infection)
5
Q
Meningitis
A
Common complication
6
Q
Ear black discharge
A
Perforation
7
Q
Ear: Pearly gray
A
Normal
8
Q
Otosclerosis
A
chalky white ear drum
9
Q
Conduction problem conditions/ disease
A
INfection
Cerumen
Otosclerorsis
10
Q
Ear conduction problem can hear better or worse in lout environment?
A
Better
11
Q
Weber lateralizes to the side of? (Ear that can hear)
A
Conduction problem
12
Q
Rhinne air vs bone conduction
A
Air 2: Bone 1
13
Q
Nose: Red
A
Acute rhinitis
14
Q
Nose: Pale/ gray/ blue
A
Allergies or chronic “itis”
15
Q
Nose: Foul discharge
A
Foreign object
16
Q
Nose: Clear discharge/ bloody
A
CSF
17
Q
Nose: Watery unilateral
A
Cribriform plate fracture
18
Q
Nose bleed
A
Epistaxis
19
Q
Nose: Mass in mucosa
A
Polyp
20
Q
Supraclavicular lymph drains …..
A
Right side; above the diaphragm
21
Q
Abnormal Rhinne test indicate
A
Air conduction problem
22
Q
What vertebra level is pancreas located
A
T10
23
Q
Epigastric, fetal position, alcoholism, ECHYMOSIS in the flank that is NOT painful
A
Pancreatitis (head)
24
Q
diseases in pancreas head
A
Pancreatitis
Cancer
25
Diseases in pancreas tail
Diabetes Melitus
26
Tests for diabetes
A1C (best) - looking for glycosylation in blood
GTT (8-12 hours)
FBS
Glycosylated Hemoglobin
27
Does pancreatitis patient experience pain?
Yes, sharp pain that goes through and patient leans FORWARD to alleviate pain
28
What can be used (substance) to help with diabetes
Chromium
29
When sugar combines with protein causing inflammation and free radicals
Glycation
30
Sensorineural hearing conditions
Presbycusis
Neuroma
Menierre's
31
GB quadrant
RUQ
32
Murphy's sign is associated with
GB
33
Female, multiparous, flatulence, distension, obese, steatorrhea, right scapular pain, jaundice
GB
34
Shilling's Shift
WBC 17,500
| Appendicitis
35
Shilling's Test
PLS
36
What quadrant is Appendicitis
RLQ
37
Where is appendicitis pain located
McBURNEY's point
| B/w ASIS and umbilicus (Right Lower)
38
Tests for appendicits
Psoas test & Obturator Test
Blumberg (Rebound tenderness)
Rovsing's (Pressure in LLQ)
Markle (Heel Jar)
39
Which quadrant is being pressed in Rovsing's
LLQ
40
What condition cause pain at every point during Blumber Rebound Tenderness
Peritonitis
41
How to test obturator
Internal and external rotate hip
42
How to do psoas test
Flex or extend hip
43
Peptic ulcer includes
Duodenal and Gastric Ulcer
44
Helicobacter Pylori, infection
Peptic ulcer
45
What study is needed for peptic ulcer
Barium Study
46
Virchow's node on the left, occult blood
Cancer
47
Elderly, alcohol problem, B12 absorption problem, PLS (stocking and glove paresthesia)
Gastritis
48
Which one is more common? Gastric/ duodenal ulcer
Duodenal - due to stress, acidic condition, lack of sleep
49
Which one may be relieved after eating? Gastric/ duodenal ulcer
Gastric ulcer
| Duodenal - 2 hours after eating
50
B12 extrinsic factor, diet (animal product)
CYANOCOBALAMIN
51
B12 intrinsic factor
Secreted by parietal cells in gut (ext and int combined to allow B12 absorption)
52
B12 function
RBC maturation
| Myelination of nerves
53
Demyelination of nerves is
Sclerosis
54
Parietal cell degradation from chronic diet abuse, proton inhibitor pump meds (Nexium)
Chronic gastritis
55
What kind of anemia is related to chronic gastritis
```
Pernicious anemia (reticulocytosis)
Megaloblastic anemia (b/c b12 helps RBC to mature)
```
56
What nerves are targeted with B12 deficiency
Posterior column
| Lateral tract
57
Increase number of immature RBC
Reticulocytosis
58
Chronic gastritis test
B12 assay
Schilling's test
ACHLORHYDRIA
59
COLON: elderly, outpouching, fiber
Diverticulosis
60
COLON: Abrupt constipation, follows polyps
Cancer
61
COLON: SKIP LESION, STRING SIGNS, rectal bleeding
Crohn's
62
COLON: stress, bloody diarrhea, MEGACOLON, stoll transplant (microbiota)
Ulcerative colitis
63
COLON: early: increased distal or late; decreased
Obstruction
64
COLON: Fluid in abdoment, with organ failure
Ascites
65
Ascites test
Fluid wave
| Puddle sign
66
How long to listen for ABOBORYGMI
5 minutes
67
Tender, swollen, boggy, IgM, leukocytopenia, lymphocytosis
Acute Hepatitis (A&C)
68
Non tender, swollen, boggy, IgG, Increase or normal WBC and enzymes
Chronic Hep
69
Leukocytopenia
Decrease WBC
70
Lymphocytosis
Increase lymph
71
Non tender, Variable (swollen or not), Hard (smooth), increase GGT
Liver cirrhosis
72
Non tender, swollen, hard (nodule), increase biopsy
Liver cancer
73
Colon disease related with HLAB27
Crohns
| Ulcerative Collitis
74
Kidney is located at which vertebra level?, which side is slightly lower
T12-L3
| Right
75
HEP abrev
HTN
Edema
Proteinuria
76
HEP, chronic failure, fat OVAL BODIES, ALL casts
Nephrosis
77
Female, ascending, E. Coli, No cast, No fever, NITRATES
Cystitis
78
PAINLESS BLEEDING
cancer
79
Male, 20 yo, sedentary lifestyle, colicky
Stones
80
Toxemia of pregnancy
Pre-eclampsia (HEP)
| Eclampsia (HEP + convulsion)
81
Proteinuria indicates Upper or Lower tract infection?
