Objective - Xtian

Question 1

normal HR/PR

Answer 1

60-100 bpm

Question 2

tachycardia HR/PR

Answer 2

> 100 bpm

Question 3

bradycardia

Answer 3

< 60 bpm except athletes

Question 4

irregular HR/RR

Answer 4

dysrhytmia

Question 5

pulse grading

Answer 5

0: absent

1+: diminished, weak or thready

2+: normal

3+: inc strength

4+: bounding or too strong

Question 6

discuss apical pulse

Answer 6

5th ICS midsternum - auscultate

full 60 sec count

Question 7

how to measure if pulse is diminished

Answer 7

use bell of stethoscope

Question 8

how to measure apical-radial pulse

Answer 8

60 secs c 2 PTs

Question 9

HTN urgency

Answer 9

no acute end-organ damage

180 or more and 110 or more

Question 10

HTN emergency

Answer 10

acute end-organ damage

180 or more and 110 or more

Question 11

discuss OH

Answer 11

drop of 20 in SBP or 10 in DBP c 10-20% inc in PR

3 min p standing from supine (60% angle) for 5 mins

Question 12

RR values

Answer 12

normal: 12-20 cpm

tachypnea: more than 20

bradypnea: less than 12

variable

Question 13

temperature values

Answer 13

afebrile: 36-37.5

febrile: 38 above

hypertherimia: more than 41.1

hypothermia: less than 35

Question 14

where to take pulse ox

Answer 14

3rd or 4th finger

Question 15

O2 sats values

Answer 15

95-100: normal

91-94: mild hypoxemia but can still PT

85-90: mod hypoxemia needs supp O2

80-85: severe hypoxemia; O2 immed

<80: severe; hospitalize

70: cyanosis and acute danger

Question 16

body types of chronic bronchitis vs emphysema

Answer 16

CB: endomorph; blue bloater

emphysema: ectomorph; pink puffer

Question 17

what to OI on extremities

Answer 17

swollen or clubbed fingers

nicotine stain

asterixis

Question 18

invasive attachments for medication/fluids

Answer 18

arterial line

IV

central line

swan-ganz catheter

Question 19

non-invasive ventilation

Answer 19

CPAP

BiPAP

ambu bag

nasal cannula

simple mask

aerosol mask

venturi mask

Question 20

invasive ventilatory devices

Answer 20

oropharyngeal

nasopharyngeal

endotracheal

tracheostomy

mech vent

chest tube thoracostomy

Question 21

chest of deformities

Answer 21

barrel chest - emphysema

pectus carinatum and excavatum

flail chest - (+) hoover’s sign

Question 22

dyspnea

Answer 22

N rate, S depth, R rhythm

accessory muscle activity

Question 23

prolonged expiration

Answer 23

COPD

fast inspi and long expi pero normal na lahat

Question 24

psychogenic disorders

Answer 24

N rate c intervals sighing

c anxiety

Question 25

heart sounds auscultation landmarks

Answer 25

aortic: 2 (R) ICS pulmonic: 2 (L) ICS tricuspid: 4(L) ICS mitral: 5 (L) ICS erb's: 3 (R) ICS apex: 5 (L) ICS

Question 26

first heart sound

Answer 26

S1 - 0.10 s closing of AV valves - ventricular sys

Question 27

second heart sound

Answer 27

S2 - < 30 ms closing of semilunar - ventricular diastole can split during inspiration - physiologic split

Question 28

ventricular gallop

Answer 28

S3 - CHF faint and low early diastolic filling after AV open

Question 29

atrial gallop

Answer 29

rapid ventricular filling after atrial contraction at late diastole before S1

Question 30

systolic murmurs

Answer 30

bet S1 and 2

Question 31

diastolic murmurs

Answer 31

bet S2 and 1

Question 32

heart sounds grading

Answer 32

1: faint 2: audible imeed 3: louder than 2 4: liud 5: very loud 6: s stethoscope

Question 33

landmarks for breath sounds

Answer 33

T2, 6, 10 axilla, nipple, subcostal

Question 34

abnormal breath sounds

Answer 34

bronchial: tubular on peripheral tissue dec or absent

Question 35

adventitious breath sounds

Answer 35

rales/crackles: fine on inspi ronchi: low pitched sonorous on expi stridor: inspi wheeze wheeze: high pitch on expi friction rubs: coarse grating on inspi/expi

Question 36

voice sounds

Answer 36

bronchophony: 99 whispered petriloquy: whisper 99 egophony: EE

Question 37

cough and sputum assessment

Answer 37

F, WF, NF, 0 COAT

Question 38

landmarks for chest symmetry

Answer 38

upper chest: 4th rib ant middle chest: axilla ant lower chest: below scap post max inhale and exhale

Question 39

ipsi mediastinal shift

Answer 39

atelectasis lobectomy pnuemonectomy

Question 40

contra mediastinal shift

Answer 40

pleural effusion organ herniation pericardial tamponade

Question 41

mediate percussion

Answer 41

resonant: hollow and low; normal hyperresonant: tympanic; air hyporesonant: dull; fluid or mucus

Question 42

tactile fremitus

Answer 42

inc vibration: lung consolidation dec: plueral effusion, pneumothorax and atelectasis

Question 43

NYHA heart failure sx

Answer 43

1: no limit on physical activity 2: slight limit c SOB, fatigue and palpitation 3: marked limitation; sx at less than ordinary 1-3: comfy at rest 4: even at rest may sx

Question 44

NYHA heart failure obj assessment

Answer 44

A: no evidence B: mild evidence C: mod esevere D: sever A-c: comfy at rest same lang nag ka evidence lng

Question 45

NYHA therapeutic classificatoin

Answer 45

A: no restriction B: no competitive sports C: restricted ordinary activity and no strenous D: ordinary restricted E: confined to bed or w/c