```
UPPER tract, DESCENDING
Indicates kidney (nephron) condition
```
82
Fever, Strep, Sequela is carditis
Nephritic (infection)
83
Strep, HEP, Cast, Proteinuria, STONES, Fever
Kidney (nephron), Upper tract, descending
84
STD, E.Coli, NITRATES, No fever, FUB (Frequency, Urgency, Burning) urination
Ascending tract, Lower tract
85
Strep story
Mouth - Kidney - Heart
86
RBC cast
Glomerulonephritis
87
WBC and Waxy cast
Pyelonephritis
88
All cast
Nephrosis
89
Hyaline cast
Normal
90
Which kind of hemorrhoids; Often symptoms free unless defecating (portal HTN)
External Hemorrhoids (Thrombosed)
91
Which kind of hemorrhoids; painful, bloody defecation
Internal hemorrhoid (Prolapsed)
92
Strain produces donut shape anus
Rectal prolapse
93
Linear tear, bloody defecation
Rectal fissure
94
Firm, palpable growth
Rectal polyps
95
Which valves are open and shut during S1 Systole?
```
AV shut (mitral, tricuspid)
Semilunar opens (Aortic, pulmonic)
```
96
Stenosis means .... and it has .... pitch, heard using .... part of stethoscope
Can't fully open
Low pitch
Bell
97
Regurgitation means (or AKA)
Insufficient, prolapse, incompetent
| High pitch, diaphragm of stethoscope
98
Auscultation point: aortic valve
Right second intercostal space
99
Auscultation point: pulmonic valve
Left 2nd ICS
100
Auscultation point: Erb's point
Left 3rd ICS
101
Auscultation point: Tricuspid
Left 4th ICS
102
Auscultation point: Mitral
5th ICS midclavicular
103
Difficult to hear, AV valves out of sync
S1 Splitting
104
S1 splitting is heard where?
Near tricuspid location (L 4th ICS)
105
S2 ONLY during inspiration, children and athletes, PULMONIC shuts LATE
Physiological S2 splitting
106
S2 splitting is heard where?
At pulmonic (L 2nd ICS)
107
S2 always split, AORTIC valve shuts EARLY d/t HTN
Pathological S2
108
S3&S4 Which one can be normal and abnormal
S3
| S4 is always abnormal
109
Low Pitch, Bell at Apex, Associated with AV regurgitation
S3
110
S3 Physiological
Under 40, often heard in children and late pregnancy
111
S3 Pathological
Over 40, called ventricular gallop
112
Midsystolic Murmur
Semilunar Stenosis
113
Pansystolic Murmur
AV Regurgitation
| Pan means all throughout systole
114
Associated with AV Regurgitation
Pansystolic Murmur
| S3
115
When does Ejection usually occur?
Usually systolic; Valve opening, Semilunar stenosis
116
Aortic Ejection .... during respiration
Stays the same
117
Pulmonic Ejection ..... with respiration
Decreases
118
Occurs in late systolic, valve shutting, mitral prolapse (apex and 2nd intercostal space)
Clicks
119
"Clicks" are evaluated in what position
Multiple position (standing, squatting, supine)
120
Occurs in very early diastole, mitral stenosis, high pitched, heard in apex in pulmonic region
Opening Snap
121
Is opening snap affected by respiration?
No
122
Opening snap is often misdiagnosed as
Pulmonic Valve Abnormality
123
Innocent murmur that is heard in children
Stills murmur
124
- Persistent opening between two major blood vessel exiting heart after birth
Patent ductus arteriosis
125
Patent ductus arteriosis is associated with ..... murmur
Machinery murmur
126
Strong association with clot formation (stroke potential)
Atrial flutter or fibrilation
127
Inflammation around the heart, rub present (4th intercostal)
Pericarditis
128
Infection of the heart muscle itself (MC is strep)
Endocarditis
129
Evaluates heart rhythms
EKG - MI, Arrhythmia
130
Evaluates chamber size and fluid (murmur, CHF, carditis)
Echocardiogram - (murmur, CHF, carditis)
131
MI Cardiac enzymes (4)
- Troponin
- CK-MB (1 hour)
- SGOT/AST (2-3 hours)
- LDH (2-3 days)
